Summary: We will not investigate Mr X’s complaint about his brother’s (Mr Y’s) care home fees. This is because the matter has not caused Mr Y any significant personal injustice which is serious enough to warrant an investigation.

The complaint

1. The complainant, whom I shall call Mr X, complains the care provider is applying a significant increase to Mr Y’s care home fees after it failed to apply its annual fee increases to Mr Y’s account for the past three years due to human error.

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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 effect 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 the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)
3. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. If they have caused an injustice we may suggest a remedy. (Local Government Act 1974, sections 34 B, 34C and 34 H(3 and 4) as amended)
4. We investigate complaints about adult social care providers. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• the action has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify our involvement, or
• it is unlikely we could add to any previous investigation by the care provider.

(Local Government Act 1974, sections 34B(8) and (9))

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How I considered this complaint

5. I considered information provided by the complainant and the care provider.
6. I considered the Ombudsman’s Assessment Code.

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My assessment

7. Mr X complains on behalf of his brother Mr Y. Mr X is Mr Y’s attorney for property and financial affairs.
8. Mr X complained to the care provider in March 2023, after it applied a 28% increase to Mr Y’s care home fees.
9. The care provider explained that, due to human error on its part, it had failed to apply its annual 5-6% fee increases to Mr Y’s account for the past three years. This error meant Mr Y was charged almost £16,000 less over the past three years than he would otherwise have been charged. It apologised to Mr X for any distress this caused and said it would not seek to recoup the past three years’ fee increases as a gesture of goodwill. It explained the recent annual fee increase put Mr Y in line with its current charges for this year which apply to all residents.
10. Mr X asked the care provider to consider applying a more gradual fee increase of only 10% per year for the next three years until it reaches the current rate in line with the gradual fee increases other residents had. The care provider declined. It said it had already waived the previous three annual fee increases which had financially benefited Mr Y significantly and it now needed to charge him its current fees in line with those paid by all the other residents. It said its current fees reflected its substantially increased operational costs since Mr Y’s last fee increase in 2020.

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Final decision

11. We will not investigate Mr X’s complaint. This is because the care provider’s fault has not caused Mr Y any significant personal injustice which is serious enough to warrant an investigation. The care provider has already acted to remedy its fault in deciding not to recoup the last three years’ fee increases from Mr Y. The outcome of this is that Mr Y has financially benefited significantly from the care provider’s fault. He has been charged almost £16,000 less than he would have been charged but for the care provider’s error. The care provider has set out the current charges for this year and its fault has had no impact on the current fees which apply to all residents. The care provider has clearly explained its position and there is nothing further we could add.

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Investigator's decision on behalf of the Ombudsman