Summary: The Council failed to consider Ms X for reablement services. It then failed to provide appropriate advice about direct payments which resulted in a significant financial loss for Ms X. The Council also failed to consider information Ms X provided about the service she received from a personal assistant.

The complaint

1. Ms X complains a social worker wrongly advised her to pay a personal assistant informally until direct payments were arranged. The Council subsequently refused to refund the money Ms X paid her personal assistant.
2. Ms X also complains the Council failed to consider information she submitted about the service she received from a personal assistant.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. If we are satisfied with an organisation’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

5. I have:

• considered the complaint and discussed it with Ms X;
• considered the correspondence between Ms X and the Council, including the Council’s response to his complaint;
• taken account of relevant legislation;
• offered Ms X and the Council an opportunity to comment on a draft of this document, and considered the comments made.

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What I found

Relevant legislation

6. Direct payments are monetary payments a council makes to an adult who it has assessed as being eligible for care and support. Direct payments allow the adult to have control over their care and support.
7. Councils must provide people with relevant and timely information about direct payments so they can choose whether to use them. Councils should support the person to use and manage their direct payments properly.

What happened

8. Ms X is in her sixties. In September 2021 she became acutely unwell with a virus which caused vertigo and nausea and impacted on her ability to care for herself.
9. Ms X contacted her GP, who advised her to contact social services. A social worker visited and assessed Ms X’s needs. The social worker advised Ms X to employ a specific personal assistant and advised her to pay the personal assistant in cash until the formalities of direct payments could be completed.
10. Ms X followed that advice and paid the personal assistant £810 in total from her own funds. She did not obtain receipts because she was not advised she needed to do so. The Council has refused to refund the amount paid because Ms X had not obtained receipts.
11. A second personal assistant was commissioned to cover any holidays and sickness of the first personal assistant. The first personal assistant became ill, and the second personal assistant took over. After two visits the second personal assistant was unable to carry on and recommended her sister carry on the role.
12. Ms X employed the sister, but she was dissatisfied with the service provided. She says there were occasions the personal assistant failed to turn up.
13. The Council completed the direct payment administration and Ms X began receiving funds to pay for her care. She says she was not given adequate advice upfront, and the information that was provided arrived too late.
14. Ms X received an invoice from the Council for £460, which she has refused to pay. She contacted the Council to provide information of the dates the personal assistant failed to turn up and said she would not pay for those dates. She asked the Council to consider the information and recalculate the invoice. She says despite chasing the Council, it has failed to do so.
15. Ms X’s health improved, and direct payments ceased in December 2021.
16. I have had sight of the Council’s complaint response to Ms X dated 31 January 2022. The author acknowledged a social worker should not have recommended a particular personal assistant. She (author) also said the social worker had been ‘reminded’ that reablement care should have been considered as this was a more appropriate service. The author advised Ms X to contact the reablement service should her illness reoccur and provided the contact details.
17. The author confirmed a social worker had advised Ms X to pay the personal assistant privately but said the social worker had denied advising Ms X to pay cash. She (author) said because Ms X had not obtained receipts the Council would not reimburse the monies paid.

Analysis

18. Direct payments must be used to meet a person’s assessed needs. Council’s must ensure that the monies are used for the intended purpose. Everyone receiving a direct payment must keep records and submit accounts to the local council showing how the money was spent.
19. In this case it is evident Ms X was provided with inaccurate advice and that her current situation is a direct result of following that advice.
20. On the balance of probability, I conclude Ms X was not advised about a specific payment method and probably not advised she needed to obtain receipts. This resulted in an avoidable injustice and in Ms X incurring a significant financial loss through no fault of her own.
21. It is also probable that Ms X would have been entitled to and benefited from reablement services had it been offered. The Council acknowledges it was a more appropriate service and advised her of the contact details for the service should her illness reoccur.
22. It is not known what financial contribution Ms X would have paid had she received reablement care. To remedy the injustice caused the Council should calculate the approximate cost to Ms X had she received the service, deduct this from the £810 Ms X paid to her personal assistant and refund Ms X the difference.
23. In respect of the outstanding invoice, I find the Council at fault for failing to consider the information Ms X provided about the service she received from the second personal assistant. To remedy the situation, it should do so and consider if amendments to the outstanding invoice are necessary.

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Agreed action

24. The Council should, within four weeks of the final decision:

• calculate the approximate cost Ms X would have incurred had she received reablement services, deduct this from £810 and refund Ms X the difference
• consider the information Ms X provided about the service she received from the second personal assistant and amend the invoice as necessary,
• ensure officers conducting needs assessments/advising service users, act in line with the Care Act.

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Final decision

25. The Council failed to consider Ms X for reablement services. It then failed to provide appropriate advice about direct payments. This resulted in a significant financial loss for Ms X. The Council also failed to consider information Ms X provided about the service she received from a personal assistant.
26. The above recommendations are a suitable way to settle the complaint.
27. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman