Summary: We will not investigate Miss X’s complaint the Council completed an inadequate care assessment and decision to reduce her mother’s direct payments. This is because there is insufficient evidence of fault.

The complaint

1. Miss X complains about the Council’s decision to reduce her mother’s direct payments. She says the Council completed an inadequate care assessment and so her mother’s care plan does not meet her needs.

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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 impact 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 there is not enough evidence of fault to justify investigating. (Local Government Act 1974, section 24A(6), as amended, section 34(B))
3. 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)

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How I considered this complaint

4. I considered information provided by the complainant and the Council.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. Miss X’s mother, Mrs Z, has care and support needs. In 2019, the Council reassessed Mrs Z’s care and support needs. The Council identified Mrs Z had 24-hour support needs and decided to increase her care and support hours from 17.5 hours a week, to 56 hours. This was provided via direct payments.
7. The Council agreed, under exceptional circumstances, for Miss X to receive part of the direct payments to enable her to provide 24 hours of support to Mrs Z. Miss X was happy with this care plan.
8. In January 2024, the Council reassessed Mrs Z’s care and support needs. Care needs are fluctuating, so councils must complete regular reviews/reassessments to ensure an individual’s needs are up to date and to ensure the care plan is appropriate.
9. The reassessment determined there was insufficient information to justify Mrs Z’s current level of support. It also found Mrs Z did not have 24-hour care and support needs. The care package proposed to meet Mrs Z’s identified care needs was 22 hours 45 minutes a week. The Council again approved for Miss X to provide the care to Mrs Z under direct payments as an exceptional circumstance.
10. Miss X was unhappy with the new care plan and said she was providing care to her mother 24 hours a day. She considered the reduced direct payment was not sufficient to meet her mother’s needs.
11. The Council reviewed Mrs Z’s care plan in September 2024. The Council noted the information Miss X provided regarding Mrs Z’s nighttime needs and agreed to increase the care package for the evening. The care package was now for 24 hours and 30 mins a week.
12. 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.
13. In this case, the Council followed the correct process to reassess Mrs Z’s care and support needs. The reassessment process involved both Mrs Z and Miss X, and both were able to input into the process and share their views. I am also satisfied the reassessment considered all relevant information.
14. The Council had a clear rationale for the reduction of Mrs Z’s care package as the reassessment found Mrs Z did not have 24-hour care needs. I also note the 2024 reassessment detailed Mrs Z had different care and support needs when compared to the 2019 reassessment.
15. While I note Miss X disagrees with the Council’s assessment, we could not find fault unless there was fault in the way the Council made its decision. I am satisfied there is insufficient evidence of fault in the way the Council completed the care reassessment and made its decision. Therefore, an investigation is not justified.

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Final decision

16. We will not investigate Miss X’s complaint because there is insufficient evidence of fault.

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Investigator's decision on behalf of the Ombudsman