Summary: We will not investigate Ms X complaint about the Council’s action when discharging Ms Y from hospital and her charges for staying at a residential care home. Ms X is complaining too late and there are no good reasons for us to look at the matters now.

The complaint

1. Ms X complains for a relative Ms Y, about her discharge from hospital in 2021, a move to a residential care home and the way the Council has dealt with charges for Ms Y’s stay at the care home. Ms X says Ms Y (and later her estate) suffered financial loss because of the Council’s actions and Ms Y’s family suffered distress.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council/care provider has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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How I considered this complaint

4. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
5. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

6. Ms X held Power of Attorney for Ms Y due to her health conditions so could act and make decisions on Ms Y’s behalf. Ms Y was admitted to hospital in May 2021. Ms X and family decided to move Ms Y to a residential care home in June 2021 due to her health needs.
7. The Council carried out a financial assessment on Ms Y in October 2021 and said she had sufficient funds to finance her own care. Ms X advised the family were trying to sell Ms Y’s home to help fund her care home fees. The Council agreed to a 12 -week property disregard from 9 November 2021 to 1 February 2022. This meant the Council would not consider the value of Ms Y’s home when assessing her financial needs for care during that time.
8. The Council carried out a further financial assessment in January 2022 and advised Ms Y needed to pay a top up towards the cost of her care. Ms X complained to the Council about Ms Y’s discharge from hospital, the 12-week property disregard, top up charge and impact onto Ms Y’s finances.
9. The Council responded to Ms X’s complaint in February 2022 and explained the actions taken and reasons for decisions. It advised Ms X to complain to us if she remained unhappy with the complaint response.
10. Ms X advised the Council in February 2022 the family had been unable to sell Ms Y’s property so asked for a period interim funding by the Council so it could loan Ms Y the money to pay her care home fees until her property was sold. The Council agreed to do so for six months until August 2022. Ms X signed an agreement with the Council she would reimburse it once the property was sold.
11. In August 2022 the Council sent Ms X an invoice for Ms Y’s fees. Ms Y declined to pay the invoice as she did not consider the agreement was valid. Ms X said it was because she disputed Ms Y’s move to the care home in 2021 and the Council’s lack of information to the family about Ms Y’s options for funding during 2021 and early 2022. The Council does not agree. It says the interim funding agreement is valid, it has a duty to protect the public purse and recover the costs owed. So, it considers Ms Y’s care home fees are due to be paid.
12. Sadly, Ms Y passed away in October 2022.
13. Ms X’s complaint about Ms Y’s discharge from hospital in June 2021 by the relevant NHS Trust and the Council and some of Ms X’s concerns about care home fees have been considered by the Local Government and Social Care Ombudsman and Health Service Ombudsman. This was through the Joint Working Group (23006822) as the Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
14. The Joint Working Group decide not to investigate Ms X’s complaint as it was considered unlikely to find fault in Ms Y’s discharge from hospital in 2021 or achieve the outcomes Ms X was seeking of a refund of care fees.
15. Ms X’s complaint about the actions of the Council following Ms Y’s discharge from hospital and financial matters was made to us in August 2024. Ms X’s concerns about the hospital discharge have already been considered by the Joint Working Groups so we would not reinvestigate these issues. In addition, Ms X’s concerns over the 12-week disregard and top up fee are late complaints as Ms X has been aware of them for more than 12 months and the Council advised her to complain to us in February 2022. Ms X has also been aware of the interim funding agreement she signed in February 2022 for more than 12 months. Therefore, I consider it was reasonable to expect Ms X to have complained to us before now especially after being clearly signposted to us by the Council in February 2022. I do not consider there are good reasons for us to exercise discretion to investigate Ms X’s concerns about the financial matters now. So, I have ended my investigation into Ms X’s complaint.

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Decision

16. I have ended my investigation into Ms X’s complaint as the matters complained about took place over 12 months ago. And it was reasonable to expect Ms X to have complained to us before now.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman