Summary: We have found fault with the Council for how it handled Mrs X’s son’s care contribution financial reassessment. This caused the family avoidable distress. The Council has agreed to apologise to Mrs X and make a symbolic payment to remedy the injustice.

The complaint

1. Mrs X complains about how the Council handled her adult son’s financial assessment in relation to disability related expenditure (DRE). She said this has led to her son paying a disproportionate and unfair charge for his care and has caused her distress and frustration.

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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 recommend a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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

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

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What I found

Law and guidance

Charging for social care services: the power to charge

6. 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)

How to assess; Thresholds; DRE

7. 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.
8. 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

9. 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.

Council’s contributions policy

10. The policy sets out how the Council will charge people a care contribution so that staff, users of services, carers and the public can understand how it makes decisions on the contributions it charges. It says that the Council automatically gives every non-residential client who receives a disability benefit (at the standard or higher rates) a lump sum banded DRE allowance to be offset against their income.
11. It recognises that people may have higher expenses than this automatic allowance. It says in such cases, they may still claim for such costs but will need to go through a more detailed DRE assessment process. If the Council agrees the costs, an allowance can made for them against the person’s income.
12. It goes on to explain what ‘reasonable costs’ might include and those that the Council would not normally consider.
13. The policy explains that service-users have the right to challenge the Council’s decision about:
• What they should contribute each week
• How the council applied the policy to calculate their allowances or contribution
• How the council decided how its discretion was applied
14. The initial stage is a review by the Council and if the person concerned remains dissatisfied with the outcome of the review, they can request an appeal that will be considered by a panel.

What happened

15. Mrs Y’s adult son, Mr Y is disabled. In February 2025, the Council told Mrs X that it would carry out a financial reassessment to calculate Mr Y’s care contributions due to a change in policy. Mrs X contacted the Council for clarification. In March, the Council contacted Mrs X to arrange the reassessment. After some disagreement about the content and parameters of the reassessment, a date was agreed for the end of May 2025.
16. The Council carried out a financial reassessment over the phone. Mrs X said she submitted an income and expenditure report supported by receipts. In July, the Council issued a letter setting out the outcome the assessment. The Council had applied an automatic DRE disregard as it said that some of the expenses that Mrs X had included were not allowable DRE.
17. Mrs X complained to the Council. The Council apologised for the delay in completing the assessment and for failing to share the Council’s DRE factsheet directly with Mrs X. It acknowledged that Mrs X disagreed with the outcome, however, it was satisfied that it had applied the correct policies to Mr Y’s assessment. The Council agreed to carry out a review of the reassessment if Mrs X provided additional information and supporting evidence.
18. In October, Mrs X contacted her MP to raise concerns about how the Council had handled Y’s financial assessment. She said it had applied a fixed DRE deduction without considering her evidence. The Council engaged with Mrs X and the MP.
19. The Council reviewed the DRE element of Mr Y’s financial assessment. This resulted in it overriding the fixed DRE deduction. The outcome was an increase in DRE and a revised lower care contribution for Mr Y. In addition, the Council wrote off a historic debt that Mr Y owed to support Mr Y in managing his expenses.
20. Mrs X brought her complaint to the Ombudsman. She said that she had not submitted additional information or evidence for the review. She said she submitted it all for the original reassessment in July and that the Council had not properly considered it then.

My findings

21. The Council accepted there was some delay in carrying out the financial reassessment. It also apologised that it failed to send Mrs X a factsheet which was available on the Council’s website. I do not consider this fault to have caused Mrs X or Mr Y a significant injustice.
22. The Council did not have any new information from Mrs X when it reviewed its decision on Mr Y’s DRE. It has since explained that during the review, the Council took a more person-centred approach and exercised officer discretion. It accepted that the extent to which the Council applied officer discretion and the explanation as to why some claimed expenses were allowed whilst others were not, could have been clearer.
23. Financial assessments need to be open and transparent to show service-users how the Council have calculated care contributions. I do not consider the Council to have demonstrated this. This was fault.
24. I consider the fault caused Mrs X avoidable distress when she believed that her son was being charged too much.
25. I have recommended the Council apologise and make a symbolic payment to remedy the injustice caused.
26. The Council said that it has reflected on the issues raised through Mrs X’s complaint and recognises the importance of ensuring that future financial assessments and reviews provide a clear audit trail. It said going forward, the Council will demonstrate:
• how it has considered evidence,
• where it has exercised officer discretion,
• the rationale underpinning decisions,
• how it communicates decisions to service users and their representatives.
27. I welcome these actions and have not recommended any additional service improvements.

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Agreed action

28. Within 4 weeks of my decision, the Council will:
1. Apologise to Mrs X for not properly considering her evidence when it carried out her son’s financial assessment.
2. Pay Mrs X £200 in recognition of the avoidable distress caused the Council’s handling of the financial reassessment.
3. Pay Mrs X £100 for the time and trouble taken for her to pursue the complaint which included contact with her MP.
29. The Council should provide us with evidence it has complied with the above actions.

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Decision

30. I find fault causing injustice.

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Investigator's decision on behalf of the Ombudsman