Summary: The Council reviewed the amount of Mrs X’s Direct Payment budget to enable her to purchase more overnight stays for her son M after she appealed its initial decision.

The complaint

1. Mrs X (as I shall call her) complains about the way the Council reviewed the care and support plan for her disabled son M, so she cannot now fund as much respite care as she says she needs.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. I considered the information provided by the Council and by Mrs X. I spoke to Mrs X. Both Mrs X and the Council had the opportunity to comment on an earlier draft of this decision, and I considered their comments and made more enquiries of the Council before I reached a final decision.

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What I found

Relevant law and guidance

5. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
6. As part of the carer’s assessment, the council must consider the carer’s potential future needs for support. It must also consider whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)
7. Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person’s care and support needs.
8. Direct payments are monetary payments made to individuals who ask for one to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs.
9. The Council reviewed its approach to Carers’ Support Allowance in January 2020 and set this out in a document “Meeting Carers’ Needs”. It assesses carers against its carers’ impact criteria which calculate the amount of days’ support required. It allocates a standard amount of £99 a day to enable carers to purchase replacement care.

What happened

10. Mrs X is the principal carer for her disabled son M, who has autism. Mrs X says M cannot read, write or communicate verbally and needs assistance with all aspects of daily living.
11. The Council funds a package of care for M which includes daycare support on weekdays during termtime, taxis to and from the daycare, 8 hours a week support separately from the daycare, and 38 hours a week support outside termtime. The Council also funded some days’ respite/replacement care to cater for Mrs X’s need for support as a carer. Mrs X says this was about 24 nights a year at the Alan Shearer Centre which M had attended since 2007 and which was familiar to him.
12. In April 2020 a social worker undertook a review of M’s care and support plan. (The review should have taken place in January 2021 but the allocated social worker left the Council’s employment.) The social worker calculated the amount of support for replacement care for M as 21 days at £99 a day (the standard rate). The care and support plan notes, “Mrs (X) scored 7 out of the 12 domains with an additional 5 points for emotional wellbeing = 12 points. This entitled Mrs (X) to up to 21 days short break per year at £99 per day. (M) usually attends the Alan Shearer Centre. The budget allocated for Mrs X for replacement care was £2079.
13. Mrs X complained to the Council when she received notification of the budget. She said the amount allocated would only pay for 6 days at the respite facility which M used. She said this was well below the 21 days which the Council had agreed was needed.
14. As a result of Mrs X’s approach the Council undertook a reassessment of her needs as a carer. It also contacted the Alan Shearer Centre. The then manager of the centre responded to the Council: “(M) generally uses the service on both weekdays and weekends but mostly weekends and has a personal budget to make payments for this. (M)’s personal budget equates to around £2000.00 per annum therefore providing approximately 10 nights per annum.”
15. The Council’s reassessment notes, “I am told that (M)'s attendance at the Alan Shearer Centre is important to (M) and his parents and very much part of his routine which is crucial to (M)'s overall wellbeing….As indicated above (M) has been attending this service since 2007.Given that (M) usually attends the Alan Shearer Centre on average 10 nights per annum approval was sought for a continuation of 10 days short break per year,…Total cost per annum £4740 and includes the annual uplift to be paid to (Mrs X) as a direct payment amount only to be used for breaks at Alan Shearer Centre, up to 10 days per year.”
16. The Council notified Mrs X of the increase.
17. Mrs X remained unhappy. She complained to the Council. She said the Council had reduced the funding for M’s respite as the amount allocated would not cover the 24 days care M needed. She said M had previously had 10 stays there a year, not 10 days.
18. The Council investigated the complaint and responded. It said the initial amount had been calculated using the carer impact criteria and approved by the funding panel at the standard £99 a day rate. It said after she had raised concerns this was less than they had received previously, it had reassessed the respite care needed and after consultation with the respite centre manager had issued the new care plan to include 10 days short break care at the enhanced rate charged by the respite centre.
19. Mrs X complained to the Ombudsman. She said the Council had not listened to her point that the funding had been reduced in real terms because M had previously had more than 10 days respite a year.
20. The Council says that the increase in the amount of budget allocated after Mrs X expressed dissatisfaction with the initial allocation enables M to have the consistency of support from the respite centre with which he has become familiar.
21. The Council says confusion has arisen over the number of ‘days’ respite funded for Mrs X’s needs as a carer: it points out that respite care always includes an overnight stay and care. It says “there was some misperception in respect of the whether or not (M’s) short breaks were calculated in terms of day care or overnight stays; this misinterpretation is largely to do with the phraseology of the invoices and social care records.”

Analysis

22. The Council assessed M’s needs and appropriately calculated the number of days’ replacement care indicated by the carers’ impact criteria which the Council had agreed in its January 2020 review. That was not fault on the part of the Council.
23. The amount of replacement care the calculated budget would purchase for M at his usual respite centre was less than he had previously had. The Council responded to Mrs X’s concerns and agreed, after it sought details from the respite centre manager, that the amount could be increased.
24. Mrs X says the Council has consistently ignored her argument that M previously had 10 stays, not 10 days replacement care. The Council has explained that there was no confusion except in terms of the language used: because it was respite care it always included overnight stays. It was not fault for the Council to obtain information from the respite centre and act on that as well as Mrs X’s representations.

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Final decision

25. I have now been able to complete the investigation on the basis there was no fault on the part of the Council in the way it calculated the amount of replacement care for M.

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Investigator's decision on behalf of the Ombudsman