Summary: Mr Z, on behalf of his niece, Ms X, complained that despite no change in her condition, the Council reduced her package of care from 69 to 51.5 hours per week. The Council followed the correct procedure to review Ms X’s care needs and then used its professional judgement to determine how to meet those needs. However, it delayed getting an occupational therapy assessment and implementing the recommendation to increase the hours to 53 per week. A suitable remedy for the distress and missed provision is agreed.

The complaint

1. Mr Z, on behalf of his niece, Ms X, complained that despite no change in her condition, the Council reduced her package of care from 69 to 51.5 hours.
2. Mr Z says this means the carers no longer have enough time to meet Ms X’s needs putting pressure on them and the family to provide appropriate support.

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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. 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

5. I considered evidence provided by Mr Z and the Council as well as relevant law, policy and guidance.
6. Mr Z 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

Care Plan

7. 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

8. 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.

Key facts

9. This section sets out the key events in this case and is not intended to be a detailed chronology.

10. Ms X is a disabled adult. She lives with her parents. Ms X has assessed eligible care needs and receives direct payments to enable her to engage carers.
11. In November 2024, the Council carried out an annual review of Ms X’s care needs. This found no change in her assessed eligible needs but resulted in a reduction in respect of the hours required to meet these needs. Ms X’s package of care reduced from 63 to 51.5 hours per week.
12. Ms X and the family were unhappy with this reduction in the package of care and so submitted a complaint on 23 January 2025. The Council responded on 20 March 2025 saying that the 51.5 hours allocated per week was sufficient to meet Ms X’s care and support needs. It said that 13 hours were allocated for Ms X to access the community independently and to enable her to participate in activities to support her mental wellbeing. It said these hours could be used flexibly to enable Ms X to choose when and how to use them. It said the review recognised the informal support provided by the family including meal preparation, maintaining a habitable environment, escorting Ms X to health appointments, managing finances and offering emotional support. It said it provided an annual carers break allocation of approximately £3,000 per year to cover the cost of replacement care when the informal carers were taking a break. The Council did not uphold the complaint.
13. The Council commissioned an occupational therapy assessment in February 2025. The visits to observe how personal care was provided to Ms X were carried out on 6 and 10 June. The outcome of the OT assessment was the recommendation to increase the package of care by an additional 1 hour 30 minutes per week. It found that insufficient time was allocated to allow Ms X to have a full body wash in the shower three times a week.
14. The recommendation was sent to the wrong email address and this error was not noticed until February 2026 when the case was presented to the funding panel. The panel requested a clear breakdown of hours and so it was deferred and then approved on 5 March. The Council says the increased direct payment was implemented on 13 April.

Analysis

15. Councils are required to complete periodic reviews of care needs. This should happen regardless of a review request or indication that circumstances have changed. Any revision of a care and support plan should involve the service user, carers and any other people who may want to be involved. I am satisfied all necessary people were involved in Ms X’s review.
16. The Council took the view that while Ms X’s care needs had not changed, her eligible needs could be met with a different package of care. It noted a justification for the revised hours saying that two carers were only required to enable transfers using the hoist and for toileting. This meant one carer would attend for an hour in the morning and evening and the second carer for 45 minutes. It said the care call in the daytime was required only for assistance with toileting and so could be reduced to 30 minutes.
17. The Council has justified the reduction in some of the care hours by the fact that two carers were not required to attend to all of Ms X’s care needs. It therefore reduced the visit time of one carer. While I note the family does not agree with this and says the carers are rushed, this is a decision the Council was entitled to take and I am not persuaded there was fault in the process leading to that decision.
18. However, it has since been shown that the reduction to 38.5 personal care hours was insufficient to meet Ms X’s needs. An occupational therapy assessment found there was insufficient time to enable Ms X to shower and so recommended and increase in hours. While the increase has been agreed, it is now almost 18 months since the reduction in the care package and this increased support is still not in place. The Council commissioned the assessment in February but did not complete it until June. It then took a further nine months to refer the matter to its funding panel. The Council has now provided further details of the timeline for the OT assessment. Most of the delay was due to an email being sent to the wrong email address. While I accept this was not intentional, it still resulted in delay which is fault. We cannot now provide this missed provision but I consider a payment to recognise the distress caused is appropriate. My recommended payment will take into account the prolonged period of time Ms X has been without this provision.
19. The Council says it took account of the informal support provided by Ms X’s family who she lived with. It says they agreed they could provide meals for Ms X when cooking for themselves as well as ensuring the house was clean. If family members agree to provide support then this can be a valid reason to reduce the care package. However, I would expect this to be formally recorded to ensure the family fully understood the implications of what they were agreeing to do. The Council accepts that in this case there is no record to show this was properly explained to the family before they agreed to taking on more informal caring. The failure to record this is fault.
20. It found that Ms X was not using the community access support for the intended purpose and so could be reduced from 20 to 13 hours which would ensure she was not secluded and could be used for activities such as swimming, theatre and using the library. The Ombudsman is concerned with administrative process and not the merits of decisions properly made even though people may disagree with them. The Council has provided an explanation for why the community access hours were reduced. While I appreciate the family does not agree with this decision, I am not persuaded there was fault in the process leading to this decision. Ms X, her family and her carers were involved in the review and so had the opportunity to provide information about how Ms X was using the hours. I have seen nothing to suggest the information on which the Council based its decision was incorrect and so I cannot criticise the decision reached.

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Action

21. To remedy the injustice caused as a result of the fault identified above the Council will, within one month of my final decision, take the following action:
• Apologise to Ms X for the fault identified. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended;
• Take action to ensure the package of care reflects the decision to increase to 53 hours per week;
• Make Ms X a symbolic payment of £1,000 to recognise the prolonged distress caused including the failure to record the family’s agreement to provide informal care and the delay in paying the extra 1.5 care hours; and
• Provide details of action the Council will take to ensure that decisions requiring panel approval are considered promptly and then actioned without delay.
22. The Council should provide us with evidence it has complied with the above actions.

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Decision

23. I have completed my investigation with a finding of fault for the reasons explained in this statement. The Council has agreed to implement the actions I have recommended. These appropriately remedy any injustice caused by fault.

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Investigator's decision on behalf of the Ombudsman