Summary: Ms X complained the Council did not take in to account her and her son, Mr Y’s individual circumstances when it completed a financial assessment for his care and support needs. Ms X also complained the Council did not allow expenses for a holiday and car as disability related expenses. There was no fault in the way the Council made its decisions.

The complaint

1. Ms X complained the Council did not take in to account her and her son, Mr Y’s, individual circumstances when it completed a financial assessment for his care and support needs. Ms X complains the Council did not allow expenses for a holiday and car as disability related expenses. Ms X stated this caused her distress and anxiety and limited Mr Y’s opportunities.

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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. 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(i), as amended)
3. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)

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How I considered this complaint

4. I read the documents provided by Ms X and discussed the complaint with her on the telephone.
5. I considered the documents the Council provided in response to my enquiries.
6. Ms 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

Care and support

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.

Council policy

10. The Council’s charging policy in place during the period of events complained about set out how it completed financial assessments. Its policy was in line with statutory guidance and stated how it would consider DRE. It stated it would include reasonable additional costs directly related to a person’s disability such as:
• other transport costs necessitated by illness or disability over and above the mobility component of personal independence payments; and
• costs of privately arranged respite care.
11. The policy set out how someone could challenge the Council's decision if they disagreed with the assessment. A person could ask for a reconsideration by a different officer. They could also appeal following the reconsideration if they still disagreed. The matter would then be considered by a technical officer who would provide a letter with the outcome of the appeal.

Personal Independence Payment

12. Personal independence payment (PIP) is a government benefit to help with extra living costs for people who have a long-term disability, which causes them difficulty in getting around or doing certain tasks. PIP is divided into daily living and mobility components. Within each category, people can receive standard or enhanced rates. The amount of PIP awarded is disregarded in a person’s financial assessment.

What happened

13. Mr Y has learning and physical disabilities and lives at home with his mother, Ms X. In 2020 Mr Y had a care plan that stated he needed 37.5 hours support a week. The support included helping Mr Y to access the community and social activities and to meet his basic care needs. Ms X supported Mr Y to meet his care needs at home and was recognised as his main carer.
14. In October 2020 the Council began the financial reassessment for Mr Y. Between October 2020 and April 2021 the Council was in communication with Ms X about the assessment.
15. Ms X asked the Council to consider a number of items as DRE for Mr Y, these included:
• car and fuel costs; and
• a holiday Ms X and Mr Y went on as respite for Mr Y.
16. In May 2021 the Council completed the financial assessment. It considered the income Mr Y received from benefits and his outgoings. The Council wrote to Ms X and told her the amount Mr Y needed to pay for his care. It said it had not allowed any disability related expenses. The letter provided an explanation about why each item was not allowed. It said:
• fuel costs were not directly related to Mr Y’s disability; and
• the holiday was not deemed as carer respite.
17. Ms X wrote to the Council and requested a reconsideration of the decision.
18. The Council reconsidered the assessment and wrote to Ms X in June. It allowed one item Ms X claimed as DRE. It reiterated its reason for not allowing the holiday costs. It said there was no evidence of fuel costs over and above the costs covered by the mobility element of the PIP.
19. Ms X appealed the financial decision in July. She said:
• Mr Y would not be able to go on holiday unless she took him, and being away from home provided her with a break, therefore the holiday costs should be considered a DRE; and
• the cost of the car and fuel exceeded Mr Y’s PIP mobility and was needed for Mr Y to access facilities.
20. The Council considered the information Ms X provided in August 2021. It did not change its decision on the holiday or car costs. The Council explained that Mr Y’s care and support plan did not specify he needed a holiday to meet his needs. It said as Ms X went with Mr Y as a carer, she did not receive respite from her caring responsibilities. It also said there were no costs, over and above the normal cost of the holiday that were as a result of Mr Y’s disability and so it was not a DRE.
21. The Council stated there was no evidence the car was purchased with Mr Y’s capital and so it would only consider the fuel costs. The fuel costs Ms X provided receipts were less than the mobility element of Mr Y’s PIP. It said Mr Y’s care and support plan showed he was able to access public transport with support, and he had carers to help him access the community. It said it would not allow the car and fuel costs as DRE.
22. Ms X contacted the Council and asked it to reconsider its decision on not allowing the holiday and car costs as DRE. She said the car was paid for out of her account but using Mr Y’s money and that she did receive respite from daily life as a result of the holiday.
23. The Council reviewed the information Ms X provided and responded to her in November 2021. It did not refer to the car costs. It said there was no evidence of additional cost of holiday accommodation to suit Mr Y’s needs, therefore the holiday costs were not DRE.
24. Ms X appealed the decision on holiday costs in January 2022. She said it was semantics about the words carer and respite as she felt she had received respite from the holiday.
25. The Council responded to Ms X in January 2022. It explained how it had considered the holiday costs against the care and support needs outlined in Mr Y’s plan and the reasons why it did not consider the costs to be DRE. It repeated the explanation it provided in August 2021.

My findings

26. We are not an appeals body. We consider if there is any fault in the way the Council made its decision. I cannot find fault in a decision made by the Council just because Ms X disagreed with it.
27. The Council completed a financial assessment for Mr Y in line with the guidance. It considered the benefits he received and his outgoings when it decided the charges he needed to pay for his care. It considered the items Ms X claimed as disability related expenditure (DRE) in line with the guidance and its own policy. It provided Ms X with a reason why it did not allow each item. It also gave detailed explanation about how it considered the holiday and car and fuel costs. There was no fault in the Council’s actions.
28. The Council reviewed the decision when Ms X requested it did so, and again when she appealed the decision. The Council reviewed its decision on the holiday costs an additional time, which was beyond the requirements of the policy. It allowed additional items as DRE when it reviewed its decision. This is in line with its policy and the purpose of having a review mechanism. There was no fault in the Council’s actions.

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Final decision

29. I have completed my investigation I did not find fault in the Council’s actions.

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Investigator's decision on behalf of the Ombudsman