Summary: Mr X complained about the needs assessment carried out by the Council into his daughter’s care provision. He says that it was not completed in line with the Council’s own policy and procedures and changed the level of support in place for his daughter. We found the Council at fault. The Council has agreed to apologise and make a symbolic payment to remedy the injustice caused. It has also agreed to complete a reassessment into the carer’s support plan.

The complaint

1. Mr X complains about the needs assessment carried out by the Council into his daughter’s (Ms Y) care provision. He says the Council’s needs assessment review of both Ms Y’s care provision and his own carer’s assessment were not carried out in line with the Council’s policies and procedures.
2. Mr X reports that this has impacted both him and his wife as carers by causing them added stress. He also believes reducing care provision will impact Ms Y, by leading to a worsening of her health and wellbeing.

Back to top

The Ombudsman’s role and powers

3. 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 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.
4. 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)

Back to top

How I considered this complaint

5. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance. Mr X and the Council had the opportunity to comment on my draft decision. I considered any comments received before making a final decision.
6. I have also considered the relevant statutory guidance, as set out below. Also, I have considered the Ombudsman’s published guidance on remedies.

Back to top

What I found

What should have happened

7. 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.
8. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months. Councils should consider a light touch review six to eight weeks after agreeing and signing off the plan and personal budget. They should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. Councils must also conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one.
9. Under 13.2 of the care and support statutory guidance around meeting needs it states that: The review process should be person-centred and outcomes-focused, as well as accessible and proportionate to the needs to be met. The process must involve the person needing care and also the carer where feasible, and consideration must be given whether to involve an independent advocate who local authorities are required to supply in the circumstances specified in the Act.
10. Under 13.3 it states: reviewing intended outcomes detailed in the plan is the means by which the local authority complies with its ongoing responsibility towards people with care and support needs. The duty on the local authority therefore is to ensure that a review occurs, and if needed, a revision follows this. Consideration should also be given to authorising others to conduct a review – this could include the person themselves or carer, a third party (such as a provider) or another professional, with the local authority adopting an assurance and sign-off approach.
11. Also 13.4 states: The review will help to identify if the person’s needs have changed and can in such circumstances lead to a reassessment. It should also identify other circumstances which may have changed, and follow safeguarding principles in ensuring that the person is not at risk of abuse or neglect. The review must not be used as a mechanism to arbitrarily reduce the level of a person’s personal budget.
12. 13.5: In many cases, the review and revision of the plan should be intrinsically linked; it should not be possible to decide whether to revise a plan without a thorough review to ascertain if a revision is necessary, and in the best interests of the person. In addition, where a review is being undertaken where a person has a carer, the local authority should consider whether the carer’s support plan requires reviewing, too.
13. 13.8: Where the local authority is satisfied that a revision is necessary, it must work through the assessment and care planning processes as detailed in sections 9-12 and 25 of the Act to the extent that it thinks appropriate (see chapter 6).
14. 13.12 The review should be a positive opportunity to take stock and consider if the plan is enabling the person to meet their needs and achieve their aspirations. The process should not be overly-complex or bureaucratic, and should cover these broad elements, which should be communicated to the person before the review process begins:

• have the person’s circumstances and/or care and support or support needs changed?
• what is working in the plan, what is not working, and what might need to change?
• have the outcomes identified in the plan been achieved or not?
• does the person have new outcomes they want to meet?
• could improvements be made to achieve better outcomes?
• is the person’s personal budget enabling them to meet their needs and the outcomes identified in their plan?
• is the current method of managing it still the best one for what they want to achieve, for example, should direct payments be considered (see chapter 11 on personal budgets)?
• is the personal budget still meeting the sufficiency test?
• are there any changes in the person’s informal and community support networks which might impact negatively or positively on the plan?
• have there been any changes to the person’s needs or circumstances which might mean they are at risk of abuse or neglect?
• is the person, carer, independent advocate satisfied with the plan?

15. Under chapter 6.5 it states: the aim of the assessment is to identify what needs the person may have and what outcomes they are looking to achieve to maintain or improve their wellbeing. The outcome of the assessment is to provide a full picture of the individual’s needs so that a local authority can provide an appropriate response at the right time to meet the level of the person’s needs. This might range from offering guidance and information to arranging for services to meet those needs. The assessment may be the only contact the local authority has with the individual at that point in time, so it is critical that the most is made of this opportunity.
16. Section 6.6 states: the assessment and eligibility process provides a framework to identify any level of need for care and support so that local authorities can consider how to provide a proportionate response at the right time, based on the individual’s needs. Prevention and early intervention are placed at the heart of the care and support system, and even if a person has needs that are not eligible at that time, the local authority must consider providing information and advice or other preventative services. Local authorities must also consider the person’s own strengths or if any other support might be available in the community to meet those needs. The assessment and eligibility framework provides for ongoing engagement with the person so where they have eligible needs they are involved in the arrangements put in place to deliver the outcomes they want to achieve.
17. 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.
18. There are three main ways a personal budget can be administered:

• as a managed account held by the council with support provided in line with the person’s wishes;
• as a managed account held by a third party (often called an individual service fund or ISF) with support provided in line with the person’s wishes; or
• as a direct payment.
  (Care and Support Statutory Guidance 2014)

19. 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

20. Mr X says that in August 2024 a review was due to take place into Ms Y’s care arrangements however this did not take place until November 2024. In November 2024 a review was undertaken into Ms Y’s care support plan.
21. In December 2024 a review meeting took place into Ms Y’s care needs. Mr X complained to the Council after this meeting due to the conduct of staff.
22. In January 2025 written confirmation of the needs assessments was sent by the Council and Mr X raised an appeal into this within the same month. Mr X says the assessment reduced the care provided due to the credit balance in Ms Y’s direct payment account.
23. A second needs assessment was completed by the Council in January 2025. Mr X also expressed his dissatisfaction with this review.
24. In March 2025 the appeal confirmed no change to the outcome of the assessment. Mr X provided further comments into this before the Council told Mr X that he could escalate the complaint to the Ombudsman in May 2025.
25. In April 2025, Mr X commissioned a private report from a social worker into Ms Y’s care needs.

Analysis

Ms Y’s needs reassessment

26. The statutory guidance set out above, confirms the Council should complete a reassessment which is person centred. The review does refer to both Ms Y and Mr X being unhappy with the reassessment and Mr X raised a complaint into the conduct of the staff after the reassessment was carried out.
27. The guidance goes on to state the review should focus on whether the person’s care needs have changed. It also must not be used as a mechanism to arbitrarily reduce the level of a person’s personal budget.
28. Within the review document, I cannot see the Council have identified that Ms Y’s care needs have changed or reduced, which would warrant a change to the care assessment. The document is focused on the build-up of credit in Ms Y’s direct payment account and that she is not using all the budgeted hours which has led to this credit balance accruing.
29. Mr X has explained that Ms Y’s sibling (Ms Z) previously acted as a personal assistant however due to a change of circumstances for Ms Z, she could no longer fulfil this role.
30. I would expect therefore the review to focus on how to replace the hours that Ms Z undertook rather than to reduce the hours that Ms Y could receive for her care.
31. I have asked the Council to provide an alternative care assessment. This is to show how it has previously or later assessed Ms Y’s care needs, but the Council has been unable to provide a fully completed one. The private social workers care report shows that Ms Y’s care needs have not reduced in recent years due to the nature of her medical condition.
32. I consider the Council at fault therefore for the reassessment of care needs in 2024. The fault has caused distress to Ms Y in feeling that her care needs were not being met. I therefore consider the Council should apologise for this.
33. Mr X has confirmed that he is happier with the reassessment of Ms Y’s care needs in 2025. We cannot recommend for Ms Y’s care provision to be set at a certain level. However once Ms Y’s current review is complete, Mr X can appeal any decision the Council makes about this.

Carer’s support plan review

34. The review of the carers’ support plan states in December 2024 that ‘all parties agree no changes need to be made; needs are being met’. The plan sets out that personal budget payments would be £110.74 in total per week however the review document then states that this would be reduced to £83.27 per week. Ms Y also reports the Council has removed the respite care.
35. The Council has provided no justification or notes to support how it decided to reduce the support due to the carers. I consider this to be fault by the Council.
36. The fault has impacted both Mr X and his wife (also a carer) by when reducing the care support for Ms Y, it has increased the level of support that Mr X and his wife have needed to provide. Mr X has explained that this has also further impacted them by the removal of respite care.
37. I find therefore the Council should apologise to Mr X and his wife for the distress this issue has caused them. It should also provide an award in recognition of this. I have considered this in line with our guidance for remedies.
38. The Council should also confirm that it will complete a re-assessment into the carer’s support plan to ensure that it meets Ms Y’s care needs.

Back to top

Action

39. Within four weeks of my final decision the Council has agreed to:
1. Provide a written apology to Ms Y for the distress caused in the failure to complete an appropriate care reassessment.
2. Confirm it will complete a re-assessment into the carer’s support plan
3. Provide a written apology to Mr X and his wife for the distress this issue has caused both in the reassessment of the carer’s support plan and the review of Ms Y’s care needs.
4. Pay Mr X £300 for the avoidable distress this issue has caused.
40. 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.
41. The Council should provide us with evidence it has complied with the above actions.

Back to top

Decision

42. I find fault causing injustice. The Council has agreed to apologise to both Ms Y and Mr X, complete a re-assessment into the carer’s support plan and provide a payment to Mr X for the injustice caused.

Back to top

Investigator's decision on behalf of the Ombudsman