Summary: Ms X complained how the Council dealt with her daughter’s direct payments account. She says the Council told her there was a nil charge for services, and then three years later it wrote to her asking for over £5,000 for backdated arrears. We find the Council was at fault for its delay in completing audits and contacting Ms X about the outstanding arrears. This caused Ms X frustration and upset. The Council waived some of the outstanding arrears and arranged a payment plan when it responded to Ms X’s complaint. This partially remedies her injustice. The Council has also agreed to apologise to Ms X to address the remaining injustice.

The complaint

1. Ms X complained how the Council dealt with her daughter’s, Ms Y, direct payments account. She says the Council told her there was a nil charge for services, and then three years later it wrote to her asking for over £5,000 for backdated arrears. She adds the Council failed to review Ms Y’s direct payments account for several years.
2. Ms X says the matter has caused distress and upset.

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The Ombudsman’s role and powers

3. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. We may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), as amended)
5. 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

6. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
7. 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 Plan

8. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. 

Direct payments

9. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.

Financial assessment

10. 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.

What happened

11. Ms Y has eligible care and support needs. She uses direct payments to meet those needs. Ms X manages Ms Y’s direct payments account.
12. The Council completed a financial assessment for Ms Y in August 2019. It sent a letter to her and said she would have to contribute £21.58 per week towards the cost of her support services at a day centre (Service B).
13. Ms X signed a direct payments agreement in September. This said Ms Y would pay £21.58 per week into the direct payments account.
14. The Council spoke to Ms X in July 2020. It noted Ms Y had stopped temporarily stopped attending Service B because of the COVID-19 lockdown. However, she was now attending again. It told Ms X that Ms Y’s direct payments would continue as normal.
15. The Council sent a letter to Ms X in late October 2021. It said since 2019 Ms Y had paid £500 into the direct payments account, which was just over 23 weeks of personal contributions. It said it may have missed other payments into account. It asked Ms X to highlight these. It also asked for invoices so it could calculate how many weeks Ms Y had attended Service B.
16. The Council sent a letter to Ms X in mid-November 2024. It said it had completed an audit and noticed the account was in arrears (£5,236.60) because she had not paid Ms Y’s personal contributions. It advised her to set up a standing order to avoid any further arrears.
17. Ms X contacted the Council for further information. The Council sent her a letter and said it completed an audit in 2021 and sent her an outcome letter asking for further information. It also said it had asked for invoices from Service B so it could see when Ms Y had attended. When it received this information, it would complete a re-audit.
18. Ms X’s advocate complained to the Council in December. He said a Council officer told Ms X in 2021 she did not have to pay Ms Y’s personal contribution. He said the Council had failed to complete regular audits and so Ms X was not liable for the arrears.
19. The Council responded to the complaint in late January 2025. It said it did not uphold the complaint as Ms X was aware of the financial contribution in 2019, and she paid £500 in March 2020. It wrote to her in 2021 about the non-payment of the financial contribution. It accepted it had failed to carry out audits, but it said this had no bearing on the financial contribution. The total outstanding contribution was £4,830.26. This calculation included the weeks Ms Y could not attend Provider B. It said it was willing to waive 12 months of financial contribution (£1,122.16) as some services were unavailable during the COVID-19 pandemic. Therefore, the outstanding amount was £3,708.10. It told her to contact it to arrange a payment plan.

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Analysis

20. We would expect councils to complete regular audits when individuals use direct payments for their care and support needs. In the direct payments agreement from 2019, the Council said it would review the agreement at least annually. The Council failed to do this. It only completed two audits in five years. This is fault.
21. The Council completed an audit in October 2021 and asked Ms X for more information. However, it failed to chase matters up when it had not received a response. This is fault.
22. Ms X says the Council contacted her in 2021 and told her she did not have to pay Ms Y’s personal contribution. However, there is no evidence of this conversation or any correspondence stating this. I am satisfied from the evidence available Ms X knew Ms Y had to pay a weekly contribution.
23. The Council’s faults have caused Ms X some frustration and upset. While I am satisfied she was aware of Ms Y’s weekly contribution, the Council’s failure to keep proper audits and chase matters up meant the arrears escalated to a level they should not have.
24. The Council agreed to waive £1,122.16 from the arrears and it encouraged Ms X to contact it and arrange a payment plan. This was after it had already re-audited the account and reduced the arrears to reflect the time Ms Y could not attend Provider B. I consider this goes some way in Ms X’s injustice. However, I also recommend the Council apologises to Ms X for the frustration and upset caused.
25. In its response to my enquiries, the Council explained the delay in completing audits was due to staff shortages and the significant impact of the COVID-19 pandemic on service delivery. It has now implemented an extensive service improvement programme, include developing a dashboard to provide real-time monitoring and management of audits. It also has a plan to clear the outstanding audits. I welcome the steps the Council has taken, and I do not recommend any further service improvements.

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Action

26. By 6 February 2026 the Council has agreed to apologise to Ms X for her frustration and upset.
27. The Council should provide us with evidence it has complied with the above action.

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Decision

28. There was fault by the Council, which caused Ms X an injustice. The Council has agreed to my recommendation and so I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman