Summary: The Council was at fault for failing to provide the full amount of care in Ms Y’s care plan, which it accepted in its complaint response. This has caused her financial injustice as she paid for private carers to top up her care package. The Council should make a payment to reflect the costs of the extra care Ms Y had paid for.

The complaint

1. Ms X complained the Council failed to provide her relative, Ms Y, with additional care following the change to her care and support plan in January 2023. Ms X and Ms Y only discovered Ms Y was entitled to this during a review in January 2025. Ms Y had paid for private carers during this time as she did not feel her care package was enough. This has caused her financial loss.

Back to top

The Ombudsman’s role and powers

2. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
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)

Back to top

What I can and cannot investigate

5. I have investigated this complaint back to January 2023. This because Ms X only became aware of having cause to complain in January 2025. It was at the annual review in January 2025 Ms X found out that Ms Y should have been receiving 47 hours of care and not 40.5 hours

Back to top

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. I considered any comments before making a final decision.

Back to top

What I found

Relevant legislation

Care Act 2014 – the Assessment of need for care and support

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.

Care Plan

10. 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

11. 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.

What happened

12. I have summarised below the key events; this is not intended to be a detailed account.
13. Ms X complained on behalf of her relative, Ms Y for who she is the appointee for finances. The Council’s records say all correspondence must be sent to Ms X.
14. Ms Y lived in supported living accommodation and received 40.5 hours of care each week.
15. In the middle of January 2023, the hospital social care practitioner reviewed Ms Y’s care needs. They increased Ms Y’s commissioned care to 47 hours per week. There are no notes available from the annual review.
16. Following the annual review meeting, the Council did not send a copy of the assessment and support plan and review document to the family. Ms X said she did not know the Council changed her relative’s care and support plan.
17. The Council said it emailed the Care Home with a purchase order for extra care hours per week for Ms Y. The total amount of care the Care Home was to provide Ms Y was 47 hours per week. The Care Home did not have a record of the email and so it did not provide the additional care.
18. Ms X told me basic daily tasks were difficult for her relative. Ms Y paid for extra care privately. The private carer provided a minimum of four hours care per week, depending on her availability.
19. The Council reviewed Ms Y’s care in March 2024. Ms X and Ms Y were both present at the review meeting. The review noted ‘in addition to the onsite carer I have a private carer visit once a day, she helps me with keeping my home tidy and assisting with anything I may need’. The social worker completed the section headed ‘assessor’s view’ within the ‘My Review’ form, she wrote Ms Y received 47 hours of care a week which was still appropriate for her needs, the care plan was to remain the same. The Council, Ms X and Ms Y did not notice the number of care hours the Care Home provided to Ms Y did not reflect what was in her care and support plan. The Council sent a copy of the My Review and the Support Plan to Ms Y with a covering letter. It did not send a copy to Ms X.
20. In January 2025, the private carer became ill and could not provide care to Ms Y. Ms X asked the Council for a reassessment and an increase in the number of care hours. The Council responded and said Ms Y already received a high care package which included 47 hours of care. Ms X told the Council her relative only received 40.5 hours care per week. This was the first time Ms X and the Council became aware Ms Y was not receiving the full amount of care hours in her care and support plan. Ms Y received 40.5 hours; not the 47 hours a week as per the review in January 2023.

The complaint

21. Ms X complained to the Council in June 2025 on behalf of her relative.

The Council upheld the complaint. It apologised that it provided Ms Y with six and a half hours per week less care than she was entitled to due to errors made between the Council and the Care Provider in its communication alongside missed opportunities to identify these errors. It said there had been no impact on Ms Y and the correct care was now in place.

22. The Council explained it learned lessons and has made service improvements. It said the reviewing team will ensure it confirms the hours of provision during the review with customers, family members and providers.
23. Ms X complained to us in August 2025. She said had the Council provided the full care package, her relative would not have needed to pay for extra care privately.

Analysis

24. The Council’s records say it should send all correspondence to Ms X, on behalf of her relative, Ms Y. After the annual review in March 2024, the Council sent a copy of the reports to Ms Y. It did not send a copy to Ms X, as it should have done. This was fault.
25. The Council upheld Ms X’s complaint and accepted it did not provide the full care as stated in her support plan due to errors made between the Council and the Care Provider in the communication of the increase in Ms Y’s assessed care package. Ms Y received six and a half hours of care less than she was entitled to over two years between January 2023 and January 2025. This is around 676 hours of care Ms X did not receive. This was fault.
26. During this time, Ms X paid for private care to top up her care package as she did not feel she received enough care. This cost her £15 per hour. This was a direct financial injustice.
27. The Council now provides the right amount of care as set out in Ms X’s care plan. There is no continuing injustice.
28. To prevent similar fault occurring, the Council now ensures it confirms the hours of provision during reviews with customers. Therefore, a further service improvement is not required.

Back to top

Action

29. Within four weeks of the final decision, the Council should write to Ms X and ask her to provide invoices for the care Ms Y paid for privately from January 2023 to January 2025. Within six weeks of the Council receiving the invoices from Ms X, it will reimburse Ms Y for the fees she has paid. The number of hours the Council reimburses should be limited to a maximum of six and a half hours care per week.
30. The Council should provide us with evidence it has complied with the above actions.

Back to top

Decision

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

Back to top

Investigator's decision on behalf of the Ombudsman