Summary: Mrs X complained the Council failed to take action to ensure it met her assessed eligible needs after she explained she was unable to use direct payments. It also failed to complete a reassessment of needs as offered in September 2025 in response to a complaint. The Council accepts it failed to complete a reassessment after cancelling the direct payments and then delayed completing this reassessment, causing uncertainty and distress. The Council proposed a suitable remedy after accepting fault in response to the Ombudsman’s enquiries which includes a symbolic payment, a reassessment and service improvements.

The complaint

1. Mrs X complained the Council failed to take action to ensure it met her assessed eligible needs after she explained she was unable to use direct payments. It also failed to complete a reassessment of needs as offered in September 2025 in response to a complaint.
2. Mrs X says she experienced distress, depression and physical pain as a result of her needs not being met.

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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 recommend 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)

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What I have and have not investigated

5. Mrs X has raised issues concerning occupational therapy assessments in connection with a disabled facilities grant as well as the issues around her assessed eligible care needs. This investigation is against the County Council in respect of how it assessed and met her eligible social care needs. The actions of the occupational therapists are connected to the issues around the disabled facilities grant application which is determined by the District Council and so are not part of this investigation.

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How I considered this complaint

6. I considered evidence provided by Mrs X and the Council as well as relevant law, policy and guidance.
7. 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

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.

Direct payments

10. 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. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.
11. The gateway to receiving a direct payment must always be through the request from the person. Councils must not force someone to take a direct payment against their will. They should not place someone in a situation where a direct payment is the only way they can get personalised care and support.
12. Councils must tell people during the care planning stage which of their needs direct payments could meet. However, councils must consider requests for direct payments made at any time and have clear and quick procedures in place to respond to them.

Key facts

13. This section sets out the key events in this case and is not intended to be a detailed chronology.

Mrs X was in receipt of direct payments to use to meet her eligible care needs specifically meal preparation, laundry and housework. The direct payment account had been set up in 2024.

14. In July Mrs X made a formal complaint to the Council. As part of this complaint she stated that her eligible care needs were not being met. She said that although the Council had given her a personal budget to employ a personal assistant, she had been unable to do this because her daughter was not able to cope with strangers in the house. Mrs X asked why the Council had not reviewed this.
15. In August, the Council spoke with Mrs X about why she had not used the direct payments. Mrs X explained that her daughter had autism and would not accept anyone coming to the house. Mrs X explained that with adaptations she felt she could manage without anyone to help. The social worker said she would explore other options.
16. The social worker emailed Mrs X on 12 August saying that for insurance reasons it was not possible for a personal assistant to prepare meals away from Mrs X’s home and deliver them to her. She suggested that a personal assistant could visit when Mrs X's daughter was away from the home. She also suggested purchasing prepared meals and using a laundry service but said direct payments could not be used for these services as they can only be used to employ a personal assistant. When Mrs X challenged this the social worker responded saying a direct payment is not a benefit and can only be used to employ a personal assistant or agency to support with eligible needs in the home or with the person present. The social worker mentioned making referrals to meals on wheels or laundry services and Mrs X asked for a referral to be made. The Council subsequently stated that a direct payment personal budget could not be used for these services and again stated it could only be used to directly commission services such as a personal assistant.
17. Mrs X continued to correspond with the Council. A carer’s assessment was completed for Mr X and Mrs X then asked if the Council could make a referral for a parent carer assessment to be completed. The Council said it would need additional information before it could carry out a reassessment for her and that a parent carer assessment would need to be completed by Children’s Service and said she would need to contact that service herself.
18. On the same day the Council responded to her complaint saying that it considered the best way forward would be to carry out a review and that her case would be allocated so a Care Act assessment could be undertaken.
19. Mrs X contacted the Council on 29 September, 20 October and 3 November about the situation. On 6 November the Council offered an interim commissioned care service pending a review. Mrs X declined this offer.
20. A social worker arranged to complete an assessment with Mrs X in February 2026. Mrs X says that the social worker said she would need to speak to panel about the reassessment. Mrs X asked the Council to provide a copy of the completed assessment and was told it had not been uploaded to the system. The Council then advised it was transferring her case to another team that would complete an assessment of her needs and determine her eligibility. During the conversation Mrs X confirmed that she would be setting boundaries with her daughter to enable someone into the property as she was not able to cope any longer without help.
21. The Council allocated the case to an officer on 25 March 2026. However, no assessment visit was completed before the Council allocated the case to a team manager in April 2026. The Council says it was allocated to a manager due to the complexity of the issues involved. To date, no action has been taken to complete the reassessment.

Analysis

22. Mrs X had eligible care needs and was given a personal budget to enable her to employ a personal assistant to meet the needs set out in her care and support plan. The budget was to be used for housework, laundry and meal preparation. Mrs X never used any of the personal budget due to the fact her daughter could not cope with someone else coming into the house.
23. The Council acknowledges that after it ended the direct payments in August 2025 it failed to take the appropriate action. It should have carried out a reassessment of Mrs X’s needs and considered how it would meet any eligible care needs. This is fault.
24. It also accepts there has been delay as the reassessment has still not been completed. The Council told Mrs X in September 2025, as part of the response to her complaint, that a reassessment would be carried out. Since then it has reallocated her case several times, including to a team leader, but still no reassessment has been completed. This is fault.
25. This reassessment should also have explored what alternative arrangements could have been made to meet Mrs X’s eligible care needs. After the Council contacted Mrs X about her not using the personal budget, Mrs X sought permission to use the budget in other ways than employing a personal assistant or using a care agency to come into the home. The information provided by the Council very clearly stated it could not be used in that way. Even when Mrs X further queried this arguing the purpose of direct payments was to enable flexibility, the Council confirmed they could only be used to employ a personal assistant.
26. In response to my enquiries on this complaint, the Council says that direct payments can be used in a variety of ways provided the expenditure forms part of an agreed care and support plan. It accepts the information provided to Mrs X was not correct and did not fully reflect the flexibility available within the direct payment framework. This is fault. It accepts there is no policy preventing a direct payment from being used to purchase a laundry or food delivery service. It says such arrangements would not be typical but could potentially be considered following an assessment of needs.
27. I also note that Mrs X requested a carer’s assessment in respect of her role as a parent caring for a child with special needs. The Council, rather than assisting with this, told Mrs X to make her own referral to Children’s Services. While councils organise themselves into different department and services, I would not understand the average member of the public to understand the bureaucratic arrangements of a large organisation and so would expect Adult Care Services to have made a referral for Mrs X. The failure to do this is fault.
28. When Mrs X made a complaint in July 2025 the Council accepted fault and proposed a remedy which included the reassessment of her care needs. However, it then failed to carry out the promised action which meant Mrs X was put to the further time and trouble of complaining to the Ombudsman even though the Council had already accepted fault. The failure to carry out the promised action is fault and a remedy for this failure is recommended.

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Action

29. To remedy the injustice caused as a result of the fault accepted in this case, the Council will, within one month of my final decision, take the following action:
• Apologise to Mrs X for the fault identified. 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;
• Carry out a full reassessment of Mrs X’s needs without further delay;
• Make Mrs X a symbolic payment of £750 to recognise the distress and uncertainty experienced;
• Make Mrs X a payment of £250 to acknowledge her time and trouble in pursuing this matter to the Ombudsman because the Council failed to take the action identified in the September 2025 complaint response;
• Take appropriate action in line with the disabled parent/enabling parents protocol including liaison with Children’s Services;
• Review how direct payment options are explained and considered by practitioners; and
• Ensure all relevant staff have a proper understanding of the flexibility of direct payments and creative approaches to meeting eligible needs.
30. The Council should provide us with evidence it has complied with the above actions.

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Decision

31. I have completed my investigation with a finding of fault for the reasons explained in this statement. The Council has agreed to implement the actions I have recommended. These appropriately remedy any injustice caused by fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman