Summary: We found fault with the Council for delays in completing a care assessment and putting in place Direct Payments for Ms X. The Council agreed to apologise to Ms X and pay her a symbolic financial gesture for the distress and lost opportunity the Council’s fault caused. We also found fault with the Council failing to put in place the correct Direct Payments from October 2025 to January 2026. The Council agreed to pay the underpaid Direct Payments into Ms X’s Direct Payment account.

The complaint

1. Ms X complained the Council delayed completion of a care needs assessment from September 2024 until June 2025. Ms X complained she had to wait longer for a financial assessment and until October 2025 for the Council to put the care package in place through a Direct Payment.
2. Ms X says the Council’s inaction left her without support causing a deterioration in her health.

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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 considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
7. Ms X and the Council had an opportunity to comment on my draft decision before I made a final decision.

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What I found

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.

Council’s guidance policy

10. The Council’s 2023 policy outlines that all assessments must be completed within 28 days of contact. The policy states that if staff cannot do this, they must discuss this with their manager as early as possible.
11. The Council’s policy details how it will prioritise assessments for those most in need and provides a guidance tool to help staff with this. Notably those with the highest risk should be prioritised for assessment first.

Direct payments

12. 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.

What happened

13. In September 2024, Ms X contacted the Council to request a care assessment. Ms X detailed her care needs to the Council and told the Council she would be contactable after mid-October 2024 to arrange an assessment. The Council placed Ms X on its waiting list for assessment.
14. In November 2024 and March 2025, Ms X contacted the Council for updates on her care assessment. On both occasions the Council advised Ms X was still on their waiting list.
15. Ms X raised a formal complaint with the Council in May 2025 about delays in completing her care assessment. The Council issued a complaint response in June 2025 apologising for its delay in allocating a social worker. The Council said it had experienced significant demand on its Adult Social Care services but had now put in place regular rescreening of referrals on waiting lists.
16. The Council attended Ms X’s property in June 2025 and completed a care assessment. The Council noted Ms X would benefit from five hours personal care and two hours social support each week. At the end of June 2025, the Council produced Ms X’s Care and Support Plan which reiterated Ms X’s care and support needs totalling seven hours care provision each week. Despite this, the Council only include the five hours of personal care in Ms X’s personal budget.
17. The Council sent financial assessment forms for Ms X which she returned by mid-July 2025. In mid-July 2025, the Council told Ms X she would not need to pay towards her care costs but would send a formal letter soon once it had confirmed this.
18. In October 2025, the Council started to pay Ms X a Direct Payment for her five hours of personal care each week.
19. The Council sent a formal letter confirming Ms X’s contribution towards her care was zero in November 2025.
20. In January 2026, following contact from Ms X, the Council reassessed her care needs and increased her provision of care from five hours each week. The Council amended Ms X’s Direct Payments to reflect this.

Analysis

Care assessment delays

21. The Care Act outlines that councils should complete care assessments within a suitable and reasonable timescale. The Council details in its own policy it considers this timescale to be up to 28 days.
22. I do not find fault with the Council for any delay in completing the care assessment from Ms X’s first contact until mid-October 2024. This is because Ms X asked the Council to only contact her after this date. However, given the Council’s 28-day timescale, I would expect to have seen the Council complete Ms X’s care assessment by mid-November 2024. The Council did not complete this assessment until mid-June 2025. This was a delay of seven months; this was fault.
23. This fault caused Ms X uncertainty about when the Council would assess her needs and potential lost opportunity at care being in place sooner.
24. Following completion of the care assessment, the Council produced Ms X’s care and support plan within a suitable timescale by the end of the month; I do not find fault.
25. However, the Council took a further three months to start paying Ms X her Direct Payments. This has added further delay to Ms X being able to source the care provision she needed despite the Council assessing her as having eligible care needs in June 2025. This was fault.

Direct payment amount

26. When the Council assessed Ms X in June 2025, it decided Ms X needed five hours of personal care and two hours of social care support. The Council reiterated this assessed need in Ms X’s care and support plan. Despite this, the Council failed to include the two hours of social care support within Ms X’s personal budget or subsequent Direct Payment.
27. The Council has acknowledged in its response to the Ombudsman it failed to include these two hours in error. This was fault.
28. This fault meant Ms X missed the two hours of social care provision funding. This lost funding started in October 2025 and lasted until the Council reassessed Ms X and updated her Direct Payments in January 2026.

Service improvements

29. In the Council’s complaint response it told Ms X it had already put in place service improvements to address the wait times for care assessments. The Council has detailed to the Ombudsman the specific measures it has put in place and how this has impacted the timeliness of its service.
30. The Council’s service improvements have improved the Council’s assessment timescales so its average wait-time now falls within its 28-day policy timescale. Because of the improvements the Council has already made in response to complaints like Ms X’s, I do not consider any further service improvements are needed.

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Action

31. Within one month of the Ombudsman’s final decision the Council will:
• Provide an apology to Ms X for the distress and lost opportunity caused through its delays completing her care assessment and delays in putting in place her Direct Payments. 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 in my findings.
• Provide Ms X with a symbolic payment of £500 for the distress and lost opportunity caused by its delays completing her care assessment and delays in putting in place her Direct Payments.
• Provide Ms X with a payment to her Direct Payments account equivalent to the missed two hours of social care funding per week the Council failed to pay from the start of the Direct Payments in October 2025 to the date the Council increased Ms X's Direct Payments in January 2026.
32. The Council should provide us with evidence it has complied with the above actions.

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Decision

33. There was fault leading to injustice. As the Council has agreed to my recommendations, I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman