Summary: Mrs B complained about how the Council carried out a care assessment and awarded direct payments and raised concerns about the Council billing her for services she did not receive, failing to take account of her reasonable adjustments and delay considering her complaint. The Council delayed completing the care assessment and putting in place direct payments, wrongly billed Ms B for services she did not receive and delayed considering her complaint. There is no evidence of fault in other areas of the complaint. Ms B has experienced distress and missed out on care support. An apology, payment to Ms B, a further financial assessment, care plan review and training for officers is satisfactory remedy.

The complaint

1. The complainant, Ms B, complained the Council:
• delayed carrying out an adult social care assessment;
• failed to carry out an adequate adult social care assessment as it failed to provide her with sufficient support for parenting, cleaning, nutrition, respite, therapy and transport;
• failed to provide her with advocacy support;
• billed her for services she had not received;
• failed to comply with its public sector equality duty by assigning a male social worker and refusing to implement reasonable adjustments for her;
• failed to put in place interim direct payments or to backdate those direct payments to November 2023;
• failed to provide her with sufficient direct payments to meet her needs; and
• delayed considering her complaint.
2. Ms B says the Council’s actions means she has missed out on care she should have received which has caused her significant stress.

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The Ombudsman’s role and powers

3. 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)
4. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
5. 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)
6. 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

7. I am exercising the Ombudsman’s discretion to investigate what has happened since November 2023. That is because that is only slightly outside the 12 month time limit and Ms B has not let the matter drop.

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How I considered this complaint

8. As part of the investigation, I have:
• considered the complaint and Ms B's comments;
• made enquiries of the Council and considered the comments and documents the Council provided.
9. Ms B @ and the organisation 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

The Care Act and the Care and Support Statutory Guidance 2014

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. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
12. 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.
13. In considering whether an adult with care and support needs has eligible needs, local authorities must consider whether:
• the adult’s needs arise from or are related to a physical or mental impairment or illness;
• as a result of the adult’s needs the adult is unable to achieve two or more of the specified outcomes;
• as a consequence of being unable to achieve these outcomes there is, or there is likely to be, a significant impact on the adult’s wellbeing.
14. An adult’s needs are only eligible where they meet all three of these conditions.
15. Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The Council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. It should confirm the final amount of the personal budget through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person's care and support needs.
16. Local authorities should consider whether the individual would have substantial difficulty in being involved in the assessment process and, if so, consider the need for independent advocacy.
17. Local authorities may combine an assessment of an adult needing care and support or of a carer with any other assessment it is carrying out either of that person or another where both the individual and carer agree, and the consent condition is met in relation to a child. This will also avoid the authority carrying out two separate assessments when the two assessments are intrinsically linked. If either of the individuals concerned does not agree to a combined assessment, then the assessments must be carried out separately.
18. Section 19(3) of the Care Act gives councils power to meet an adult’s needs for care and support if the needs appear urgent even if an assessment has not taken place.
19. Councils should have clear procedures to deal with social care complaints. Regulations and guidance say they should investigate and resolve complaints quickly and efficiently. A single stage procedure should be enough. The council should include in its complaint response:
• how it considered the complaint;
• the conclusions reached about the complaint, including any required remedy; and
• whether it is satisfied all necessary action has been or will be taken by the organisations involved; and
• details of the complainant's right to complain to the Local Government and Social Care Ombudsman.

The Council’s procedure for direct payments

20. A direct payment is a cash amount so a person can arrange their own care and support.
21. Local authorities have a duty to offer a direct payment to adults that are eligible for social care support.
22. A direct payment is one way for a person to receive their personal budget.
23. A direct payment must be used to pay for care as set out in the support plan or care plan and they are designed to provide a lot of scope as to how a person decides to meet their care needs.

Equalities Act

24. Under the Equality Act 2010 public sector organisations have to make changes in their approach or provision to ensure services are accessible to disabled people as well as everybody else. Reasonable adjustments can mean alterations to buildings by providing lifts, wide doors, ramps and tactile signage, but may also mean changes to policies, procedures and staff training to ensure that services work equally well for people with learning disabilities.

What happened

25. Ms B has PTSD and is a single parent of a son with ADHD and autism. Ms B’s son is currently not attending school.
26. The Council’s records show Ms B contacted the Council about a request for a care assessment in December 2023. Ms B said she was chasing a request from November 2023.
27. Ms B contacted the Council again in January 2024 to say she needed respite due to her son’s needs. The social worker suggested Ms B contact children’s services and her GP.
28. Ms B contacted the Council again to say her son’s meltdowns had increased in violence, frequency and severity and she needed a needs assessment as soon as possible. Ms B also put in a complaint.
29. A Council social worker contacted Ms B and completed an initial assessment in January 2024. The Council told Ms B it had placed her case on the waiting list for a social worker.
30. The Council assigned Ms B a social worker on 31 May who met with Ms B on 12 and 19 June.
31. Ms B chased the Council in August and raised concerns about the lack of support. The Council apologised and offered Ms B £100. In response Ms B again asked the Council to complete the care assessment.
32. A Council social worker contacted Ms B in September to suggest dates for a meeting. In response Ms B asked for an emergency budget so she could pay for respite. Ms B agreed to the meeting but said she would need to arrange for somebody to accompany her.
33. The Council’s social worker and manager visited Ms B on 31 October. The Council followed that up with an email on 4 November to confirm it had agreed to refer Ms B to the home care pilot. That was an interim service while the Council completed a full assessment. That began in December 2024.
34. Ms B chased the Council about the care assessment and direct payment in December 2024.
35. The Council met with Ms B’s advocate on 10 December. At that meeting Ms B’s advocate made clear the home care pilot service was not suitable for Ms B. The Council provided Ms B and her advocate with a draft of the care assessment.
36. The Council held a support planning meeting with Ms B and her advocate on 20 December and completed the care assessment and care plan. At that meeting all agreed Ms B would receive a direct payment and the Council agreed to backdate that to 10 December.
37. The Council contacted Ms B about some information it needed for the direct payment process. The Council also sent Ms B a financial assessment. That financial assessment told Ms B she would have to pay £52.55 per week towards her care package. The Council asked Ms B to provide further evidence to support the assessment.
38. Ms B contacted the Council in January 2025 to say she needed extra personal assistant (PA) support hours and respite care hours and a taxi allowance. Council officers met with Ms B and her advocate in February 2025.
39. The Council sent Ms B an invoice for commissioned care on 26 February. The Council later cancelled that invoice as Ms B pointed out she had not received any care.
40. The Council processed the direct payments form in March 2025. The Council confirmed the budget which included £25 per hour for childcare due to Ms B’s son’s complex needs. That direct payment is now in place and covers:
• three hours per week for support with cleaning the kitchen, bathroom, toilet and bedrooms;
• 10.5 hours per week for support with admin tasks;
• 3.5 hours per week for support and prompting with personal care and grooming;
• 7 hours per week for support to prepare a food plan for the week, order it and support for learning how to cook and prepare basic meals;
• 12 hours per week for support with childcare.

Analysis

41. Ms B says although she asked for a care assessment in November 2023 the Council did not complete one until December 2024. Ms B says although the Council completed a partial assessment earlier in 2024 it wrongly referred her to children’s services rather than recognising she was entitled to an assessment as an adult with care needs.
42. The Council accepts it delayed completing the care assessment. The Council also accepts the officer that dealt with Ms B showed confusion about the interaction between adult and children’s services. As I said in paragraph 17, the statutory guidance is clear there are circumstances where a combined assessment would be appropriate to avoid the person needing care having to complete separate assessment processes. While there is some reference in the Council’s paperwork to possible joint working with children services I have seen no evidence the Council considered carrying out a combined assessment with children’s services and that is fault.
43. I am also concerned about the delays in this case. Although the Council says it does not have a record of contact from Ms B in November 2023 the documentary records show Ms B chasing the Council for a response to her contacts in November 2023 when she contacted the Council in December 2023. I am therefore satisfied, on the balance of probability, Ms B had asked for a care assessment in November 2023.
44. I recognise the Council carried out part of the assessment in June 2024. However, that was still a seven month delay from when Ms B asked for an assessment. I am also satisfied the Council did not complete the full care assessment until December 2024. That is more than 12 months after Ms B asked for an assessment and is fault. I am concerned about that in Ms B’s case as she had made clear to the Council she was at crisis point. I am therefore concerned there is no evidence the Council put in place any initial support for Ms B until December 2024. That is also fault as the Care Act gives the Council power to make care provision if it decides a person’s needs are urgent even if it has not yet completed an assessment. As Ms B now has a significant care package I consider it likely, on the balance of probability, she has missed out on support due to the Council’s delays.
45. I recommended, as part of the procedural remedy for this complaint, the Council put in place a process to monitor/manage requests for care assessment so urgent cases are prioritised and cases are not left to drift. I also recommended the Council carry out a training session for those completing adult social care assessments about the interplay between children’s and adult services and the circumstances in which a combined assessment might be appropriate. The Council has agreed to my recommendations.
46. Ms B says the Council’s care assessment is inadequate and does not reflect the full extent of her needs. I am satisfied the care assessment the Council completed in December 2024 was completed with full involvement from Ms B and her representative. I am also satisfied because of that assessment the Council set up a significant care package. I therefore could not say the assessment was inadequate, although I have made clear that assessment was significantly delayed and the Council should have considered whether to complete a combined assessment with children’s services. I am satisfied the Council has made clear it intends to review that care package over time to establish whether it is enough to provide for Ms B’s needs. I welcome that.
47. Ms B says the care assessment has not put in place any provision for cleaning or nutrition. I am satisfied the care plan the Council put in place included three hours a week to cover cleaning and seven hours a week for food planning. I am therefore satisfied the assessment covers those issues.
48. For respite, I recognise Ms B is concerned the 12 hours childcare support the Council has put in place is insufficient. I am satisfied though the Council has not put that 12 hours in place as respite provision. Instead, I am satisfied the Council has put that provision in place so Ms B can access her university course. It is clear from the care assessment the Council has referred Ms B back to children’s services to access any respite or parenting support.
49. As I said earlier, there is an expectation those needing care should only have to give their information to the Council once. I have criticised the Council in this case for not considering whether to complete a combined assessment with children’s services. I also take into account though that Ms B already had some involvement with children’s services and the child in need process had been offered to her. In those circumstances I understand why the Council would have listed the support available through children’s services in the assessment. As Ms B has now had her care package in place for six months I consider a reasonable way forward would be for the Council to complete a review which should include liaison between adult social care and children’s services around the respite and parenting support issues. The Council has agreed to do that.
50. I also recognise the care plan does not cover therapy. However, I would expect therapy to be a service for the NHS to provide, rather than the Council. There is also nothing in the assessment to suggest the Council identified the need for therapy provision. I therefore have no grounds to criticise it.
51. I am, however, concerned there is no evidence the Council followed up on the issue of transport. The assessment recorded Ms B’s needs around this area and the social worker was to follow up to find out whether Ms B would be entitled to taxi care or a blue badge. I cannot see that this has been followed up on and that is fault.
52. As a personal remedy for the failings in the care assessment process I recommended the Council apologise to Ms B. I also recommended the Council pay Ms B £1,000 to reflect the impact on her of having to go without care provision for more than 12 months. The Council has agreed to my recommendations.
53. Ms B says the Council failed to provide her with any advocacy support. Ms B says as she struggles to engage with care planning she needed advocacy support in place. Having considered the documentary evidence I have not identified any requests from Ms B for the Council to put in place advocacy support. I note though the need for an advocate is set out in Ms B’s reasonable adjustment passport. I am satisfied though the documentary evidence shows Ms B brought an advocate with her to various meetings. I am also satisfied Ms B’s advocate was involved in the care planning process. In those circumstances I see no reason why the Council would have identified the need to source an advocate for Ms B. I therefore have no grounds to criticise the Council.
54. Ms B says the Council billed her for services she had not received. The Council accepts that is the case and has confirmed it has cancelled those costs. Charging Ms B for care she did not receive is fault. I am concerned about that because Ms B had highlighted the impact of receiving incorrect bills on her mental health. There is also evidence in the documentary records of the Council agreeing to ensure that did not happen. Sending Ms B bills for services she did not receive is therefore fault. I welcome the fact the Council has cancelled those costs.
55. Ms B says the Council failed to comply with its public sector equality duty by assigning her male social worker and in refusing to implement her reasonable adjustments passport.
56. Having considered the documentary records I have not identified Ms B raising any concerns with the Council about working with a male social worker. Nor is there anything in Ms B’s reasonable adjustments passport to suggest she could not work with a male worker. In those circumstances I cannot criticise the Council for assigning Ms B a male social worker. I note though when the Council identified the cause of Ms B’s PTSD it changed the social worker, which I welcome.
57. I am satisfied the Council has received a copy of Ms B’s reasonable adjustments passport, which is detailed. I recognise there were occasions where the Council did not follow some of the passport, such as when it did not provide information to Ms B in bullet points. I am satisfied though the Council adjusted that and has tried to follow Ms B’s reasonable adjustment passport. I therefore do not consider this warrants a finding of fault.
58. Ms B says the Council delayed putting in place direct payments and failed to backdate those payments to November 2023. The Council accepts setting up the direct payment could have been managed better. That added a further delay and that is fault. I cannot criticise the Council though for not backdating the direct payment to November 2023. The Council has backdated the direct payment to the date of the care plan, which is what I would expect it to do.
59. I recognise Ms B does not believe the direct payment amount is enough to meet her needs. However, I am satisfied the Council has taken into account Ms B’s concerns about the level of the direct payment by increasing the amount it usually pays for childcare. I am satisfied that was to reflect the concerns Ms B raised about her son’s specialist needs. As I am satisfied the Council’s calculation of the direct payment reflects the provision it has agreed to put into place I have no grounds to criticise it. The Council should though have included details of the amount agreed in Ms B’s care plan and failure to do that is fault.
60. I have a concern though about how the Council decided the amount Ms B has to pay towards her care package. Based on the documentary evidence I have seen I cannot see the Council has considered whether Ms B has disability related expenditure which it should take into account. Failure to do that is fault. As part of the remedy for the complaint I recommend the Council discuss with Ms B whether she has any disability related expenditure and carry out a further financial assessment. If, following that financial assessment, Ms B’s contribution goes down I recommend the Council backdate that to December 2024.
61. Ms B says the Council delayed considering her complaint and then only responded to part of it. The evidence I have seen satisfies me Ms B put in her complaint in January 2024. However, there is no evidence the Council responded to that complaint until August 2024. That delay is fault. I am also concerned the Council’s response to the complaint did not address all the concerns Ms B had raised. That is also fault. As remedy for that I recommend the Council remind officers dealing with complaints of the need to follow the timescales set out in the Council’s complaints procedure and to ensure it responds to all parts of the complaint.
62. As I am satisfied Ms B has experienced significant distress because of the faults identified in this statement I recommend the Council pay her an extra £500. That makes a total financial remedy of £1,500.

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Action

63. Within one month of my decision the Council should:
• apologise to Miss B for the distress and upset she experienced due to the faults identified in this decision. The Council may want to refer to the Ombudsman’s updated guidance on remedies, which sets out the standards we expect apologies to meet;
• pay Ms B £1,500;
• consider the concerns Ms B has raised about transport and investigate whether further support should be put into place for her in relation to that;
• carry out a further financial assessment with Miss B to find out whether she has any disability related expenditure which needs to be deducted from any contribution she has to make towards her care. If that results in Miss B’s contribution reducing the Council should backdate that assessment to December 2024; and
• remind officers dealing with complaints of the need to follow the timescales set out in the Council’s complaints procedure and to ensure complaint responses cover all the issues raised.
64. Within three months of my decision the Council should:
• review the care package to establish whether it meets Ms B’s needs. That review should include discussions with children’s services about respite and parenting support options; and
• put in place a process to manage/monitor request for care assessments so urgent cases are prioritised and cases are not left to drift;
• carry out a training session for those completing adult social care assessments to cover the interplay between adult social care and children’s services and the circumstances in which a combined assessment might be appropriate.
65. The Council should provide us with evidence it has complied with the above actions.

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Final decision

66. I find fault causing injustice. The Council has agreed actions to remedy the injustice.

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Investigator's decision on behalf of the Ombudsman