The Ombudsman's final decision
Summary: We will not investigate Ms B’s complaint about the Council’s actions regarding her mother’s, Ms C’s, care and support. This is because the Council’s actions have not caused a significant enough injustice to warrant an ombudsman investigation.
The complaint
Ms B complained about the way the Council arranged care for her mother Ms C. Ms B says the Council: Misled her about funding; Failed to respond to her request for Ms C to be placed in a care home close to where she, Ms B lives; Failed to discuss her concerns with the Care Provider; Failed to communicate adequately with Ms B.
Ms B says the Council should look into s117 aftercare funding for Ms C, arrange for a Deprivation of Liberty Safeguards (DoLS) so Ms C can go home, and reimburse the care fees Ms C has paid to date.
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 effect 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 an investigation if we decide the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)
How I considered this complaint
I considered information provided by the complainant.
I considered the Ombudsman’s Assessment Code.
My assessment
The Council says it has regularly communicated with Ms B about Ms C’s care planning. It says letters were sent to her address and to Ms C directly in the care home about paying for residential care. The Council says it advised Ms B a form would be sent by the Finance Team which needed to be completed in order to assess whether Ms C should contribute towards her care fees. It confirmed the form has not been returned therefore Ms C’s care fees are currently assessed at the full cost of her care.
The Council says Ms C was able to understand questions asked and had good insight into the options available to her when she was spoken to about where she should live. Ms C was able to communicate she wanted to remain in the home. The Council says although it had discussed Ms B’s concerns with the Care Provider, including whether Ms C could be moved to a different placement, it had not communicated with Ms B about these points. The Council apologised for this oversight. The Council says while alternative placements are sourced, Ms C’s current placement remains suitable for her.
The Council confirmed Ms C was not detained under section 3 of the Mental Health Act, consequently, she is not entitled to s117 aftercare funding. It also confirmed Ms C has no medical needs requiring a checklist for Continuing Health Care (CHC) funding.
Further investigation by us could not add to the Council’s response. If Ms B wants the Council to consider Ms C’s financial situation she should complete the financial assessment form and return it to the Council. Without a completed financial assessment form, the Council is not at fault for charging a person the full cost of their care.
The Council has explained what communication it had with Ms B and apologised for not notifying her of the outcome of discussions. The Council has also explained under GDPR it cannot disclose all of Ms C’s personal information. We could achieve no more than this even if we investigated or make a different finding.
Section 117 after care funding applies to specific circumstances. The Council has confirmed Ms C does not meet the criteria. We cannot tell the Council Ms C should have been eligible for s117 aftercare funding on discharge from hospital.
Mental Health Act 1983 (legislation.gov.uk) The Council says Ms C is not eligible for CHC funding. If Ms B has evidence that Ms C would have been eligible for CHC funding she can ask the NHS to consider a retrospective application. We cannot say Ms C should be eligible for CHC funding.
https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care Ms B says Ms C wants to go home but cannot because of the DoLS in place. The Council says Ms C cannot manage at home. If Ms B disputes this she will need to ask the Court of Protection to consider her request. We cannot say where Ms C should live.
Final decision
We will not investigate Ms B’s complaint because the Council’s actions have not caused a significant enough injustice to warrant an ombudsman investigation.
Investigator's decision on behalf of the Ombudsman