Summary: We will not investigate Mr X’s complaint about the charges from his late father’s Care Provider. There is not enough evidence of fault to justify an investigation.

The complaint

1. Mr X complains about the charges from his late father’s Care Provider. He says the Care Provider told him that it would refund his father’s whole month’s care costs while he was in hospital, but later told him that only a partial refund was due.

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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 there is not enough evidence of fault to justify investigating. (Local Government Act 1974, section 24A(6), as amended, section 34(B)).
3. The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)

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How I considered this complaint

4. I considered information provided by Mr X and the Care Provider.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. The Care Provider in its response to Mr X’s complaint, admitted that it was not clear to Mr X about the refund when he contacted it to discharge his father from the care home.
7. I have reviewed the contract signed by Mr X for his father. Under section 2.4 it confirms that accommodation fees will be applicable during a time that a resident has temporarily vacated their room.
8. Also, under section 14.5, it confirms the price payable will continue to be applicable if the resident vacates their room temporarily for any reason, until the contract has been terminated (in accordance with the termination clauses).
9. The Care Provider has admitted to being unclear to Mr X about this when he contacted them to discharge his father from care and I consider it correct for it to apologise about this.
10. However, there is insufficient evidence of fault in the Care Providers refusal to refund his father’s care costs when he was in hospital. Under the terms of the contract it states that charges would continue even if the resident were not present at the care home. For this reason, I will not investigate Mr X’s complaint
11. I note that Mr X believes the contract terms are unreasonable however that would require a determination from the courts, and it would be reasonable for him to use this in these circumstances.

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Final decision

12. We will not investigate Mr X’s complaint because there is insufficient evidence of fault which would warrant an investigation.

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Investigator's decision on behalf of the Ombudsman