Summary: There was fault by the Council. It took too long to review Mr K’s care needs and his financial assessment when he moved to supported living. It has also failed to properly consider whether the additional cost to Mr K of social activities to meet his care needs, are disability related expenditure for the purposes of calculating how much he should pay towards his care. Mr K has not missed out on care provision, but he and his mother have been left uncertain as to whether his contribution has been properly calculated. The Council has agreed to apologise to Mr K’s mother, make a symbolic payment and complete a new financial assessment.

The complaint

1. Mrs X complains on behalf of her son, Mr K. She says the Council failed to properly consider Mr K’s Disability Related Expenditure when it assessed his finances and decided how much he should contribute to the cost of his care.
2. Mrs X says that this means that Mr K does not have enough money to pay for the activities needed to achieve the outcomes of his Care Act assessment.

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The Ombudsman’s role and powers

3. 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)
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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How I considered this complaint

5. I considered evidence provided by Mrs X and the Council as well as relevant law, policy and guidance.
6. Mrs 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

The law and guidance

7. A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in places other than care homes. A council can choose to charge for non-residential care following a person’s needs assessment. Where it decides to charge, the council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17)
8. Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment.
9. Councils can take disability-related benefit into account when calculating how much someone should pay towards the cost of their care. When doing so, a council should make an assessment to allow the person to keep enough benefit to pay for necessary disability-related expenditure (DRE) to meet any needs it is not meeting. The Care and Support Statutory Guidance sets out a list of examples of such expenditure. It says any reasonable additional costs directly related to a person's disability should be included. What counts as DRE should not be limited to what is necessary for care and support. For example, above average heating costs should be considered.

What happened

10. Mr K is disabled and he was living at home with his mother, Mrs X. The Council assessed his care and support needs and commissioned a package of care. This included social activities such as sports sessions, as well as some specific social and leisure activities. According to Mr K’s care assessment, these activities are needed to make sure that Mr K develops and maintains personal relationships, and to make sure that he makes use of the facilities in the local community. The Council arranged for a care provider to deliver these to Mr K. The package of care included the cost of the activities.
11. In October 2024, Mr K moved to supported living accommodation and the Council stopped the care provider supporting him with the sports and leisure activities because the new travel costs would be too expensive to continue with the same provider. Instead, the Council made an interim care and support plan. This said that Mr K would receive 14 hours per week of 1:1 support to take part in activities of his choice.
12. Mrs X told the Council that now Mr K had to pay the cost of social activities, whereas when he lived at home, the provider paid for this as part of his care package. Mrs X told the Council that it was difficult for Mr K to afford these. She asked the Council to consider counting the costs of the social activities as a DRE. This would reduce Mr K’s contribution and ensure that he had the money to pay for social activities to meet the aims of his care plan.
13. In February 2025, Mrs X sent the Council receipts and other details of the cost of the activities.
14. Mrs X asked the Council to take these costs into account as disability related expenditure when assessing Mr K’s contribution to his care charges. She set out that these activities are part of Mr K’s care and support plan and are directly related to his disability not just to promote his wellbeing, but also because he requires specialist and adapted equipment, support worker assistance, and accessible transport with supervision. Mrs X said that Mr K could not afford to pay for these himself.
15. Mrs X also asked the Council to consider Mr K’s spending on ready meals, eating out and takeaways as DRE. She said this was because the current care and support plan did not allow enough support to help Mr K with cooking a meal.
16. In May 2025, the Council carried out a new financial assessment. It found that he would need to contribute to the cost of his care. It allowed him DRE of additional laundry and bedding, clothing, shoes and some health-related expenses.
17. Mrs X continued to pursue the matter with the Council. In August, the Council told Mrs X that the food costs are considered general living expenses and covered by Mr K’s basic personal allowance. The Council also said that social activities are not automatically included in a financial assessment as DRE, but it recognised that these are important to Mr K’s wellbeing. It said that to determine whether it could support these costs it could review Mr K’s care and support plan. It said that it should have reviewed his needs sooner.
18. Mrs X complained to the Council. In October, the Council responded to Mrs X’s complaint. It said:
• It will carry out a new financial assessment but it would be more effective to carry out a social care reassessment beforehand.
• It has considered the request to include the extra expense of ready meals and eating out as a DRE but has decided these costs are not an extra expense incurred directly due to Mr K’s disability.
• Mr K’s current Plan says he can prepare simple meals and ready meals, and he can use the microwave to heat food. As he is in supported living accommodation there is support on hand outside of his 1:1 hours to help develop his independent living skills.
• For costs to be considered DRE they must be reasonable additional costs directly related to a person’s disability. It needs to review Mr K’s social activities to make sure these meet his needs and to decide if the expenses are directly required.
• Mrs X should wait for the new social care reassessment and the Council will contact her shortly about this. The Council will then review the DRE. In the meantime, Mrs X should gather supporting information about the costs and details of the aims of Mr K’s sporting and leisure activities.
19. The Council reviewed Mr K’s social care needs in January 2026. This noted that Mrs X was unhappy with the financial assessment because she thinks that Mr K does not have enough money for activities to meet his care needs. The Council found that the package of care was working well for Mr K. It found he had settled well into supported living accommodation and was enjoying activities with the other people living there. The assessment says that Mr K gets 1:1 support of 14 hours per week and he was using this to go to places of interest, and to do sport and leisure activities. Mr K also gets additional 1:1 and shared support for inside his flat. Again, the assessment said these activities are needed to make sure that Mr K develops and maintains personal relationships, and to make sure that he makes use of the facilities in the local community.
20. The Council completed a new financial assessment in April 2026. It allowed some DRE but again, these are related to additional laundry, clothing, and bedding costs rather than the extra cost of meals, and sports and leisure activities as requested by Mrs X.
21. In response to my investigation, the Council has explained that when Mr K moved to supported living, he was still provided 1:1 support, and this is a consistent alternative to the care provision he had while living at home. It says it has identified that Mr K needs additional social group activities, but Mrs X has not given specific details or receipts for these and so disallowed the costs.

Was there fault by the Council causing injustice to Mr K and Mrs X?

22. The Council took too long to reassess Mr K’s care needs. It made a new interim support plan after Mr K moved to his supported living accommodation and it should have completed an annual review of his needs by September 2025. Instead, the Council did not review Mr K’s care needs until January 2026.
23. Mr K’s care needs and his support did not change and so the delay did not mean that he missed out on support. However, it is likely that it caused Mrs X distress and frustration, not least because the Council had told her it needed this review before it could reconsider whether to include the cost of his social activities as DRE.
24. The Council also did not complete the new financial assessment until April 2026. Again, the Council took too long to do this causing Mrs X distress and frustration.
25. The Council says it did not allow the cost of Mr K’s social activities as DRE because Mrs X had not given them details of these.
26. The Council’s website says a person will need to show invoices and receipts as evidence for all their proposed DRE. The Council is entitled to ask for information about the DRE, but this does not necessarily have to be receipts. It only needs sufficient information to show that the person has incurred expenditure, that this is related to their disability, and needed to meet the care plan.
27. With regard to Mr K’s case, there is fault by the Council here. Mrs X had given details in February 2025. These may have been out of date, and so the Council may have needed up to date information. However, a key reason for completing the care needs and financial reviews was for the Council to consider whether to allow this DRE. I would expect the Council to have asked for the details it needed if the information it had was not sufficient.
28. I cannot say that had the Council considered this adequately, it would have allowed these costs as DRE. However, its failure to do so has left Mr K and Mrs X uncertain as to whether he has been charged too much towards the cost of his care.
29. The Council did consider Mrs X’s request that it assess Mr K’s ready meals as a DRE. It decided that the costs of ready meals or other food is not a DRE because it is an item required by the general population and it consider this regular expenditure. This is for the Council to decide. It has considered Mr K’s circumstances and has explained its decision. As long as there is no fault in how the Council has considered this, I cannot criticise its decision. If Mrs X disagrees with the decision, she can request a review under the Council’s charging policy.

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Action

30. The Council will within one month of the date of this decision:
• Apologise to Mrs X. 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.
• Review whether the cost of Mr K’s social activities are DRE, requesting more information from Mrs X if needed. It should write to Mrs X with its decision.
• If the Council decides that the DRE are allowed and this changes, Mr X’s care charge contribution, it should backdate the application of the DRE to when Mr X’s care fee contribution changed, on the basis that if properly considered the DRE would have been applicable then.
• Make a symbolic payment to Mrs X of £200 in recognition of the distress and frustration it has caused her as she tried to resolve the issue.
31. The Council should provide us with evidence it has complied with the above actions.

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Investigator's decision on behalf of the Ombudsman