Summary: We found fault with the Council for its poor communication with Mr X about reducing his care hours, reducing his care hours without assessment or suitable explanation and failure to provide his full social care provision. The Council’s fault caused Mr X to source more care hours than the Council funded, uncertainty and distress for six weeks about what provision would be put in place and six months without full social care provision. The Council has already settled the outstanding balance with Mr X’s care provider which directly addresses the reduction in his care hours. The Council has agreed to apologise to Mr X and provide payments for the distress, uncertainty and loss of service caused by the Council’s fault.

The complaint

1. Mr X complained the Council changed his care hours and completed a financial assessment, increasing his contribution from £0 to £58 per week, without telling him. Mr X said the Council declined his appeal through welfare rights and did not tell him he needed to make a new appeal. Mr X says he now owes the care provider in excess of £15,000 in unpaid fees because of this and has needed to move to a commissioned care provider rather than Direct Payments.
2. Mr X says the Council reduced his care plan from 42 hours to 21 hours over a couple of years despite his health care needs increasing. Mr X says the Council failed to keep him suitably updated about the reduction in his care provision.
3. Mr X says he contacted the Occupational Therapist following the reduction in his care package who confirmed they needed to refer him for a review, but this did not happen.
4. Mr X says the Council failed to refer him to an advocacy service despite asking for this various times.
5. Mr X also complained the Council failed to ensure a social care provider commissioned to provide seven hours of support was providing this.

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The Ombudsman’s role and powers

6. 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)
7. 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)
8. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
9. 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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What I have and have not investigated

10. I have referred to matters in 2023 within this investigation for context and comparison but have only investigated Mr X’s concerns since 2024. Our investigation solely looks at matter within the last 12 months of Mr X bringing the complaint to the Ombudsman. There is no good reason to exercise discretion to investigate Mr X’s complaint beyond this point. I have ended my investigation as of August 2025.

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How I considered this complaint

11. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
12. Mr X and the Council had an opportunity to comment on my draft decision before I made a final decision.

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What I found

Rules and regulations

Assessments, reassessments and arranging care

13. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. 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. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
14. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months.
15. Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. It should confirm the final amount of the personal budget through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person’s care and support needs.
16. There are three main ways a personal budget can be administered:

• as a managed account held by the council with support provided in line with the person’s wishes;
• as a managed account held by a third party (often called an individual service fund or ISF) with support provided in line with the person’s wishes; or
• as a direct payment.
  (Care and Support Statutory Guidance 2014)

17. 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.
18. Section 28 of the Care Act says “Having reviewed an independent personal budget, a local authority must:

• if it revises the independent personal budget, notify the adult to whom the independent personal budget relates of the revisions and provide an explanation of the effect of each revision, or
• if it does not revise the independent personal budget, notify the adult accordingly”.

What happened

Background information

19. In 2022, Mr X signed a Direct Payment agreement with the Council. This Direct Payment agreement confirmed Mr X agreed to manage his own care using the Direct Payments and that he would need to make his assessed financial contribution towards the cost of his care. The Council assessed Mr X as having a nil contribution to the cost of his care.
20. In 2023, the Council wrote to Mr X to advise it had reviewed his Direct Payments and his contribution was now £58.91. The Council provided a breakdown of its calculations. The Council sent a reminder to Mr X later in 2023 about the need to contribute towards his Direct Payments.

Matters relating to this complaint

21. In May 2024, the Council sent Mr X his annual review letter for his care contributions. The Council said it had increased his assessed contribution to £68.86 and provided a breakdown of its calculations.
22. Following Mr X’s discharge from a hospital stay in June 2024, the Council told Mr X it considered he no longer need double-handed care. The Council proposed to reduce his care hours from 42 hours per week to 29 hours per week alongside the 7 hours of social care provision.
23. In November 2024, the Council approved the reduction in Mr X’s care hours to 29 hours Direct payments and 7 hours social care provision. The Council did not include Mr X in this decision or tell him about the outcome.
24. In December 2024, Mr X’s care provider handed in notice to Mr X because of unpaid care fees. Mr X contacted the Council to source a new provider in January 2025 and asked about a referral to advocacy.
25. The Council made a request for a commissioned service for Mr X following the date his Direct Payments stopped. The Council recommended 29.75 hours per week provision alongside the 7 hours social care provision. The Council’s head of service rejected 29.75 hours until a review of Mr X’s needs could be completed. The Council’s head of service agreed to 22.75 hours expecting an updated assessment and support plan going to panel within two weeks.
26. The Council made a referral to advocacy for Mr X and completed a new assessment of his care needs. The Council noted Mr X’s concerns about the proposed reduction of his care hours to 22.75 hours each week. Mr X also expressed his wish to retain 7 hours each week of social car and 20 hours of contingency support. The Council confirmed it had put in place a commissioned provider for Mr X but the assessment confirmed no details about a decision over the number of hours.
27. At the end of January 2025, the commissioned care provider handed in notice for Mr X because it could not meet his care needs. The care provider gave 28 days’ notice.
28. In February 2025, the council referred Mr X for an Occupational Therapist assessment. Mr X advised his social care provider was not providing the full seven hours support. The Council spoke with the social care provider who confirmed it was only providing three hours support each week but said Mr X would benefit from more hours.
29. On 17 February 2025, Mr X put in a formal complaint to the Council. Mr X complained:
• His care provider cancelled his care because he owed £15,000 in underpayments.
• The Council told him the underpayments were for his care contributions but when he agreed to Direct Payments the Council told him his contribution was nil.
• When the Council told him he needed to contribute towards the cost of his care he appealed this but heard nothing back.
• The Council reduced his care package from 42 hours to 29 hours each week in June 2024 but neither he nor his care provider was told about this. Mr X said he continued to source 42 hours care from his care provider. Mr X said the Council has reduced his care hours again, now to 21 hours.
• The commissioned care provider he had moved to had not provided good quality care and had handed in its notice and he did not know what was going to happen when this provider stopped.
• His social care provider had reduced his hours to three hours each week for the last six months.
• An Occupational Therapist assessment had still not completed an assessment of him.
• A third-party care alarm provider was now saying he owed three years’ worth of charges.
30. The Council completed an Occupational Therapy assessment at the end of February 2025. The Occupational Therapist made recommendations for a ramp and a new shower chair.
31. By the end of February 2025 the Council had produced a new care and support plan for Mr X. This included 22.75 hours of commissioned care each week alongside the 7 hours of social care provision. This care and support plan included the Occupational Therapist’s assessment. The Panel approved the hours outlined in Mr X’s care and support plan.
32. The Council provided a new commissioned provider for Mr X from the day following the end of the previous commissioned care provider.
33. On 11 March 2025, the Council issued a stage one complaint response to Mr X The Council said:
• It told Mr X about the changes to his care package in June 2024 and again in January 2025.
• Mr X was responsible for managing his Direct Payments and failure to pay his assessed financial contribution was Mr X’s fault. The Council said it was Mr X’s responsibility to settle any balance owed with his previous care provider.
• It had referred Mr X to advocacy in January 2025. The Council provided contact details to Mr X so he could find out when they would allocate him an advocate.
34. Mr X sought consideration of his complaint further.
35. In March 2025, the Council finished installing the ramp in Mr X’s property and installed the new shower chair.
36. On 2 April 2025, the Council issued a final complaint response to Mr X. The Council said:
• It told Mr X he needed to contribute to the cost of his care since 2023 and payment of his contribution was his responsibility.
• It was Mr X’s responsibility to tell his chosen care provider about the reduction in his care package as he had agreed to Direct Payments. Any over-provision of care hours was therefore Mr X’s responsibility to pay for.
• It had referred Mr X for advocacy in January 2025 and followed this up in March 2025.
• It completed a visit in 2024 to reassess Mr X’s care needs and, following this, decided to reduced Mr X’s care hours. The Council said it decided to reduce Mr X’s care hours further in January 2025 which was agreed by Panel in March 2025.
• The commissioned care provider handed in notice because it could not meet Mr X’s care needs in line with Mr X’s wishes. The Council said it arranged a new commissioned care provider which it put in place.
• It had decided to preserve Mr X’s seven hours of social care provision in his care and support plan.
• The Occupational Therapist made suggestions to help Mr X including a ramp and new shower chair which it had put into place. The Council said it had since contacted Mr X who confirmed he was happy with the new shower chair.
• Mr X agreed a direct debit with the third-party care alarm provider but stopped this in 2021. The Council said this is the reason for the debt owed.
• If Mr X’s social care provider was not providing the seven hours care each week it could find an alternative provider for Mr X.
37. The Council completed a revised financial assessment for Mr X in June 2025 and outlined his care contributions. The Council detailed its calculations.
38. The Council continued to liaise with Mr X’s social care provider about increasing his hours. Because the Council could not get the social care provider to increase Mr X’s hours, it sourced a new provider in August 2025.
39. In November 2025, the Council settled the full outstanding balance Mr X owed to the care provider he had in place until January 2025.

Analysis

Direct Payments

40. When Mr X agreed to Direct Payments with the Council, he signed an agreement. This agreement confirmed he would manage his own care using the Direct Payments, including making any assessed financial contributions towards the cost of care.
41. The Council made Mr X aware that he needs to pay his client contributions towards the cost of his care in both 2023 and 2024. I do not find the Council at fault if Mr X has not paid these client contributions. Since Mr X managed his care through a Direct Payment he is responsible for repayment of any underpaid client contributions to his chosen care provider.
42. The debt Mr X owes to the care provider is not entirely from unpaid client contributions. Some of the debt is owed because Mr X continued to source 42 hours of care each week until the end of his Direct Payments. This was despite the Council reducing Mr X’s funding to 29.75 hours each week.
43. In June 2024, the Council told Mr X it “proposed” to reduce his care hours but did not confirm it had done so with him. The Council also did not update Mr X’s care and support or take any action to follow through on this proposal. When the Council did reduce Mr X’s care hours in November 2024, it did not consult Mr X about this or share the outcome with him. This was fault by the Council.
44. Since the Council did not tell Mr X about the reduction in his care hours and, therefore, his Direct Payments, he would not have known to reduce the 42 hours each week he was sourcing. The Council only made Mr X aware of the reduced hours following cessation of the Direct Payments and moving to the commissioned provider. The Council’s fault directly caused Mr X to accrue extra charges for the extra care hours he sourced.
45. The Council settled the full balance owed by Mr X to the care provider in November 2025. This balance included the charges accrued through the fault of the Council, as identified in paragraphs 42 to 44, and charges accrued through Mr X not paying his client contributions. By settling this balance, the Council has removed any injustice caused through its fault.

Change to a commissioned provider

46. Following Mr X’s chosen care provider handing in notice, Mr X asked the Council to source a commissioned provider for him. The Council arranged a new commissioned provider without a break from the Direct Payments. The Council also arranged a new commissioned care provider without a break following the original care provider confirming it could not meet Mr X’s needs as he wished.
47. The Council has managed Mr X’s transition from Direct Payments and between care providers without a break in care. The Council handled the transition between services appropriately and I do not find fault.

Care Plan reviews and reductions

48. The Ombudsman is not an appeal body, so cannot comment on the merits of judgements and decisions made by councils in the absence of fault in the process. Neither are we a court, and so cannot determine or define the law.
49. The decision about what provision is suitable for Mr X is at the discretion of the Council. However, the Care Act makes clear that councils must tell the service user and explain any reasons for the reduction in their personal budget. The ‘Care and Support Statutory guidance’ also says: “The plan must detail the needs to be met and how the needs will be met and will link back to the outcomes that the adult wishes to achieve in day-to-day life as identified in the assessment process and to the wellbeing principle in the Act”.
50. As explained in paragraphs 42 to 44, I found fault with the Council failing to include Mr X in, or tell Mr X about, the reduction to his care and support plan. I have already considered this injustice and I will not address this again here.
51. In January 2025, the Council approved a reduction to Mr X’s care hours to 22.75 hours. The Council did this despite a recommendation to maintain Mr X’s 29.75 hours and without any reassessment of Mr X’s care needs. A council should not reduce a person’s care hours without reassessment or review, especially when this also goes against the recommendations from the social worker. The Council also failed to explain to Mr X in January 2025 why it was reducing his care hours. This arbitrary reduction in Mr X’s care hours without explanation was fault.
52. When the Council decided to reduce Mr X’s care hours, it said it expected a care assessment and revised care and support plan to be completed within two weeks to go to panel. The Council did not meet this timescale by three weeks; this was fault.
53. By the end of February 2025, the Council completed a further assessment of Mr X, including an Occupational Therapist assessment. The Council produced a revised care and support plan and considered a reduction to the care hours of 22.75 hours per week was suitable. The Council maintained this decision at panel and explained the reduction in the care hours, including sharing the care and support plan with Mr X. The Council had corrected its previous fault and decided to reduce Mr X’s care hours, which it was entitled to make, in a correct manner. While Mr X may not have agreed with the reduction in his hours or removal of contingency hours, I cannot find fault with the Council for this.
54. The fault has caused an injustice to Mr X because he has experienced confusion, uncertainty, and distress about the reduction in his provision and how this would meet his needs for six weeks.

Occupational Therapy assessment

55. Mr X complained the Council delayed completion of an Occupational Therapist review.
56. The Council received a referral for an Occupational Therapist review in February 2025 following the decision to reassess Mr X in January 2025. The Council completed this Occupational Therapist assessment in February 2025 with the full support outcomes of this assessment in place by April 2025.
57. The Council acted in an appropriate and timely manner in completing the Occupational Therapist assessment, I do not find fault.

Advocacy

58. Mr X sought advocacy in January 2025. Within three days of Mr X’s request for advocacy the Council made a referral to an advocacy service. The Council acted promptly in referring Mr X for advocacy, contacted the advocacy service again in March 2025 and provided Mr X with contact information so he could also contact the advocacy service directly.
59. If a person requests advocacy a council should consider placing any reassessment on hold while it awaits appointment of an advocate. In Mr X’s circumstances, doing so would have put Mr X at a disadvantage as the Council had already reduced his care package when he made the request for an advocate. Had the Council placed a hold on Mr X’s assessments it would have delayed putting in place the Occupational Health provisions which helped support Mr X while he was already on lower care hours. I do not find fault with the Council.

Social Care provider

60. The Council has evidenced it provided funding to Mr X’s social care provider throughout 2024 and 2025. The Council met its responsibility to fund this service as outlined in Mr X’s care and support plan. I do not find fault with the Council for this.
61. Since Mr X did not tell the Council the social care provider was not providing the required hours until February 2025, the Council would not have been aware of any problems.
62. When Mr X told the Council in February 2025, it contacted the social care provider immediately and got confirmation from the provider it was providing less than half the hours Mr X was entitled to.
63. From February 2025 to August 2025, Mr X continued to receive less than half the hours he was entitled to from the social care provider. While the Council was in contact with the social care provider and ultimately made the decision to change providers, the lack of provision for these six months was fault by the Council. This fault meant Mr X missed suitable social care provision as outlined in his care and support plan during this time. This caused Mr X a loss of service during this period.

Third-party alarm provider

64. Mr X made a private direct debit arrangement with the third-party alarm provider to pay for the service this company offered. Mr X was responsible for management of this direct debit arrangement and this was not the responsibility of the Council.
65. The Council has considered this direct debit arrangement as a Disability Related Expense in each financial assessment. This means the Council has allowed funding for this as exempt from his client care contributions, reducing his contribution towards his care costs at the equivalent cost of this direct debit.
66. Any debt owed to this third-party is not caused by the actions of the Council; I do not find fault.

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Action

67. Within one month of the Ombudsman’s final decision the Council should:
• Provide an apology to Mr X for the injustice caused to him through the Council’s failure to advise about the reduction in his care hours before January 2025, reducing his care hours without assessment in January 2025 and failing to deliver the full social care provision from February 2025 until August 2025.
• Provide Mr X with a payment of £250 for the distress, uncertainty and confusion It’s fault, through reducing the care hours without assessment or explanation, caused him.
• Provide Mr X with a payment of £400 for the failure to provide his full social care provision detailed in his care and support plan for six months.
68. The Council should provide us with evidence it has complied with the above actions.

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Decision

69. There was fault leading to injustice. As the Council has agreed to my recommendations, I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman