The Ombudsman's final decision
Summary: We will not investigate this complaint about the Council’s decision to fund Mrs D’s care needs in the community rather than in residential care. This is because the Council has determined Mrs D’s care needs can be met in the community and so there is insufficient evidence of the decision causing a significant enough injustice to warrant our involvement.
The complaint
The complainant (Mr Q) complains on behalf of his mother (Mrs D) who has care needs and lives in residential care along with her husband. Mr Q says Council has wrongly overturned an evidence-based assessment that Mrs D was eligible for Council funded support in residential care without giving any reasons.
In summary, Mr Q says the alleged fault has meant that Mrs D will not be able to afford to self-fund her residential care placement which is where she lives with her husband. He says the Council decision will unfairly result in Mrs D and her husband no longer being able to live together. As a desired outcome, Mr Q and Mrs D want the Council to reverse its latest decision and provide support for her to continue to live in residential care.
The Ombudsman’s role and powers
We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide: any fault has not caused injustice to the person who complained; or any injustice is not significant enough to justify our involvement; or (Local Government Act 1974, section 24A(6), as amended, section 34(B)).
How I considered this complaint
I considered information provided by the complainant and the Council. I also considered the Ombudsman’s Assessment Code.
My assessment
The Council carried out a care assessment of Mrs D’s needs which confirms she is eligible for support and assistance. I recognise that Mr Q and Mrs D’s preference is that this support is given in residential care so she can remain living with her husband who also lives at the care placement. However, the Council is only required to provide support in order to meet the determined eligible needs of a service user. The Council maintains that Mrs D is still eligible for support, but it has determined that those needs can be met in the community as opposed to in residential care. I have not been provided with any complaint information or evidence to suggest that Mrs D’s care needs cannot be met within the community.
I can only accept a complaint where the alleged fault has caused a significant and personal injustice. This means making an assessment as to whether Mrs D has been or will be caused serious loss, harm of distress as a result of the alleged fault. In my view, the Council’s decision does not affect Mrs D’s care needs from being met as she will continue to receive Council support, just not in residential care. I have considered Mr Q’s central position that the Council’s decision separates Mrs Q from living with her husband. That said, I do accept the Council’s response to this point in that care and support services in the community will facilitate Mrs D being able to have regular visits to see her husband. For these reasons, there is insufficient evidence that any fault has caused Mrs D to suffer a significant enough injustice to warrant out involvement.
Final decision
We will not investigate this complaint because there is insufficient evidence that the Council’s decision has caused Mrs D to suffer a significant enough injustice to warrant out involvement.
Investigator's decision on behalf of the Ombudsman