Summary: Mr X complains on behalf of his son, Mr Y, that the Council wrongly reduced his care package and did not include his privately arranged weekend care as a disability-related expense. We found fault in the Council’s decision-making process. The Council also delayed issuing an appeal decision. This is fault. This caused Mr Y to pay more for his care and caused undue distress. The Council agreed to apologise to Mr X and Mr Y, offset any monies against the debt on Mr Y’s client account and pay the recommended financial remedy. It should also review Mr Y’s care plan and supported hours.

The complaint

1. Mr X complains on behalf of his son, Mr Y. He says the Council wrongly reduced the supported hours in his care package without explanation. He also complains the Council did not allow the private weekend care as part of his disability-related expense which caused a higher client contribution rate that was unsustainable. Mr X appealed the decision but the Council continued to take recovery action on payments due despite an ongoing appeal that was delayed. This caused undue distress.

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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. 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 considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
5. Mr 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 legislation and guidance

Carer’s Assessment

6. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
7. As part of the carer’s assessment, the council must consider the carer’s potential future needs for support. It must also consider whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)

Care Plan

8. 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.

Personal Budgets

9. 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.

Direct payments

10. 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. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.

What happened

11. Mr X moved to Barking with his son Mr Y. Mr Y’s previous council provided 35 hours of funded care Monday to Friday and a personal budget to support privately arranged weekend care for Mr Y. The new Council, London Borough of Barking and Dagenham, reduced Mr Y’s care package to 20 hours a week. Mr X disagreed with this decision. The Council eventually increased the hours to 30 hours per week.
12. The Council also did not disregard the private weekend care as a disability related expense in the financial assessment and included it when assessing Mr Y’s contribution towards the cost of care. It said it did not disregard the weekend care because it was not a necessity, but a personal choice to have private care on the weekend.
13. The Council did not include the weekend care as part of the care plan or personal budget, for the same reason that it was considered a personal choice.
14. Mr X complained to the Council in September 2024. He appealed the Council’s decision at the end of November 2024. The Council took nearly a year to provide an appeal decision.

Analysis and recommendations

15. The Council reduced Mr Y’s weekly supported hours from 35 to 20 hours originally, then increased it to 30 hours. The Council did not provide any formal written response to Mr X explaining the reasons for reducing the hours or how it calculated those hours. During the course of our investigation, the Council said 35 hours per week was not agreed because there was an expectation on the parents to provide some care support as they lived with Mr Y. But the Council did not complete a carers assessment to properly consider the parents needs and ability to support Mr Y’s care needs. This is fault. The Council should have completed a carers assessment before making that decision. The Council also failed to communicate this to the parents, so they were left with undue distress and confusion around their son’s reduced care. We recommend the Council reviews Mr Y’s care plan and provide a clear breakdown of how it made its decision.
16. The Council did not consider the privately arranged weekend care as a disability related expense. It also did not include it in the care package or provide a personal budget for it. The Council said this is because the private weekend care was a personal choice and not a necessity. The Council has since accepted fault that it should have disregarded the weekend care costs as a disability related expense. It offered to offset any monies that would have been disregarded in 2024 against the debt that has built up on the unpaid client contribution account. This is a fair remedy for the injustice caused.
17. The Council took over a year to provide a decision to Mr X’s appeal. This is fault. It caused undue distress, uncertainty and confusion. The Council accepted fault and offered £1000 during the course of our investigation. This is a fair financial remedy for the injustice caused.

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Action

18. Within four weeks of our final decision, the Council will:
• Apologise to Mr X and Mr Y for the delay, uncertainty and confusion caused. 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 the monies it would have disregarded at financial assessment towards the debt accrued on the client account. Provide a clear breakdown to Mr X of how it calculated the amount to be paid.
• Pay £1000 to Mr X for the delay, uncertainty and confusion caused.
19. Within two months of our final decision, the Council should:
• Review Mr Y’s care plan and the number of supported hours. Provide a clear explanation for how the Council calculated the hours to be provided against Mr Y’s needs.
20. The Council should provide us with evidence it has complied with the above actions.

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Decision

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

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Investigator's decision on behalf of the Ombudsman