Summary: The Council is at fault in the way it carried out Mr X’s financial assessment and calculated his disability related expenditure (DRE). The Council has agreed to apologise to Mr X’s representative, Mrs Y, and complete a review of Mr X’s care plan and a new financial assessment.

The complaint

1. Mrs Y complained about how the Council decided the weekly assessed contribution her adult son, Mr X, needed to pay towards the cost of his care. She says the assessment did not take into account the expenses Mr X has because of his individual needs. She says the amount the Council asked him to contribute means he needs to reduce his activities which will impact his well-being and will leave him in debt.

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The Ombudsman’s role and powers

2. 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)
3. 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)
4. 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

5. I considered evidence provided by Mrs Y and the Council as well as relevant law, policy and guidance.
6. Mrs Y and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I have and have not considered

7. In deciding to investigate a complaint we 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 any fault has not caused injustice to the person who complained, or any injustice is not significant enough to justify our involvement (Local Government Act 1974, section 24A(6), as amended, section 34(B))
8. As a part of her complaint Mrs Y said the bills she received from the Council contained the wrong address for Mr X. I have not investigated or made comment on this matter as, even if I were to find the Council at fault, Mrs Y received the bills and the Council changed the address so this caused no injustice to Mr X or Mrs Y.

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What I found

Relevant Law and Statutory Guidance

Assessment

9. 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. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
10. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.

Care Plans

11. 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.

Reviews

12. 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.

Charging for social care services: the power to charge

13. 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)
14. 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.
15. 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)

Disability Related Expenditure

16. 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.

The Council’s charging policy

17. The Council calculates a person’s financial contribution using its Charging Policy. This considers a person’s income, capital and appropriate expenses.
18. Disability related expenditure is considered as a necessary additional expense to meet needs that are not met by the Council that a person incurs due to disability or condition. Decisions for claims of DRE will be based on a care plan and in consultation with a Social Worker.
19. The Council sets the DRE allowances it makes in line with the guidelines of the National Association of Financial Assessment Officers.

What happened

20. The following is a summary of the events and correspondence.
21. Mr X has autism and a learning disability. He lives in a flat where he has lived since 2021. He receives one to one support through the day and shared support at night.
22. Mrs Y is Mr X’s mother. She provides support to Mr X and is also his financial appointee.
23. A financial assessment in 2022 determined that Mr X was not required to make a financial contribution to the cost of his care and support.
24. In December 2024 the Council wrote to Mr X to advise it had completed an annual financial assessment and calculated Mr X needed to pay a weekly charge of £165.85 towards the cost of his care. This was because his income had increased since the last financial assessment.
25. In March 2025 the Council wrote to Mr X to advise him it had reduced the amount he needed to contribute to £75.30 per week, rising to £78.10 from April 2025. This was because the previous calculation did not include Mr X’s disability related expenditure (DRE). It had calculated his DRE as £90.55 per week.
26. In April 2025 the Council completed an annual review of Mr X’s care and support plan and concluded the support in place was working well. Mr X’s support plan outlined a number of activities he enjoyed and said he had an active lifestyle.
27. In April 2025 Mrs Y submitted an appeal of the Council’s DRE calculation on behalf of Mr X. She said he could not afford to pay the calculated cost. Mrs Y detailed many of Mr X’s expenses including those related to food, laundry, clothing and petrol.
28. During April and May 2025 Mrs Y had email correspondence with the Financial Assessment Team to provide further information about Mr X’s expenses.
29. In May 2025 Mrs Y told the Council Mr X could afford to pay £20 a week towards the cost of his care until his next review.
30. In June 2025 the Council said it could refer Mr X to its debt team to assist Mr X to make a debt repayment plan, for his outstanding financial contribution.
31. In June 2025 Mrs Y made a complaint to the Council. In the complaint Mrs Y said:
• The Council’s first financial assessment had not included any DRE.
• The DRE form focused on physical disability and did not account for needs associated with learning disability and autism, particularly those related to social activities that were essential to mental stability and well-being.
• There had not been an individual consideration of Mr X’s needs.
• Mr X could not afford to pay his new assessed charge of £78.10 per week.
• Mr X had been referred to a debt team but had no debts.
32. Mr X’s care provider also wrote to the Council. They said Mr X needed the opportunity to go out in the community to reduce his distress and to help develop his cognitive skills. They said exercise helped to address his sensory needs and improve his motor skills and social skills. They said without these Mr X would be at risk of isolation and heightened anxieties which could lead to self-injurious behaviours.
33. The Council responded to the complaint in July 2025. It said it had completed the financial assessment correctly based on the information it had and the assessed charge would remain. The Council said Mrs Y could provide details of Mr X’s expenses if she had further evidence.
34. Mrs Y made a further complaint in July 2025.
35. The Council responded in August 2025. In its response the Council:
• acknowledged the DRE form may not fully capture the needs of individuals with a severe learning disability and autism. It said it would welcome any additional information Mrs Y was able to provide regarding Mr X’s relevant costs.
• offered Mrs Y an opportunity to meet with a member of the finance team to discuss Mr X’s financial assessment.
36. Mrs Y met with the Council and Mr X’s care provider in September 2025. Together they discussed Mr X’s activities and whether his financial contribution would limit his ability to participate in activities he needs. The finance officer said they would discuss with the Social Worker whether Mr X’s activities were necessary for his well-being and whether they could be included in his care package.
37. In November 2025 the Finance Team contacted Adult Social Care to ask if it considered outings essential to Mr X’s welfare. It responded that community activities would usually be funded by the person and not through a care package, adding that consideration of whether these costs could be incorporated into Mr X’s care package would need to be discussed with a manager.
38. In February 2026 the Council reassessed Mr X’s financial assessment and reduced his contribution to £60.62 per week. It said this amendment was made due to an error in calculating his DRE.

Findings

39. In December 2024 the Council completed a financial assessment for Mr X. In this it did not consider any DRE or Mr X’s individual circumstances. This is fault and caused distress for Mrs Y as it sent her incorrect information. The Council provided an appropriate remedy for this injustice when it completed a new financial assessment for Mr X.
40. During May and June 2025 there was some confusion between the Council and Mrs Y in their email communications. Mrs Y said Mr X could pay £20 a week towards the cost of his care package. The Council took this to mean he could pay £20 per week in debt repayment for the financial charge he had accrued between December 2024 and June 2025. The Financial Assessment Team suggested it could refer Mr X to the debt team to discuss this arrangement. I do not consider this misunderstanding to be fault.
41. Mrs Y complained the Council’s DRE form focused on physical disability. In its complaint response the Council acknowledged the form may not fully capture the needs of individuals with a learning disability and autism. The form does offer the opportunity to add any disability related expenses not detailed elsewhere. On balance, I do not consider the quality of the DRE form to constitute fault or maladministration. Although the Council has recognised the form could be improved and this is something it may wish to consider.
42. In September 2025 the Council said it needed to discuss and consider whether Mr X’s activities were necessary for his well-being and whether they could be included in his care package. Adult Social Care told the Finance Team that community activities were usually funded by the person and that consideration of whether these costs could be incorporated into Mr X’s care package would need to be discussed with a manager. There is no evidence this matter was discussed with a manager or that any further discussions took place. This is fault and caused uncertainty to Mr X as to whether his care package was appropriate to meet his needs.
43. The review of the Support Plan completed in April 2025 said Mr X enjoyed a number of social activities and led a busy and active lifestyle. It said his needs were met through his one to one support. There is no evidence to show the review considered whether Mr X needed funding for any activities within his support plan to meet his specific needs. This is fault and caused uncertainty to Mr X and Mrs Y.
44. In the DRE calculation completed in February 2026 the Council adhered to its policy in the items it included. However, Annexe C of the Care and Support Statutory Guidance says councils should consider any reasonable additional costs related to a person’s disability. I have not seen any evidence to show how the Council considered Mrs Y’s request for disability related expenditure to meet the cost of his activities which Mrs Y considers necessary to meet his needs. This is fault and added to Mrs Y’s frustration and uncertainty.
45. It is for the Council, not the Ombudsman, to decide if any allowance for Mr X’s activities should be included within his support plan or as DRE. As I have found fault in the way the Council assessed Mr X’s social care needs and how it calculated his disability related expenditure, I have made recommendations for the Council to reassess these.

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Agreed Action

46. Within one month of this decision the Council has agreed to:
• Apologise to Mrs Y for the frustration and uncertainty caused by the:
1. the failure to consider whether Mr X’s activities were necessary for his well-being and, if so, how these needs could be met.
2. the failure to consider whether Mr X had any reasonable costs related to his activities as a part of his disability related expenditure.

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.

47. Within three months of this decision the Council has agreed to:
• complete a reassessment of Mr X’s care and support needs and a review of his support plan. This should include consideration of any eligible need for social activity and exercise and how these needs should be met.
• complete a reassessment of Mr X’s DRE, ensuring the assessment is based on Mr X’s updated care plan and in consultation with a social worker. Any changes to Mr X’s DRE should be backdated to December 2024.
48. The Council should provide us with evidence it has complied with the above actions.

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Decision

49. I find fault causing injustice which the Council has agreed to remedy.

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Investigator's decision on behalf of the Ombudsman