Summary: There was fault by the Council which failed to carry out a timely review of the late Mrs X’s care and support. This caused Mr X avoidable uncertainty about the outcome. The Council will apologise for causing this uncertainty.

The complaint

1. Mr X complained about his late mother Mrs X’s care and support and financial assessment. He said the Council:
• Failed to change her care package to include shopping
• Failed to send him notification of the outcome of a financial assessment and charge.
2. Mr X also complained about call timings by a previous care agency.
3. Mr X said the fault caused avoidable distress and a financial loss.

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The Ombudsman’s role and powers

4. We may investigate a complaint on behalf of someone who has died or 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) and 34C(2), as amended)

5. Mr X had a power of attorney for Mrs X. I am satisfied he is a suitable person to complain about her care.
6. 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.)
7. 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)
8. 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

9. I investigated the complaints in paragraph one. I did not investigate the complaint in paragraph two because it is late and there is no good reason for Mr X’s delay.

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How I considered this complaint

10. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
11. Mr X 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 found

Relevant law and guidance

12. Data protection principles say personal data must only be collected for specific purposes and not processed further in an incompatible manner.
13. If a council decides a person is eligible for care, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether and to what extent the needs meet the eligibility criteria and specifies the needs the council is going to meet and how this will be done. The council should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
14. Statutory Guidance explains a council should review a care and support plan at least every year, on request or in response to a change in circumstances. The purpose of a review is to see how a care and support plan has been working and to decide if any revisions need to be made to it. The council should act promptly after receiving a request for a review. (Care and Support Statutory Guidance, Paragraphs 13.19-21 and 13.32)
15. The Care Act spells out the duty to meet an adult’s eligible unmet needs (needs which meet the eligibility criteria that are not being met by a different source). (Care Act 2014, section 18)
16. The law allows councils to charge for care and support they arrange. Detailed regulations and guidance set out the financial assessment and charging process councils need to follow. Disability Related Expenditure (DRE) are expenses that a person has to pay connected to their disability. They are an allowance in a person’s financial assessment and reduce their weekly charge. DRE can include specialist items and services such as wheelchairs. They can include extra heating or laundry costs, equipment and aids and regular payments such as wheelchair insurance and gardening costs. Statutory guidance says:
• A council must leave a person with enough money to pay for necessary DRE to meet needs that are not being met by the local authority
• The care plan may be a starting point for considering DRE, but councils need to be flexible. (Care and Support Statutory Guidance Annex C, 39 and 41)

What happened

Care Act reassessment/review

17. Mrs X was eligible for care and support and received a home care package arranged and funded by the Council.
18. A social worker reviewed Mrs X’s care and support in October 2024. Mr X was involved with the review. The social worker noted:
• Mrs X had four care visits each day for administering medicine, monitoring walking, changing pad, helping in and out of bed and meal preparation, assisting with a wash or shower and preparing meals and drinks.
• Mr X said he had arranged privately for someone to come for two hours three days a week to support with shopping, cleaning, ordering medication.
• Mr X said he had power of attorney for health and welfare and finances. The social worker asked for copies
• Mr X said the care agency were brilliant and he had no concerns with this agency.
• An occupational therapist confirmed the visits could be changed as two carers were not needed at lunch or tea. The social worker spoke with the agency which agreed they could provide care safely with one carer at lunch and in the evening.
19. Mrs X’s care and support plan set out her eligible needs including:
• Managing and maintaining nutrition. This was being met by carers supporting her with meals and drinks and a private carer doing shopping
• Maintaining a habitable home. This was being met by a private home help and carers supporting with light household tasks.
20. The social worker and Mr X spoke in October. He said Mrs X had just been sent a letter saying she owed £7800 for her care charges. He said he had not received any letters about Mrs X’s FA or her charges or invoices although he had said these needed to be sent to him.
21. At the end of November, another social worker and Mr X spoke. The social worker had noted previously that Mr X was happy to continue with the private care arrangement but was now querying whether shopping and housework could be added to her care plan and council funding including to cover the cost. Mr X went on to say on-line shopping had been tried and did not work well as Mrs X was housebound and could not get to the door in time. Mr X asked for a reassessment/review. The social worker said Mrs X’s case would go on a waiting list, but they could not give a timescale for completion of the reassessment.

Financial assessment and charge

22. The Council’s adult social care finance records show Mr X’s wife completed a financial declaration form in 2021 which formed the basis of Mrs X’s financial assessment (FA) and resulted in a nil charge. The financial declaration form said Mrs X was having private domestic help for three hours every two weeks which cost £9 an hour (or £13.50 a week)
23. The Council reviewed the FA in 2022 and calculated Mrs X’s charge at £79. It included a weekly DRE allowance of £13.50 for domestic help. The Council wrote to Mr X about the revised charge in April 2022, but the letter went to his previous address. It noted Mrs X had been receiving additional benefits and advised Mr X that it had not backdated the change in circumstances, but he needed to inform the Council of changes in future.
24. The FA was reviewed again in 2023 due to national increases in benefits which the Council was aware applied to everybody on those benefits. This resulted in an increase to Mrs X’s charge. (The same DRE allowance was applied for domestic help as the previous year.) This time, the Council sent the letter to Mrs X in April 2023 advising her of the new charge.
25. The Council reviewed the FA again after Mrs X’s death in February 2025 and in response to additional evidence and allowance claims by Mr X. A letter to Mr X in April 2025 said Mrs X’s charge would be £59 from October 2024. The Council had included additional allowances including £20 a week for domestic help.

Complaint to the Council and its response

26. Mr X complained to the Council in April 2025. He said he had provided the Council with his change of address two years ago. The Council provided two responses to his complaints. I have summarised the key points below:
• It was assessed that Mrs X required support with daily activities including shopping. Shopping does not always need to be met by a care provider and could be net by other arrangements including family, friends and voluntary services
• Mrs X had a financial assessment in 2021 and her charge was nil. It was reviewed in 2022 and her additional benefit income was included so she had a charge of £79. The FA included allowances for housing and DRE (including £13.50 a week for domestic help). There was another review of the FA in 2023 to reflect increases in benefit rates. The charge was £89.
• The letter was sent to his old address in 2022 as the finance team did not know he had moved. In 2023, the letter was sent to Mrs X. The yearly reassessments were based on increases in benefits determined by central government.
• The council tax department was made aware of his change of address, but it would not share this information with social care.
• Mrs X did not have care in Apri 2024 so there was no review of the FA. It has subsequently been reviewed.
• The Council only received a copy of the power of attorney from him in October 2024

Findings

Failed to change Mrs X’s care package to include shopping

27. There is no evidence in the Council’s record of the October 2024 care and support review to indicate Mr X raised any concerns or objections to the private domestic help arrangement that he had put in place. So I do not regard the Council to be at fault in concluding the arrangement could remain unchanged. The care and support plan set out the agency care required to meet Mrs X’s eligible unmet needs. This is in line with section 18 of the Care Act so there is no fault.

28. However, Mr X asked for a change to Mrs X’s care and support plan at the end of November 2024. The Council placed her on a waiting list for a review. The plan was not reviewed by her death in February 2025. Guidance expects reviews to take place promptly upon request. Three months was not prompt and was fault. It caused avoidable uncertainty about what the outcome might have been for Mrs X’s care and support arrangements and funding.

29. Although the Council did not conduct a prompt review of Mrs X’s care and support, Mrs X had a DRE allowance for private domestic help in her FA which reduced her charge (so she paid less than she would have done otherwise). This is in line with Care and Support Statutory Guidance.

Failed to send him notification of the outcome of a financial assessment and charge

30. Mr X told the Council’s council tax/revenue department that he had moved in 2022 and so he expected the social care department would also be aware. We would not expect the council tax/revenue department to share Mr X’s new address with the adult social care department as this would not be in line with the purpose limitation in the data processing principles as I have set out in paragraph 12. The onus was on Mr X as his mother’s power of attorney to notify adult social care of his change of address at the time he moved. There is no fault by the Council.

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Agreed action

31. Within one month of the final decision, the Council will apologise for the avoidable uncertainty caused by the failure to conduct a prompt review of Mrs X’s care and support. We publish guidance on remedies which sets out our expectations for how councils should apologise effectively to remedy injustice. The council should consider this guidance in making the apology I have recommended in my findings.

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Decision

32. I find fault causing injustice. The Council has agreed action to remedy injustice.

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Investigator's decision on behalf of the Ombudsman