Summary: Miss X complained the Council left her without Personal Assistant support for around three months after her existing arrangements ended, failed to provide interim support while it reassessed her needs, and did not keep her properly informed. There is fault in the Council’s actions. This caused avoidable distress, uncertainty, loss of support, and reliance on informal care to meet her daily needs. The Council has agreed to apologise, make a symbolic payment and service improvements to remedy the injustice caused.

The complaint

1. Miss X complained that Council left her without Personal Assistant (PA) support for approximately three months between late December 2024 and April 2025. She said she informed Adult Social Care her PA support would be ending in December 2024 but was told a reassessment was required before funding could be agreed. She said no interim support was arranged and her Direct Payments were not available, which resulted in her PAs stopping work.
2. Miss X said she struggled to meet her daily care needs during this period, including eating, dressing and taking medication, and had to rely on and pay friends and family for support. She also complained about delays, poor communication, and a lack of updates regarding her care and funding. She said this caused her distress and left her without necessary care and support.

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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. 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 Miss X and the Council as well as relevant law, policy and guidance.
6. Miss 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

Relevant law and guidance

7. 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.
8. The council must provide interim arrangements to meet care and support needs to cover the period the Council is considering a request for direct payments. Where accepted, the council should record the decision in the care or support plan. Where refused, the council should explain its decision in writing to the person who made the request. It should also tell the person how to appeal against the decision through the local complaints procedure. (Care and Support Statutory Guidance 2014)

What happened

9. Miss X received direct payments to employ a PA. She contacted the Council in November 2024 requesting a reassessment of her care needs and changes to her PA arrangements. The Council advised there would be a waiting period for reassessment and said her direct payment would continue during this time.
10. Miss X’s PA arrangement ended in late December 2024. Miss X contacted the Council in early January 2025 to say her PA had finished and that she required support. The Council prioritised her case and arranged a Care Act review, confirming this in writing on in mid-January 2025. A telephone review took place two weeks later.
11. Miss X did not have PA support in January 2025.
12. Following the review, the Council progressed arrangements for new PAs. This included referral to a charity and completion of employment and eligibility checks. Funding for support was agreed in principle on mid-March 2025, subject to administrative requirements.
13. Miss X continued to contact the Council in March 2025 for updates. Her PA support was confirmed as starting on 9 April 2025.
14. The Council says Miss X’s direct payment remained active throughout this period and payments continued into the managed account. It says new PAs could not be paid until required checks were completed.
15. The Council accepted in its response to this investigation that it did not offer interim arrangements when Miss X reported she had no PA support. It apologised for this.

Analysis

Continuity of care

16. The key issue is the Council’s actions after it was informed in early-January 2025 that Miss X no longer had PA support.
17. Miss X told the Council her PA support ended and that she required support with daily living tasks. The Council remained responsible for considering how her eligible needs would be met, regardless of how the PA arrangement came to an end.
18. The Council prioritised the case and arranged a review. However, there is no evidence it considered or arranged interim support to ensure Miss X’s eligible needs continued to be met while the reassessment and new arrangements were progressed.
19. The Council says Miss X had contingency arrangements, including support from family and friends, and that the service is not an emergency response service. These factors provide context but do not remove the Council’s responsibility to consider whether temporary support was required once it knew formal support had ended.
20. The Council accepted it did not offer interim support and apologised. There is also no clear evidence of a new risk assessment that considered the impact of the loss of support. This was fault.

Direct Payments

21. Miss X said her Direct Payments were not available and that this contributed to her PAs stopping work.
22. The evidence shows the Direct Payment remained active and payments continued into the account. The issue was that new PAs could not be paid until the necessary checks and arrangements were completed.
23. There is no evidence the Council suspended or withdrew Miss X’s Direct Payment. There was no fault in relation to Direct Payments.

Delay in arranging new support

24. There was a period between the review in January 2025 and the implementation of new PA support in April 2025.
25. This period included referral to a charity and completion of employment and eligibility checks for self-employed PAs. Some of this process was not wholly within the Council’s control.
26. There is insufficient evidence to conclude that the overall time taken to set up the new arrangements was fault.
27. However, the Council remained responsible for ensuring Miss X’s needs were met during this period. The fault lies in its failure to consider interim support.

Communication

28. The Council maintained some communication with Miss X during this period. However, it did not clearly advise or offer interim support options when Miss X reported she had no PA support.
29. This contributed to uncertainty but lies within the fault identified above.

Overall finding

30. The Council was not responsible for the initial loss of PA support in December 2024. However, once it was informed that Miss X no longer had support, it failed to properly consider or arrange interim support to ensure her eligible needs were met. This was fault.
31. The evidence does not support a finding that the Council stopped Direct Payments or that all subsequent delay was due to fault. However, the failure to act promptly to address the loss of support led to a period where Miss X did not have appropriate formal care in place.

Injustice

32. Miss X experienced a period without formal care while new arrangements were put in place. She reported difficulty managing daily living tasks and relied on support from friends and family.
33. This caused her avoidable distress, uncertainty, and a loss of support, as well as reliance on informal care.
34. Miss X did not evidence the payments she made to friends and family for support due to poor health. This should be provided to the Council to calculate any financial loss due to the lack of interim support.

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Action

35. Within one month of our final decision, the Council has agreed to:
• Apologise to Miss X for the injustice caused by the faults 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 in my findings.
• Pay £300 to Miss X to recognise the avoidable distress, uncertainty and loss of support caused by the failure to consider interim provision.
• Consider any evidence Miss X provides of payments made to friends, family or other expenses for care during the period without support, and reimburse reasonable costs where supported by evidence.
36. Within 3 months of our final decision, the Council has agreed to:
• Review its procedures for responding when a person reports their care arrangements have ended, to ensure there is a clear requirement to consider and record whether interim or alternative provision is needed to meet eligible needs pending reassessment.
37. The Council should provide us with evidence it has complied with the above actions.

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Decision

38. I find fault causing injustice. The Council has agreed actions to remedy injustice.

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Investigator's decision on behalf of the Ombudsman