Summary: Ms X complained the Council failed to properly assess her care and support needs and delayed communicating the outcome of its March 2025 Care Act assessment. There is fault in the Council’s delay and consideration of Ms X’s fluctuating needs during the March 2025 assessment. This caused distress, uncertainty, time and trouble and a loss of opportunity to have her needs properly considered sooner. The Council agreed actions to remedy the injustice caused.

The complaint

1. Ms X complained the Council failed to properly assess her care and support needs under the Care Act 2014. She said the assessment completed in March 2025 did not accurately reflect the impact of her medical conditions, pain and fatigue on her daily life. She also complained about delay, poor communication, and the Council’s handling of her requests for support. Ms X said this caused her distress and uncertainty and meant she was left without support she needed.

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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 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)
3. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
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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What I have and have not investigated

5. This investigation looks at the Council’s handling of the Care Act assessments completed in March 2025 and November 2025. Ms X complained to us in September 2025 about the March 2025 assessment and the Council’s decision that she did not have eligible needs. Ms X raised further concerns after this about NHS Continuing Healthcare (CHC), care planning, and events following the November 2025 assessment. I have considered some of this information for context only. I have not investigated these matters as part of this complaint because they relate to newer complaint issues which should be considered separately by the Council.

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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.

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What I found

Relevant guidance and legislation

Assessment

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.

What happened

10. Ms X has long-term health conditions which cause chronic pain, fatigue, mobility difficulties and fluctuating needs.
11. The Council completed a Care Act assessment with Ms X by telephone in March 2025. The assessment recorded Ms X experienced pain, fatigue, digestive issues, mobility difficulties and flare-ups related to her condition. It also recorded she was able to manage personal hygiene, shopping, preparing meals, driving and household tasks independently, although these activities caused pain and fatigue. The assessment concluded Ms X did not have eligible needs under the Care Act and no further intervention was required.
12. The Council did not send Ms X the outcome of the March 2025 assessment promptly. Ms X contacted the Council in April 2025 seeking an update but received no response. The Council did not issue the assessment outcome until July 2025, around four months after the assessment. Ms X then complained to the Council in late-July about the delay, poor communication, and the assessment outcome.
13. The Council completed a further Care Act assessment in November 2025. The assessment was completed face-to-face at Ms X’s home. The assessment recorded detailed information about the impact of Ms X’s conditions on her daily life, including significant pain, fatigue, unpredictable flare-ups, mobility difficulties and problems managing personal care, dressing, nutrition, toileting and maintaining her home environment during flare-ups.
14. The November 2025 assessment found Ms X had eligible needs under the Care Act. The Council concluded Ms X required support with personal care, dressing, nutrition, mobility, toileting, medication and domestic tasks during periods when her condition flared up.
15. The Council said in response to our enquiries, the March 2025 assessment was completed by telephone because Ms X agreed to this instead of waiting longer for a face-to-face visit. The Council said Ms X did not say she wanted carers at that stage and the assessment concluded she was managing independently. The Council accepted there was a delay in progressing and communicating the outcome of the March assessment.

Analysis and findings

16. Councils must assess whether an adult has needs for care and support and whether those needs are eligible for support under the Care Act 2014. When carrying out an assessment, councils should consider not only whether a person can complete a task, but whether they can do so safely, consistently, within a reasonable time and without significant pain, distress or risk.
17. There is no fault in the Council deciding to complete the March 2025 assessment by telephone. The evidence shows Ms X agreed to this approach. But the Council must ensure the assessment is sufficiently detailed and properly considers the impact of a person’s needs.
18. The March 2025 assessment recorded Ms X experienced significant pain, fatigue, flare-ups and mobility difficulties. It also recorded that many daily activities caused pain and exhaustion. Despite this, the assessment largely focused on the fact Ms X was able to complete tasks independently. The records do not show the Council sufficiently considered the cumulative impact of Ms X’s fluctuating condition, including whether she could carry out tasks repeatedly, safely and without significant pain or exhaustion.
19. This is significant because the November 2025 assessment identified eligible needs based on broadly the same underlying issues. The Council did not provide evidence of a clear or material change in Ms X’s circumstances between March and November 2025. The later assessment provided a fuller analysis of the impact of Ms X’s fluctuating needs and flare-ups.
20. The evidence shows, on balance, the March 2025 assessment did not adequately consider the impact of Ms X’s fluctuating needs and the effect of pain and fatigue on her ability to achieve Care Act outcomes. This is fault.
21. There is also fault in the delay following the March 2025 assessment. The Council accepted there was delay in progressing the matter and communicating the outcome to Ms X. Ms X should not have needed to chase the Council for an update several months after the assessment.

Injustice

22. The Council’s faults caused Ms X avoidable distress, frustration and uncertainty. The inadequate March 2025 assessment meant Ms X was left uncertain about whether her eligible needs should have been identified earlier. The delay in communicating the outcome also caused avoidable time and trouble in chasing the Council for updates.
23. Ms X had savings above the financial threshold for Council funding. It is not possible to conclude she would have received Council-funded care had the Council completed a proper assessment in March 2025. The injustice is limited to uncertainty and meant Ms X lost the opportunity to have her needs properly assessed and considered sooner, including whether support planning would have progressed earlier.

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Action

24. To remedy the injustice caused, within one month of our final decision, the Council agreed to:
• Apologise to Ms X for the injustice caused. 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 £250 to Ms X to recognise the distress and uncertainty caused by the Council's failure to adequately assess her fluctuating needs and the delay in communicating the outcome of the March 2025 assessment.
• Pay £150 to Ms X to recognise the avoidable time and trouble she experienced in chasing the Council for updates and pursuing the matter.
25. Within three months of our final decision, the Council agreed to:
• Review its practice for assessing and recording fluctuating needs during Care Act assessments, including how assessors consider the impact of pain, fatigue, and variability on a person’s ability to achieve Care Act outcomes.
26. The Council should provide us with evidence it has complied with the above actions.

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Decision

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

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Investigator's decision on behalf of the Ombudsman