The Ombudsman's final decision
Summary: We will not investigate this complaint about the Council’s handling of the late Mrs Y’s care charges because further investigation would not lead to a different outcome.
The complaint
Mr X, as executor of his late mother’s will, complains the Council demanded payment for care charges in error and only addressed this after he complained. And it did not properly address his complaint about its failure to arrange Continuing Health Care (“CHC”) funding.
The Ombudsman’s role and powers
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, or any fault has not caused injustice to the person who complained, or any injustice is not significant enough to justify our involvement, or we could not add to any previous investigation by the organisation, or further investigation would not lead to a different outcome, or it would be reasonable for the person to ask for a council review or appeal. (Local Government Act 1974, section 24A(6), as amended, section 34(B))
How I considered this complaint
I considered information provided by Mr X and the Council.
I considered the Ombudsman’s Assessment Code.
My assessment
In October 2024 Mr X complained the Council had issued Mrs Y a bill for care home charges incurred from 18 August to 28 August 2024 in error. In its August 2025 complaint response the Council confirmed it had cancelled the invoice and no charges were due for that period. Any remaining injustice is not significant enough to justify an investigation.
Mr X says the Council told him Mrs Y’s care would be funded by CHC however there is no written record of this and the Council denies this. Where it is one person’s word against the other we cannot make a finding of fault. Therefore further investigation would not lead to a different outcome. I note the Council has said it will improve its communications around funding in any event.
On 12 November 2024 Mrs Y went into a care home funded by Funded Nursing Care, a client contribution subject to a financial assessment and third party top up. Records show Mr X was made aware of this and on 7 November the Council had told him a decision on CHC would be made in the community.
On 22 November Mr X asked the Council to complete a CHC checklist however Mrs Y then passed on 20 December 2024 before this had been actioned.
In response to Mr X’s complaint the Council explained it would usually carry out a CHC checklist after a person’s recovery period to ensure it reflected a person’s ongoing and long term care needs. This is in line with the Care Act guidance. There is no evidence of undue delay in the Council completing the CHC checklist and so there is not enough evidence of fault to justify an investigation.
The Council told Mr X it could not backdate the CHC checklist as Mrs Y had passed. However, it explained the executor (upon evidence of their position) could request a retrospective review of Mrs Y’s needs, which would enable an assessment for CHC. The Council says Mr X has not asked for a review. I will not investigate as it is reasonable for Mr X to ask the Council for a review.
Final decision
We will not investigate Mr X’s complaint because further investigation would not lead to a different outcome.
Investigator's decision on behalf of the Ombudsman