Summary: Ms X complained about the standard of care she received from providers commissioned by the Council, the way the Council carried out a care assessment of her needs and how it charged her for care. We found the Council at fault for the way it carried out a care assessment and for delays carrying out a new assessment. To remedy the injustice caused the Council agreed to apologise to Ms X and make a payment to her for the distress caused.

The complaint

1. Ms X complains about:
• The standard of care she received from several care providers commissioned by the Council since 2022.
• The way the Council assessed her care needs in 2024.
• The communication she received around paying for her care since 2022.

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The Ombudsman’s role and powers

2. 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)
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 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)
4. 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)
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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What I have and have not investigated

6. I have not investigated matters before December 2023 as too much time has passed. Ms X brought her complaint to the Ombudsman in December 2024. I am satisfied there are no good reasons why Ms X could not have complained about matters before December 2023 sooner. In coming to this decision I considered Ms X had support from advocates to help her with her complaints.
7. I have referred to some events before December 2023 in the ‘what happened’ section below but only for context.

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How I considered this complaint

8. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
9. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Law and guidance

10. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
11. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.
12. 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.
13. The Council applies a standard weekly DRE expenditure allowance of £24.16.

What happened

14. Ms X had care needs and received support from a provider commissioned by the Council in December 2022.
15. In December 2023, Ms X started to receive support from a different provider, Provider A. Ms X raised concerns about the support worker working with her. The records showed Ms X was supported two times by the support worker. Ms X raised concerns that on one occasion the support worker had her makeup done and on the same trip left Ms X for a period of time. The support worker’s version of events was that they wanted to get involved in the activity Ms X had chosen, so got their makeup done alongside Ms X. The support worker also said they left Ms X to buy a drink from a juice bar next to where the makeup appointment was and the support worker told Ms X she was doing this.
16. Ms X also raised concerns about a meeting held with Provider A in early January 2024 and that a staff member was on their computer. At this meeting Ms X told Provider A which staff member she wanted to support her, however this did not happen. Ms X did not receive any further support from Provider A.
17. In early February 2024, the Council commissioned Provider B to support Ms X. At first Ms X agreed to have two hours of support per week and gradually increase this once she became familiar with the team at Provider B.
18. Ms X’s care with Provider B only lasted until 5 March 2024 as the Council carried out an new assessment of Ms X’s needs and found she did not have eligible care needs.
19. Ms X raised concerns about Provider B, namely that when she cancelled a support appointment she could not re-use these hours. She also raised concerns about the support worker she had been assigned. Ms X and Provider B arranged to meet to discuss this but Ms X’s care was cancelled following her new assessment in March 2024.
20. In April 2024 Ms X complained to the Council about the care assessment it carried out.
21. The Council responded to Ms X’s complaint in July 2024. The Council said the way it recorded the assessment was confusing and it should have communicated the decision to not find her eligible for care with her so there was an opportunity for Ms X to respond and discuss this. The Council agreed it would carry out a new assessment of Ms X’s care needs.
22. Ms X raised a further complaint in July 2024. Ms X complained about the standard of care she has received since 2022. She also complained how the Council managed and communicated her care charges to her since 2022, including how it had calculated DRE.
23. The Council said it allocated Ms X’s new care assessment to a social worker in June 2024. In September 2024, it allocated the assessment to a new social worker and has no notes about what happened from June to September 2024.
24. From September 2024 the new social worker, at Ms X’s request, arranged several meetings with Ms X and her advocate which took place from the end of September to the end of November 2024. In late December 2024 the Council provided Ms X with a draft copy of her care assessment. After Ms X asked for some changes, the Council completed the final assessment in early February 2025.
25. On 14 January 2025, the Council responded to the complaint Ms X made in July 2025. The Council:
• Apologised for the delays in responding and offered Ms X £150 for the time and trouble she experienced as a result of these delays.
• Recognised that when Ms X received support from Provider A it left her without support from early January 2024 until early February 2024 as it could not identify a suitable support worker for her. The Council also said it could not substantiate Ms X’s version of events about the support she received from Provider A.
• Said Provider B recognised it could have better explained that she could not bank hours with it and that it could not offer a high level of flexibility each week in terms of when Ms X wanted support. The Council said Provider B also said it could have looked more at Ms X’s interests when deciding on a suitable support worker and will do this in future.
• Told Ms X she had £350 outstanding on her care account and sent her a breakdown of these charges. The Council apologised that it did not consider whether Ms X had DRE higher than the standard minimum local allowance the Council applied. The Council said if Ms X wanted to send it evidence of further DRE it would look at this and backdate any charges if it found this was DRE.
26. Ms X remained dissatisfied and complained to the Ombudsman. Ms X left the Council area in February 2025.

Analysis

Standard of support Ms X received

27. In relation to Provider A, Ms X said the support worker left her and also took part in the activity she had booked. On balance I do not find the Council at fault here. I have Ms X’s word against the support workers. However I have looked at the notes made during the times Provider A supported Ms X and am satisfied the Council was not at fault for the level of support Provider A gave Ms X.
28. The Council was at fault for the period between 8 January 2024 and 4 February 2024 when she was left without support. While it is welcomed that the Council recognised this it has not offered Ms X a suitable remedy for the injustice she suffered. Ms X was entitled to some support during this period and did not receive this.
29. I have not found the Council at fault for the level of support from Provider B. While Ms X was unhappy with the support workers, this seems to be as a result of personal differences as opposed to the level of support received. In addition, I have no evidence that the support Ms X received was inadequate.
30. Ms X also raised concerns about Provider B as it would not let her bank her hours when she did not use them. I do not have any evidence that Provider B communicated this to Ms X. This is fault. Provider B said it told Ms X and the social worker that she could not bank hours, however it accepted it could have better explained this to Ms X. Provider B also said it could have looked to match Ms X with a support worker with similar interests and going forward this is what it would do for others.

Care assessment in 2024

31. The Council has acknowledged it recorded the assessment in a confusing way and did not communicate its findings to Ms X so she had the chance to discuss these. This was fault. The Council agreed to carry out another assessment to remedy this injustice. Had the Council believed the assessment was carried out properly I do not consider it would have offered to re-assess Ms X’s care needs.
32. There was some delays reassessing Ms X’s care needs between June 2024 and September 2024 as the social worker who had Ms X’s case did not contact her. This was fault. After the Council re-allocated Ms X’s case in September 2024, the social worker arranged several meetings at Ms X’s request and completed the care assessment.
33. Ms X’s circumstances do not appear to have changed during the course of this complaint yet she had a care plan which said she was eligible for care. In 2024 this changed following a new assessment which said she was not eligible for care. Then the Council completed a further assessment in 2025 which said she was eligible for care. Ms X will have experienced uncertainty about the outcome of the 2024 care assessment and uncertainty about whether she should have continued to receive support from March 2024 until February 2025 if the Council had completed the assessment without the concerns it mentioned in its complaint response.

Charging

34. I am satisfied that the Council has resolved this through its complaints response to Ms X. The Council recognised there was fault with how it communicated charging information to Ms X and sent her a breakdown of the outstanding charges.
35. In relation to DRE, the Council recognised it could have considered whether Ms X had DRE above the standard local minimum allowance. The Council offered to consider Ms X’s circumstances again if she provided evidence of further DRE. I am satisfied these actions remedy any injustice caused to Ms X.

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Agreed Action

36. Within one month of my final decision the Council agreed to:
• Apologise to Ms X for the above faults. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings.
• Pay Ms X £100 to recognise the distress she experienced as a result of having no support from January 2024 to February 2024.
• Pay Ms X £500 to recognise the distress she experienced as a result of the way the Council carried out the 2024 care assessment and the uncertainty that she may have missed out on receiving support.
37. The Council should provide us with evidence it has complied with the above actions.

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Decision

I find fault causing injustice. The Council agreed t the above actions to remedy the injustice caused.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman