Summary: There was fault by the Council as it failed to properly consider whether a contribution towards household costs should be deducted during the financial assessment process for care costs. Carrying out a reassessment and backdating any overpayment to the family remedies the injustice.

The complaint

1. The complainant, who I shall call Mr X, complains his family were not told in advance there would be a financial contribution towards care costs when his disabled child (Miss C) turned 18.
2. Mr X also complains about the financial assessment for Miss C’s care costs. Mrs X says the Council has not deducted a contribution towards rent and Council Tax before calculating the financial contribution.

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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 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)
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(i), as amended)

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How I considered this complaint

5. I read the papers put in 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 organisation 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

8. Mr X says his family were not told in advance there would be a financial contribution towards care costs when a child turned 18.
9. The Council says officers told Mrs X this at a meeting in June 2023 before her child was 18. The notes of the meeting support this. Mr X says his wife disputes this. As I was not at the meeting there is no way for me to decide exactly what was said. There is evidence to support that officers told Mrs X about the financial assessment so I cannot find fault on this point.
10. Mr X also complained the Council has not deducted a contribution towards rent and Council Tax before calculating the financial contribution towards care costs.
11. In response to my enquiries the Council has said that it is willing to include a contribution of £50 per week towards household costs in the financial assessment. Mr X has confirmed that he is happy with this, although disappointed that it has taken a complaint for the Council to agree to this.
12. Mr X complains the Council has not made an allowance for his daughter’s contribution towards Council Tax. The Council has said that the family receive a 25% discount on Council Tax due to Miss C’s disability and so no allowance for Council Tax was given.
13. I have noted Mr X’s comments but I consider the Council has considered the issue of the Council Tax and made a decision not to allow a specific amount for this in the financial assessment. This is a decision the Council is entitled to make and I can find no evidence of fault.
14. Mr X also raises several concerns about the Disability Related Expenses (DRE) the Council has considered as part of the financial assessment.
15. The Care and Support Statutory Guidance 2014 (Care Act 2014) contains the guidance for DRE in Annex C. It says where disability-related benefits are taken into account, the Council should make an assessment and allow the person to keep enough benefit to pay for necessary disability-related expenditure to meet any needs which are not being met by the Council. The following additional costs of any specialist items needed to meet the person’s disability needs should be included, for example:
• specialist washing powders or laundry.
• additional costs of special dietary needs due to illness or disability (the person may be asked for permission to approach their GP in cases of doubt).
• special clothing or footwear, for example, where this needs to be specially made; or additional wear and tear to clothing and footwear caused by disability.
• additional costs of bedding, for example, because of incontinence.
• any heating costs, or metered costs of water, above the average levels for the area and housing type.
• occasioned by age, medical condition or disability.
• purchase, maintenance, and repair of disability-related equipment, including equipment or transport needed to enter or remain in work; this may include IT costs, where necessitated by the disability; reasonable hire costs of equipment may be included, if due to waiting for supply of equipment from the local council.
• other transport costs necessitated by illness or disability, including costs of transport to day centres, over and above the mobility component of DLA or PIP, if in payment and available for these costs.

It may be reasonable for a council not to allow for items where a reasonable alternative is available at lesser cost. For example, a council might adopt a policy not to allow for the private purchase cost of continence pads, where these are available from the NHS.

16. Mr X has asked for an allowance of £10 per week towards the electric used by Miss X’s specialist equipment and heating costs. The guidance in Annex C says any heating costs, or metered costs of water, above the average levels for the area and housing type should be included. The Council’s policy says the same, that it would make an allowance over the use for a typical households power costs of a similar property. The Council has said that as Mr X’s household fuel bills are below average levels they did not make an allowance for this. I find no fault on this point.
17. Mr X has asked for an allowance of £10 per week for bedding. The Council has agreed to an allowance of £4.21 per week to cover the cost of replacing the bedding 3 times per year. As the Council has considered this point and reached a view on an acceptable payment, I find no fault on this point. Mr X can supply receipts if he considers they have paid more than £4.21 per week and the Council can reconsider this if needed.
18. Mr X has asked for an allowance of £50 per week towards Miss X’s weight gain diet. The Council has said that this could be considered as a DRE if there was evidence from a medical professional and evidence of expenditure. The Council has also said that an allowance for wipes and creams can also be made if receipts are provided. The Council’s view is in line with Annex C and so I find no fault on this point. I understand Mr X’s view that as he did not know he needed receipts it is difficult for him to provide them now to get the costs backdated. So, I consider that if he can provide medical evidence for the weight gain diet, the Council should consider whether to backdate this also.
19. Mr X makes the point that if there was a list of possible DRE he would have been aware of what could be included and this may have prevented him having to complain. While every person’s DRE will be different, according to their needs I do think the Council could ensure that service users are aware of the guidance in Annex C as a minimum.
20. Mr X has also asked for an allowance for the cost of school meals. I cannot see why this is an expense specifically related to disability so I cannot reach a view on this point.

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Agreed action

21. Within one month of the decision on this complaint, the Council should:
• Reassess Miss C’s financial contribution to include the £50 per week towards household costs, back date this to her 18th birthday and refund any over payments made by the family.
• Consider any evidence provided by the family of the weight gain diet as DRE, backdate this to Miss C’s 18th birthday if included and refund any over payments made by the family.
• Produce or amend guidance to families on DRE so they are aware of possible expenses that could be included under the Care and Support Statutory Guidance 2014 (Care Act 2014) Annex C.
22. The Council should provide us with evidence it has complied with the above actions.

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Final decision

23. I have completed my investigation of this complaint. This complaint is upheld and I consider the recommendations above a satisfactory remedy to the injustice caused.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman