Summary: There was fault by the Council. It failed to provide care and support to meet Ms X’s eligible unmet needs between August 2024 and January/February 2025. It failed to ensure Ms X’s transition from commissioned services to a direct payment went smoothly. Complaint responses were superficial, did not address all the issues or offer an adequate remedy for the loss of care and support and avoidable distress. Communication was also below our expected standards. The Council also failed to inform Ms X why she could not use a relative as her personal assistant and failed to process invoices meaning there was a further month where Ms X was without essential domestic support. The Council will apologise and make a payment to reflect the avoidable distress and loss of service.

The complaint

1. Ms X complained the Council:
1. Failed to provide care and support to meet her eligible needs for several months
2. Mishandled transferring her case to direct payments meaning essential cleaning support was stopped
3. Failed to properly consider and reply to her complaints
4. Failed to do financial assessments and gave conflicting information about arrears.
2. Ms X said this caused distress and anxiety which had a negative impact on her mental health. The loss of care placed huge strain on her and her family.

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The Ombudsman’s role and powers

3. We do not normally investigate a complaint unless we are satisfied the organisation knows about the complaint and has had an opportunity to investigate and reply. We may investigate a premature complaint (one that has not had a response from the council) if we consider it unreasonable for the council to respond. (Local Government Act 1974, section 26(5), section 34(B)6)
4. 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)
5. Service failure can happen when an organisation fails to provide a service as it should have done because of circumstances outside its control. We do not need to show any blame, intent, flawed policy or process, or bad faith by an organisation to say service failure (fault) has occurred. (Local Government Act 1974, sections 26(1), as amended)
6. 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

7. I have investigated complaints (a) to (c) between August 2024 and August 2025 when Ms X complained to us.
8. I have not investigated complaint (d) because it is premature. The financial assessment did not form part of Ms X’s complaint to the Council in October 2024. It did not become an issue until summer 2025. It is reasonable for the Council to provide a full written response addressing Ms X’s complaint under its complaint procedure.

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How I considered this complaint

9. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
10. Ms 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

11. The Care Act spells out the duty to meet eligible needs (needs which meet the eligibility criteria). (Care Act 2014, section 18)
12. An adult’s needs meet the eligibility criteria if they arise from or are related to a physical or mental impairment or illness and as a result the adult cannot achieve two or more of the following outcomes and as a result there is or is likely to be a significant impact on well-being:
• Managing and maintaining nutrition
• Maintaining personal hygiene
• Managing toilet needs
• Being appropriately clothed
• Making use of the home safely
• Maintaining a habitable home environment
• Accessing work, training, education
• Making use of facilities or services in the community
• Carrying out caring responsibilities.

(Care and Support (Eligibility Criteria) Regulations 2014, Regulation 2)

13. If a council decides a person is eligible for care, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether and to what extent the needs meet the eligibility criteria and specifies the needs the council is going to meet and how this will be done. The council should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
14. The care and support plan must set out a personal budget. A personal budget is a statement which specifies the cost to the local authority of meeting eligible needs. (Care Act 2014, section 26)
15. A personal budget can be taken:
• As a managed account held by the local authority with support provided in line with the persons wishes;
• As a managed account held by a third party with support provided in line with the persons wishes;
• As a direct payment (a direct payment or DP is money a person gives to a council to meet agreed needs).
16. Care and Support Statutory Guidance says the following about DPs:
1. After considering the suitability of the person requesting the direct payment against the appropriate conditions in the Care Act, the local authority must make a determination whether to provide a direct payment. The local authority must provide interim arrangements to meet care and support needs. Where a direct payment is refused, the person making the request should be provided with written reasons that explain the decision. (12.18)
2. A DP is designed to be used flexibly and there should be no unreasonable restriction as long as it is used to meet eligible care and support needs. (paragraph 12.35)
3. A council may refuse to allow a DP to be used to pay for care from a close family member living in the same household, except where the council decides this is necessary (paragraph 12.36)
17. A council should review a care and support plan at least every year, on request or in response to a change in circumstances. The purpose of a review is to see how a care and support plan has been working and to decide if any revisions need to be made to it. The council should act promptly after receiving a request for a review. (Care and Support Statutory Guidance, Paragraphs 13.19-21 and 13.32)
18. A council should revise a care and support plan where circumstances have changed in a way that affects the plan. Where there is a proposal to change how to meet eligible needs, a council should take all reasonable steps to reach agreement with the adult about how to meet those needs. (Care Act 2014, sections 27(4) and (5))

LGSCO’s Principles of Good Administrative Practice

19. We expect councils to act fairly and proportionately and to be open and accountable. This includes:
• Explaining clearly the rationale for decisions and recording them and
• Stating the criteria for decision-making and giving reasons.
20. We also expect councils to put things right. This includes putting mistakes right quickly and effectively, providing clear information on how to complain and operating an effective complaints procedure including offering a fair and appropriate remedy when a complaint is upheld.
21. We expect councils to be citizen focussed. This means dealing with people helpfully promptly and sensitively.

What happened

2024

22. Ms X has disabilities and is eligible for care and support. She was receiving a package of home care which the Council commissioned with a care agency. The agency gave notice in the middle of July 2024 and Ms X’s care stopped. The records indicate Ms X had been receiving 15 hours a week of care and support to meet her eligible needs and some of this care and support was to provide assistance in the home and with cooking to support needs around parenting.
23. The social worker informed Ms X in October that they had been unable to identify a care provider and they could discuss DPs. Ms X said she was overwhelmed with worry and frightened she may fail her degree course.
24. The social worker apologised to Ms X for poor communication and also that they could not provide an immediate response to her concerns. Ms X said her child was having to provide her care and support and was also suffering.
25. Ms X complained to the Council in October. She said she had asked for a DP and for her adult daughter to be her personal assistant (PA) and the Council had not given her a response. She said the Council had not commissioned her care because it could not find a provider.
26. The social worker told Ms X in a meeting in October that a council manager had said verbally that the Council would not agree to Ms X using a DP to pay her adult daughter to be her PA. The Council has not provided any written decision with its reasons for refusing Ms X’s request.
27. The Council provided a brief response to Ms X’s complaint by email at the start of November. The email did not signpost Ms X to the LGSCO. When asked, the Council told us it considered its internal complaint procedure complete. The Council’s complaint response said

“ I understand subsequent to your email, you have met with [a council officer] and as a result, they have agreed to undertake the following:

Exploration of direct payments

Look into an interim cleaning agency

Contact the university about support

I hope the meeting has given clarity around your concerns and what actions they will be undertaking to try and support you.”

28. The case records indicate officers identified an agency to provide temporary cleaning support to Ms X in November. Ms X said she was pleased, but she queried whether the three hours the Council was commissioning was the only care she would get. She said her assessment said she needed 15 hours. The response given was that this was the only available time the agency had and was an interim arrangement.
29. Between November 2024 and January 2025, there are many internal emails between senior officers and managers of the Council about which departmental budget funding for Ms X’s care package would come from and seeking approval from the relevant senior manager.

2025

30. The cleaning agency did not start providing a service to Ms X until the middle of January 2025 for six hours a week. Ms X’s regular social worker was on long-term leave and her case was managed by the duty team and then by a temporary worker. The records include notes of several calls from Ms X in distress between January and August 2025.
31. Ms X emailed the social worker and the complaints team in January. She reported ongoing difficulties, said she had only had one three-hour call to date and her draft care plan was in ‘bureaucratic limbo’. There was no response from the complaints team. Ms X raised concerns about the number of hours care and support she was currently receiving.
32. A temporary social worker emailed Ms X in February. Ms X confirmed the cleaning agency (six hours a week) and also a care agency (five hours a week) had both started. She raised some concerns about call timings and duration. The social worker said they would revert to her after making enquiries. There is no record of a follow up email or discussion.
33. The Council’s DP team had some contact with Ms X in April. The DP team noted Ms X said she did not agree with her current (draft) care plan for the DP which reduced her care hours to 11 hours a week and that she wanted to speak to a social worker. The DP team asked for Ms X to be allocated a new social worker as the temporary one had left.
34. The care and support plan dated May 2025 said the Council would provide five hours of commissioned care with a care agency and six hours a week with a cleaning agency until a PA or other provision was in place. The plan set out Ms X’s eligible needs (in all of the domains set out in paragraph 12) and her desired outcomes. It gave Ms X’s personal budget.
35. There is no evidence of substantive progress on addressing the concerns Ms X had raised about the hours in her care and support plan in May. The DP team made a note saying the DP was on hold and the plan consisted of five hours of home care and six hours of cleaning.
36. In May, the cleaning agency told the Council they were not being paid. Also in May, the care agency told Ms X the Council would be stopping using them at the end of June (the records indicate it did not stop). Ms X told a social worker she was worried about this. Ms X also told a social worker that the version of the care plan she possessed did not have cleaning hours on it.
37. The case notes indicate the Council’s administrative team were waiting for Ms X to return DP terms and conditions before activating the DP. Ms X continued to query the care plan. She did not return the terms and conditions signed.
38. In June 2025, Ms X told a duty social worker she still wanted her adult daughter to be a PA and cleaner for her.
39. In July, a manager from the DP team spoke to Ms X. Ms X said she wasn’t aware of a terms and conditions document and could not understand why the process of securing a DP was so difficult. She was concerned no-one was understanding her needs and she wanted face to face discussions because of her communication needs.
40. In August, the cleaning agency told the Council it was suspending the service to Ms X because the Council had not paid invoices between March and July. The cleaning agency said it would inform Ms X. Ms X then rang a council officer in tears.
41. Also In August, Ms X emailed the complaints team. She said:
• despite repeated complaints she was still without essential cleaning support and the cleaning agency had stopped attending because the Council had not paid its invoices.
• the Council had not arranged for her to move to DPs or provided appropriate support around setting up the DP.
• there was poor communication from various teams in the Council.
• she was desperate.
42. There was no written response from the complaints team. The complaints team made the relevant senior manager aware of Ms X’s contact.
43. Ms X complained to the LGSCO at the end of August.
44. Internal case records indicate invoices were paid, but there was a four-week period from the end of July to the end of August where Ms X did not receive support from the cleaning agency.

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Findings

Failed to provide care and support to meet her eligible needs for several months

45. The Council is at fault. It has a duty to meet Ms X’s eligible needs. She was without care and support between August 2024 and January/February 2025 when the Council commissioned two agencies. The fault caused Ms X and her child avoidable distress for an extended period and a loss of a care and support service to which there was a legal entitlement. Some of the delay was due to a lack of care providers willing or able to take on Ms X’s care package. This is service failure. Taking between November 2024 and January 2025 to resolve internal budgetary issues was fault and should not have delayed service provision for Ms X.

Mishandled transferring her case to direct payments meaning essential cleaning support was stopped

46. There should have been a smooth streamlined process of moving Ms X from commissioned care to DPs. The Council was at fault because:
1. Ms X was getting 15 hours a week of care and support until July 2024. The care and support plan of May 2025 said 11 hours. Ms X queried the reduction in hours multiple times when she was given sight of a draft version of the care and support plan. As the case was being managed by the Council’s duty team for several months, there was no continuity and no significant steps taken to try and resolve the dispute. I am not satisfied the Council took reasonable steps to agree the revision to the care and support plan before implementing the reduction. This was not in line with Section 24(7) of the Care Act 2014 and was fault causing avoidable distress.
2. Ms X should have had a written decision on her request for her adult daughter to be employed as her cleaner and PA using a DP when she raised it in October 2024. If the Council had decided she could not use her daughter as a PA, it should have explained why with reference to the reasons in CSSG and legislation as I have set out in paragraph 16. The Council failed to act in line with law, guidance or our expectations as I have set out in paragraph 19. This was fault causing avoidable frustration.
3. The cleaning agency’s invoices appear not to have been paid because Ms X was in an administrative black hole not of her making. The DP was agreed in principle, but it was not formally in place because Ms X had not returned the paperwork and was querying the reduced hours. Even so, the Council should have ensured her eligible needs were met by ensuring continuity of commissioned care and the agency continued to receive payment while the DP and care plan issues were being resolved. The failure to pay the agency was poor administration and was fault causing Ms X avoidable distress because the agency suspended her care for non-payment of invoices.

Failed to properly consider and reply to her complaints.

47. Complaint handling was woefully inadequate. The Council failed to give a full response to Ms X’s concerns, failed to identify key areas of fault or injustice or to offer an appropriate, meaningful remedy. It failed to signpost Ms X to the LGSCO. It failed to respond to further complaints in January and August 2025. These were missed opportunities to provide a full response to Ms X’s ongoing issues and to provide a meaningful remedy for the injustice caused.

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Agreed Action

48. Within one month, the Council will issue:
• An apology. 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.
• A payment of £1500 to Ms X to reflect the loss of care and support provision between August 2024 and January/February 2025 and the loss of domestic support in August 2025. This is an exceptional case. I have taken into account the hours of care and support in the care package, the stress to Ms X and her child, the frequent attempts she made at resolving the issue and her contemporaneous statements expressing high anxiety. The lack of care placed Ms X and her daughter at risk of harm.
• An additional payment of £500 to reflect the time and trouble caused by poor complaint handling.
49. Within two months, the Council will:
• Complete a review of Ms X’s care and support plan. This should be done by a face-to -face meeting with relevant parties. It should include discussion of (1) Ms X’s concerns about the reduction in hours of care and support and (2) of her request for her daughter to be her PA.
• Issue a written decision with a clear explanation of:
1. whether Ms X’s daughter can be her PA
2. The number of hours of care and support required to meet Ms X’s eligible needs.
50. I have not recommended training in complaint handling for council staff, because the Council already agreed to provide this in September 2025 as an outcome to another LGSCO investigation.
51. The Council should provide us with evidence it has complied with the above actions.

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Decision

52. I find fault causing injustice. The Council has agreed action to remedy the injustice.

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Investigator's decision on behalf of the Ombudsman