The Ombudsman's final decision
Summary: We will not investigate this complaint about financial assessment for adult social care charges. This is because there is not enough evidence of fault. The Council completed the assessment in line with its relevant policy and explained the reasons for its decision.
The complaint
Ms B says the Council has failed to properly consider the disability related expenditure of her relative, Mr C. Ms B says this has negatively affected Mr C’s wellbeing, reduced his social inclusion, and he does not have independence, choice, and control over how he spends his income.
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: there is not enough evidence of fault to justify investigating, or further investigation would not lead to a different outcome.
(Local Government Act 1974, section 24A(6), as amended, section 34(B)) We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
How I considered this complaint
I considered information provided by the complainant.
I considered the Ombudsman’s Assessment Code.
My assessment
When you receive adult social care, the Council must assess what, if anything, you can afford to pay towards your care support. Part of this financial assessment considers extra costs you might have because of your disability or care need; this is known as disability related expenses (DRE).
The Ombudsman’s role is not to assess what should be DRE, but to look at whether there is any fault in how the Council has made its decision.
The Council completed an appeal where a panel of professionals reconsidered Mr C’s DRE. The Council wrote to Ms B with the outcome of the appeal, setting out its reasons for what it would or would not allow as DRE.
There is no evidence of fault in how the Council made its decision, and so the Ombudsman cannot criticise it even though Ms B disagrees with the decision. It is hard for anyone living on a low income; people must make difficult decisions on how to spend their tight budget. The Ombudsman cannot say Mr C’s lack of choice and control is caused by Council fault.
Final decision
We will not investigate Ms B’s complaint because there is not enough evidence of fault to justify investigating. The Council has followed its policy, relevant law, and guidance to complete its financial assessment for Mr C’s contribution to his care costs. The Council has accounted for the extra costs Mr C has because of his disability, and explained why it will not include all the sought items of DRE. The Ombudsman could not add to the Council’s investigation or reach a different outcome. The Ombudsman cannot question the Council’s decision, even though Ms B disagrees with it.
Investigator's decision on behalf of the Ombudsman