Summary: We will not investigate Mrs X’s complaint about a care bill the Council sent her for her mother’s care and support placement. This is because there is insufficient evidence of fault.

The complaint

1. Mrs X complains about a care bill the Council sent her for her mother’s care and support placement. She says she cannot afford the charges.

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The Ombudsman’s role and powers

2. 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 an investigation if we decide there is not enough evidence of fault to justify investigating. (Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

3. I considered information provided by the complainant and the Council.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. Mrs X’s mother required a placement in a care home to meet her care and support needs. The Council sent Mrs X an invoice for the third party top up fees she agreed to pay. The Council said this covered the period July 2022 to November 2023.
6. In May 2022, the Council emailed Mrs X to tell her there was a price difference of over £500 per week between the preferred care home and the local authorities fees. The Council asked Mrs X to confirm if she could pay the third party top up.
7. In September 2022, the case records showed a discussion was held with Mrs X regarding the third party top up. It recorded that the officer explained the difference between a third party top up and her mother’s client contributions. It detailed Mrs X’s verbal agreement to pay the third party top up of just over £503 per week.
8. Also in September 2022, the Council sent Ms X an email containing different information sheets which detailed what a third party top up was and who would be responsible for paying it. The information sheet makes it clear a third party top up is required if a person chooses to move into a care home that is more expensive than the local authority rate. It also details that someone other than the resident would need to pay the additional amount. A paying for care factsheet was also provided which again provided clear details of what a third party top up was and how it worked.
9. The cover letter sent to Mrs X set out how much the Council would pay towards the placement and that a third party top up of just over £503 per week was required. The letter confirmed a third party, such as a family member, should make the payment and that it would be payable for the length of the placement.
10. The Council also provided us with a copy of the signed third party top up agreement which Mrs X signed at the end of September 2022. This agreement set out what a third party top up was, whose responsibility it was to pay it, and the amount that was payable. The agreement also set out the start date of the agreement was July 2022, and that the third-party contributor agrees to pay the balance to the Council starting from this date.
11. In October 2022, Mrs X sent an email to the Council where she asked the Council to confirm she would get written confirmation of the amounts to be paid by myself and from her mother’s account. This highlights Mrs X was aware that she needed to pay a payment separately from her mother’s account. Therefore, this implies Mrs X understood her responsibility for paying the third party top up. It is reasonable to have expected Mrs X to raise questions directly with the Council if she was confused or concerned about the third party top up.
12. Therefore, an investigation is not justified as we are not likely to find fault with the Council. This is because the Council provided full and clear information to Mrs X about what a third party top up is and whose responsibility it was for making this payment. The Council also provided clear information about how much the top up was each week and the start date of the third party top up. There is no evidence to suggest Mrs X queried or raised any concerns about the arrangement. Further, given she signed the third party top up agreement, this implies she understood and agreed with the terms set out in the agreement, including the amount payable each week.

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Final decision

13. We will not investigate Mrs X’s complaint because there is insufficient evidence of fault.

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Investigator's decision on behalf of the Ombudsman