Summary: There was fault by the Council when considering some disability related expenditure during a financial assessment. The Council failed to properly record its reasons whether certain expenses, including physiotherapy, were a disability related expense. Re-considering the disability related expenses remedies the injustice to Ms X and her late mother.

The complaint

1. The complainant, Ms X, complains for her late mother, Mrs M. Ms X says the Council has not properly considered Mrs M’s Disability Related Expenses (DRE) when carrying out a financial assessment.

2. Ms X says that Mrs M was caused a financial injustice, as she believes that some of the DRE should be allowed, which would have reduced the financial contribution required towards care costs.

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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 future we may recommend 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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How I considered this complaint

5. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
6. Ms 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

7. On 21 May 2025 Mrs M started to receive care from carers at home. Ms X had completed the forms for a financial assessment on 2 May 2025.
8. The Council wrote to Mrs M on 10 June 2025. The Council said that Mrs M would need to contribute £77.11 per week towards the cost of her care until 10 August 2025, £89.50 after that date. The Council included the following DRE per week:
• £12.39 for incontinence supplies for the first 12 weeks. The Council said to Ms X ‘we are unable to allow these after the initial 12 weeks and I would advise that you ask your doctor for an incontinence assessment to determine your eligibility for them to supply you with these’.
• £26.58 for Council Tax.
• £4.89 for additional laundry
• £5.00 for the online delivery charge for shopping.
9. After Ms X made an official complaint and some further correspondence, the Council wrote to Mrs M on 15 January 2026. The new financial contribution was assessed as £65.23 per week until 10 August, £77.62 per week from 11 to 17 August and £109.15 from 18 August 2025 onwards. The Council added the following DRE to those listed above per week:
• £6.25 for clothing.
• £5.23 for carpet cleaner, shampoo caps, a blanket and duvet.
10. Ms X’s main complaint is that she considers the cost of private physiotherapy for Mrs M should have been included as a DRE. Ms X has explained that Mrs M was on the waiting list for NHS physiotherapy and had only a few sessions which did not continue so she paid for a private physiotherapist to help Mrs M’s mobility.
11. The Council has said, in response to my enquiries ‘the Council does not provide allowances for services that are provided by the NHS. If the service is unavailable, this complaint would need to be addressed by the NHS Community Rehabilitation Team’.
12. The Care and Support Statutory Guidance says that any reasonable additional costs directly related to a person’s disability should be considered DRE and that what counts as DRE should not be limited to what is necessary for care and support. While the guidance includes examples of what can be considered DRE it is clear the list is not intended to be exhaustive.
13. The Council refused Mrs M’s claim for physiotherapy to be considered a DRE. It says the NHS should supply physiotherapy and so it does not consider it a DRE.
14. The guidance does not specifically exclude any items and so I consider the Council is wrong to say that physiotherapy cannot be considered a DRE. There is nothing to show that NHS physiotherapy was a reasonably available alternative to the private physiotherapy Mrs M paid for. So, I consider this issue is worthy of further consideration by the Council.
15. In coming to this view, I have considered another complaint to the Ombudsman which included a recent court judgement RW v Royal Borough of Windsor and Maidenhead [2023] EWHC 1449 (Admin). The case relates to DRE for an autistic adult but I consider the judgement provides a framework for what a council should consider when determining whether spending is DRE. My view is the Council should ask itself the following:
• Is the need disability related?
• Are the costs necessary and reasonably incurred?
• Are the costs for care and support?
16. I have not seen evidence to show that ongoing physiotherapy, of the sort Ms X described as so beneficial for her mother, was available to Mrs M on the NHS and so it is possible it was necessary for her to purchase it privately. While the physiotherapy could be regarded as health care rather than social care, it is still a form of care and the Council has a general duty to support wellbeing. So I believe the Council should not dismiss the claim without consideration of Mrs M’s specific circumstances.
17. Ms X also lists a number of other expenses she considers should have been considered DRE. These include:
• Household cleaning products. The Council has said that it would not consider standard items that a household would use as a DRE. Again, I do not consider that the Council has properly considered these items. The Council has not considered whether Mrs M’s disability meant that additional cleaning products were required above normal household use.
• Skin Care and Laxative products not supplied by the doctors. The Council has said ‘If these are essential items, then they should be prescribed via the doctor. The Local Authority does not provide allowances for services that are provided by the NHS’. Again, I consider the Council has fettered its discretion. It appears to have a blanket policy of refusing certain items, without properly considering whether they are disability related, necessary, and for care and support.
18. In response to my enquires, the Council has agreed to reassess if the cost of physiotherapy, household cleaning products and skin care and laxative products are DRE if receipts are provided. This remedies the injustice to Ms X.

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Action

19. Within two months of the date of the decision on this complaint, the Council should:
• Carry out a review of the DRE in respect of the cost of physiotherapy, household cleaning products and skin care and laxative products in consultation with Ms X. If the Council decides they are DRE it should recalculate the client contribution and notify Ms X.
20. The Council should provide us with evidence it has complied with the above actions.

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Decision

21. I have completed my investigation and 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