Summary: We will not investigate Ms X’s complaint about the Council not providing her with enough care hours and about the Council’s refusal to allow her food expenses to be considered disability related expenditure. This is because there is insufficient evidence of fault.

The complaint

1. Ms X complains the Council is not providing her with enough care hours. She also complains about her financial assessment and the Council’s refusal to consider her food expenses as disability related expenditure (DRE).

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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. In June 2024, the Council completed a care needs assessment for Ms X. The Council completed a reassessment in December 2024. The reassessment identified Ms X needed 30 hours of care a week to meet her eligible needs.
7. Ms X says this was not sufficient as she considers she needs 24 hours care a day. Ms X says she cannot move without support and needs to be moved every three hours to avoid blood clots.
8. I have reviewed both care assessments and am satisfied there has been no fault in the way it was completed. Ms X was involved in the care assessment and able to provide information about her circumstances and needs. The care assessment noted:
• Ms X has pain in her back which affects her mobility and ability to complete tasks.
• Ms X is bed bound some days due to the pain.
9. There was no reference within the care assessment of any need for Ms X to be moved every three hours.
10. An investigation is not justified as we are not likely to find fault with the way the Council completed the care assessment. Therefore, the Council is allowed to determine how much care and support is necessary to meet Ms X’s identified eligible care needs.
11. Further, the Council had agreed to complete a new care assessment with a different social worker. However, the Council explained it has not been able to progress with this as Ms X had declined to be involved while her complaint was ongoing. It is open to Ms X to engage with the Council to allow it to complete the new care assessment to enable it to review whether the care hours are appropriate to meet Ms X's eligible needs.
12. Ms X also complained about the financial assessment completed by the Council. She says the Council has not allowed her food expenses as DRE. Ms X said she has been diagnosed with an eating disorder, and this is why her food expenses are so high.
13. The Council explained there is no evidence Ms X had been diagnosed with an eating disorder. The Council said the medical evidence shows Ms X has a diagnosis of depression and a symptom of this is overeating.
14. An investigation is not justified as the Council has provided a clear rationale for why it has not agreed to allow food expense as DRE. The Council is allowed to make its decision as it properly considered all relevant information before reaching its decision.
15. The Council also explained that Ms X’s assessed contribution is now lower due to a change in the statutory living allowance rate the Council now allows in financial assessment. The Council said it now applies the rate which was previously only applied to those over pension age and said it has made this decision for equity reasons. This meant that everyone under pension age, other than those who have above the capital threshold, will pay less.
16. An investigation is not justified as the Council can exercise discretion to disregard more than just the minimum income guarantee set by the government. In addition, this benefits Ms X as her assessed contributes are now lower.

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Final decision

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

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Investigator's decision on behalf of the Ombudsman