Summary: Ms Y complained about the Council’s financial assessment into Mr X’s care costs. She says that this has not been completed correctly and this has impacted Mr X by reducing his income so he cannot support his wife. We found the Council at fault which caused Mr X injustice. It should apologise, make payment to Mr X and reassess Mr X’s financial contributions.

The complaint

1. Ms Y complains about the Council’s financial assessment into Mr X’s care costs. She says that it has not completed this correctly. In summary her main areas of dispute are that:
• The Council has not disregarded the Industrial Disablement Benefit (IDB) that Mr X receives.
• The Council should not have used the higher rate of disability related expenditure because it is for night-time care, something which the Council does not provide.
• The Council has failed to consider that Mr X should have an income to look after his wife, and the Council is considering Mrs X’s savings in its calculations.
2. Ms Y says that this has impacted Mr X by causing him worry and distress in feeling that he is not able to support his wife.

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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. When 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. 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 Y and the Council as well as relevant law, policy and guidance. Ms Y and the Council had an opportunity to comment on the decision before it became final.
7. I have also considered the relevant statutory guidance, as set out below. Also, I have considered the Ombudsman’s published guidance on remedies.

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What I found

What should have happened

8. 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)
9. 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. Councils have no power to assess couples according to their joint financial resources. A council must treat each person individually. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.
10. People receiving care and support other than in a care home need to keep a certain level of income to cover their living costs. Councils’ financial assessments can take a person’s income and capital into consideration, but not the value of their home. After charging, a person’s income must not reduce below a weekly amount known as the minimum income guarantee (MIG). This is set by national government and reviewed each year. A council can allow people to keep more than the MIG. (Care Act 2014)
11. 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. For example, above average heating costs should be considered.

What happened

12. Ms Y explains that Mr X started to receive the higher rate of disability living allowance (DLA) because he needed night-time care support. Previously he had received the middle rate. Ms Y says that because of these changing needs, a new assessment was made into his care costs by the Council.
13. Ms Y says the Council’s new assessment into his DRE has not considered Mr X’s night-time care costs.
14. The Council says the regulations are silent on whether the Council should only consider the higher level of DLA if the person care assessment identifies a night care need. It says its approach is therefore to take account of the higher rate for all people.
15. Ms Y also raised concerns about the Council taking Mr X’s IDB as income as part of his financial assessment. She says that it should be disregarded from the assessment so Mr X can use it on disability related expenditure in the way the benefit is intended.
16. The Council says that IDB is considered an income related benefit and it has therefore considered it as part of the financial assessment.
17. As part of the complaint following the financial assessment completed in 2025, Ms Y also raised concerns the Council failed to consider that Mr X was supporting his wife (Mrs X) through his income. The Council say that it has reviewed Mrs X’s finances and considered her income separately to Mr X.

Industrial Disablement Benefit

18. As part of the Care Act 2014, the Government has provided statutory guidance on care and support. Under Annex C of this guidance, the only reference to IDB is in the context of a care home. As Mr X is not in a care home but receiving care from home, this cannot be considered in this context.
19. I have checked the Department of Works and Pensions’ guidance on IDB. It states the amount a person receives from IDB can affect how much they or their partner can receive from other benefits.
20. Also, the Government’s guidance on IDB states that ‘all Industrial Injuries Disablement Benefits, except Industrial Death Benefit, are tax free. They are payable in addition to other incapacity and disability benefits but considered against income-related benefits’.
21. There is no guidance on what the IDB payment should be used for or spent on. The Council has also completed a DRE to consider Mr X’s disability related expenditure which it has used in its calculation. Overall, I cannot find fault with the way the Council considered IDB as part of Mr X’s financial assessment, as there is no guidance or legislation to state that it must be disregarded.

Night-time care costs

22. I have reviewed the DRE completed for Mr X and it does not include expenses that Mr X incurs for his night-time care costs. The Council has confirmed that it does not provide night-time care at home for Mr X.
23. Under the statutory guidance, in Annex C, section 40 states that: ‘In assessing disability-related expenditure, local authorities should include the following. However, it should also be noted that this list is not intended to be exhaustive, and any reasonable additional costs directly related to a person’s disability should be included:

1. (a) payment for any community alarm system
2. (b) costs of any privately arranged care services required, including respite care
3. (c) costs of any specialist items needed to meet the person’s disability needs, for example:
1. (i) Day or night care which is not being arranged by the local authority

24. The Council’s own policy on charging states under section 3.23 that ‘the Care Act is silent on whether councils should take account the highest rate of disability allowance into account, even though some of these higher rates are explicitly paid to reflect the provision of care in both the day and night. The council will, therefore, take the higher rates into account’.
25. Although the policy states that it can consider the higher rate of DLA, the guidance also makes it clear the Council should be considering the costs incurred in providing night-time care (if this need is assessed) in the DRE. The Council says that it has not done this because no evidence of costs was provided in the application or the appeal for the DRE.
26. However, Ms Y has repeatedly through her complaint raised the issue regarding the higher rate of DLA. I consider the Council should have investigated this and requested evidence of the night-time care costs, to ensure that the financial assessment was completed fairly.
27. I therefore consider the Council should complete a reassessment into Mr X’s charges and consider his night-time care costs in his DRE assessment. It should provide any reasons for its decision to Mr X and allow him to appeal this decision if required.
28. I consider the failure to consider these costs has impacted Mr X by causing him distress in his belief the Council were not treating him fairly. I have considered this impact in the overall award below and I also find the Council should apologise to Mr X.

Mrs X’s financial assessment

29. In Annex C under section 5 it states that ‘Only the income of the cared-for person can be taken into account in the financial assessment of what they can afford to pay for their care and support. Where this person receives income as one of a couple, the starting presumption is that the cared-for person has an equal share of the income. A local authority should also consider the implications for the cared-for person’s partner.’
30. I have asked the Council for Mrs X’s financial assessment, or consideration of how Mr X’s income can support his wife and the Council has been unable to provide this. The Council has mentioned Mrs X’s savings, however this is not income. I consider the failure from the Council to evidence how it has considered Mrs X’s finances to be fault by it.
31. I therefore find the Council should complete an assessment into Mrs X’s and Mr X’s income and provide a detailed reasoning for how it has considered the implications towards Mrs X and her income. It should allow Mr X to appeal if applicable any following decision made.
32. I have also considered the impact that this issue would have had on Mr X. Ms Y has explained that by feeling that he is unable to support his wife has been extremely distressing for Mr X. I recognise the uncertainty that this situation would have caused Mr X and that this would have been upsetting for him. I have considered this avoidable distress in my award below.

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Action

33. Within four weeks of the final decision, the Council has agreed to:
1. Provide an apology to Mr X for the avoidable distress this issue has caused him.
2. Pay Mr X £250 for the impact of the distress caused by the fault experienced in the consideration of the financial assessments.
3. Complete a reassessment of Mr X’s financial contribution to consider his night-time care costs.
4. Complete a reassessment of Mr and Mrs X’s income to consider the impact of Mrs X, considering the implications for the cared-for person’s partner.
5. Provide detailed reasoning for both reassessments completed and allow Mr X to appeal any resulting decisions made.
34. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings.
35. The Council should provide us with evidence it has complied with the above actions.

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Decision

36. I find fault causing injustice. The Council has agreed to apologise, make payment and complete assessment to remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman