Summary: There is no evidence of fault by the Council. It properly assessed Ms X’s needs and offered commissioned care to meet her eligible needs while her preferred PA arrangement was explored. Ms X declined the care offered on more than one occasion.

The complaint

1. Ms X complains the Council failed to meet her assessed care and support needs.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. 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)
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 information provided by Ms X;
• considered correspondence between Ms X and the Council, including the Council’s response to the complaint;
• made enquiries of the Council and considered the response;
• considered relevant legislation;
• offered Ms X and the Council an opportunity to comment on a draft of this document, and considered the comments made.

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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.

Key facts

8. Ms X is in her thirties and lives in her own home. She has mental health issues which affect her day-to-day life.
9. Ms X has eligible care and support needs under the Care Act. Before the events complained about, she received support from a Personal Assistant (PA).
10. The Council reviewed Ms X’s care and support needs on 13 February 2025. The review was attended by Ms X, her mother and the care provider. The Council noted that Ms X had started employment, working Monday to Friday from 8am to 12pm and every fourth Saturday. It also noted that she had been using some of her support hours for dog walking, which the Council did not consider to be an eligible outcome. The reviewing officer explained this to Ms X and recorded it the case notes.
11. Following the review, the Council reduced Ms X’s support from 18 to 10 hours a week and completed a revised support plan. Ms X did not agree with the reduction and said the plan did not accurately reflect her needs.
12. The Council arranged support from a care agency. The service started on 31 March 2025.
13. A further review took place on 19 May 2025. Ms X raised concerns about the care provider, including that it was not responding to her messages. She also said she needed support with administrative tasks, including bills, benefit applications and renewing her driving licence. The reviewer recorded a discussion with Ms X about her request for support to buy non-prescribed medication. The reviewer informed Ms X that care staff could not purchase medication without a prescription. The care provider said Ms X was not fully engaging with the service and had cancelled care calls amounting to around four to six hours a week. Ms X requested a change of care provider and requested a different care provider. The first care provider ceased providing care on 23 May 2025.
14. The Council commissioned a different care provider. The support commenced on 9 June 2025. Ms X had expressed a preference for an agency experienced and confident in supporting neurodivergent people.
15. A further review took place on 25 July 2025, attended by Ms X, her partner, mother, advocate and representatives of the care provider. Ms X raised concerns about the service, including that carers sometimes arrived late. The care provider reported that Ms X continued to cancel care calls, amounting to around four to six hours a week.
16. Following the review, Ms X’s partner reported that she was experiencing stress after work when trying to complete her personal care before care staff arrived. The Council considered adjusting the visits to better fit Ms X’s routine, including one-hour visits on Tuesdays, Wednesdays and Thursdays. The Council reduced the support package from 10 to 7 hours a week and completed a revised support plan.
17. Ms X said she would prefer her support to be provided by a PA. She raised concerns about finding a PA willing to provide seven hours of support a week. The Council explained that care hours were based on assessed needs and outcomes rather than the availability of a PA. It encouraged Ms X to continue with a commissioned care provider while a PA was sourced and told her about its personal budget support service (PBSS). A referral was made to PBSS to assist with PA recruitment. Ms X declined interim commissioned care.
18. Ms X says the Council did not provide sufficient support to help her find a PA and that the allocated social worker acted in a hostile manner towards her. No PA was recruited following the referral.
19. Ms X says she did not receive support after July 2025. She says this affected her mental health and resulted in financial difficulties.
20. Between September and November 2025, the Council offered Ms X commissioned care from a care agency. Ms X declined the offer.
21. Ms X contacted the Council on 16 January 2026 to request a review of her care needs. The Council added Ms X to its allocation waiting list.
22. Ms X received support from the NHS mental health crisis team between 6 and 10 February 2026. The crisis team made a referral to the Council on 24 February 2026.
23. The Council allocated a social worker to Ms X. The social worker contacted Ms X on 3 March and 26 March 2026, when a date was arranged to reassess her needs. The social worker also referred Ms X to a specialist support service for younger people to see whether it could provide interim support.
24. From 19 April 2026, the Council says Ms X has received support from its reablement team for one hour a day, seven days a week. The Council says this support was intended to help it better understand Ms X’s current needs.
25. In May 2026, the Council offered Ms X a choice of three care providers. Ms X selected one of the providers and informed the Council of her choice.
26. The Council’s current position is that Ms X is receiving one hour of support a day, seven days a week through its reablement service and has a care package in place. A referral remains in place to support the recruitment of a PA.

The Council’s response to enquiries from this office

27. The Council acknowledges there were difficulties in the relationship between Ms X and the allocated worker, but says the worker continued to support Ms X to achieve her outcomes. It said workload pressures meant it could not initially allocate a different worker, but this was done when Ms X contacted the Council again.
28. The Council said it explained the difficulty of recruiting a PA for seven hours a week and continued to offer support through a commissioned care package. It also said its personal budget support service had concerns about Ms X’s ability at that time to manage the administration involved in employing a PA.
29. The Council said Ms X’s support plans reflected her assessed needs at the time. Following reviews, it concluded that she required less support than originally identified and reduced her support hours accordingly.

Analysis

30. It is not the Ombudsman’s role to determine the level of care and support Ms X should receive. The Ombudsman’s role is to consider whether the Council properly assessed Ms X’s needs and acted in accordance with the law and statutory guidance
31. The evidence shows the Council offered Ms X a commissioned care package on a number of occasions to meet her assessed eligible needs. Although this was not her preferred option, it would have provided support while her preference for a PA was explored. Ms X declined the commissioned care offered on more than one occasion. This is relevant when considering the period during which she says she was without support, as this was not solely due to the Council’s actions.
32. The evidence indicates that the Council completed reviews of Ms X’s care and support needs and considered the information available at the time. The reviews appear to have been carried out properly and without fault. The Ombudsman cannot question the merits (decisions) of the Council’s professional judgement about Ms X’s assessed needs or the resulting level of support.
33. The Council also made a referral to its personal budget support service to assist Ms X with recruiting a PA. While it is less clear what practical assistance was provided following that referral, the evidence does not establish fault. The Council met its duty of care by offering support to meet Ms X’s assessed eligible needs, while also taking steps to explore her preferred PA arrangement.
34. From the evidence I have seen, the Council properly assessed Ms X’s needs, offered support to meet those needs and took steps to explore her preferred PA arrangement. Ms X’s decision to decline the commissioned care offered also contributed to the period during which she says she was without support.

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Final Decision

35. There is no fault by the Council. It properly assessed Ms X’s needs and offered commissioned care to meet her eligible needs while her preferred PA arrangement was explored. Ms X declined the care offered on more than one occasion.
36. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman