The Ombudsman's final decision
Summary: We will not investigate Ms C’s complaint about the Council’s assessment of Mr D’s finances. This is because it is unlikely we would find enough evidence of fault to warrant an investigation.
The complaint
Ms C complained about the Council’s assessment of Mr D’s finances and Disability Related Expenditure (DRE). Ms C says the Council failed to take into consideration the additional costs Mr D incurs related to his complex needs such as therapeutic interventions, weighted blankets, and ear defenders. Additionally, Ms C says the Council has not considered Mr D purchases his own continence wear and bedding and without proper funding he will not be able to have regular overnight stays with his family or access his voluntary work placement.
The Ombudsman’s role and powers
The Ombudsman investigates 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 may decide not to continue with an investigation if we decide: there is not enough evidence of fault to justify investigating, or we could not add to any previous investigation by the organisation, or further investigation would not lead to a different outcome, or we cannot achieve the outcome someone wants, or there is another body better placed to consider this complaint.
We investigate complaints about councils and certain other bodies. We cannot investigate the actions of bodies such as the NHS. (Local Government Act 1974, sections 25 and 34A, as amended) (Local Government Act 1974, section 24A(6))
How I considered this complaint
I considered information provided by the complainant and the Council.
I considered the Ombudsman’s Assessment Code.
My assessment
The Council investigated Ms C’s complaints and explained Mr D lives in a residential setting which meets his needs. In addition to the care and support provided in the home, Mr D receives 28 hours of 2:1 support each week. The Council has assessed Mr D as having income enough to contribute £106.40 per week from his weekly income of £193.85 towards his care which leaves him with £87.45 a week to pay for items not funded by the NHS or the Council.
Social care charging arrangements for 2021/22 have been set out in a circular issued by the Department of Health. It confirms levels, including capital limits and the Personal Expenses Allowance (PEA) for local authority supported care home residents, will remain at their current levels. Local authorities are required to act under the guidance set out in the circular.
The circular confirms that for the financial year 2021/22: capital limits remain at their current level—lower capital limit is £14,250 and upper capital limit is £23,250; PEA for local authority supported care home residents remains at its current level of £24.90 per week; Minimum Income Guarantee for people receiving local authority arranged care and support other than in a care home remains at its current levels savings credit disregards remain at their current levels of up to £5.75 per week for individual supported residents and up to £8.60 per week for couples.
https://www.gov.uk/government/publications/social-care-charging-for-local-authorities-2021-to-2022 The Council has assessed Mr D’s contribution towards his residential care in line with the guidance set out by the government and we could not say this is fault. The Council has also explained many of the costs incurred by Mr D when visiting his home are activities which it is not responsible for funding. It has advised Ms C disability related wear and tear of clothing can be considered as DRE. It advised Mr D’s Social Worker can make the request for a disregard if receipts are provided. We could not add to this point.
Ms C says Mr D requires therapeutic interventions. The Council says Mr D’s sensory costs are funded by the NHS which are met by direct payment through the Clinical Commissioning Group (CCG). It explained this should include the weighted blanket Ms C referred to. The Council explained if Ms C has concerns about the current level of funding provided by the CCG she should raise this with the CCG in the first instance. Continence wear is also a health matter and should be considered by the CCG. We cannot consider health matters or NHS funding and as advised by the Council; Ms C will need to raise her concerns about Mr D’s therapeutic intervention costs with the CCG.
Final decision
We will not investigate Ms C’s complaint because there is not enough evidence of fault with the actions taken by the Council to warrant an Ombudsman investigation.
Investigator's decision on behalf of the Ombudsman