Summary: I found there was no fault in the Council’s decision not to provide Direct Payments to allow Y’s parents to act as Personal Assistants (PAs). The Council offered to provide care via different PAs and it reached its decision in Y’s case properly having considered all the relevant information.

The complaint

1. Mrs X complains the Council has failed to put a care package in place for her disabled son, Y, following his transition from Children’s Services to Adult Social Care in January 2025. She says a care package of 70 hours per week was agreed but has not been implemented.
2. Mrs X complains that her son’s social worker has not been consistent, invents excuses for not providing support and has tried to remove her son from home. She alleges the social worker’s actions feel like discrimination and racism.
3. Mrs X states the situation has placed stress in the family and her husband has had to leave work to support her in providing her son’s care.

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The Ombudsman’s role and powers

4. 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)
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. We are investigating the events of the complaint from January 2025 (when Y transitioned to Adult Social Care) to June 2025 (when Mrs X came to us following the Council’s final response to her complaint).

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How I considered this complaint

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

The Care and Support (Direct Payments) Regulations 2014

9. Paragraph 3 of the regulations states that, generally, direct payments should not be made to pay family members to provide care if they live with the service user. The regulations state that family members can be paid to act as Personal Assistants (PAs) via direct payments as an exception, provided the Council considers it is necessary to do so in individual cases.

The Council’s Direct Payments Policy (April 2025)

10. Section 6 of the policy states the Council must ensure that carers are able to fulfil their caring responsibilities. This is so that the needs of the service user are met, but also to ensure any difficulty in achieving the required outcomes does not cause an impact on the carer’s wellbeing.
11. The policy indicates that a third party can manage a direct payment account on behalf of the service user. It explains that the person managing the account would be responsible for monitoring the wages, invoices and timesheets of the service user’s PA. As a result, a PA could not manage the account as well as providing care without this causing a conflict of interests.

Mental Capacity and Decision Making

12. The Mental Capacity Act 2005 is a framework for making decisions and acting on behalf of people who lack the mental capacity to make particular decisions for themselves. The Act (and the Code of Practice 2007) describes the steps a person should take when dealing with someone who may lack capacity to make decisions for themselves. It describes when to assess a person’s capacity to make a decision, how to do this, and how to make a decision on behalf of somebody who cannot do so.
13. The Act says someone over 16 years of age will be presumed to have capacity to reach their own decisions unless it is established that they don’t.
14. The Act states that someone should not be treated as lacking capacity or unable to make a decision based on their age, appearance or assumptions about their condition or behaviour. Nor should they be treated as lacking capacity because they make what others may perceive to be ‘an unwise decision’.
15. Councils must assess someone’s ability to make a decision when that person’s capacity is in doubt. How it assesses capacity may vary depending on the complexity of the decision.

Background

16. Y is a disabled young person who lives with his family.
17. Y was due to turn 18 in January 2025 when he would transition to Adult Social Care (ASC) services. Mrs X told me Y had an agreed care package of 35 hours per week of support with Children’s Services.
18. The Council says, while Y was being supported by Children’s Services, a care act assessment identified that he was eligible for supported accommodation and he had initially agreed to consider this.
19. Y was allocated an ASC social worker to support his move into adulthood. The social worker began looking for a supported accommodation service. However, when the Council conducted a fresh care act assessment in November 2024, Y indicated that he would like to remain at home, with his mother as his main Personal Assistant (PA), providing care. The assessment noted Y’s uncle was also prepared to act as a PA and he had been supporting the family, particularly at weekends. However, the document also suggested Y’s uncle was reviewing his role as he also had his own family but stated he could step in at certain times.
20. The assessment noted that Y’s condition had deteriorated in the last 12 months. It provided significant detail about Y’s health and conditions.
21. The assessment stated Y’s family acknowledged their home was not suitable to meet Y’s needs, but they were concerned that proposed adaptations would significantly impact the functioning of their home. The family stated they felt let down by delays in services and provision of equipment that they put down to council budget constraints.
22. During January there were numerous emails between Y’s family and the Council about arranging direct payments to fund family members becoming Y’s PAs.
23. A Continuing Health Care (CHC) assessment took place in early 2025. CHC was declined. Taking this into account the Council agreed, in principle, to provide funding for 70 hours of care for Y. This was based on the needs that had been identified during the CHC assessment process and reflected that care needed to be double-handed (two carers were needed for safe moving and handling).
24. In correspondence and discussion with the Council Mr and Mrs X asked the Council for significantly more hours. They later agreed to accept 70 hours of care and support. Mrs X expressed a preference for an agency to manage the taxes and payments.
25. The Council explained that it needed to establish details of how the care would be delivered before it could be put in place. It needed to establish who would be providing what care for Y and when. Its case notes show that officers also wanted to find out if Mr and Mrs X were using the equipment provided and if care was being delivered safely. Officers noted they could not commission, or agree to fund care that may be unsafe for Y or unsafe for Mr and Mrs X. In addition, it needed to establish contingency measures in the event that Y’s parents were ill or unable to fulfil their caring roles.
26. The Council also noted it could not agree someone acting as a PA also managing Y’s personal budget.
27. At a professionals meeting in February, medical professionals stated Y had missed several important appointments and reviews. This was of concern.
28. In February 2025 an OT assessment confirmed that two carers would be needed for manual handling. The Council met Mr and Mrs X at the end of February to discuss Y’s care needs and how they would be fulfilled. Officers noted Mrs X wished to be a main carer, with Y’s uncle. However, the officers understood Y’s uncle could not provide support all of the time. The Council asked if there were other relatives or family friends who may be able to act as PAs for Y. It stated agency carers to work with Mrs X may be possible, but this may present a challenge. It noted contingency plans were still needed.
29. As part of understanding how the care would work in practice, the Council considered it was necessary to meet Y’s uncle to ensure he understood Y’s care and support needs and to establish if he needed training for moving and handling, which would be necessary to provide care for Y. A meeting with Y’s uncle had not been made possible by the family.
30. The Council explained at a meeting in March with Y’s parents that it needed to ensure both the carers and Y would be safe. The Council, again, sought clarity about what the arrangements for Y’s care would be. It sent a follow up email to Mr X to explain its concerns. Because there was a lack of clarity about the care arrangements, the Council stated it could not agree to Mrs X being Y’s PA. It noted the family had stated it did not want outside carers, so the Council would speak to Y directly to understand his views and consent.
31. In early and mid-March council officers visited Y while he was at college. They explained their concerns and asked Y for his view. Y indicated that he did not want formal carers. He wanted his parents to look after him.
32. After gaining legal advice, the Council determined that they could not fund care for Y which was delivered by family members in the same household. Officers met Mr and Mrs X to explain this on 21 March. The Council asked if the family could propose people who did not live with them, to act as formal PAs so the Council could put a package of care in place using other PAs. The Council stated they would need to recruit two. Officers explained they were not removing the parents’ role as informal carers, but formal carers were needed to ensure a safe package of care was in place for Y. The Council wished to provide a package of care but could not agree to fund Mr and Mrs X as PAs for the reasons it had already discussed with them.
33. In late March the Council made a referral for an advocate for Y. They visited in April and spoke with Y. Y confirmed he wished to live at home and receive care from his parents. He would not want care from others, even if his parents were unable to provide care for any reason.
34. In April 2025 ceiling track hoists were installed at Mr and Mrs X’s home. Bathing equipment was also provided and installed.
35. In May 2025 a moving and handling assessment took place. This noted various equipment that the family had to manage Y’s needs. This included ceiling tracks and hoists, a profiling bed, bathing equipment and a stair climber for use on the stairs. The assessor noted that, at present, the family were manually lifting Y on and off the stair climber and wheelchair when downstairs. It noted a ceiling track hoist (or mobile hoist) was needed downstairs to avoid this. However, the family had declined this.
36. Following further legal advice in mid-2025, the Council decided it could not provide funding for Y’s parents or uncle to act as PAs for Y. The Council noted that Y had capacity to make decisions, and he had decided that he would only accept care from his parents. The Council had provided an advocate to discuss this with Y and ensure he understood the situation.
37. The Council wrote to Y to explain its decision in detail. It also attempted to meet Y at college to explain the letter, but Y declined to see officers. The letter made clear that the Council strongly believed a package of care was needed for Y, but this could not be provided using his parents as PAs. The Council stated it had faced various barriers to providing care for Y and despite the efforts of various officers and professionals, it had been unable to overcome these. The Council explained why and noted that it had offered a package of care to provide Y with two carers. This remained something the Council could provide and the council would work with Y to develop a safe package of care if they had his cooperation and understanding of the issues.
38. Mrs X told me no care or support had been provided from the point Y became 18, despite Y requiring care and having eligible needs. She stated the social worker did not check how they were coping and did not offer any options or temporary care arrangements. Mrs X complained to the Council as a result. She stated social workers had not been consistent and made excuses for not providing care.
39. The Council did not uphold Mrs X’s complaint and reiterated its position about care arrangements for Y. As she was dissatisfied with the Council’s position Mrs X brought a complaint to the Ombudsman.

Was there fault by the Council

40. Our role is not to decide whether we agree or disagree with what a council did. Instead, we look at whether there was fault in how it made its decisions. We can only criticise a council if we conclude there was fault in how it decided something. We cannot question a properly made decision or say the outcome should have been different.
41. The default position set out by the Direct Payment (DP) regulations is that DPs will not ordinarily be paid to allow family members living with a service user to act as PAs. Councils have discretion to agree to family members acting as paid formal carers, but in this case, the Council has decided it should not do so.
42. I have considered the steps the Council took to consider how to provide Y’s care. I looked at the Council’s records and the information it took account of when making its decision. While this is clearly a complex situation and a difficult decision, I found no fault in the Council’s decision not to agree to fund Mr and Mrs X and Y’s uncle as his PAs. I say this because:
• In making its decision, the organisation took account of the relevant regulations and government guidance. Its decisions were also in keeping with its direct payment policy. Direct payment regulations state that providing DPs for care from close family members, living in the same household is generally not allowed. It is only allowed, by exception where it is necessary.
• The Council sought information from Mr and Mrs X on a number of different occasions to satisfy itself that any care provided by Mr and Mrs X and/or Y’s uncle would be carried out safely and it would meet Y’s needs. It did not get the reassurances it needed. Also, Y’s uncle did not meet officers so they could assess his suitability, availability and willingness to act as Y’s PA.
• The Council recorded concerns that Mr and Mrs X were not always using equipment and providing Y’s care in safe manner. It found Mr and Mrs X had been resistant to officers’ attempts to address these concerns.
43. As the Council could not agree to Mr and Mrs X being Y’s PAs, they proposed a package of care with other PAs being employed. Y and Mr and Mrs X were adamant that they would only agree to care being provided by Mr and Mrs X (and possibly Y’s uncle).
44. I understand that Mrs X was concerned about the Council seeking to speak to Y alone. She considered this was an attempt to remove her son from home and influence his decisions. I found no fault in the Council’s approach. Y is an adult. As Y’s decision meant the Council could not put a care package in place, the Council made sure he understood the situation and had capacity to make this decision. The Council met with Y alone and arranged for advocacy for him for this reason. It was satisfied that Y did have capacity to make this decision and he was able to articulate his views. This was appropriate and good practice in this situation, as there were significant implications of the decision; the council could not provide a package of care in the way Y and his family wanted and there was no clear way forward.
45. Because the Council was aware that Y had eligible needs, and as the situation stood it could not provide a package of care, it also took legal advice. The Council wrote a detailed letter to Y to explain its decision (that it also tried to meet with him to explain in person). The letter stated the Council was willing to put care in place but it would need Y’s engagement and agreement to find alternative carers to do so. So, I found the decision was properly explained.
46. I recognise that the situation is difficult, and Y does not, ideally, wish to receive care from formal carers. He would rather receive care from Mr and Mrs X only. However, the Council has explained why it does not consider it is able to fund care via Mr and Mrs X. This is a difficult decision, but one it is entitled to make. I consider it has reached its decision properly having regard for the law and input from other professionals. I have no grounds to question its decision.
47. It is open to Y to discuss any concerns he has about formal carers with the Council or via an advocate to seek a way forward and to try to overcome these concerns to enable him to receive the care he needs.

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Decision

48. I find no fault by the Council.

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Investigator's decision on behalf of the Ombudsman