Summary: We will not investigate this complaint about how the Council assessed Miss X’s contribution to her care costs. It is unlikely we would find fault with how the Council had made its decision or that an investigation would achieve a different outcome. Miss X’s mother, Mrs Y, can also ask the Council for an appeal through its financial assessment policy.

The complaint

1. Mrs Y complained, on behalf of her daughter, Miss X, about how the Council decided what Miss X should contribute towards the costs of her care in 2025. Mrs Y says the Council:
• wrongly decided it should not make an allowance for some of the extra costs Mrs Y says Miss X has to pay because of her disability;
• communicated with her poorly; and
• sent invoices directly to Miss X which it should have sent to Mrs Y instead.
2. As a result, she says the Miss X is having to pay too much towards the costs of her care and that they were both caused avoidable distress. She wants the Council to re-do the financial assessment and arrange a meeting with her and Miss X as part of this.

Back to top

The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• any fault has not caused injustice to the person who complained, or
• any injustice is not significant enough to justify our involvement, or
• further investigation would not lead to a different outcome, or
• it would be reasonable for the person to ask for a council review or appeal.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

4. 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)
5. We may investigate a complaint on behalf of someone who cannot authorise someone to act for them. The complaint may be made by:

• their personal representative (if they have one), or
• someone we consider to be suitable.

(Local Government Act 1974, section 26A(2), as amended)

Back to top

How I considered this complaint

6. I considered information provided by the complainant.
7. I considered the Ombudsman’s Assessment Code and the Council’s Adult Social Care Charging Policy.

Back to top

My assessment

8. Mrs Y is the legal representative for her daughter, Miss X, and I am satisfied she is a suitable person to complain on behalf of Miss X.
9. In late 2024 Mrs Y asked the Council to review how much Miss X should contribute towards her social care costs.
10. The Council carried out a financial reassessment in early 2025 in which it allowed some of the costs Mrs Y had claimed, and asked for more evidence about some of the other costs.
11. Mrs Y asked the Council for a new financial assessment. The Council offered to treat this as a request for an appeal, but Mrs Y said she did not want to appeal. Instead, she provided more evidence to the Council and then made a complaint.
12. The Council considered the additional evidence Mrs Y provided and made a new decision about Miss X’s contribution. Around the same time, it also responded to Mrs Y’s complaint.
13. Based on the extra evidence from Mrs Y, the Council allowed some more of the costs she had asked it to, but it refused to allow some of the other costs. In its response to her complaint the Council explained why it had decided not to allow those costs. It apologised for not calling Mrs Y when it had agreed to and confirmed that it was no sending invoices to Mrs Y instead of Miss X.
14. It is not our role to decide which extra costs the Council should and should not allow; that is the Council’s responsibility. Our role is to assess whether the Council made its decision properly. We cannot question a decision the Council has made if it followed the right steps and considered relevant evidence.
15. It is unlikely we would find fault with how the Council decided which costs to allow and which not to. The Council clearly considered the evidence and information Mrs Y provided, and has clearly explained its decisions. There is, therefore, insufficient evidence of fault to justify further investigation.
16. Under the Council’s Adult Social Care Charing Policy, Mrs Y has the right to ask the Council for a review of its decision. Now that the Council has considered all the information Mrs Y has provided, it would be reasonable for her to ask the Council for a review, if she still disagrees with its decision.
17. The Council has apologised to Mrs Y for not calling her back when it said it would. That apology is a suitable remedy for the injustice caused by the Council’s poor communication; it is unlikely an investigation by the Ombudsman would achieve a different outcome.
18. There is also no evidence the Council continued to send invoices for Miss X’s contribution directly to her after Mrs Y asked it not to, or that this caused significant injustice to either Miss X or Mrs Y.

Back to top

Final decision

We will not investigate Mrs Y’s complaint because it is unlikely we would find fault with how the Council had made its decision and it is reasonable for her to appeal if she disagrees with it.

Back to top

Investigator's decision on behalf of the Ombudsman