Summary: X complains about the Council’s failure to complete the support planning process after it assessed their eligible care and support needs in 2024. X also complains about misinformation the Council provided about how any support may be funded. We find fault because the Council delayed in completing the support plan and did not set out how it could meet X’s eligible needs. The Council has agreed to apologise, make a symbolic payment and contact X.

The complaint

1. The complainant, who I will call X, complained the Council:
1. failed to put direct payments in place for them to arrange their own care;
2. changed its stance to say it would not pay a direct payment;
3. expected X to fund their own care from their Personal Independence Payment (PIP) award; and
4. refused to review their care and support needs and instead required them to be reassessed.
2. X said they arranged their care at their own expense, which caused them a significant financial detriment. X said they have at times been left without the support they need, causing risk and detriment to their wellbeing. They said they have also been caused significant distress and their health has worsened.

Back to top

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)

Back to top

How I considered this complaint

5. I considered evidence provided by X and the Council as well as relevant law, policy and guidance.
6. X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

The Ombudsman’s previous investigation

7. X is an adult with care and support needs. X complained to the Ombudsman previously and we made a decision in February 2025. As part of that investigation we considered matters up until August 2024. In summary we found the following.
• The Council was at fault for not properly considering whether it needed to complete a Care Act assessment for X after it received a referral in February 2024. The Council closed the case prematurely and signposted X to a charity despite X telling the Council the charity could not help. This caused frustration.
• The Council was responsible for unacceptable delay in completion of the assessment which did not happen until August 2024. This was six months after the initial referral. This fault caused uncertainty about whether X should have received support earlier to meet their needs.
• The Council failed to consider the need for reasonable adjustments (RA) and repeatedly contacted X by telephone despite requests for email contact only. This caused X distress.
• To remedy the injustice caused by fault the Council agreed to pay £200 in recognition of the frustration and uncertainty caused by the delayed assessment. The Council also agreed to remind relevant officers of the need to check and follow any agreed RA requests before contacting service users.
8. As we have previously investigated a complaint from X about adult social care matters, we will not consider anything which happened before August 2024. This is to avoid re-investigating the same issues already considered by us. Earlier events may be referred to in this statement for context only.

Events leading to this complaint

9. In July 2024 a social worker contacted X to arrange a home visit to complete the assessment which we found previously to be subject to delay.
10. The Council completed the assessment on 13 August 2024. This concluded that X needed some support to manage everyday tasks. The Council said it needed to seek a suitable provider to support X’s eligible needs and went on to say: “[X] used to manage a micro provider but this stopped some time ago and [X] has been without support since. [X] is overwhelmed at the thought of organising another micro provider and would prefer a commissioned service at this time”.
11. Two days after the assessment the social worker emailed X to confirm the agreed actions, one of which was to explore, “other ways we can commission a service for you to support areas of need”.
12. The social worker emailed X’s advocate in January 2025 to confirm they were leaving their role but said X’s case would remain within the team. The social worker said that X can look into micro providers and the Council will reinstate their direct payments, pending agreement for funding.
13. At the end of January 2025 X emailed the Council to chase up the allocation of the new social worker. X reiterated they had unmet support needs. X also told the Council they needed contact by email rather than telephone.
14. The newly allocated social worker emailed X on 12 February 2025 to arrange a visit to discuss their care and support needs. Around this time the social worker also emailed a copy of the August 2024 Care Act assessment to X. They asked X to look over the assessment and confirm any changes.
15. The social worker also shared a fact sheet with X which explained that, once support is planned, the Council will complete a financial assessment, and X may be required to contribute to the cost of their care and support. The sheet also explained that most state benefits are considered in the financial assessment including the PIP daily living component.
16. In March, X emailed their social worker to say they had been too unwell to read through the assessment. X asked the Council not to contact them unless for urgent reasons.
17. X’s new advocate met with X in late May 2025 to help read through the assessment and consider any suggested amendments. Following their meeting the advocate emailed X to say: “In terms of direct payments, it is expected that you use PIP to pay your micro provider directly and or through social services. The PIP care component will be taken into consideration by financial services and will be factored in when it comes to calculating your financial contribution”.
18. X responded to the advocate to say: “I am honestly quite frustrated by the response of ASC [Adult Social Care] because I already advised them I was self-funding through PIP and I didn’t actually want to go down the DP route. I did it before and was treated very poorly through the process. I would obviously want to avoid putting myself through that again…. I personally don’t want to apply for DP because of my previous negative experience”.
19. In August 2025 the Council emailed X’s advocate to advise they would close X’s case as they are not providing a “reviewable service”. The Council said it would look to re-open their case in the future if X’s situation changed.
20. It was at this time the social worker also advised: “… we are unable to provide reviews for individuals who are funding or intend to fund their own support via PIP, but I would encourage you to make a new referral if your situation should change in the future”.
21. On 14 August 2025 the Council completed a support plan which said that X would benefit from low level support with essential tasks, such as taking out rubbish, washing up and general household tasks. The support plan said: “[X] is sourcing and paying for [their] own support with [their] PIP allowance”.
22. In response to our enquiries the Council confirmed it did not complete a financial assessment for X following the Care Act assessment completed in August 2024. The Council says this was due to X’s decision to self-fund their care.
23. The Council also confirmed it did not explore the possibility of a commissioned service. It acknowledges there was a gap between completion of the assessment and reviewing the contents with X. It says this was partly due to the delay in X reading through and responding to the assessment due to their ill-health.
24. The Council says X chose to fund their support privately during this period and did not want to pursue direct payments. It therefore took no further action.

Was there fault in the Council’s actions causing injustice to X?

25. The August 2024 Care Act assessment identified eligible care and support needs and recorded that X would prefer a commissioned service because they felt overwhelmed by arranging support independently. The Council also told X it would explore options for commissioning support. However, the Council has been unable to provide evidence it subsequently explored or offered a commissioned service. Nor did it progress the support planning process in a timely manner. While around eight weeks of the delay was because of X's ill-health and reduced engagement, the remainder was because of avoidable drift by the Council.
26. As a result, the Council did not progress matters to the stage of deciding how X's eligible needs would be met, whether X qualified for Council-funded support and, if so, what contribution they would need to make following a financial assessment. On balance, I consider it possible X's decision to arrange self-funded support was influenced by the delay and lack of progress. This creates uncertainty as to whether X would otherwise have received funded support from the Council.
27. The Council is correct to say that X told their advocate in 2025 they were self-funding support through their PIP award and did not wish to pursue direct payments. However, these comments were made in the context of a discussion about direct payments and financial contributions. Declining direct payments is not the same as declining a commissioned service. The Council has already acknowledged that information provided to X about reviews and funding arrangements was unclear and has apologised for this.
28. However, the fault I have identified goes beyond the way the Council communicated with X. This is because the Council is unable to provide evidence to show it considered how X’s eligible needs, as identified in the August 2024 assessment, would be met. This includes whether a commissioned service should be offered. In the absence of this, I find the Council at fault. This fault caused X injustice because it created uncertainty about whether they would have received funded support had the Council progressed matters properly.
29. Furthermore, the Council declined to progress X's complaint to the second and final stage of its published complaints process because it said X had had not received a service for some years. However, the Council's Adult Social Care complaints policy confirms that complaints can be made not only by people who receive or have received services, but also by people affected by the Council's actions or omissions. As X's complaint concerned the Council's assessment and support planning, the Council did not have adequate grounds to refuse to progress the complaint. This fault caused injustice in the form of time and trouble.

Back to top

Action

30. Within four weeks of our final decision, the Council has agreed to:
• contact X in writing and offer an opportunity to discuss their current care and support needs and complete any outstanding support planning arising from the August 2024 assessment. If X agrees, the Council will consider the appropriate means of meeting any eligible needs, including whether commissioned support is needed and any financial assessment required to decide X's contribution towards the cost of any care.
• pay £250 and apologise to X for the uncertainty, time and trouble caused by the fault identified in this statement. 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.
31. We publish the Complaint Handling Code which sets out best practice in how councils should deal with complaints. In this case, we found the Council at fault because it wrongly rejected X’s stage two complaint for reasons which were not in accordance with its own policy. In order to prevent similar faults from happening in future, within eight weeks of our final decision the Council will consider our guidance and tell us what action(s) it will take to improve the way it deals with complaints.
32. The Council will provide us with evidence it has complied with the above actions.

Back to top

Decision

33. I find fault causing injustice. The Council has agreed to complete the actions listed in the section above to remedy injustice caused by fault.

Investigator’s decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman