Summary: Miss X complained the Council has discriminated against her due to her disability and has failed to meet her request for reasonable adjustments. Miss X also complained about errors in her financial assessment in relation to her benefit details and her Disability Related Expenditure. And that the Council stopped her direct payments for four weeks without any notice or explanation. We found the Council’s failings in communication and the delay in responding to Miss X’s correspondence are fault. As was the failure to correctly update Miss X’s address on all of its systems. These faults have caused Miss X a significant injustice and impacted her health and wellbeing. The Council will apologise and make a payment to Miss X.

The complaint

1. Miss X complained the Council has discriminated against her due to her disability. She say the Council has failed to meet her request for reasonable adjustments and has ignored her autism passport and reasonable adjustment documents. This has led to a significant barrier in her communication with the Council.
2. Miss X also complained about errors in her financial assessment in relation to her benefit details and her Disability Related Expenditure. And that the Council stopped her direct payments for four weeks without any notice or explanation.
3. In addition Miss X complained the Council failed to update her address correctly and sent confidential to her old address for two years, causing her significant distress.

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The Ombudsman’s role and powers

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 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)
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)
6. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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How I considered this complaint

7. I considered evidence provided by Miss X and the Council as well as relevant law, policy and guidance.
8. Miss 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

Care and support

9. A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in places other than care homes.
10. 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. One of the ways a personal budget can be administered is through direct payments. 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. 
11. A council can choose to charge for non-residential care following a person’s needs assessment. Where it decides to charge, the council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17)
12. Where a council has decided to charge for care, it must carry out a financial assessment to calculate how much an individual should contribute to the cost of their care. The assessment must comply with the principles in law and guidance, including that charges should not reduce a person’s income below the Minimum Income Guarantee (MIG). This is set by national government and reviewed each year.
13. If a person incurs expenses directly related to any disability he or she has, the Council should take that into account when assessing his or her finances. This is called disability related expenditure (DRE).
14. The Care and Support Statutory Guidance sets out key principles the councils should take into account when making decisions on charging. The principles include that the approach to charging should be clear and transparent, so people know what they will be charged.

Equality Act 2010

15. The reasonable adjustment duty is set out in the Equality Act 2010 and applies to anybody which carries out a public function. It aims to make sure that a disabled person can use a service as close as it is reasonably possible to get to the standard usually offered to non-disabled people.
16. Service providers are under a positive and proactive duty to take steps to remove or prevent obstacles to accessing their service. If the adjustments are reasonable, they must make them.
17. The duty is ‘anticipatory’. This means service providers cannot wait until a disabled person wants to use their services but must think in advance about what disabled people with a range of impairments might reasonably need.

What happened here

18. Miss X is autistic and has asked the Council to make reasonable adjustments to enable her to access it services. Miss X is not able to use the telephone and her preferred method of communication is in written form. She says she provided the Council with a copy of her autism passport and a reasonable adjustment document, but the Council has ignored this. Miss X says communicating with the Council causes her overwhelming psychological distress and has been a problem for years.
19. Miss X has a package of care and support which she arranges and pays for through direct payments. The Council carries out financial assessments each year and prior to 2024 has determined Miss X did not have to pay a contribution towards the cost of her care.
20. In April 2024 Miss X informed the Council of a change in her benefit claims and provided details of her DRE with supporting evidence. The Council completed a new financial assessment and wrote to Miss X in early June 2024 with details of her new contributions with effect from January 2024.
21. The letter set out the DRE costs it had allowed and those it had declined and explained it used information from the Office of National Statistics (ONS) when calculating potential DRE in respect of electricity, gas, food and water.
22. Miss X disputed the assessment. She sent the Council additional information and pointed out incorrect information and inaccuracies in the calculations. The Council acknowledged Miss X’s letter but did not respond substantively. Miss X says her direct payments then stopped on 3 July 2024 for a period of four weeks without any warning or explanation. This meant she was unable to pay her carers.
23. On 12 July 2024 Miss X made a formal complaint to the Council about its failure to make reasonable adjustments and the significant problems she was experiencing in communicating with the Council. Miss X also complained the financial assessment was not written in autism friendly language and contained incorrect information and calculations in relation to her benefits and DRE. And that her direct payments had ceased without any notification or explanation. Miss X referred to her autism passport which recorded that uncertainty, a lack of communication, not being allowed a reasonable time to respond, and a lack of clear and concise information caused her significant levels of distress.
24. In addition, Miss X complained about a potential data breach as despite notifying the Council of her change of address the Council had continued to send invoices to her previous address for the past five years.
25. On 23 July 2024 the Council wrote to Miss X advising it had re-assessed her financial contribution. The Council amended Miss X’s benefits and DRE and now calculated her contribution towards her care charges was once again nil.
26. In September 2024 Miss X made further representations in support of her complaint. She asserted the Council was not adhering to its own policies and procedures when conducting her financial assessment and in dealing with her DRE. Miss X was also unhappy the Council had contacted her support worker to seek to arrange a face to face meeting to review her DRE. Miss X could not see the purpose of a meeting and said a face to face meeting placed her at a distinct disadvantage. She would require significant reasonable adjustments for this to go ahead.
27. Miss X had also now received a response to her subject access request, which confirmed the Council has sent her personal data to her previous address between September 2019 and December 2021.
28. Miss X told the Council she considered the severity of the disability discrimination she had suffered had forced her to a position where she need to obtain legal support.
29. The Council carried out a further financial assessment and wrote to Miss X on 14 October 2024. It said that Miss X’s charge from 4 November 2024 would be nil and that the Council did not require any further information from Miss X regarding DRE.
30. The Council responded to Miss X’s complaint on 25 October 2024 and apologised for the delay in responding. The Council also acknowledged it had not always responded to Miss X’s communication as quickly as it should have and that the delays would be frustrating.
31. In relation to Miss X’s DRE, the Council noted it had not provided a breakdown of the calculations and said this would be addressed going forward. The Council also confirmed it did not wish to put Miss X under the pressure of a meeting in person and would complete the review by email or correspondence. It recognised a meeting was not in line with the reasonable adjustments Miss X had requested and apologised for the upset this had caused.
32. The Council said it had shared Miss X’s complaint with the financial assessment team and asked them to review their communication to ensure they were working in a way that best meets Miss X’s needs. It would also share Miss X’s complaint with the officer responsible for promoting good practice and improving how the Council supports adults with autism. The officer could then consider what lessons can be learned.
33. In addition the Council said it had not stopped Miss X’s social care funding but rather that Miss X’s new weekly assessed contribution cancelled out the following two payments. It said this was an error which was corrected and the funding reinstated. The Council apologised for the confusion this had caused.
34. The Council also said it would investigate Miss X’s concerns about data breaches.
35. Miss X was not satisfied with the Council’s response and asked for her complaint to be escalated. Miss X did not consider the Council had adequately addressed her concerns of disability discrimination.
36. The Council acknowledged Miss X’s request and said it would consider whether further investigation was appropriate. As Miss X did not receive a further response she contacted her MP for assistance.
37. Despite her MPs intervention, Miss X has still not received a stage 2 response to her complaint. In April 2025 she asked the Ombudsman to investigate her concerns.
38. In response to our enquiries the Council says that based on information provided by Miss X it agreed not to contact her by telephone. All communication was instead to be provided in writing, either by post or email. The Council says it recorded Miss X’s communication preferences on the relevant financial system at the time they were agreed, on 17 September 2019.
39. The Council says it also agreed any telephone communication would take place with Miss X’s personal assistant. The adult social care team undertook a review of Miss X’s needs in February 2024 and arranged for this to take place at the Council’s officers rather than Miss X’s home, in line with her preferences. It says the completed review indicates Miss X’s allocated worker had a good understanding of Miss X’s autism.
40. In relation to Miss X’s DRE, the Council says Miss X’s submissions were reviewed in line with its policy, using ONS data. It also says that DRE is only applicable when a person contributes towards their care costs. When assessed as a nil charge, DREs do not apply. The Council also reiterated it did not stop Miss X’s direct payment in June 2024. Rather the change from a nil contribution to chargeable impacted on the amount paid into her direct payment account. The backdated charges were deducted from the direct payment, cancelling out the next two 4-weekly payments. When Miss X was reassessed as nil charge, the missed direct payments were released.
41. The Council says that following Miss X’s complaint it has provided addition training to staff in the financial assessment team. It also now completes quality checks every month, including that communication preferences have been followed.
42. In addition the Council has confirmed that while Miss X’s address was correctly updated on its adult social care system, the finance system continued to issue remittance slips to her previous address. The Council says Miss X reported this to the direct payments customer support team on 2 December 2021 and it updated the finance system on 7 December 2021.
43. The Council says it considered Miss X’s complaint under its adult social care complaints policy and procedure so a stage 2 investigation was not applicable. It acknowledges it agreed to review the additional information Miss X provided and consider if any further outcomes were required. The Council apologises it did not send a review response to Miss X

Analysis

44. Although the Council has adhered to Miss X’s request for written communication, and has not attempted to contact her by telephone, it is clear there have been failings in it communication with Miss X. The Council accepts it has not responded to Miss X’s correspondence as promptly as it should have or in line with the Council’s target timeframes.
45. The Council also failed to advise Miss X in June 2024 that the reassessment from a nil charge to a contribution towards her care would affect the following month’s direct payments. Nor did it allow Miss X the opportunity to challenge this change before recovering the backdated charges. These failings in communication and the delay in responding to Miss X’s correspondence are fault.
46. As was the failure to correctly update Miss X’s address on all of its systems in 2019. This meant Miss X’s personal information was sent to an incorrect address for two years.
47. There was also fault in the complaints process. There was a significant delay in responding to Miss X’s complaint. Miss X complained to the Council in July 2024 but did not receive a substantive response until October 2024. The Council then failed to respond to Miss X’s request for a review of her complaint.
48. Miss X disputes the Council’s calculation of her DRE and believes greater amounts should be allowed. The Ombudsman is not an appeal body. It is not our role to carry out financial assessments, decide what contribution someone should make to their care costs, or decide whether certain expenses should be classed as DRE. Our role is to investigate the process a council followed, to assess whether it made its decision properly. We cannot criticise a council where officers have followed the correct procedures and reached a reasoned decision.
49. The Council has considered Miss X’s DRE in line with its policy, having regard to ONS data. This is not fault. The Council’s assessment has determined Miss X does not have to make a contribution towards the cost of her care. Had the Council allowed additional DRE, this would not have affected the outcome.
50. The Council’s failings have caused Miss X distress and uncertainty and have had a detrimental impact on her health and wellbeing. Miss X says she is currently in a state of autistic burn out as a consequence of the Council’s actions, which is significantly affecting her day to day functioning. Miss X’s level of distrust is such that she no longer feels able to communicate directly with the Council’s financial assessment team.
51. In response to the draft decision the Council has confirmed Miss X’s adult social care allocated worker will be her single point of contact until her care needs review is completed. It notes this allocated worker also completed Miss X’s review last year. While it cannot guarantee it will be the same allocated worker for every review the Council will try to ensure as much consistency as possible.
52. The Council says a number of single points of contact already exist for specific areas within the direct payment support services (DPSS). It says it can provide a single point of contact across all DPSS if needed. They would liaise across other finance teams to provide Miss X with a coordinated response.
53. In addition the Council has confirmed Miss X’s special communication factor for all communication to be in writing only has been added to her social care records.
54. The Council has also made training on learning disability and autism mandatory for all adult social care staff to increase awareness and knowledge of individuals with autism. The Council’s DPSS staff and complaints team will also complete this training, and the Council aims for this to happen by the end of March 2026. In addition, as a result of Miss X’s complaint the Council says it has developed a Quick Reference Guide to support its staff working with autistic people

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Action

55. To remedy the injustice caused by the faults identified the Council has agreed to:
• apologise to Miss X for the distress and uncertainty and the impact on her health and wellbeing caused by the fault identified. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology I have recommended;
• pay Miss X £500 to recognise the distress, uncertainty and impact on her health and wellbeing she has experienced as a result of the Council’s failings.
• consult with Miss X regarding whether she would like a single point of contact for direct payment support services.
56. The Council should take this action within one month of the final decision and provide us with evidence it has complied with the above actions.

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Decision

57. 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