Summary: Ms Y complained that the Council failed to safeguard her relative Ms X, consider her needs as Ms X’s primary carer and reimburse her for care she arranged. There is no fault in how the Council assessed Ms X’s care and support needs or carried out a carers assessment for Ms Y. The Council also addressed Ms Y’s complaint about outstanding payments for Ms X’s care without fault.

The complaint

1. Ms Y complained the Council failed to:
1. safeguard her relative Ms X and consider the needs of Ms Y as her primary carer;
2. provide meaningful outcomes for Ms X or Ms Y after upholding complaints;
3. pay Ms Y for care she has provided to Ms X to meet her needs; and
4. properly assess Ms X around her decision-making capacity.
2. Ms Y says the matter has caused distress. She wants the Council to reimburse her for the care she provided for Ms X.

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The Ombudsman’s role and powers

3. 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)
4. When considering complaints, we make findings based on the balance of probabilities. This means that we look at the relevant available evidence and decide what was more likely to have happened.
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. I have investigated Ms X’s complaint from May 2024 to May 2025 when she brought her complaint to the Ombudsman.
7. Matters after May 2025 would be the subject of a new complaint, to the Council in the first instance.

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How I considered this complaint.

8. I considered evidence provided by Ms Y, Ms X and the Council as well as relevant law, policy and guidance.
9. Ms Y, Ms 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, Policy and Guidance

Safeguarding

10. A council must make enquiries if it thinks a person may be at risk of abuse or neglect and has care and support needs which mean the person cannot protect themselves. An enquiry is the action taken by a council in response to a concern about abuse or neglect. An enquiry could range from a conversation with the person who is the subject of the concern, to a more formal multi-agency arrangement. A council must also decide whether it or another person or agency should take any action to protect the person from abuse. (section 42, Care Act 2014)

Assessment

11. 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.
12. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.

Care Plan

13. 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.

Reviews

14. 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.

Personal Budgets

15. 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.
16. 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)

Direct payments

17. 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.
18. The gateway to receiving a direct payment must always be through the request from the person. Councils must not force someone to take a direct payment against their will. They should not place someone in a situation where a direct payment is the only way they can get personalised care and support.
19. Councils must tell people during the care planning stage which of their needs direct payments could meet. However, councils must consider requests for direct payments made at any time and have clear and quick procedures in place to respond to them.
20. After considering the suitability of the person requesting direct payments against the conditions in the Care Act 2014, the council must decide whether to provide a direct payment. In all cases, the council should consider the request as quickly as possible.
21. The council must provide interim arrangements to meet care and support needs to cover the period in question. Where accepted, the council should record the decision in the care or support plan. Where refused, the council should explain its decision in writing to the person who made the request. It should also tell the person how to appeal against the decision through the local complaints procedure. (Care and Support Statutory Guidance 2014)

Carer’s Assessment

22. 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.
23. 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)

Carer’s Budgets and Respite

24. The Care Act 2014 says the council may meet the carer’s needs by providing a service directly to the adult needing care. The carer must still receive a support plan which covers their needs, and how the council will meet them. The carer’s personal budget must be an amount that enables the carer to meet their needs to continue to fulfil their caring role. It must also consider what the carer wishes to achieve in their day-to-day life. Part of the planning process should be to agree how the carer will use the personal budget to meet their needs. (Care and Support Statutory Guidance 2014)

What happened

25. Ms Y is the primary carer for her relative Ms X.
26. In November 2024 the Council carried out an assessment of Ms Y’s needs as a carer for Ms X.
27. In mid-December 2024 the Council carried out a review of Ms X’s care and support plan. It acknowledged Ms X and Ms Y’s request to stop direct payments, used to employ a personal assistant (PA) and said it would explore options for Ms X to be moved to a long-term shared living placement.
28. At the beginning of January 2025, the Council began commissioning Ms X’s care and support for 41 and a half hours a week through provider A. It also made enquiries into shared/supported living options and ensured Ms X was placed on a waiting list for long term supported living. It also made a referral for Ms X to have a psychology assessment.
29. In late January 2025, Ms Y raised 31 points of complaint with the Council, including a failure to:
• act on safeguarding concerns and provide care in line with legislation;
• seek housing options beyond the current provision and risk to Ms X
• ensure the wellbeing of Ms Y as a primary carer
• provide safe transition between direct payments and agency support; and
• compensate Ms Y for private payments made due to Ms X’s missing support
30. In its response the Council said:
• Ms X received a care assessment and corresponding support plan in 2021. A learning disability screening was also completed but was inconclusive. Reviews of the plan had been carried out regularly in line with legislation.
• In June 2024, Ms Y raised concerns about the level of support offered to Ms X and it had received a subsequent safeguarding concern. As a result, a review was completed with support hours increased. Ms X was receiving National Health Service (NHS) therapy sessions and was also signposted to other relevant support groups.
• Ms X’ s care, including respite provision was monitored in July, August and October 2024 with Ms X reporting it was working well.
• In November 2024, Ms X reported to her GP that she felt anxious during a respite stay. She made a self-referral for therapy and her assigned mental health worker (MHP) provided support and advice.
• Safeguarding reports in December 2024 and January 2025 had been independently reviewed. A decision was made not to progress to a safeguarding enquiry but to continue with case management support which records showed had happened.
• The need for housing options was not raised until June 2024. In September 2024, Ms X told her MHP, her care and respite support was working well. In November 2024 Ms Y had requested specialist supported accommodation and advice had been sought by Ms X’s MHP about potential placements.
• At the request of Ms Y, an independent living assessment was carried out for Ms X in November 2024 and she was supported in applying for a disabled facilities grant (DFG). Ms X moved house before the required adaptations could be made to her property.
• Ms Y has an lasting power of attorney (LPA) for delegation of financial decisions only. There has been no evidence showing Ms X lacked capacity in relation to her health and welfare, therefore she retains the right to make decisions about her own care.
• Ms X previously employed her own personal assistants (PA). Her support was now commissioned by the Council via provider A with respite provided through provider B. Both PAs previously employed by Ms X were moved by Transfer of Undertakings (Protection of Employment) (TUPE), for continuity for Ms X. Transition visits to the respite placement were also arranged.
• The Council funds 41.5 hours of PA support to allow Ms X to access her preferred activities.
• While Ms X became eligible for care in 2021, It had failed to carry out a carers assessment for Ms Y until 2024; and
• Since mid-February 2025 Ms X was living in privately sourced accommodation. The Council was aware there was a desire to register the person with whom she was living as a carer with provider B.
31. In March 2025 Ms Y escalated her complaint, she said:
• the complaint response had not been timely and failed to address all 31 points raised.
• it failed to acknowledge that Ms Y had organised the positive outcomes including the referral for home adaptations and the sourcing of a new placement;
• there was no meaningful outcome to the lack of support she had received as Ms X’s carer;
• they were still waiting for change in Ms X’s care, such as a direct payment plan for her live in carer;
• a new social worker was needed; and
• she was still awaiting reimbursement for the care she had arranged to meet Ms X’s social care needs.
32. At the beginning of March 2025, the Council carried out a review of Ms X’s care and support plan. It was agreed that the commissioned support would end in August 2025 and Ms X would again be provided with direct payments. The Council also referred Ms X to occupational therapy for assessments.
33. In April 2025, after a meeting with Ms Y, the Council provided its stage two response, it said:
• it apologised for a seven-day delay in its response. The Council said it had informed Ms Y it would not be within the 20 days;
• Ms X’s MHP had been in regular discussion with Ms X and Ms Y around care and support options. Ms X had rejected some of these and also sought her own advice independently from other professionals.
• Ms X had capacity to make her own decisions, and this must be respected as per the Mental Health Act 2005 even if Ms Y does not agree.
• It had failed to offer Ms Y a carers assessment until November 2024. It needed to improve processes for identifying and offering carers assessments as an ongoing process rather than carrying out one off assessment when concerns are raised. The carers assessment had determined ongoing support for Ms Y and Ms X to receive respite. It had a duty to ensure eligible needs are met and deemed the support and services in place for Ms X and Ms Y suitable. These would be kept under review.
• Ms Y had arranged a live in carer for Ms X, had informed the Council direct payments would not cover the expense and she had already paid for the service. It was aware Ms Y wanted an alternative option funded through direct payments such as a live in carer through provider B and interim support whilst this was organised. It understood the frustration around the time taken but it must comply with statutory requirements and established process. Ms X’s allocated worker had been in regular communication regarding this.
• Ms X remained satisfied with the social worker and had capacity to make decisions relating to her support.
• Ms Y advised she had needed to pay for and arrange support during crisis as provider A had been unable to support Ms X. It was aware some valid invoices had been received, and Ms Y had been asked to clarify remaining expenses and obtain invoices. If these could be provided, they could be validated and reimbursement arranged.
• The stage one response had not clarified what safeguarding concerns Ms Y had referred to. It was now clear this was to do with a relationship Ms X was in. No safeguarding concerns had been raised previously relating to this and would have been investigated as necessary if they had.
• In mid-April 2025, Ms X had a psychological assessment, this recommended Ms X be provided with supported living, carers and respite.
34. In mid-May Ms Y remained dissatisfied with the Councils actions and asked the Ombudsman to investigate.

The Councils response to us

35. It had made further referrals to the learning disability team and was supporting the friend Ms X now lived with in becoming a carer with provider B. It said Ms X had received support from an advocate from March 2025.
36. It had requested Ms Y provide invoices for the period January 2025 to March 2025. It had agreed to pay one of the invoices received but this payment remained outstanding. It said this would be paid when the necessary bank details had been provided by Ms Y. It said it had explained to Ms Y why the other invoices would not be paid and had requested further information from Ms Y relating to these, which it had not received.

Analysis

37. The Council recognised it had not carried out a carers assessment for Ms Y until she raised concerns in mid-November 2024, however I have not seen evidence that it was aware this was required until Ms Y’s request. The evidence shows it carried out an assessment shortly after Ms Y’s request, has provided the identified support, responded to Ms X’s further concerns and included her in all subsequent reviews and decisions. Notably this includes identifying Ms Y as providing ‘informal support’ in Ms X’s care and support plan, with formal Council commissioned support still required for her eligible needs. There is no fault in the Council’s actions.
38. The evidence shows the Council kept Ms X’s care and support under regular review, made changes where requested and appropriate, considered Ms X’s capacity around decision making, carried out identified actions from reviews and provided signposting to Ms X for additional support. It has also identified and considered Ms Y’s role as her carer in each of the reviews. I find no fault with the Councils actions.
39. The Council has reviewed and requested additional information relating to the payments for care Ms Y says she needed to provide. It has advised the Ombudsman that one payment has been agreed and will be processed. Further, I have not seen evidence to show Ms X was not provided with the care and support in her plan during the investigation period. I find no fault with the Councils actions.

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Decision

40. I found no fault.

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Investigator's decision on behalf of the Ombudsman