Summary: Mrs X complained about the way the Council assessed Mrs Y’s care and support needs. The Council was at fault for failing to implement the remedies agreed in its complaint response. The Council has agreed to apologise, complete the remedies, and make a payment to recognise the injustice caused.

The complaint

1. Mrs X complains about the way the Council assessed Mrs Y’s care and support needs since August 2023. Mrs X says the assessments have not been good enough and the Council has failed to follow the Care Act guidelines which has caused a lot of distress and frustration.

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The Ombudsman’s role and powers

2. 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)
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. The law says we cannot normally investigate a complaint unless we are satisfied the organisation knows about the complaint and has had an opportunity to investigate and reply. However, we may decide to investigate if we consider it would be unreasonable to notify the organisation of the complaint and give it an opportunity to investigate and reply. (Local Government Act 1974, section 26(5), section 34(B)6)
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(1), as amended)

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What I have and have not investigated

6. We cannot usually investigate events that took place more than 12 months before a complaint was raised with the Ombudsman. We can only exercise discretion to look back further if there are good reasons to do so.
7. Mrs X complains about care act assessments that were completed for Mrs Y in September 2023 and December 2023. However, Mrs X first brought this complaint to the Ombudsman in March 2025, meaning anything that took place before March 2024 has been raised late.
8. I have seen no good reason why Mrs X could not have brought her complaint to the Ombudsman sooner, so I have started my investigation from March 2024 and specifically considered whether the Council actioned the remedies from its final complaint response.
9. We also cannot usually investigate complaints unless we are satisfied the Council has had a chance to look into them first. This includes events that are linked to or ongoing from the complaint that has been brought to us.
10. Mrs X has confirmed she made a subsequent complaint to the Council and intends to raise that with us under separate cover. For this reason, I have only investigated up to the Council’s final response of June 2024.
11. Any mention below to events that took place before March 2024 or after June 2024 are for reference only.

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How I considered this complaint

12. I considered evidence provided by Mrs X and the Council as well as relevant law, policy and guidance.
13. Mrs 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

Relevant law and policy

14. 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.
15. 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.
16. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs.

What happened

17. I have summarised below some key events leading to Mrs X’s complaint. While I have considered everything submitted, this is not intended to be a detailed account of what took place.
18. Mrs Y had been known to the Council’s Adult Social Care team for several years. Following a hospital stay, Mrs Y was discharged home in September 2023. The Council completed a care act assessment of Mrs Y’s needs and found she needed support with managing her fluid intake, taking her medication, and maintaining a habitable home environment.
19. Mrs X arranged for a private carer to meet Mrs Y’s identified needs, with the Council providing direct payments to cover this.
20. Mrs X had to chase the Council to arrange the direct payments and make payments herself in the meantime. When the Council arranged the direct payments, it also reimbursed Mrs X for the payments already made to that point.
21. The Council reviewed Mrs Y’s needs and produced a new support plan in December 2023. This stated Mrs Y had no eligible care needs, but said she was receiving support from a privately commissioned carer.
22. In December 2023, the Council stopped making direct payments to Mrs X.
23. Mrs X complained to the Council in March 2024. Mrs X explained she had been unhappy with the service Mrs Y had received from the Council for some time. Mrs X said:
• The Council had ignored her concerns it was too soon for Mrs Y to return home in September 2023;
• She had to arrange a private carer only because the Council said its team did not have the capacity to support Mrs Y’s needs;
• She had to chase for weeks before the Council started making direct payments which had now come to a stop without warning;
• There were inaccuracies and misrepresentations in the care assessments, making them unreliable and untrue;
• The Council had failed to identify all of Mrs Y’s eligible support needs;
• A caseworker from the Council had attended Mrs Y’s home unannounced and looked through her private correspondence;
• She felt the social workers were not qualified for the role; and
• The care assessments were causing considerable stress for Mrs Y and she did not want to keep going through them.
24. In April 2024, the Council arranged for an independent party to complete a care act assessment for Mrs Y. This found Mrs Y required support across all areas of eligible needs. The assessment concluded support planning should take place to meet Mrs Y’s needs in her home. It also requested a carer’s assessment for Mrs X.
25. The Council commissioned an independent report into Mrs X’s complaint. The report found:
• There were inconsistencies in the Council’s notes and assessments, and these did not always show how decisions had been made;
• Not all agreed direct payments had been made and were stopped without warning, though these had now been backdated and would continue to be made;
• There were several misrepresentations in Mrs Y’s assessments and failures to fully record her circumstances; and
• The assessments failed to show Mrs Y’s eligible needs were all adequately assessed, but an independent care act assessment had now taken place to rectify this.
26. The Council wrote to Mrs X in May 2024 to confirm it accepted the conclusions of the report. The Council said:
• In future anyone carrying out assessments would properly familiarise themselves with previous assessments;
• The direct payments had now been reinstated;
• It was sorry for the unnecessary stress, frustration and anxiety caused and offered to pay £500 in recognition of this;
• It would improve its record keeping and retain documents relevant to care; and
• It would work to improve its communication.
27. Mrs X asked the Council to reconsider her complaint as she had concerns about the findings and the person who undertook the report and not all her points were answered.
28. The Council provided its final response to Mrs X’s complaint in June 2024. The Council said the findings from its initial response still stood. The Council said the person who completed the initial complaint response was well-placed to do so. The Council said it felt the £500 previously offered remained suitable but agreed a communication plan should be drafted with Mrs X within 28 days.
29. In response to our enquiries, the Council confirmed that since January 2025 it has a new recording system in place to ensure all previous support plans are reviewed and resulting actions, such as changes or new assessments are quality checked by management before being signed off. This system also ensures previous information is considered and included in new assessments. The Council also confirmed it completed a communication pathway that was agreed with Mrs X and was implemented since August 2024. However, the Council said it could find no evidence the £500 offered to Mrs X had ever been paid or that an apology had been provided.

Analysis

30. As explained in paragraphs 6 – 11 above, I have not reinvestigated the substantive matter of Mrs X’s complaint as this predates the start point of my investigation. I also have not investigated events subsequent to the Council’s final complaint response as Mrs X is free to raise a new complaint about these.
31. The Council’s response to Mrs X’s complaint appears to be comprehensive in giving the Council’s view of the issues raised. Where the Council accepted it was at fault it put forward proportionate remedies for the injustice caused, and I do not find fault with its complaint response.
32. Based on the information the Council has provided, I am satisfied it acted correctly in reinstating and backdating the direct payments and putting processes in place to improve communications and prevent a recurrence of the identified issues going forward. I do not find it at fault here.
33. However, the Council has confirmed it cannot evidence that it provided Mrs X with an apology for the injustice caused by the identified faults or paid her the £500 it offered to reflect this. This amounts to fault and would have caused Mrs X more time and trouble in having to remain in the complaints process which is injustice.

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Action

34. The Council should complete the following actions within one month of the date of this decision:
• Write to Mrs X to apologise for the inconsistencies in its notes and Mrs Y’s care assessments, the poor communication, for stopping the direct payments, and for the delay in completing the remedy on Mrs X’s complaint. 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 Mrs X the £500 previously offered in recognition of the identified injustice.
• Pay Mrs X a further £100 to recognise the additional time and trouble she has been put to by having to continue pursuing this complaint due to the Council’s failure to fully implement the agreed remedies.
35. The Council should provide us with evidence it has complied with the above actions.

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Decision

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

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Investigator's decision on behalf of the Ombudsman