Summary: Mrs X says that the Council has failed to take all her Disability Related Expenditure into account, as part of her financial assessment. Although this was upsetting for Mrs X, the Ombudsman has found no fault by the Council.

The complaint

1. Mrs X complains that the Council has increased her contribution towards her care. She also complains that the Council has failed to consider the following expenses as disability related expenses (DRE):

• Internet
• Specialist soap and shampoo.

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The Ombudsman’s role and powers

2. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. I have considered the information provided by Mrs X and discussed the complaint with her. I made enquiries of the Council and considered the information it provided.
5. I provided Mrs X and the Council with a copy of my draft decision and invited their comments. I considered the comments I received.

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What I found

6. Mrs X has multiple physical and mental health issues and 27 diagnosed illnesses as stated in her support plan.
7. Mrs X complains about the contribution she had to make towards her care and support services. She says the Council has failed to take into account specific expenditure required to meet her needs.
8. Specifically, Mrs X complains that the Council has failed to consider the following as disability related expenses:

• Internet
• Specialist soap and shampoo

9. Councils must assess a person’s finances to decide what contribution he or she should make to a personal budget for care. Where disability related benefits are taken into account as income a council should make an assessment and allow the person to keep enough benefit to pay for the necessary disability related expenditure (DRE) that they are incurring to meet any care needs that are not being met by the Council. This means that if a person’s DRE increases, the contribution they pay towards their care package decreases.
10. A DRE is defined by the Department of Health as for “items where the user has little or no choice other than to incur the expenditure in order to maintain independence or quality of life”.
11. The Guidance says DRE should be considered when:

• The extra cost is needed to meet a person’s specific needs due to a medical condition or disability, as identified in the Council’s care and support assessment;
• The cost is reasonable and can be verified; and
• It is not reasonable for lower cost or free alternative item or service to be used. If a lower cost alternative could have been used the expense considered will be capped at the lower cost of the item.

What happened in this case

12. In March 2017 the Council completed an assessment for Mrs X. Mrs X was living with her husband at the time and the ‘couple assessment’ came out as £0.00. Mrs X’s circumstances changed and in March 2019 the Council re-assessed Mrs X as a single person. The financial assessment recorded her benefits as income and detailed the expenses she incurs. Mrs X was assessed as being able to contribute £5.60 per week towards her care with effect from May 2019
13. Mrs X complained to the Council about the charge. The Council reviewed the financial assessment and:

• removed the internet cost of £6.47 as DRE;
• reduced the excess clothing to the maximum allowed in accordance with the National Association of Financial Assessment Officer (NAFAO) guidance to £11.25;
• included the “Sit and Shop” walking aid which had not been previously included.

Mrs X was assessed as being able to contribute £14.58 towards her care with effect from May 2019

14. Mrs X remained dissatisfied and appealed the Council’s decision. She said that access to the internet was life saving to her as she was unable to go to the shops to check food labels. The appeal panel considered Mrs X’s case on 30 May 2019 and upheld the decision that the internet was not a DRE. The panel also removed soap and shampoo as a DRE because it said Mrs X’s care plan stated that she received these item on prescription. As a result, Mrs X’s financial contribution was increased to £21.51.

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Analysis

15. It is not for the Ombudsman to say whether the Council should or should not include items as DRE or at what amount. Rather, he looks at whether there is fault by the Council in how it reached its decision.
16. I understand Mrs X’s surprise and concerns that her contribution towards her care has increased. However, the Council has carried out a financial assessment in each occasion that complies with law and guidance. The Council was entitled to recalculate Mrs X’s contribution in line with increases in her benefits, in this case she was assessed as a single person and received full Employment Support Allowance. The increase in benefit would mean that Mrs X’s contribution would also increase, because her income had gone up.
17. The Council has some discretion about what it considers to be DRE. The Ombudsman would generally expect the Council to consider using its discretion to disregard expenditure, where the person has provided clear evidence that it has a direct link to their disability. Mrs X told the Council that the internet is life saving to her as she is unable to get out and about to the shops to check food labels. The Council has considered Mrs X’s comments and decided that the internet was an everyday expense and should not be included as DRE. Mrs X’s support plan indicated that she is prescribed specialist creams and shampoo and therefore the Council decided that the NHS should cover these costs.
18. The Council has explained to Mrs X the DRE it has accepted and those which it did not. The Council considered these in accordance with guidance and its policy and therefore, I find no fault in the way it reached its decision.

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Final decision

19. I have completed my investigation on this basis, finding no fault by the Council.

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Investigator's decision on behalf of the Ombudsman