Summary: Mr X complained about the Council’s handling of his care and support needs. We do not found fault in the overall progression of Mr X’s care and support planning or in the arrangements made for his direct payments once he confirmed he wished to proceed. However, we do find fault in the delay completing the financial assessment, the Council incorrectly advising Mr X he was required to contribute towards his care costs, failures to consistently record and implement agreed reasonable adjustments, and delays in complaint handling. These faults caused Mr X avoidable distress, frustration, uncertainty, and time and trouble. The Council has agreed to apologise and make a payment to Mr X.

The complaint

1. Mr X complained about the Council’s handling of his care and support needs since January 2024. In particular, he said the Council:
• delayed completing his care and support and financial assessments and providing direct payments to enable him to arrange care;
• wrongly advised him from April 2025 that he was required to contribute to his care costs;
• failed to make reasonable adjustments in its communication; and
• handled his complaint poorly.
2. Mr X says these issues delayed his access to necessary support, created barriers when engaging with Council services, and caused him distress and uncertainty.

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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. 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

5. 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)
6. Although Mr X’s complaint relates to events beginning in January 2024, he did not bring his complaint to us until August 2025, which is slightly outside the 12-month time limit. However, I have exercised discretion to investigate the full period. This is because it was reasonable for Mr X to allow the Council time to respond to and address his concerns before approaching us. In addition, the matters complained about form part of a continuous sequence of events, and it would not be reasonable or practicable to separate them.

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How I considered this complaint

7. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
8. 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 legislation and regulations

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 Plan

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.

Personal Budgets

12. Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. It should confirm the final amount of the personal budget through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person’s care and support needs.
13. There are three main ways a personal budget can be administered:

• as a managed account held by the council with support provided in line with the person’s wishes;
• as a managed account held by a third party (often called an individual service fund or ISF) with support provided in line with the person’s wishes; or
• as a direct payment.
  (Care and Support Statutory Guidance 2014)

Direct payments

14. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.

Charging for social care services: the power to charge

15. 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)
16. 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.

The Council’s Adult Social Care Charging Policy from April 2024

17. The Council’s policy states it does not charge for certain community-based services, including internal and commissioned domiciliary care (also known as homecare) provided to people receiving care and support. It also does not charge where such services are arranged and paid for through a personal budget or direct payment, including care delivered by a personal assistant.
18. However, the policy states the Council may charge for other types of community-based support arranged through a personal budget or direct payment. This includes services which are not classed as homecare, such as support to access the community.

NHS Continuing Healthcare Assessments

19. Where it appears a person may be eligible for NHS Continuing Healthcare (NHS CHC), councils must notify the relevant integrated care system (ICS). NHS CHC is a package of ongoing care arranged and funded solely by the NHS where the individual has been found to have a ‘primary health need’ as set out in the National Framework for NHS Continuing Healthcare and NHS-Funded Nursing Care. Such care is provided to people aged 18 years or over, to meet needs arising from disability, accident or illness.
20. Individuals may need care and support provided by their local council and/or services arranged by ICSs. Councils and ICSs therefore have a responsibility to ensure the assessment of eligibility for care and support and for CHC respectively take place in a timely and consistent manner. If, following an assessment, a person is not found to be eligible for NHS CHC, the NHS may still have a responsibility to contribute to that person’s health needs, either by directly commissioning services or by part-funding the package of support. Where a package of support is commissioned or funded by both a council and an ICS, this is known as a ‘joint package of care’. A joint package of care could include NHS-funded nursing care and other NHS services that are beyond the powers of a council to meet.
21. Complaints about NHS CHC are dealt with by the Parliamentary and Health Service Ombudsman.

Equality Act

22. The Equality Act 2010 provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. It offers protection, in employment, education, the provision of goods and services, housing, transport and the carrying out of public functions.
23. The Equality Act makes it unlawful for organisations carrying out public functions to discriminate on any of the nine protected characteristics listed in the Equality Act 2010. They must also have regard to the general duties aimed at eliminating discrimination under the Public Sector Equality Duty.
24. The ‘protected characteristics’ referred to in the Act are:

• age;
• disability;
• gender reassignment;
• marriage and civil partnership;
• pregnancy and maternity;
• race;
• religion or belief;
• sex; and
• sexual orientation.

Reasonable adjustments for people with disabilities

25. The reasonable adjustment duty is set out in the Equality Act 2010 and applies to any body which carries out a public function. It aims to make sure that a disabled person can use a service as close as it is reasonably possible to get to the standard usually offered to non-disabled people.
26. Service providers are under a positive and proactive duty to take steps to remove or prevent obstacles to accessing their service. If the adjustments are reasonable, they must make them.
27. The duty is ‘anticipatory’. This means service providers cannot wait until a disabled person wants to use their services, but must think in advance about what disabled people with a range of impairments might reasonably need.

What happened

28. In January 2024, the Council completed a care and support assessment for Mr X.
29. In March, Mr X told the Council he wished to receive a personal budget by way of a direct payment so he could employ a personal assistant to help meet his eligible needs.
30. In April, the Council completed a care and support plan. This included five hours of weekly support, to be provided through a direct payment, to assist Mr X with correspondence and maintaining a habitable home environment. The plan also recorded Mr X’s communication needs, including:
• correspondence to be sent by post rather than email;
• copies of correspondence to be sent to his representatives; and
• support with completing forms.
31. The Council also sent Mr X information about completing a financial assessment and setting up a direct payment. However, Mr X wished to delay progressing support until he moved into his new property.
32. Mr X says he contacted the Council in July 2024 to inform it that he had moved into his new property and wished to proceed with arrangements for a direct payment. However, I have seen no evidence of any contact with the Council’s adult social care team at that time. The available records show that, in late July 2024, Mr X informed the Council’s housing team that he was moving into the property.
33. In September the Council emailed Mr X to ask whether he wished to proceed with a direct payment and relevant information was sent to him by post.
34. A carer supporting Mr X responded and reminded the Council that email should not be used to contact him in line with his agreed reasonable adjustments. The carer confirmed Mr X had since moved and now wished to proceed. The carer also explained Mr X would need support to complete the required forms.
35. The social worker later spoke with Mr X. He confirmed he could manage short telephone calls of up to 10 minutes, but any longer discussions should take place face-to-face.
36. A new social worker was allocated to Mr X and visited him to review his needs following his move. The Council’s case records state that Mr X requested a home visit from someone who could explain the direct payment process. Mr X disputes this account and says he asked for support with completing the financial assessment required before the direct payment could be arranged.
37. The social worker contacted the Council’s direct payments team and requested a priority home visit. The Council recorded Mr X’s reasonable adjustments on its social care system, including:
• no communication by email;
• telephone calls to be limited to 10 minutes; and
• longer discussions to take place face-to-face.
38. Mr X also requested an assessment for NHS Continuing Healthcare (CHC) funding. The Council completed the necessary referral paperwork without delay and notified the relevant Integrated Care System, which subsequently arranged a Decision Support Tool meeting to consider whether Mr X met the criteria for CHC funding.
39. The direct payment team arranged an appointment to speak to Mr X, however noted that a decision was yet to be made whether he would be funded by CHC.
40. In October, a member of the direct payments team visited Mr X at home to explain the process and begin completing the required forms. However, as a financial assessment had not yet been completed, these could not be finalised.
41. Later that month, a review of Mr X’s support plan was finalised.
42. In November, the Council agreed funding for Mr X’s support package.
43. In December, Mr X’s social worker referred him to the financial assessment team and shared details of his reasonable adjustments.
44. Shortly after this, the Decision Support Tool outcome found Mr X was not eligible for CHC funding.
45. In January 2025, the Council carried out a face-to-face financial assessment. Mr X attended the Council’s offices and was supported to complete a financial declaration form. Mr X says he was later told he would not need to contribute towards the cost of his care. Around this time, the remaining direct payment paperwork was completed.
46. Following completion of the required paperwork, the Council set up Mr X’s direct payment and backdated it to November 2024, when funding had been agreed.
47. In April, the Council introduced a revised charging policy. The policy confirmed that homecare services, including support delivered by a personal assistant through a direct payment, were non-chargeable. However, some other forms of community-based support, such as support to access the community, remained chargeable.
48. In June, the Council wrote to Mr X informing him that, following a financial assessment, he would be required to contribute towards the cost of his care from the end of that month.
49. Mr X queried this with the financial assessment team. He says he was told his care package had been recorded as including chargeable services and was advised to contact adult social care to resolve the issue.
50. Later that month, Mr X attended the Council’s offices. He says a duty social worker indicated the charge appeared to be an error but advised that it would need to be corrected by a social worker rather than the finance team.
51. Mr X contacted the Council again a week later seeking an update. He was told no changes had yet been made and that he remained liable for the charges. He was again directed to contact adult social care.
52. Later that month, Mr X, with support from his personal assistant, made a formal complaint. He said:
• he had wrongly been told he must contribute towards his care despite the Council’s charging policy;
• correspondence had not been provided in large print in line with his reasonable adjustments; and
• repeated attempts to resolve the matter had caused him stress and anxiety.
53. He asked the Council to apologise, provide compensation, improve coordination between teams, confirm his reasonable adjustments, and ensure adjustments were properly recorded and followed in future.
54. Mr X says he contacted the financial assessment team again, but staff had no record of his previous contact or visit to the Council’s offices.
55. In July, having received no complaint response, Mr X made a further complaint about the Council’s failure to respond and his ongoing concerns.
56. Mr X says he chased the complaint again by telephone in August 2025.
57. The Council later updated its records to state that Mr X required correspondence in large print.
58. In August 2025, the Council issued its complaint response. It explained that although Mr X had completed a financial declaration form earlier in the year, a full financial assessment had not been completed until June 2025, which led to the letter advising him of a financial contribution. The Council said its records showed Mr X’s support plan included both home-based support and support to access the community, which would be chargeable under its policy. It apologised for failing to provide correspondence in large print, explaining it was not aware of this adjustment request. The Council asked Mr X to confirm his communication needs so its records could be updated. The Council also agreed to review Mr X’s support plan to clarify the nature of the support being provided. Pending that review, it said any charges applied from June 2025 onwards would be waived. However, the complaint response itself was not provided in large print.
59. Since bringing his complaint to the Ombudsman, Mr X has received an updated care and support plan increasing his support package to eight hours per week to assist with domestic tasks and daily living activities.
60. In response to my enquiries, the Council acknowledged there was a delay between January and June 2025 in completing Mr X’s financial assessment. It said this was due to staffing shortages within the financial assessment team. However, the Council said Mr X had not suffered any financial disadvantage because charges were not backdated to the start of his care package and were only applied from June 2025 onwards.
61. The Council also confirmed that all charges applied from June 2025 had since been waived. It confirmed Mr X is not required to contribute towards the cost of his care because his support package does not include chargeable community access services.
62. The Council explained that reasonable adjustments should ordinarily be:
• identified at the first point of contact or assessment;
• discussed and agreed with the individual;
• recorded on the Council’s social care and complaints systems;
• visible to relevant teams, including finance and direct payments; and
• reviewed at key stages of involvement.
63. The Council said reasonable adjustments requested by Mr X between 2024 and 2025 were discussed and implemented as those requests were identified.

My findings

Delayed completion of assessments and direct payments

64. Mr X says he informed the Council in July 2024 that he wished to proceed with a direct payment. However, the available evidence does not show that this information was communicated to the adult social care team at that time. On the balance of probabilities, I am satisfied the Council was not aware of Mr X’s intention to proceed until September 2024, when this was clearly communicated and recorded.
65. The Council then took steps to progress matters. It arranged visits, completed the necessary paperwork, and referred the matter for financial assessment. I have not seen evidence of avoidable delay or drift in the Council’s handling of the care and support assessment, support planning, or direct payment process during this period.
66. However, there was a delay between January and June 2025 in completing the financial assessment. The Council accepts this was caused by staffing shortages within the financial assessment team. This was fault.
67. I have nevertheless considered whether this caused Mr X a significant injustice. I note the Council did not backdate any charges to the start of the care package and ultimately waived all charges applied from June 2025 onwards. In those circumstances, I am satisfied the delay did not cause Mr X a significant financial injustice.

Incorrect advice about care charges

68. In June 2025, the Council informed Mr X he would be required to contribute towards the cost of his care. The Council later accepted this was incorrect and confirmed his package did not include chargeable community access services.
69. It is unclear precisely why the error occurred. The evidence suggests this may have resulted either from administrative error or from earlier records indicating Mr X may receive community-based support, which would have been chargeable under the Council’s policy.
70. Regardless of the cause, the Council provided incorrect information to Mr X about his liability to pay care charges. This was fault.
71. I recognise this caused Mr X avoidable uncertainty and frustration, particularly as he had to repeatedly contact different teams to try to resolve the matter. However, I also note the Council waived all charges and confirmed Mr X was not required to contribute towards the cost of his care. Therefore, while the fault caused distress and inconvenience, it did not result in a significant financial injustice.

Reasonable adjustments

72. The evidence shows the Council was aware from 2023 that Mr X required reasonable adjustments to communication. In April 2024, the Council specifically recorded that Mr X required correspondence by post rather than email, limitations on telephone calls, and support with completing forms.
73. However, these adjustments were not consistently recorded across the Council’s systems. As a result, when a new social worker became involved in September 2024, they contacted Mr X by email despite the agreed communication arrangements. This was fault. The failure to accurately record and share agreed reasonable adjustments created a risk that Mr X would face barriers in accessing services.
74. I have not found this particular incident caused Mr X a significant injustice. Mr X’s unpaid carer responded promptly to the email and clarified the agreed communication arrangements. Following this, the social worker updated the records and ensured the information was shared with the relevant teams involved in Mr X’s care and support.
75. I have also considered the wider evidence regarding reasonable adjustments. The Council has provided detailed information showing it made a number of adjustments to support Mr X in accessing services, including arranging face-to-face meetings, limiting telephone contact, communicating by post, and involving representatives and carers where appropriate.
76. At the time Mr X made his complaint, the Council had not recorded that he required correspondence in large print on its care management system. In those circumstances, I do not find fault in the Council’s earlier correspondence not being provided in that format. However, once the issue had been specifically raised as part of the complaint, the Council should have ensured its complaint response was issued in large print. Its failure to do so was fault and created an avoidable barrier to Mr X engaging fully with the complaint process.
77. Overall, I am satisfied the Council took a number of appropriate steps to support Mr X’s access to services and there is no evidence of a wider systemic failure in its approach to reasonable adjustments. The faults identified in this investigation arose from failures in recording and implementing agreed adjustments consistently.
78. The Council has since asked Mr X to confirm his communication needs and updated its records accordingly. This is an appropriate step to reduce the risk of similar issues occurring in future.

Complaint handling

79. The Council delayed responding to Mr X’s complaint. Its response was issued 16 working days outside its published timescale.
80. During this period, Mr X had to chase the Council on more than one occasion for an update. In addition, the complaint response was not provided in large print despite the nature of Mr X’s complaint specifically raising concerns about communication adjustments.
81. This was fault and caused Mr X avoidable frustration, inconvenience, and additional time and trouble pursuing his complaint.

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Action

82. To remedy the injustice caused by the above faults, within four weeks of the date of my final decision, the Council has agreed to:
• apologise to Mr X in line with our guidance on Making an effective apology; and
• pay Mr X £150 to recognise the distress, uncertainty and time and trouble caused.
83. The Council should provide us with evidence it has complied with the above actions.

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Decision

84. I find fault causing injustice. The Council has agreed actions to remedy injustice.

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Investigator's decision on behalf of the Ombudsman