Summary: Ms Q complained about the way the Council has dealt with her requests for disability related expenses for her child. We do not consider the Council is at fault so have not recommended any remedy.

The complaint

1. Ms Q complains about the way the Council has dealt with requests for disability related expenses (DRE) for her adult child, A. She says the Council has not followed guidance or explained its reasons. Ms Q says the Council has caused her distress and impacted her mental health.
2. Ms Q seeks a reassessment of her child’s DRE and a payment in acknowledgement of the distress caused.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
4. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
5. 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

6. I have considered information provided by the Council and Ms Q, alongside the relevant law and guidance.
7. Ms Q and the Council have had the opportunity to comment on a draft decision before this final decision is made.

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What I found

Law, guidance and Council policy

8. Councils can take disability-related benefit into account when calculating how much someone should pay towards the cost of their care. When doing so, a council should make an assessment to allow the person to keep enough benefit to pay for necessary disability-related expenditure (DRE) to meet any needs it is not meeting. The Care and Support Statutory Guidance sets out a list of examples of such expenditure. It says any reasonable additional costs directly related to a person's disability should be included. What counts as DRE should not be limited to what is necessary for care and support. For example, above average heating costs should be considered.
9. The Council’s policy says it will consider the eligible needs, the Care and Support Plan, and evidence of costs to determine what is a DRE.
10. The policy says that if evidence is provided within a month of the assessment and the DRE is then accepted, the reduction in care charges will be backdated to the date of the assessment. If evidence is provided later than this, the reduction will not be backdated, and if evidence is not provided the DRE will not be accepted.
11. The Council gives a range of examples of what may constitute DRE.

What happened

12. Ms Q has an adult child (A), who has disabilities. A has a care and support plan in place.
13. The Council carried out a financial assessment in January 2024. The Council explained that as A’s benefits had increased since its last assessment, she would now be required to make a weekly contribution to her social care. The financial assessment included a reduction in this charge for A’s DRE.
14. Ms Q complained about the financial assessment. The Council visited her to discuss and review the assessment in person in March 2024. The Council concluded that a lower sum would be accepted as DRE and confirmed an amended weekly charge. It also gave a backdated bill for charges from January 2024. It offered an option for a payment plan for this payment. It also confirmed it would still consider any further evidence Ms Q provided to support her claim for further DRE to be deducted from the weekly charge.
15. Ms Q made a formal complaint, including a list of what she considered to be DRE and asked that they be included in A’s assessment.
16. In April 2024, the Council reviewed the financial assessment again. It considered further evidence Ms Q had provided and accepted one further item and provided its reasons for not accepting another item as DRE.
17. Ms Q remains unhappy as she says the Council has not followed guidance or explained its reasons in reaching its decisions.

Analysis and findings

18. The Ombudsman is not an appeal body. This means we do not take a second look at a decision to decide if it was wrong. Instead, we look at the processes an organisation followed to make its decision. If we consider it followed those processes correctly, we cannot question whether the decision was right or wrong, regardless of whether you disagree with the decision the organisation made.
19. The Council is able to make its own decision as to whether it accepts an item as DRE or not, as long as it is acting within the relevant guidance and its own policy.
20. I have seen the Council carried out a financial assessment, and considered each of the items of DRE claimed by Ms Q. It notified her of its timeline for her to appeal or provide further evidence if she did not agree.
21. The Council extended its appeal deadline and reviewed its decision in person with Ms Q when she did not agree, and then carried out another further review when she provided more evidence.
22. The Council is not required to disregard its previous financial assessment, and I am satisfied an independent officer reviewed the decision following Ms Q’s concerns about its January assessment.
23. The Council has provided detailed reasons why the items it has not accepted as DRE have been declined.
24. The Council has shown that it has considered A’s individual needs and circumstances in reaching its decision.
25. I am satisfied the Council has followed guidance and policy in the way it has dealt with A’s assessment and is therefore not at fault.

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Final decision

26. We find the Council is not at fault for how it has dealt with this matter.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman