Summary The Council failed to properly assess Mr X’s care needs in 2024 leading to a wrongful reduction in his support package. Consequently, Mr X missed out on services to which he was entitled to receive. It also delayed in dealing with complaints about this.

The complaint

1. Mr X complains about the way the Council dealt with a review of his direct payments, a delay in completing a review of his sensory impairment needs, and a failure to adhere to reasonable adjustments. He also complains the about the way in which the Council dealt with his complaints about this.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. 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)
3. 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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How I considered this complaint

4. I have:

• considered the complaint and discussed it with Mr X;
• considered information the Council provided to this office;
• taken account of relevant legislation;
• offered Mr X and the Council an opportunity to comment on a draft of this document, and considered the comments made.

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What I found

Relevant legislation

5. The Care Act 2014 and the Care and Support Statutory Guidance set out how councils must assess and meet identified needs for care and support.
6. Councils must carry out an assessment for any adult with an appearance of need for care and support. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. If a council decides a person has eligible needs, it must set out how it will meet those needs in a care and support plan.
7. The Care Act 2014 gives local authorities 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 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 local authority must involve any carer the adult has.
8. The council must set a personal budget as part of the care and support plan. The personal budget is the money the council has worked out it will cost to arrange the necessary care and support for that person.
9. Where local authorities have determined that a person has any eligible unmet needs, they must meet these needs.
10. Councils must take into consideration a person’s preferences. However, recent case law (R (Davey) v Oxfordshire County Council) found while a claimant’s preferences had to be taken into account, these had to be distinguished from their needs for care. The court of appeal found the Council’s duty is not to achieve the outcomes which the individual wishes to achieve but to assess whether the provision of care and support would contribute to those outcomes. The wishes of the individual may be a primary influence, but they do not amount to an overriding consideration.
11. The guidance sets out that, in determining how to meet needs, a council may also take into reasonable consideration its own finances and budgetary position. This includes the importance of ensuring that the funding available to the council is sufficient to meet the needs of the entire local population. It says the council may reasonably consider how to balance that requirement with the duty to meet the eligible needs of an individual in determining how an individual’s needs should be met (but not whether those needs are met). However, the local authority should not set arbitrary upper limits on the costs it is willing to pay to meet needs through certain routes – doing so would not deliver an approach that is person-centered or compatible with public law principles. The authority may take decisions on a case-by-case basis which weigh up the total costs of different potential options for meeting needs and include the cost as a relevant factor in deciding between suitable alternative options for meeting needs. This does not mean choosing the cheapest option; but the one which delivers the outcomes desired for the best value.
12. The guidance also sets out the detail of how the personal budget will be used is set out in the care and support plan, or support plan. At all times, the wishes of the person must be considered and respected. For example, the personal budget should not assume that people are forced to accept specific care options, such as moving into care homes, against their will because this is perceived to be the cheapest option.
13. The guidance sets out the personal budget must be an amount that is the cost to the local authority of meeting the person’s needs. In establishing the ‘cost to the local authority’, consideration should therefore be given to local market intelligence and costs of local quality provision to ensure that the personal budget reflects local market conditions and that appropriate care that meets needs can be obtained for the amount specified in the budget. 

Background

14. Mr X is in his fifties and lives in his own home with his partner, who has his own care needs. Mr X and his partner are co-dependant in most aspects of their day-to-day living.
15. Mr X is blind; he has a guide dog for support and has aids within his home to enable him to live safely. The Council previously assessed Mr X’s care needs and allocated a direct payment £27.50 per week, to enable him to pay for services.
16. The Council informally reviewed Mr X’s needs in June 2024. A reviewing officer visited Mr X and informed him he could no longer use his direct payment to pay for window cleaning and gardening services, and that this must cease with immediate effect. The reviewer told Mr X the Council did not ordinarily fund such tasks.
17. The reviewing officer emailed Mr X a copy of the assessment document. The document was not in large font as per Mr X’s requirements. He alerted the Council to this and subsequently received a copy in his preferred font in July 2024.
18. Mr X was dissatisfied with the outcome of the review, and refused to sign his direct payment agreement, he believed doing so would confirm his agreement to the proposed budget and consequently, he would not be able to challenge the decisions made.
19. Mr X sought support from an advocate and submitted a formal complaint to the Council in September 2024. The Council acknowledged the complaint the same day and three days later sent Mr X an email confirming the points of complaint.
20. Mr X heard no more from the Council until November 2024, when it contacted him to apologise for the delay in responding to the complaint. Mr X heard nothing further, so his advocate contacted the Council in December 2024 to chase a response. A council officer responded saying a response would be provided by xmas eve. The officer contacted Mr X’s advocate on xmas eve to say it would not be able to respond as promised.
21. The Council provided a complaint response on 8 January 2025. Mr X was dissatisfied with the response believing it did not address all the issues raised. The Council said a further complaint response would be provided within ten days. Mr X received the response on 7 February 2025. He remained dissatisfied. His advocate sent further emails to the Council on 10 and 17 February 2024 requesting a response to all the points raised.
22. The Council responded to Mr X’s advocate in March 2025. It confirmed Mr X was on a priority waiting list for reassessment by the sensory team and said he had had ‘active involvement’ from the team in previous months. The issue of window cleaning and gardening remained unaddressed.
23. Mr X submitted a complaint to this office in March 2025.
24. The Council sensory team reviewed Mr X’s needs in April 2025. The assessor noted Mr X’s dual sensory impairment and made numerous recommendations including, access to his car, parking outside his home, transport to reduce his partner’s caring responsibilities. The assessor noted Mr X was at risk of becoming socially isolated.
25. The Council reassessed Mr X’s care needs in May 2025. The assessor noted Mr X to be low in mood, which was said to be unusual for him. Mr X said he was miserable and disheartened by the lack of support from social services and was refusing food/fluid and medication in an attempt to end his life. The assessor alerted Mr X’s GP. The assessor recorded Mr X to have eligible needs in the following areas:

• maintain a habitable home;
• managing correspondence and finances;
• making use of facilities/services in the community;
• managing and maintaining nutrition;
• being able to make use of his home safely.

26. The Council increased Mr X’s personal budget from £27.50 per week to £233.50 per week, which the Council said could be used flexibly to meet his needs, including window cleaning and gardening services.
27. Mr X was referred to a charity to support him to source a personal assistant. The Council was concerned at the lack of progress in sourcing a personal assistant, as Mr X was without support during the process. The Council wrote to Mr X on 25 July 2025 to offer interim alternatives, including an alternative personal assistant, and/or support provided from a care agency. Mr X declined saying he had coped without support since February 2024 and preferred to wait for the recruitment of his preferred personal assistant.
28. The Council says the care and support plan remained at draft during the recruitment of a personal assistant. Once confirmed, and hourly rates identified the details would then be added to the care and support plan and be submitted to the Council’s funding panel for approval.

Current situation

29. Mr X expects to complete the employment checks for his personal assistant in October 2025, at the time of writing this report Mr X is awaiting confirmation of a date from the Council.

Analysis

30. It is not the Ombudsman’s role to decide if a person has social care needs, or if they are entitled to receive services from the Council. The Ombudsman’s role is to establish if the Council has assessed a person’s needs properly and acted in accordance with the Care Act.
31. In this case, the Council failed to do so.
32. Needs assessments should consider a persons’ physical and psychological needs. It must consider how a person’s needs may change or fluctuate and consider how this impacts on their wellbeing.
33. The Council’s review of Mr X’s needs in June 2024 was flawed because it failed to take account of needs arising from his sensory impairment. It also failed to take account of the co-dependency between Mr X and his partner. Consequently, Mr X missed out on support to which he was entitled to receive.
34. The Council was incorrect in its initial position that gardening and window cleaning are not tasks it ‘usually funds’. A key underpinning principle of direct payment arrangements is to provide personalised care. The Council should not make blanket decisions about usual funding for specific tasks. In doing so the Council is fettering its discretion, which is unlawful.
35. The Council offered Mr X a temporary care service in July 2025, which he declined. In offering a temporary commissioned service the Council fulfilled its legal obligation under the Act to meet Mr X’s eligible care needs. Therefore, the injustice caused to Mr X from missed services span June 2024 to July 2025.
36. The Council acknowledged and apologised to Mr X for its failure to provide a copy of his assessment in large font before the complaint came to this office. Whilst Mr X was undoubtedly caused unnecessary frustration and inconvenience, I do not consider the injustice caused to be significant. The Council remedied the situation immediately it was alerted and took action to prevent a repeat occurrence. I consider this an appropriate remedy, with no further recommendation required from this office.
37. In respect of Mr X’s complaint about a delay in completing a review of his sensory needs. Legislation does not set a specific number of days or weeks for completing such assessments. However, in this case the request resulted directly from the Council’s decision to remove services from Mr X and therefore should have been completed sooner.
38. In respect of Mr X’s personal budget amount. An indicative budget should be shared with a service user, and any representative at the start of support planning. The budget should be kept under review with a final personal budget set when a support package is agreed. Those involved should be made aware that the budget can go up and down during the support planning process. In this case, the Council informed Mr X of the indicative budget in May 2025, it has yet to finalise the figure because it is waiting on confirmation of hourly rates of the proposed personal assistant. There is no fault by the Council in doing so.
39. The Council took too long to respond to Mr X’s complaint and failed to address all points of his complaint. This added to Mr X’s stress and uncertainty. The Council did apologise for the delay in its complaint response letter to Mr X in January 2025. However, despite this there were further delays in responding to emails from Mr X’s advocate and a failure to address the issue of window cleaning. This issue was resolved after the complaint was submitted to this office.

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Agreed Action

40. Our remedies aim to try to put the person back in the position they would have been if the fault had not happened, in this case we cannot achieve that. Therefore, the recommendations below symbolise and acknowledge the distress and difficulties Mr X has been put through because of the Council’s failings.  
41. The Council should within four weeks:

• apologise to Mr X for the failings set out above;
• pay Mr X £250 in acknowledgement of his time and trouble pursuing the complaint and;
• pay a further symbolic payment of £1000 to acknowledge the distress and risk of harm caused by the Council’s failings.

42. The Council should within three months:

• consider any training needs of officers completing or overseeing needs assessments under the Care Act
• provide this office with evidence of the above.

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Final Decision

43. The Council failed to properly assess Mr X’s care needs in 2024 leading to a wrongful reduction in his support package. Consequently, Mr X missed out on services to which he was entitled to receive. It also delayed in dealing with complaints about this.
44. The recommendations above represent a suitable remedy for the injustice caused to Mr X.
45. It is on this basis; the complaint will be closed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman