Summary: A person complained on behalf of Miss X that the Council reduced her hours of care when the care company changed. We find the Council acted in line with the law and guidance when it decided Miss X’s new care package met her needs, and therefore do not find it at fault.

The complaint

1. Miss X complained the Council reduced her hours of care, without any review or reassessment being done, when the company providing her care changed.
2. She says this meant she had to change the time she went to bed and she did not get the level of care she needed.

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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. We may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 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)

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How I considered this complaint

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

Law and Guidance

Assessment

8. 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.
9. 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

10. 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

11. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. The Care and Support Statutory Guidance (the Guidance) says councils should review plans at least every 12 months.
12. The Guidance says a review may result from a change in needs or circumstances that a council becomes aware of. It says a review should be a positive opportunity to consider if the care plan is enabling a person to meet their needs. It should cover broad elements including a change in circumstances, what is working in the plan, what is not working and what might need to change.

What happened

13. These are the key events. It is not a detailed chronology of everything that happened.
14. Miss X has high care and support needs. She lives in a supported living home. The Council previously assessed her as requiring a combination of 1:1 and 2:1 support at all times. It provided her a care plan and personal budget.
15. From 2024, Miss X’s care was provided by a company I shall call Care Provider A. It provided a mix of 1:1 and 2:1 care, and care in the night.
16. The Council carried out a planned review of Miss X’s care plan in November 2024.
17. At the end of January 2025 Care Provider A told Miss X and the Council it intended to stop providing Miss X’s care.
18. In February the Council identified a different company it thought could provide Miss X’s care. I shall call this company Care Provider B.
19. Care Provider B started gathering information to decide whether it could provide Miss X’s care.
20. At the beginning of March the Council reviewed Miss X’s care plan to help prepare for the change in care provider. It involved Miss X, a family member, one of her carers, and the care home manager in the review. The review paperwork recorded information gathered at the meeting and the Council’s professional analysis of her care needs.
21. Throughout March the Council and Care Provider B spoke to one another about Miss X’s proposed care package. They agreed a care package that was similar, but not identical, to that delivered by Care Provider A. The new care package provided a mix of 1:1 and 2:1 care, and care in the night.
22. Also throughout March Miss X’s family member raised concerns that a reduction in care would negatively affect Miss X.
23. Care Provider B took over Miss X’s care from Care Provider A at the end of March.
24. In early April Miss X’s family member raised concerns the new care package was not meeting Miss X’s care needs.
25. The Council had a meeting with Care Provider B in early April. The record shows it was to check the new care package was meeting Miss X’s needs. It recorded Care Provider B said her needs were being met and she was going out into the community.
26. The Council phoned Miss X the next day and asked her about her care. The record shows Miss X said she was happy at her home and felt well supported. She wanted her 2:1 care to remain as it was. She said she had support when she wanted to go out.
27. The Council contacted the family member of Miss X that had raised concerns. It said it had spoken to Miss X who was happy. The Council said the new care package met Miss X’s needs and her care plan would be reviewed, with Miss X’s input, soon.
28. In May the Council started to make arrangements to carry out a review of Miss X’s care plan to check the new care package was meeting her needs.
29. A person complained to us on behalf of Miss X later in May.

Analysis

30. The Ombudsman is not an appeal body. This means we do not take a second look at a decision to decide if it was wrong. Instead, we look at the processes an organisation followed to make its decision. If we consider it followed those processes correctly, we cannot question whether the decision was right or wrong, regardless of whether an individual disagrees with the decision the organisation made.
31. I have considered the Council’s approach to managing the change from Care Provider A to Care Provider B. The evidence shows it did so by conducting a review of Miss X’s care plan in March in preparation for the change. The review gathered information from Miss X and others involved in her care.
32. The records show the Council considered the change in Miss X’s proposed new care package later in March. It took account of the information gathered in the review and information from Care Provider B, and decided the new care package met Miss X’s needs. I find this was a professional judgment the Council was entitled to make because it gathered and considered the relevant information.
33. The Council then spoke to Miss X in early April. This was shortly after the new care package started. It recorded she was happy with the level of care.
34. It also planned another review of Miss X’s care plan to check her care needs were being met, which it started organising in May.
35. I am satisfied the Council’s actions and decisions, taken as a whole, were carried out in line with the Care Act 2014 and the Guidance. I do not find fault in the way the Council decided the new care plan met Miss X’s needs, and kept that decision under review
36. I acknowledge Miss X’s family member disagreed that the new care plan met Miss X’s needs. However, because I have found no fault in the way the Council made its decision, I cannot question whether that decision was right or wrong. 

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Decision

37. I find no fault because the Council’s decision the new care plan met Miss X’s needs was made in line with the law and statutory guidance. I do not uphold the complaint and have completed my investigation.

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Investigator's decision on behalf of the Ombudsman