Summary: Mr X complained about the Council’s decision to reduce his package of support when it was no longer funded by the health service. We did not find fault with how it made this decision.

The complaint

1. Mr X complained about the Council’s decision to significantly reduce the amount of support he received to meet his care needs. He says this caused significant distress and poses a risk to his health and welfare.

Back to top

The Ombudsman’s role and powers

2. 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)
3. 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)

Back to top

How I considered this complaint

4. I considered evidence provided by Mr X and the Council, as well as relevant law, policy and guidance.
5. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

Back to top

What I found

Care plan assessment and reviews

6. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan. 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. 
7. The guidance says reviews in general must not be used to arbitrarily reduce a care and support package. However, it says there are occasions when a change to a plan is required but there has been no change in levels of need.
8. In determining how to meet needs, the council may take into reasonable consideration its own finances and budgetary position, and must comply with its related public law duties. This includes the importance of ensuring that the funding available to the council is sufficient to meet the needs of the entire local population. A council may reasonably consider how to balance that requirement with the duty to meet the eligible needs of an individual in determining how an individual’s needs should be met.

What happened

9. Mr X, lives independently and has care and support needs. For several years, he employed three personal assistants to help with personal care, shopping, accessing the community as well as supporting him to manage his chronic health condition. This included some overnight support, where necessary. This package of care (82 hours per week) was funded by the NHS.
10. In 2025, the NHS carried out a review and decided Mr X was no longer eligible for health funding. This was because it was decided his needs were not predominantly heath-related. He was told a social care package was more appropriate. A referral was made to the Council to carry out an assessment of Mr X’s care and support needs.
11. A social worker visited Mr X at home and carried out an assessment. She then completed a care an sudpport plan that determined Mr X should receive 16 hours of support every week.
12. Mr X challenged this outcome, via a complaint. His complaint was not upheld.

Analysis

13. It is entirely understandable why Mr X was surprised and distressed when his support was reduced so drastically, when his circumstances had not changed. The decision of the NHS to withdraw funding is not part of this investigation, I can only consider the actions of the Council. There was no legal obligation to continue the previous level of support. The Council was entitled to make its own decision based on its own assessment of need, and different eligibility criteria.
14. I have identified no fault in how it made its decision to reduce Mr X’s care hours. In accordance with relevant guidance, its focus was on a strengths-based approach around independence and capabilities, which is not fault. The social worker reviewed relevant evidence, took account of Mr X’s eligible needs and outcomes, and considered the views of Mr X. She explained her reasons.
15. I appreciate Mr X strongly disagreed with the Council’s decision and disputed that his complex needs could be met within 16 hours. However, these are matters of professional judgement. It was a decision the Council was entitled to make. As I have not identified fault in the process, I cannot question the merits of it or say it should have reached a different outcome.

Back to top

Final decision

16. I have found no fault. On this basis, I have completed my investigation.

Back to top

Investigator's decision on behalf of the Ombudsman