Summary: Mrs X complained the Council wrongly asked her daughter, Miss Y, to contribute to the costs of her care and support using her benefit money. The Council was at fault for not considering Mrs X’s claimed expenses and confirming the position to her at the earliest opportunity, and for not passing on information from its financial assessment team when Mrs X asked for a re-assessment. The Council agreed to apologise for the frustration and uncertainty this caused. However, there was no fault in the Council’s financial assessment.

The complaint

1. Mrs X complained the Council wrongly asked her daughter, Miss Y, to contribute to the costs of her care and support using her benefit money. Mrs X said the benefit money is for her daughter’s living expenses, but the Council is only leaving her with £30.65 a week, which does not cover her expenses.
2. Mrs X said she asked to provide the Council with evidence of her daughter’s expenses, but the Council refused and would not consider the evidence she provided. The Council’s complaint response also did not address this.
3. The situation has caused distress and impacted the family financially.

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The Ombudsman’s role and powers

4. 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)
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. As part of the investigation, I considered the complaint and the information Mrs X provided.
7. I made written enquiries of the Council and considered its response along with relevant law and guidance.
8. Mrs X and the Council now have an opportunity to comment on my draft decision. I will consider their comments before making a final decision.

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What I found

Charging for permanent residential care

9. The Care Act 2014 (section 14 and 17) provides a legal framework for charging for care and support. It enables a council to decide whether to charge a person when it is arranging to meet their care and support needs, or a carer’s support needs. The charging rules for residential care are set out in the Care and Support (Charging and Assessment of Resources) Regulations 2014 and councils should have regard to the Care and Support Statutory Guidance.
10. When the Council arranges a care home placement, it must follow the regulations when undertaking a financial assessment to decide how much a person must pay towards the cost of their residential care.
11. In assessing what a person can afford to pay, councils must take into account their income. There are different approaches to how income is treated depending on whether a person is in a care home or receiving care and support in their own home.
12. In some circumstances, councils may choose to treat a person as if a financial assessment had been carried out. In order to do so, the council must be satisfied on the basis of evidence provided by the person that they can afford, and will continue to be able to afford, any charges due. This is known as a ‘light-touch’ financial assessment.
13. Councils must regularly reassess a person’s ability to meet the cost of any charges to take account of any changes to their resources. This is likely to be on an annual basis, but may vary according to individual circumstances. However, this should take place if there is a change in circumstance or at the request of the person.

Benefits

14. Councils may take most of the benefits people receive into account. However, they need to ensure that in addition to the minimum guaranteed income or personal expenses allowance – details of which are set out below – people retain enough of their benefits to pay for things to meet those needs not being met by the council.
15. Any income from the following benefits must be taken into account when considering what a person can afford to pay from their income towards the cost of their care and support in a care home:
• Employment and Support Allowance or the benefits this replaces such as Severe Disablement Allowance and Incapacity Benefit.
• Personal Independence Payment (Daily Living component).
• Universal Credit.

Personal expenses allowance

16. Councils must leave the person with a minimum amount of income. This is known as the Personal Expenses Allowance (PEA) and the amount is set out in regulations and updates sent via a local authority circular. Anything above this may be taken into account in determining charges.
17. The PEA is the weekly amount that people receiving local authority-arranged care and support in a care home (residents) are assumed to need as a minimum for their personal expenses. It is intended to allow residents to have money for personal use. Based on a financial assessment of their resources, individuals must be left with the full value of their PEA. It is then up to them to determine how they spend it.

What happened

18. I have summarised below some key events leading to Mrs X’s complaint. This is not intended to be a detailed account of what took place.
19. Mrs Y was born prematurely and suffered a brain haemorrhage. She has Autism Spectrum Disorder, severe learning disability, challenging behaviour and anxiety disorder.
20. Mrs Y went to a placement at the David Lewis College in 2013 as there was nowhere locally that could meet her needs. David Lewis specialises in Epilepsy and brain damage, and has all relevant services on site. Mrs Y completed college with David Lewis in 2016 and then moved on to a permanent residential placement with them. She has one to one support for activities and tasks within the home and engages in activities including a work placement and trips to the cinema, theatre, and restaurants. Mrs Y continues to come home during holiday periods.
21. The Council carried out a review of Mrs Y’s care needs in November 2024. It noted the weekly costs of Mrs Y’s residential placement were £4,148.19 and Mrs Y did not contribute to the costs. The Council then referred Mrs Y for a financial assessment.
22. Following a light touch financial assessment, the Council wrote to Mrs Y’s father in February 2025 stating that it calculated Mrs Y should contribute £128.90 a week towards the cost of her care and support.
23. Mrs X complained to the Council on 9 February 2025. She said she received a disturbing letter sent to Mrs Y care of her husband. Mrs X said her husband is not Mrs Y’s main carer and has Alzheimer's. She said the Council’s letter stated Mrs Y may now owe money for her care. However, the Council previously confirmed it would fund Mrs Y’s care for 52 weeks of the year. She said the Council had sent the letter without checking Mrs Y’s details and had not contacted the correct person. It should have contacted Mrs X. Mrs X said Mrs Y had no other finances apart from ESA, which is used to pay for clothes, personal items and recreation at David Lewis. She asked the Council to confirm it made an error and correct the matter.
24. The Council responded to Mrs X’s complaint on 11 March 2025. It said it completed a Care Act review for Mrs Y which led to a request for a financial assessment. The request included Mrs Y’s father as representative as the allocated social worker did not know he was no longer able to do so. It apologised for any distress this caused. The Council said it amended its records as soon as it became aware.
25. The Council said historically Mrs Y was in an education setting, which was not funded by adult social care. Mrs Y is now beyond education; hence adult social care now funds the placement. After previous financial assessments and discussions, the Council set the assessed charge as nil. Adult social care regularly request financial assessments as the Council does charge for care, and for residential placements. The adult is then left with a PEA from their income, currently set at £30.15. The rest of their income is used to pay towards their care.
26. The Council considered it completed Mrs Y’s financial assessment correctly for a permanent residential placement.
27. Mrs X emailed the Council on 22 March 2025. She said when Mrs Y transferred to adult services the Council confirmed there would be no charge to her. Mrs X said she was responsible for Mrs Y’s personal expenses for toiletries, clothes, and recreation (like days out). She paid a monthly invoice to David Lewis using Mrs Y’s ESA. She also said there was some general expenses she paid for Mrs Y. She said all Mrs Y’s finances are checked by the Court of Protection. This was why she had asked for a meeting to show the Council the expenses, but her request was declined. Mrs X again asked for a meeting to show her evidence.
28. Internal Council emails in April 2025 show the finance team considered that if Mrs Y’s placement is classed as residential then the financial assessment is correct. If the expenses Mrs X claimed relate to Mrs Y’s needs, then there is a question about whether they should be contracted within the agreement with David Lewis. If they are exceptional expenses, they could be included in the financial assessment as eligible need, but that is not for the financial assessment service to decide. That would be a decision for adult social care.
29. Further internal emails in April state the Council looked into the matter and did not identify any additional needs for Mrs Y. The Council considered none of the expenses Mrs X claimed are intended to meet Mrs Y’s identified needs. The Council noted it had already provided Mrs X with details of its charging policy and residential financial assessments. It could not add anything further. The Council had issued a response confirming the financial assessment is correct and no further expenses can be considered within it. The PEA is there to cover the cost of the activities Mrs X paid for.
30. The Council spoke to Mrs X on 6 May. Mrs X was unhappy the Council had not done a financial assessment. The Council advised it completed a light touch financial assessment based on information from the Department for Work and Pensions (DWP). It said Mrs Y was in residential care so it cannot add expenses. She has a personal allowance of £30.65 a week, for toiletries and personal costs. Mrs X said Mrs Y had expenses for recreational activities like going to the cinema. The home will then invoice Mrs X, and she uses Mrs Y’s ESA to pay for this. This is why she feels the financial assessment is not correct. She did not feel Mrs Y should have to miss out on activities because she cannot pay for them. The Council told Mrs X it would request a financial assessment and would speak to adult social care to understand why care is now chargeable.
31. Mrs X emailed the Council on 9 May thanking it for making clear the reason for the financial assessment at this stage. She said she appreciated all that was described. Mrs X said she had paid bills from David Lewis, including invoices she provided the Council copies of, and there was a further bill for March that she was about to pay. She said she told David Lewis that in future she would have to pay back around 80% of the ESA to the Council for Mrs Y’s care costs, and she would have to adjust Mrs Y’s expenses, meaning outings should be low cost. Mrs X said she now understood and appreciated what payment she had to make to the Council. She said the bills from February left her in a concerning financial situation so she would appreciate the charges starting from April, as she had already paid February and March invoices to David Lewis.
32. Mrs X telephoned the Council on 22 July chasing an update.
33. Mrs Y’s social worker telephoned Mrs X after the Council reallocated the case. The social worker arranged to visit Mrs X on 15 October for a review and to go through her accounts.
34. The Council wrote off the outstanding debt of £803.65 on 8 October as it may cause Mrs X financial hardship.
35. At the review, the social worker noted Mrs X was getting invoices from David Lewis which she could no longer afford. Invoices included leisure activities, restaurants, cinema trips and Amazon payments. The social worker noted David Lewis has activities on site, so these extra activities are not essential to Mrs Y’s wellbeing. They advised Mrs X she needs to stop authorising these payments.
36. The social worker noted Mrs Y continued to come home during holidays, and payments for one-to-one support during these times needed deducting from Mrs Y’s care package going forwards. The Council would also request a refund for past holidays.
37. Mrs X was grateful the Council agreed to support her with Mrs Y’s client contribution arrears, but asked for the contribution to be reviewed because she said the current information held by the finance team is incorrect. She said the Council did not complete a financial assessment for Mrs Y, she was not asked for any information, so she did not know what the Council took into account when deciding how much Mrs Y should contribute. Mrs X wanted a home visit, or someone to call her, to capture the correct information.
38. Mrs X also wanted to request disability related expenditure (DRE) for their trips to visit Mrs Y at David Lewis (petrol and hotel costs). This was because she said the decision to move Mrs Y to David Lewis was not in their control, as nowhere locally could meet her needs.
39. Mrs X emailed the social worker on 16 October. She gave dates when Mrs Y would be home in October and December. She said Mrs Y receives £323.50 every two weeks in ESA and she pays £262.20 to the Council for her care, leaving her with around 19% of her ESA. Mrs X said she needs money for visit to Mrs Y at David Lewis, including petrol for the 424-mile round trip and their hotel stay.
40. Mrs X emailed the social worker on 10 November advising Mrs Y was migrating from ESA to Universal Credit and the new payment would start in December. Mrs X did not know how much the payment would be. Mrs X also said she had put the last ESA payment from 4 November into a separate account, rather than paying the Council for Mrs Y’s client contribution, while the Ombudsman investigation was ongoing.
41. The social worker emailed the financial assessment team to request a reassessment, as they could only see a light touch assessment, and asked for this to be face to face. They also advised Mrs Y would be migrating from ESA to Universal Credit in December.
42. The finance team confirmed there was only a light touch assessment because Mrs Y received means tested benefits. Previous assessments were sent to Mrs Y’s father as per information on the account. They confirmed a new financial assessment was not needed as all current benefits are correct, so the assessment is correct. Expenses incurred in residential care are covered by the £30.65 personal allowance set by Government. Once Mrs Y migrates to Universal Credit Mrs X can send the paperwork and the Council will update the financial assessment if necessary.
43. The social worker asked the financial assessment team to contact Mrs X to explain this to her.

My investigation

44. Mrs X told me the social worker who carried out the review in January 2025 did not know Mrs Y and made a mistake. There had been a meeting a long time ago, possibly 2017, where the Council agreed Mrs Y would not have to pay anything towards the cost of her care. She said the Council had not done a financial assessment before.
45. Mrs X said David Lewis does not pay for recreation, so when the Council took Mrs Y’s benefit money it left her with nothing.
46. Mrs X said she continually asked the Council for a financial assessment, but it never considered her expenses and has not seen the receipts for Mrs Y’s spending which she sends to the Court of Protection. Mrs X gets bills from David Lewis for Mrs Y’s recreation. David Lewis buys things for Mrs Y, such as clothes, and then sends Mrs X a bill.
47. Mrs X does not accept the Council’s decision about how much Mrs Y must contribute. She said it is not correct. She started paying the Council due to its threats of debt collection. She also confirmed the Council wrote off around £800 of the arrears.
48. Mrs X said Mrs Y’s ESA has migrated to Universal Credit and she has been holding the payments since November 2025, waiting for our decision.
49. Mrs X also said Mrs Y comes home for about 10 weeks a year, and does not need the one-to-one support the Council pays David Lewis for during this time. She said the Council has not made any adjustments for this.
50. The Council told me Mrs Y lives in a residential care home, and she does not have any expenses which it could take into account for her financial assessment since she is not a homeowner. The Council confirmed the costs Mrs Y pays a contribution towards covers her accommodation, all meals, her personal care, and utilities.
51. The Council provided me with a revised purchase order to David Lewis, showing it claimed back one to one support costs for holiday periods. However, this did not affect the amount Mrs Y contributes, as the weekly placement costs even without one-to-one support still far exceed the amount Mrs Y contributes.
52. The Council said it is considering the expenses Mrs X incurs when visiting and supporting Mrs Y as part of a carers assessment.

Analysis

53. I can appreciate Mrs X’s frustration when the Council said it intended to ask Mrs Y to pay a contribution to the costs of her care, as the Council had agreed to fully fund Mrs Y’s care in the past. However, the Council must review Mrs Y’s care arrangements each year, and it has the right to charge her a contribution to the cost of her care and support. I found it did this in line with statutory guidance and was not at fault.
54. There was no full financial assessment with input from Mrs X. However, Mrs Y’s only income according is ESA. The Council can get this information from the DWP, so it could complete a reliable light touch financial assessment for Mrs Y.
55. The financial assessment the Council sent to Mrs X said Mrs Y had no expenses. Mrs X told the Council this was incorrect, and Mrs Y does have expenses. However, the Council did not address this at the time of Mrs X’s complaint. It should have contacted Mrs X for details of the expenses so it could consider them and confirm its decision. While it may be rare for councils to allow additional expenses to be included in a financial assessment for people in permanent residential care, it should have spoken to Mrs X about the expenses before dismissing her complaint. If it had done so, it could have explained the position to her than, rather than having to do so several months later. That was fault, and it will have caused Mrs X some uncertainty and frustration, but it did not ultimately alter the outcome.
56. The Council’s adult social care service later confirmed the expenses Mrs X paid to David Lewis, for things like leisure activities and eating out, are not essentials to meet Mrs Y’s needs so would not be included as eligible expenses for her financial assessment.
57. Mrs X continued to ask the Council for a meeting with the financial assessment team to explain its decision, or for a new assessment. However, Mrs X had earlier told the Council she understood why it was charging Mrs X the amount it was charging. And a meeting to show invoices for the activities at the care home was not something the financial assessment team needed to see. The invoices were seen by adult social care, who confirmed they were not essential activities to meet Mrs Y’s needs, so could not be included in her financial assessment. I therefore do not criticise the financial assessment team for not considering it was necessary to meet Mrs X or carry out a re-assessment. However, I did not see evidence the Council’s adult social care team passed this message on to Mrs X, which is fault. The financial assessment team explained the position to the adult social care team, and adult social care should have passed this information on to Mrs X. As above, this will have caused Mrs X some uncertainty and frustration, but did not affect the outcome.
58. I found the Council has now submitted a revised purchase order to David Lewis to recover the costs it paid for one-to-one support that was not needed when Mrs Y returned home for holidays. Those one-to-one support costs, while not insignificant, are only a fraction of the total weekly costs the Council pays to David Lewis for Mrs Y’s care. This amount is not significant enough to affect the amount Mrs Y must contribute.

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Agreed Action

59. Within four weeks of my final decision the Council will:
• Apologise to Mrs X for not considering her claimed expenses and confirming the position to her at the earliest opportunity, and for not passing on information from its financial assessment team when Mrs X asked for a re-assessment. The Council should acknowledge the uncertainty and frustration this caused Mrs X.
60. The Council should provide us with evidence it has complied with the above actions.

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Final Decision

61. I found the Council at fault for not considering Mrs X’s claimed expenses and confirming the position to her at the earliest opportunity, and for not passing on information from its financial assessment team when Mrs X asked for a re-assessment.

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Investigator's decision on behalf of the Ombudsman