Summary: The Council is at fault for the lengthy delay in completing Ms X’s financial assessment review and its limited communication during this period. This caused Ms X avoidable distress and uncertainty about her care costs. There is not enough evidence to show that the assessment decision itself was flawed or caused a financial injustice.

The complaint

1. Ms X complains the Council failed to accept any disability related expenses when reviewing her assessment, which she said took ten months to complete. She says this caused her significant distress and financial hardship.

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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 final response to the complaint;
• taken account of relevant legislation;
• offered Ms X and the Council an opportunity to comment on a draft of this document.

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What I found

Relevant legislation

5. The Care Act 2014 requires a council carrying out a financial assessment to assess a person’s financial resources and ability to contribute towards their care costs. The detailed rules for carrying out the assessment are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014.
6. The Care and Support Statutory Guidance also provides guidance on how councils should assess disability-related expenditure.

Key facts

7. Ms X has eligible care needs and receives services from the Council. She is required to contribute towards the cost of her care. The Council’s initial financial assessment, dated 29 November 2024, resulted in a contribution of approximately £75 per week.
8. On 29 November 2024, Ms X asked the Council to review the assessment because saying a number of disability-related and household expenses had not been included. She said that, due to a period of ill health, her new personal assistant had helped with the original assessment, and not all her relevant expenses had been identified.
9. On 11 December 2024, Ms X provided details of her income and expenditure with supporting evidence. This included costs for council tax, medication, therapy, dental treatment, insurance, telephone and internet services. On 30 December 2024, she provided further information, including a spreadsheet listing 56 disability- or illness-related purchases and receipts for several of the larger items.
10. During January and February 2025, the Council asked for further information about some of the expenses, including council tax, fragrance-free products and how often certain items were purchased. Ms X provided further receipts, invoices and medical evidence about her medical conditions, dietary requirements and sensitivity to chemicals and fragrances. On 4 February 2025, the Council confirmed it had received the information and said it was seeking further guidance.
11. Ms X contacted the Council for updates on 11 and 26 March and again on 2 June 2025. She provided further information about therapy, medical consultations, Motability vehicle fuel, food and shopping delivery costs, rent and council tax. On 26 March, the Council said that any reduction in her contribution would be backdated.
12. On 16 June 2025, Ms X provided a dietician’s letter about her diet and said she intended to complain to the Ombudsman. On 21 June 2025, she made a formal complaint to the Council about the delay in completing the review.
13. Ms X received a response dated 2 October 2025 in which the Council explained its reasons not to amend the financial assessment, apart from an allowance for cleaning. It said there was insufficient evidence to show that some costs were related to disability, and that lower-cost alternatives were available for some items.
14. Ms X disagrees with the decision. She says the evidence she provided shows that her health needs result in additional costs and that some household, food, personal care, transport, equipment, water and therapy expenses should have been considered. She says she not provided every receipt referred to in her list of expenditure because she understood the Council would inform her if further receipts were required, and it had not done so.
15. Ms X also raised concerns about the time taken to complete the review and the resulting financial uncertainty and care-cost debt.

Council’s response to the complaint

16. In its complaint response dated 2 October 2025, the Council apologised for the delay and lack of communication during the financial review. It explained that financial assessments are based on individual’s circumstances, the information provided, and relevant care and support information.
17. The Council said it could only consider expenses supported by receipts or invoices. It considered the evidenced expenses but decided not to make any changes to Ms X’s financial assessment.
18. In summary, the Council’s reasons were that:

• food and delivery costs should generally be met from Ms X’s existing allowance, as her personal budget included time for her PA to prepare meals;
• not enough evidence had been provided to establish that the additional costs of food, cleaning products and sunscreen were disability-related, and it considered that suitable lower-cost alternatives were available;
• some purchases, including dairy products, appeared inconsistent with the dietary sensitivities described;
• makeup was considered a personal choice and suitable lower-cost alternatives were available;
• supplements were considered healthcare costs that would normally be met through NHS prescribing or as a personal choice;
• it could not establish that the water filter, VOC mask, air purifier, vacuum filter or latex mattress topper were disability-related expenses;
• private therapy was considered something that should be prescribed through the NHS;
• the laptop was considered an everyday item rather than a disability-related expense; and
• a solid wood bed was considered a general household expense.

19. The Council concluded that there was not enough evidence to justify amending the assessment. It said Ms X could provide details of any other disability-related expenses, together with an explanation of why they were disability-related, evidence of the cost and how often the expense occurred, for further consideration. It confirmed Ms X was required to contribute £75.13 per week towards her care.

Analysis

20. The Ombudsman is not an appeal body. The role is to consider whether the Council followed the correct process when carrying out Ms X’s assessment.
21. Where a Council has considered the relevant information and followed the correct process, the Ombudsman cannot question the merits (outcome) of that decision simply because Ms X disagrees with it.
22. The main issue here is whether the Council properly considered Ms X’s request to review her financial assessment and the disability-related expenses requested.
23. The evidence I have seen shows the Council considered the information and the evidence Ms X provided and gave reasons for not allowing the individual expenses. It also explained what further information would be needed to consider any additional disability-related costs.
24. However, there was a significant delay between Ms X’s request for a review in November 2024 and the Council’s decision in October 2025. The Council has apologised for the delay and the lack of communication during this period.
25. Ms X provided substantial information, including medical evidence, receipts, invoices and explanations of how her health conditions affected her expenditure. The Council considered the expenses but did not accept them as disability-related, mainly because it considered there was insufficient evidence, cheaper available alternatives, or the costs were normally regarded as general or healthcare expenses.
26. The evidence does not show that Council failed to consider Ms X’s information or that it was required to accept the expenses simply because they were linked to her health conditions. However, some of the reasons given for rejecting particular expenses could have been more clearly linked to Ms X’s individual circumstances.
27. The main fault here is the delay. Ms X made repeated requests for updates and continued to provide information while waiting for the review to be completed. The delay caused uncertainty about her contribution and, on the information provided, avoidable distress.

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Agreed Action

28. The Council should, within four weeks of the final decision, apologise to Ms X for the delay in completing the review and the resulting distress and uncertainty.

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Final Decision

29. The Council is at fault for the lengthy delay in completing Ms X’s financial assessment review and the limited communication during this period. This caused Ms X avoidable distress and uncertainty about her care costs.
30. There is not enough evidence to show that the assessment decision itself was flawed or caused a financial injustice.
31. The above recommendation is a suitable way to settle the complaint.
32. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman