Summary: There is no evidence of fault in the Council’s financial assessment of Mrs X’s contribution towards care charges. The Council helped Mrs X to claim an increase in Disability Living Allowance and backdated its financial assessment after the DWP decided her claim. The Council’s decision to divide the cost of a large purchase over a year when calculating Disability Related Expenditure was also without fault. Mrs X would have been able to claim the whole cost if she had continued with Council carers, but decided to pay for care privately instead.

The complaint

1. The complainant, Mr X, complains for his wife Mrs X. They complain the council unreasonably decided to backdate charges when it became aware the complainant received extra benefit in 2020.
2. They also complain about the Council’s decision to divide the cost of a bed over 12 months as a Disability Related Expenditure (DRE). This meant that when they decided to use private care services the Council had only allowed for half the cost of the bed. Mr and Mrs X say that they have suffered financial loss because of the Council’s actions.

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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 cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
4. 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

5. I read the papers submitted by Mr X and discussed the complaint with him.
6. I considered the Council’s comments about the complaint and any supporting documents it provided.
7. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

DLA payments

8. The Council arranged a package of care for Mrs X at home. In March 2019 a financial assessment was carried out, which noted Mrs X received low rate care and high rate mobility DLA. The Council assessed Mrs X as having to contribute £18 per week from May 2019 when the care began.
9. The Council helped Mrs X to fill in a form in June 2019 to get her DLA reviewed as her care needs had changed and the Council felt she should be receiving a higher amount.
10. On 29 November 2019 Mrs X telephoned the Council’s Financial Assessment Team and said she had received a letter about DLA.
11. The Council officer visited her in December 2019. At this visit Mrs X showed the Council officer a letter saying that she had been awarded high rate care DLA, backdated to May 2019. The Council asked for copies of Mrs X’s bank statements due to the DLA increase.
12. Mrs X sent the bank statements to the Council on 24 January 2020. These showed a backdated payment of high rate DLA was paid to Mrs X in November 2019.
13. The Council said the Care Act 2014 statutory support and guidance allows for the inclusion of backdated DLA as income and advises that the backdated awards should be treated ‘as income over the period for which they are payable’. On 5 February 2020, a financial reassessment took place to include the higher rate of DLA. Mrs X was told on 5 February 2020 that the cost of her care was £54 per week and this would be backdated to May 2019.
14. Mr X telephoned the Council in March 2020, as they had got an invoice for £900 for the backdated care charges. Mr X disputed the invoice but has now paid the backdated charges and cancelled the Council’s care services.
15. The Care Act 2014 is clear that Council’s should take most benefits into account when carrying out a financial assessment. Only the mobility component of DLA should be disregarded so I find no fault in the Council taking in account Mrs X’s care component of DLA.
16. Mr X told me on the telephone that he thinks his wife signed the forms to apply for DLA but then forgot about it.
17. The Council has said the additional benefit awarded to Mrs X was a change in her circumstances and it reviewed her financial assessment to take into account the change and increase in her income for the relevant period. The Council told me in response to my enquiries that it made the decision to backdate the financial reassessment as the DLA claim was not a new award, it was an increase to an existing DLA claim.
18. I have looked at all the information from the Council and Mr X. I can find no evidence of fault in the Council’s decision to backdate the financial assessment to include the increased DLA payments. I understand that Mrs X may have forgotten about the claim, as it took a long time to get a decision. However, when she received the lump sum of backdated benefit the Council had to decide whether to exercise discretion to backdate its assessment. Given that Mrs X was already receiving DLA and the Council had helped her to claim the increased payments I can understand the Council’s reasons for including it in its financial assessment and backdating the changes.

DRE payments

19. Mr and Mrs X say that an un-named Council officer told them that they could reclaim the cost of a bed that was purchased for Mrs X.
20. In its response to Mrs X’s official complaint, the Council has said that it has treated the bed as a DRE. It divided the cost of the bed up over the 1 year guarantee period of the bed, i.e. 52 weeks and took this into account as a DRE. So, the Council invoiced Mrs X for £41 per week for care costs rather than £54.
21. The Council has said that in its view the DRE process cannot be used to reimburse Mrs X for the cost of the bed. Instead, the DRE process should be used to reduce the financial strain on the service user for the period that they are receiving local authority care.
22. Mrs X received care from May to November 2019, so they complain that she has not received full reimbursement for the cost of the bed. They have received £295 but the cost of the bed was £600.
23. I can find no fault by the Council on this point. The Council accepted the cost of the bed as a DRE and would have continued to allow for the cost of this if Mrs X had continued to receive care. However, once Mrs X stopped receiving care via the Council there was no longer a reason for the Council to continue to allow for the cost. The Council’s decision to divide the cost of a large item over a year is a sensible approach to the cost of a large item.

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Final decision

24. I have completed my investigation of this complaint. This complaint is not upheld as I have found no evidence of fault.

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Investigator's decision on behalf of the Ombudsman