Summary: The Council delayed assessing and meeting Mr X’s eligible care and support needs under the Care Act 2014, causing him avoidable stress and difficulty

The complaint

1. Mr X complains the Council failed to properly assess and meet his care needs. He says he is not getting the care he needs, such as transport to appointments, and that he struggled to communicate with his support worker.

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The Ombudsman’s role and powers

2. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), 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)

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How I considered this complaint

4. I have:

• considered the complaint and discussed it with Mr X;
• considered the correspondence between Mr X and the Council, including the Council’s response to his complaint;
• made enquiries of the Council and considered the responses;
• taken account of relevant legislation;
• offered Mr X and the Council the opportunity to comment on a draft of this document.

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What I found

Relevant legislation

5. A council must carry out an assessment of any adult who seems to need care and support. 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 appropriate their carer or any other person they might want involved. (Care Act 2014, section 9). Having identified eligible needs through a needs assessment, the council has a duty to meet those needs. (Care Act 2014, section 18)
6. If a council decides a person is eligible for care, it must prepare a care and support plan. This must set out the needs identified in the assessment. The care and support plan should consider what 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. 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.
7. The Care and Support Statutory Guidance sets out that authorities should conduct a periodic review of the care and support plan. It says ‘The periodic review should be proportionate to the needs to be met, and the process should not contain any surprises for the person concerned. Periodic reviews and reviews in general must not be used to arbitrarily reduce a care and support package. Such behaviour would be unlawful under the Act as the personal budget must always be an amount appropriate to meet the person’s needs. Any reduction to a personal budget should be the result of a change in need or circumstance’.

Background

8. Mr X is a man in his thirties. He lives with his mother and siblings. He has a history of mental health difficulties, which are linked to past trauma and a diagnosis of post-traumatic stress disorder (PTSD). He also experiences episodes described as ‘blackouts’.
9. In 2024, Mr X’s health and wellbeing declined, and in January 2024 he contacted the Council to request a Care Act assessment.
10. The Council completed an assessment in July 2024. The assessment identified Mr X had eligible care and support needs in relation to managing and maintaining personal hygiene, maintaining nutrition, developing and maintaining family and other personal relationships, and accessing the local community.
11. The Council says it did not immediately put a full care and support plan in place following the assessment. Instead, it referred X for targeted short-term support to assist him to attend health appointments and re-engage with community mental health services. It says this support was provided through a ‘team around the person approach’, which included referral to a community support worker to support Mr X with accessing appointments and re-engaging with services. The Council says this represented a proportionate response at that time, as the Council considered Mr X’s needs could be managed through short-term coordinated support rather than a formal long-term care package.
12. Mr X was dissatisfied and frustrated by the level of support provided and felt the Council only took action after he contacted it to make a complaint.
13. A further Care Act assessment was started on 29 April 2025 and completed on 13 May 2025. Following this assessment, the Council completed a care and support plan which it says met Mr X’s eligible needs. Under the section ‘managing nutrition and being able to make use of the home safely, the assessor recorded that Mr X usually ate one meal a day, prepared by his sister as part of a family meal and that Mr X was eligible under this domain because, without support and reminders from his family, his memory and attention difficulties could place him at risk of accidental fire and affect his physical wellbeing. It also limited the control he had over his day-to-day life. Mr X was found to have eligible support needs under managing his personal hygiene, maintaining family and other relationships, and accessing the community. In respect of accessing the community the assessor recorded Mr X’s wishes, that he believed a support worker for two hours per week would support him to increase his exposure to the community and develop his confidence with the aim of being in the community independently.
14. The Council says the care and support plan considered both Mr X’s, met and unmet needs, including the support already provided by family members. It says the plan was intended to promote Mr X’s independence in the community and in attending appointments. The Council commissioned a formal package of care to support Mr X with accessing the community and managing his mental health needs. This included support to attend appointments, build confidence and reduce anxiety. The care package was commissioned on 4 June 2025.
15. In August 2025, the mental health team supporting Mr X contacted the Council regarding his request for social care to arrange or fund transport to a hospital appointment. Mr X says an officer from the Council told him that his support worker would provide transport to attend appointments.
16. The Council confirmed this was not included in Mr X’s care and support plan. It informed the mental health team that the care agency supporting Mr X could assist him to book a taxi and provide support to attend the appointment, with the aim of allowing time for the working relationship between Mr X and support staff to develop.
17. Mr X was dissatisfied with the support provided by his support worker. He said the support worker was unhelpful and that he felt he was paying for the worker to simply walk around with him. He also reported that communication was difficult due to a language barrier.
18. Mr X submitted a formal complaint to the Council in early August 2025. On 11 August 2025 a council officer contacted Mr X to discuss the complaint. The Council says during that conversation the officer explained that following Mr X’s assessment and subsequent care and support plan, the support worker’s aim was to provide Mr X with support to help him to become more independent and there was no agreement that he would be provided with transport to appointments.
19. In late August 2025, Mr X contacted the Council to request a change of care provider. The Council agreed to this request and commissioned a new provider on 10 September 2025. However, Mr X later cancelled an introductory meeting with the new provider and declined all support from the Council, stating he was frustrated with delays and that he preferred to receive support from a neighbouring Council’s mental health team. Mr X lives on the boundary between two local authority areas and therefore, unusually, has the option of accessing services from either Council.
20. Mr X refused to pay his assessed contribution towards the cost of his care. He said the situation had negatively affected his health and wellbeing, caused him significant frustration, and left him feeling neglected by the Council over a prolonged period. He also said his mental health had deteriorated to the extent that crisis services and the ambulance service became involved. Mr X says he feels he was misled about transport support and about what would be included in his care and support plan. He says that, after agreeing to the plan, he lost trust and confidence in the Council, which caused him anger and upset.
21. The Council arranged a home visit to Mr X on 7 October 2025 to discuss his financial contribution, travel expenses, and his unmet eligible needs. Mr X continued to decline services. He agreed to update the Council following his appointment with the mental health team in the neighbouring Council.
22. On 22 October 2025, the Council emailed Mr X to check in with him. Mr X replied stating that he did not wish to receive support from the Council, and the Council subsequently closed his case.
23. The Council’s complaint response dated 15 October 2025, states Mr X’s assessment identified that he would benefit from a community support worker to support him to be more independent in the community.
24. In response to enquiries from this office the Council acknowledges that there was a delay in completing elements of the assessment process. It says this was previously recognised and addressed within the Council’s complaint handling process, and an apology was issued to Mr X. Aside from the acknowledged delay, the Council says it is satisfied that it took proportionate action.
25. The Council says Mr X is not currently in receipt of Council arranged support, having indicated in October 2025 that he did not wish to continue engagement with or receive further services from the Council at that time. The Council says it respected these wishes and reaffirmed that a reassessment would remain available should Mr X wish to re‑engage.

Analysis

26. It is not the Ombudsman’s role to determine the level of care and support Mr X should receive. Rather, the Ombudsman’s role is to consider whether the Council properly assessed Mr X’s needs and acted in accordance with the law and statutory guidance.
27. In this case, I find the Council did not do so.
28. Under the Care Act 2014, councils must carry out assessments that are both proportionate and comprehensive. Assessments should consider a person’s physical and mental health needs, any fluctuating conditions, risks to wellbeing, and the outcomes the person wishes to achieve. Councils must also ensure their decisions are evidence-based and keep care and support arrangements under review where appropriate.
29. The Act places a duty on councils to meet eligible care and support needs. Although promoting independence is an important principle of the Act, this should be achieved through the provision of appropriate and timely support, not by leaving eligible needs unmet. Section 18 of the Care Act 2014 states that where an adult has eligible needs and is ordinarily resident in the authority’s area, the Council must meet those needs. That did not happen here.
30. Mr X contacted the Council in January 2024. However, the Council did not complete an assessment until July 2024. Following that assessment, the Council still failed to identify and meet all of Mr X’s eligible needs.
31. The Council says its intention was to promote Mr X’s independence, which was an outcome he identified as important to him. However, independence is promoted through the provision of support at the time it is needed. In this case, the lack of appropriate support did not increase Mr X’s independence. Instead, it caused him avoidable stress and unnecessary difficulty.
32. Mr X’s eligible needs were not fully met until June 2025, when the Council finally commissioned services to address all identified needs. This delay was significant and contrary to the Council’s duties under the Care Act 2014 which says councils should ensure eligible needs are met in a timely manner and should not allow unnecessary delays in care and support provision.
33. I therefore find fault in the way the Council assessed and met Mr X’s care and support needs.
34. There is nothing in Mr X’s care and support plan to indicate support workers would provide transport to appointments. The plan says support workers would support Mr X to attend appointments, but it does not specify they would transport him. On the evidence available, I do not find fault by the Council on this point.
35. Mr X says he had discussions with a Council officer about transport provision. However, I cannot make a finding on those conversations because I was not present and there is insufficient evidence to establish exactly what was said.
36. I am unable to reach a finding on Mr X’s complaint that he experienced difficulties communicating with his support worker. While I cannot make a finding on this point, the Ombudsman would expect councils and care providers to ensure support workers are able to communicate effectively with the people they support.
37. In relation to Mr X’s outstanding contributions towards his care and support costs, I am unable to require the Council to waive these charges. The available information indicates that Mr X was made aware, prior to accepting the support, that a financial contribution would be required.

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Agreed Action

38. The Council should, within four weeks of the final decision:

• Apologise to Mr X in writing for the delays in assessing and meeting his eligible care and support needs.
• Pay Mr X £500 to recognise the distress, uncertainty, avoidable stress, and inconvenience caused by the delay in meeting his eligible needs between January 2024 and June 2025.
• Review its procedures to ensure care assessments are completed within a reasonable timescale and that identified eligible needs are met without unnecessary delay.
• Remind relevant staff of the Council’s duties under the Care Act 2014 and associated statutory guidance, particularly the duty to meet eligible needs and the importance of keeping care and support arrangements under review.
• Provide the Ombudsman with evidence it has completed these actions.

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Final Decision

39. The Council delayed assessing and meeting Mr X’s eligible care and support needs under the Care Act 2014, causing him avoidable stress and difficulty
40. No fault was found regarding transport to appointments because this was not included in Mr X’s care plan and there was insufficient evidence about discussions with Council staff.
41. The above recommendations are a suitable way to settle the complaint.
42. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman