Summary: We will not investigate Miss X’s complaint about charges for her mother’s care. The Care Provider has apologised and provided a partial refund. A further investigation by us would not lead to a different outcome.

The complaint

1. Miss X complains about charges for her mother’s care. She says the Care Provider charged for services that were not needed or provided. Also, the Care Provider was unclear about the costing for a premium room which it offered for free after the first room was dirty and needed maintenance.

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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 or continue an investigation if we decide:

• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome

(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 Miss X and the Care Provider.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. Miss X says the Care Provider was not honest with how it calculated its charges.
6. I have reviewed the contract before the care began and care costs are £1,510 per week. After this a costed care plan listed the costs as £1,510.80 per week. When Miss X’s mother was admitted, these costs were recalculated at £1,619.03 due to a reassessment of her needs. An invoice dated 1 June 2024 set the care costs at £1,510 per week with a total balance due of £9,710 for six weeks of care. This invoiced sum is in line with the care costs set out in contract.
7. The Care Provider did not accept all the charges were wrong, however it did offer to provide a rebate of £1,000 in consideration of the complaint which Miss X at first accepted.
8. The Ombudsman has published guidance to explain how we calculate remedies for people who have suffered injustice because of fault by a council or care provider. Our primary aim is to put people back in the position they would have been in if the fault by the council or care provider had not occurred.
9. I note the first room was dirty and needed maintenance and the Care Provider apologised and agreed to move Miss X’s mother to a premium room at no extra cost. Also, there were incidents of a fall, and a catheter fitted incorrectly during her mother’s stay there.
10. Overall, I do not consider these incidents show the care plan was not being met for a prolonged time which would warrant the reimbursement of these fees for the whole period.
11. It follows that in the circumstances of this complaint, I am satisfied that £1,000 is a suitable amount to remedy and the Ombudsman would not recommend more. Therefore, I will not investigate this complaint any further.

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Final decision

12. We will not investigate Miss X’s complaint because further investigation would not lead to a different outcome.

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Investigator's decision on behalf of the Ombudsman