Summary: Mr D complained the Council failed to properly assess his care and support needs. We found fault as the care and support plan is unclear about how it will meet Mr D’s needs. The Council has agreed to finalise a new care and support plan which clearly sets out how many hours of support is needed for health appointments and whether or not Mr D requires transport to meet his eligible needs.

The complaint

1. Mr D complained the Council:
• Failed to properly assess his care and support needs in 2025, leading to a reduction in his support hours.
• Wrongly told him he cannot use his care and support to attend hospital appointments, despite his mobility needs.
• Wrongly told him he did not meet the criteria to attend day services.
• Refused to allow another support worker to reassess him.
2. Mr D says the loss of support has left him unable to attend medical appointments, forced him to pay for taxis, and caused severe stress that has worsened his existing health conditions. He wants his previous support hours reinstated and a new assessment by a different social worker.

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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 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)
4. 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)
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 spoke to Mr D about his complaint and considered the information the Council’s response to my enquiries and relevant law and guidance.
7. Mr D and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Care and support

8. The Care Act 2014 requires local authorities to carry out an assessment for any adult with an appearance of need for care and support. The assessment determines what the person's needs are and whether the person has any needs which are eligible for support from the council.
9. Where councils have determined that a person has any eligible needs, they must meet those needs. The person's needs and how they will be met must be set out in a care and support plan.
10. Councils should keep care and support plans under review, at least every 12 months. They should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met.

What happened

11. I have summarised the key events, this is not meant to describe everything that happened.
12. The Council reassessed Mr D’s care and support needs in March 2025. The assessment found that he needed help with cooking, shopping, and attending appointments, which he had sometimes missed because of anxiety. It says at the previous review, Mr D’s support hours had been temporarily increased from 3.5 to 9 hours a week to help with meal preparation and health appointments.
13. The assessment noted that Mr D was eligible for the higher rate of the mobility element of the personal independence payment (PIP) benefit and therefore had a Motability car. A carer drove for him, as he did not use public transport due to anxiety and was learning to drive. The assessment says Mr D attended health appointments alone and the carers would wait in the car.
14. Mr D said he was not currently attending a day service because he wanted to focus on his driving lessons. The assessment says Mr D was avoiding social isolation through his relationship with his wife, friendships, family contact, and community activities.
15. The Council issued a care and support plan on 20 May which said Mr D required three hours of support per week for carers to use the Motability car to take Mr D shopping and to appointments. The plan says Mr D was aware that whilst the carers could support him to attend appointments, they could not provide a taxi service funded by the Council. The Council would consider referring Mr D for travel training.
16. Mr D complained. He said he could not attend appointments unless the carers drove him and he needed more than three hours per week support. He asked for a new assessment to be done by a different social worker.
17. The Council replied to the complaint on 11 July. It said Mr D could use the three hours per week support to help him attend appointments and visit family but he could not use the carers as a taxi service.
18. The Council then arranged to meet Mr D and his advocate to discuss the assessment and care plan. Mr D’s provisional driving license was withdrawn due to health issues.
19. On 2 December, the Council met Mr D and the advocate again in response to his request for a reassessment. The Council said that he did not meet the criteria to attend day services as he was not at risk of social isolation. It said he could use public transport or taxis to attend appointments. These could be funded by the PIP mobility payments if he gave up his Motability car. Mr D did not wish to do this.
20. The Council told me in March 2026 that a revised care and support plan had not yet been agreed or issued.

My findings

21. It is not the Ombudsman's role to decide what, if any, care and support a person needs. That is the Council's role. My role is to consider if the Council has followed the correct process for establishing a person's needs and if it acted correctly when this process was complete. I look at what information the Council considered when it assessed Mr D, and if it took account of his wishes. If the Council has considered all this information properly, we cannot find it at fault just because the service user disagrees with its decision, or outcome of an assessment.
22. I have therefore considered the care and support assessment carried out in March 2025 and the care and support plans issued in May 2025 and July 2025.
23. In relation to attending a day service, I find no fault in the way the Council decided that Mr D was not eligible for this. The assessment considered the activities he took part in with his family and friends and the Council has decided that he could avoid social isolation by using universal services. There is no fault in the way the Council made this decision, so I cannot criticise it.
24. The assessment says Mr D needs support for shopping and attending appointments. The care and support plan says this can be met with support of three hours per week, it suggests two hours of this is for shopping.
25. But there is no information about how many health appointments Mr D has to attend or how long they are or how long it takes to get to them. It is therefore unclear how the Council has decided that one hour per week for appointments is the right amount of support. I find fault in the care and support plan as it is not clear what Mr D’s needs are in relation to appointments and how these will be met.
26. The May care and support plan also says that Mr D cannot use the carers as a taxi service as the Council did not fund this. But the Council cannot have an unconditional policy not to fund transport. Attending health appointments is essential to a person’s wellbeing so the care and support assessment must consider whether Mr D needs support with transport to meet this eligible need. Mr D said he could not use public transport due to anxiety. The Council has to consider this and decide whether Mr D needed support with transport to get to appointments. If so, it should fund this.
27. There is mention of trying travel training, but it is unclear if this was done. The Council later suggested Mr D gave up his Motability car so that he could use his benefits to pay for taxis, but it is unclear whether this would be affordable. I have seen no advice to Mr D about whether he could ask for taxi fares to be considered as disability related expenditure or consideration about whether funding carers to drive the car would be more cost-effective.
28. I find the Council has not clearly decided whether or not Mr D requires transport to meet his eligible care and support needs. This is fault. It causes injustice to Mr D as he is uncertain how his needs will be met.
29. I note that the Council has been reviewing the care and support plan for several months. It should complete this as soon as possible and ensure the plan is clear about how many hours support Mr D needs to attend health appointments and whether he requires transport to meet his eligible care and support needs. If he does, this should be funded by the Council. Or the plan should say how Mr D will transport himself.
30. In response to my draft decision, the Council said Mr D’s worker had now completed the assessment and shared a draft with Mr D and his advocate to enable his comments to be added.
31. The Council agreed to:
• explore with Mr D the health conditions that require frequent hospital attendance and the frequency of these appointments.
• explore the need for transport to appointments and continue to encourage enablement and travel training.
32. The Council said a new support worker could be allocated for future annual reviews.

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Action

33. Within a month of my final decision, the Council has agreed to finalise Mr D’s care and support plan. The plan should be clear whether about how many hours support Mr D needs to attend health appointments and whether he requires transport to meet his eligible care and support needs.
34. The Council should provide us with evidence it has complied with the above actions.

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Decision

35. There was fault by the Council. The actions the Council has agreed to take remedy the injustice caused. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman