Summary: Mr C complains the Council failed to provide support it had promised and delayed increasing a direct payment. The Council is at fault for delays in sending Mr C a support plan and paying his direct payment. To remedy the complaint the Council has agreed to apologise to Mr C, make him a symbolic payment, and repay his additional care costs while he waited for his direct payment. The Council will also remind staff to send support plans in a timely manner and review how it manages direct payments to prevent future delay.

The complaint

1. The complainant who I refer to as Mr C complains the Council did not provide the care it had agreed to. It also failed to provide Mr C with a support plan and delayed increasing his direct payment. Mr C says because of these faults he had to pay for private care and had time, trouble, and anxiety because of the lack of provision.

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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. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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

4. I considered information Mr C provided. I made enquiries of the Council and asked it questions. I considered the following:-
• the Council’s response to my enquiries;
• case recording;
• Mr C’s support plan reviews relevant to this complaint;
• Care Act 2014 and the associated Care and Support Statutory Guidance.
5. Mr C and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Background information

6. Mr C is autistic and has difficulties with anxiety. He lives in the community and has care to support him. In March 2023 Mr C contacted the Council to ask for a review of his care package as he felt it did not meet his needs. Around the same time he received the result of an earlier complaint with the Ombudsman. This found the Council was at fault for failing to assess and provide services promptly.

What should have happened

7. The Care Act spells out the duty to meet eligible needs (needs which meet the eligibility criteria). (Care Act 2014, section 18)
8. If a council decides a person is eligible for care, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether and to what extent the needs meet the eligibility criteria and specifies the needs the council is going to meet and how this will be done. The council should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
9. A direct payment is money a council gives to an adult who asks to receive one to meet their eligible care and support needs. (Care and Support Statutory Guidance, paragraph 12.1)
10. Councils must have in place clear and swift processes to respond to requests for a direct payment. (Care and Support Statutory Guidance, paragraph 12.10)

What happened

11. Officer X met with Mr C on 29 March and reviewed his care and support plan.
12. Mr C says during this meeting officer X agreed to several extra hours. On 28 April the Council telephoned Mr C about the hours it would provide. This was a temporary care package over a 12 week period. Mr C says this was less than previously agreed. By the end of May Mr C had not received an updated support plan and his direct payments were not in place. Mr C complained to the Council by phone on 24 May. He chased up the direct payment again on 14 June and the Council put this into payment on 16 June.
13. The Council responded to Mr C’s complaint on 23 June and attached a new support plan. The complaint response said it was usual practice to discuss the hours as part of care planning. It accepted it should have contacted Mr C before finalising the support plan for Mr C’s views on the support hours. It apologised for the lack of communication and the delay in sending Mr C an updated support plan.
14. In recognition of these failures the Council increased Mr C’s care package by 2 extra hours twice a week as part of the temporary increase in care. Mr C had asked for a change in social worker which the Council also agreed. The Council said,
15. “We should be clear on our timescales for making changes to a care plan and the package or payments, and that these should be made clear to you. In this case we did not meet the standards we would expect with regards to our communication or responsiveness in making changes and I apologise for this and for the distress that it caused you in having to get a resolution.
16. As a remedy, in addition to the apology provided, we have made adjustments to the care plan…”.

Was there fault causing injustice?

17. The Council has already accepted that communication between officer X and Mr C lacked clarity and the Council should have contacted Mr C before finalising the support plan. The Ombudsman welcomes early acceptance of fault and the Council’s remedy.
18. The Council reviewed Mr C’s support plan on 29 March but did not send a new support plan until it dealt with Mr C’s complaint on the 23 June. This is not in line with the Care Act 2014 and is fault.
19. The Council delayed in making the direct payment and did not offer an alternative in the interim. This is not in line with the Care and Statutory Support guidance which says councils must have swift processes for setting up direct payments and councils must meet assessed eligible needs, and is fault.
20. Although the Council did put the care package in place and some additional care; because of the Council’s failures Mr C had avoidable time and trouble in contacting the Council to chase up both his support plan and his direct payment. Mr C already experiences anxiety and this was worsened by the Council’s delay and actions. Mr C paid privately for extra care in the intervening period on the basis the Council had agreed to a support package and direct payment. The Council has not backdated Mr C’s direct payment and I therefore consider the Council should repay his private care costs for the extra care the Council agreed to meet.
21. It is disappointing and concerning that despite Mr C’s recent upheld previous complaint the Council has again delayed in supporting Mr C.

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Agreed action

22. I have found fault which has caused Mr C injustice. I consider the following agreed actions are suitable to remedy the complaint.
23. Within one month of the final decision the Council will:
1. in addition to the Council’s previous apology for some failures identified. It should reissue the apology considering the findings in this statement;
2. make a symbolic payment of £150 in acknowledgement of the distress and anxiety caused by the delays;
3. repay Mr C’s care costs for the extra care agreed by the Council on 28 April. This is on the condition Mr C provides the Council with receipts for the extra care he bought from 28 April until the Council put direct payments into place.
24. Within three months of the final decision the Council will through a staff circular, team meeting or other method remind staff about:-
1. the importance of providing people with a copy of the support plan promptly, and advising them of the need to discuss any changes to the support plan before reissuing;
2. processing direct payments promptly;
3. offer prospective recipients an alternative way to meet their needs if there is a delay in processing a direct payment.
25. Within three months of the final decision the Council will review the process followed from the point it agrees to a direct payment to its payment. This should identify how long it takes and what steps are required to ensure payments are made in a timely manner.
26. The Council should provide us with evidence it has complied with the above actions.

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Final decision

27. I consider there was fault by the Council which caused Mr C injustice. I consider the actions above are suitable to remedy the complaint. I have completed my investigation and closed the complaint on this basis.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman