Summary: Ms X complained the Council took more than 11 months to assess her needs for adult social care support. We find the Council at fault for part of the delay which caused distress and uncertainty. The Council agreed to apologise and make a symbolic payment to remedy the injustice.

The complaint

1. Ms X complains the Council took more than 11 months to allocate a social worker to assess her need for care and support. She said the Council’s delays caused stress, depression and missed direct payments for care provided by a family member whom I shall refer to as Y.
2. She would like the Council to provide backdated direct payments.

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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. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
5. 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)
6. 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.
7. 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

8. I have investigated from May 2024 when Ms X first requested support until June 2025 when the Council arranged support.
9. Ms X complained to us in October 2025. Matters before October 2024 happened more than 12 months before she complained to us. Those matters are therefore late.
10. There is evidence of a misunderstanding about the difference between a Care Act Assessment and a Carer’s Assessment, and Ms X regularly contacted the Council during the whole period. I have decided these are good reasons to exercise my discretion to investigate the matters that are late.

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How I considered this complaint

11. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
12. 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

Law and guidance

Care Act Assessment

13. 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.
14. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs.

Carer’s Assessment

15. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a Carer’s Assessment. A Carer’s Assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.

Refusal of assessment

16. An adult with possible care and support needs or a carer may choose to refuse an assessment. In these circumstances councils do not have to carry out an assessment.

Care and Support Plan

17. 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.  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.
18. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs.
19. After considering the suitability of the person requesting direct payments against the conditions in the Care Act 2014, the council must decide whether to provide a direct payment. In all cases, the council should consider the request as quickly as possible.

What happened

20. This is a summary of key events. It is not a complete chronology of everything that happened.
21. Ms X contacted the Council in May 2024. She requested adult social care support. She said she needed a social worker. This type of contact is called a self-referral.
22. Ms X chased the Council for a reply in June.
23. In July she reported a deterioration in her health. She said managing her personal care had got harder. She said she was increasingly reliant on her family member Y.
24. Later in July the Council had an initial conversation with Ms X about her care needs. It recorded she had clearly defined care needs and received assistance from Y.
25. The Council went on to record that Ms X said she had good days and bad days. It recorded, on that basis Ms X did not believe a timetabled package of care would suit her requirements. It recorded she requested a Carer’s Assessment for Y.
26. In early August the Council decided to refer Y for a Carer’s Assessment. Y was put in a queue to be allocated a case worker.
27. Ms X chased the Council for updates in August and September.
28. In mid-September the Council had a telephone conversation with Ms X. The Council recorded it explained that Y was on the waiting list for a Carer’s Assessment. They would be contacted by a case worker once allocated. It recorded Ms X was happy and said she got anxious if she did not get an update.
29. In mid-October Ms X telephoned the Council. She expressed her dissatisfaction. She said she had made a referral in May and that no one had come back to her.
30. Later in October a Council officer from the waiting list team telephoned Ms X. The Council recorded Ms X confirmed she did not want formal care and was happy with the support she got from Y. It recorded Ms X said she wanted her current level of support from Y to continue. The Council agreed to chase the Carer’s Assessment for Y.
31. In late October another Council officer telephoned Ms X. The Council recorded Ms X said Y did not need a Carer’s Assessment. It recorded Ms X said she was the one that was sick and had asked for the assessment for herself in May. The officer told Ms X she would have a discussion with her manager.
32. At the end of October the Council recorded a relevant manager considered the records about Ms X. The manager identified miscommunication. The Council recorded it had established Ms X did want a Care Act Assessment and Y did not want a Carer’s Assessment. The Council therefore added Ms X to the waiting list for a Care Act Assessment. It removed Y from the waiting list for a Carer’s Assessment. It considered the information it had about the urgency of Ms X’s needs. It also backdated Ms X’s request to May so as not to disadvantage her.
33. In mid-January 2025 Ms X contacted the Council to chase her Care Act Assessment. She said her needs had increased. This was because her health had worsened. The support she got from her family had reduced.
34. The Council allocated a social worker to Ms X’s case in late March. The social worker completed a Care Act Assessment with Ms X in April. The Council then finalised a Care and Support Plan for Ms X in May. It assessed Ms X as being entitled to 11 hours of care.
35. The Council did a financial assessment and arranged to fund Ms X’s care via direct payments that started in mid-June.
36. Ms X made a formal complaint to the Council in September.
37. The Council responded to Ms X’s complaint later in September. It partially upheld her complaint about the time it took to carry out a Care Act Assessment. It apologised.
38. Ms X complained to us in October.

Analysis and findings

The period between May 2024 and October 2024

39. This was the period between Ms X’s self-referral and the Council establishing that Ms X wanted a Care Act Assessment for herself, not a Carer’s Assessment for Y.
40. In a conversation with me, Ms X said she did not ask for a Carer’s Assessment for Y, nor say she did not want a Care Act Assessment for herself, at any time.
41. The Council’s records contradict Ms X’s account.
42. I have decided the available evidence shows, on the balance of probabilities, Ms X said she wanted a Carer’s Assessment for Y, not a Care Act Assessment for herself, during this period. This is because I have decided it is more likely than not that the Council’s records are accurate.
43. For this reason I find no fault with the Council’s decision not to allocate a social worker to complete a Care Act Assessment for Ms X during this period.

The period between October 2024 and June 2025

44. This was the period in which the Council added Ms X to the waiting list for a Care Act Assessment, allocated a social worker, completed the assessment, finalised her Care and Support Plan and arranged the necessary care via direct payments.
45. I have considered whether the Council did so in a suitable and reasonable timescale considering the urgency of Ms X’s needs and any variation in those needs.
46. The records show the Council considered the urgency of Ms X’s care needs when it first established she wanted a Care Act Assessment for herself at the end of October 2024. The Council noted Ms X was supported by Y at that point and decided there was not significant risk. It therefore decided to apply a relatively low priority that had a lengthy wait time. It recorded the priority rating could be increased at any point with new incoming information.
47. I find no fault in the way the Council organisation made its decision at the end of October. This is because it had regard to the relevant information when it considered the urgency of Ms X’s needs.
48. The Council then took a further five months to allocate a social worker to start the assessment process. It did this at the end of March.
49. I find the Council did not allocate a social worker in a suitable and reasonable timescale.
50. This is because Ms X reported her care needs had increased at the beginning of January 2025. It is also because the Council had backdated her request for an assessment to May 2024. This meant the effective timescale between Ms X’s request and the allocation of a social worker was ten months.
51. I acknowledge the Council said it has a high demand for assessments. However, I have decided the factors above mean the five month timescale, on balance, was not suitable and reasonable in this case. This was fault
52. The fault caused significant injustice to Ms X in the form of distress and uncertainty. I recommend the Council apologise to Ms X and make a symbolic payment to remedy the injustice.
53. I have decided I cannot recommend backdated direct payments. This is because I cannot say, even on the balance of probabilities, what care Ms X would have been assessed as needing if the Council had allocated a social worker sooner.
54. I have considered the Council’s actions after it allocated a social worker at the end of March. The Council completed Ms X’s Care Act Assessment in April, finalised a care and support plan in May and arranged the necessary care via direct payments in June. I find the Council completed these steps in a reasonable timescale. I therefore find no fault beyond the end of March.

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Action

55. Within four weeks of the date of my final decision the Council will:
1. Apologise to Ms X for the delay in allocating a social worker to assess her care needs. 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.
2. Make a symbolic payment of £150 to acknowledge the injustice caused by the delay.
56. The Council should provide us with evidence it has complied with the above actions.

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Decision

57. I find the Council at fault for some delay in completing a Care Act Assessment causing injustice of distress and uncertainty. The Council has agreed actions to remedy the injustice. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman