Summary: Ms X complained the Council wrongly refused to treat the costs associated with her assistance dog as Disability Related Expenditure. The Council failed to properly consider her request. This was fault and caused Ms X uncertainty, frustration and time and trouble. The Council agreed recommended actions to remedy the injustice caused.

The complaint

1. Ms X complained the Council wrongly refused to treat the costs associated with her assistance dog as Disability Related Expenditure when assessing her contribution towards the cost of her care. She said the Council wrongly focused on the fact the dog supported her mental health rather than physical care needs and failed to properly consider the evidence she provided. She also said the Council gave inconsistent reasons for refusing the claim.
2. Ms X said she has paid a higher contribution towards her care than she should have, experienced distress and uncertainty and spent considerable time and trouble pursuing the matter.

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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 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

Relevant legislation and guidance

Charging for social care services: the power to charge

7. 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)
8. 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.

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.

What happened

10. Ms X received a package of non-residential care from the Council. The Council assessed how much she should contribute towards the cost of that care following a financial assessment.
11. Ms X asked the Council to allow several items as Disability Related Expenditure, including costs associated with her assistance dog. She said the dog had been trained to support her during panic attacks, improve her confidence and help her access the community.
12. Ms X provided information about owner-trained assistance dogs together with information about the costs she incurred in maintaining the dog.
13. The Council accepted some of Ms X's claimed Disability Related Expenditure, including cleaning costs. However, it refused to allow the costs associated with the assistance dog.
14. The records show officers explained the costs were not allowable because the dog supported Ms X's mental health rather than the physical needs for which the Council provided care. Officers explained the costs may have been considered differently had the dog assisted with physical tasks related to Ms X's physical conditions.
15. Ms X complained. She said the Council wrongly distinguished between physical and mental health needs and failed to properly consider the evidence she provided.
16. The Council did not uphold the complaint. It said Ms X told it the dog was not a trained assistance dog and that it could not identify any eligible needs the dog was meeting that were not already met through her care package.
17. During this investigation the Council explained its decision was not based on the dog being owner-trained or on the contents of Ms X's care and support plan. Instead, it said there was insufficient evidence to demonstrate the dog carried out specific disability-related tasks or that the associated costs qualified as Disability Related Expenditure. The Council acknowledged shortcomings in its communication and offered to carry out a fresh review of Ms X's Disability Related Expenditure as part of her annual review.

Analysis and findings

18. The Council was entitled to ask Ms X to provide evidence that the expenditure arose because of her disability, represented an additional cost and was reasonable. It was also entitled to decide the evidence did not justify allowing all or part of the claim. The Council was not required to accept the claim simply because Ms X described her dog as an assistance dog.
19. But records show the Council refused the claim because the dog supported Ms X's mental health rather than the physical needs for which it provided care. While the Council could take Ms X's care and support plan into account, it should not have treated this as the limit of what could qualify as Disability Related Expenditure. The Council should have considered whether the claimed expenditure met the relevant criteria for Disability Related Expenditure. Not doing so amounts to fault.
20. The evidence also showed the Council knew Ms X said her dog supported her during panic attacks and helped her manage anxiety. But the records did not show the Council properly considered whether those functions could give rise to disability-related expenditure. Instead, it largely rejected the claim because those functions related to mental rather than physical health. This was fault.
21. The Council was entitled to request further evidence about her dog’s role and the costs claimed. Ms X already provided information about owner-trained assistance dogs and the costs she incurred. But the evidence did not show the Council clearly explained what further information it required before refusing the claim. The clearest requests for evidence about her dog’s disability-related tasks came after the original decision had already been made. This was fault.
22. The Council's records also show it later agreed to reconsider the Disability Related Expenditure decision. But there is no clear record identifying the evidence considered, the reasoning applied or how the final decision was reached. Good administrative practice requires councils to keep adequate records of important decisions. This was fault.
23. The Council's complaint response repeated the original reasoning, and stated Ms X said her dog was not a trained assistance dog. That was not an accurate reflection of Ms X's position, as she consistently said her dog was owner-trained. The response also failed to clearly explain why the evidence provided was considered insufficient. This was fault.
24. During this investigation the Council explained its decision was based on insufficient evidence that her dog carried out disability-related tasks or that the claimed costs qualified as Disability Related Expenditure. That explanation could provide a reasonable basis for refusing the claim. But it is materially different from the reasons recorded at the time.
25. There is fault in the way the Council considered Ms X's request for assistance dog costs to be treated as Disability Related Expenditure.

Injustice

26. It cannot be concluded the Council should necessarily have allowed the costs claimed by Ms X. That decision remains one for the Council following a proper assessment. However, because of the faults identified, Ms X was left uncertain whether some or all the claimed expenditure should have reduced her assessed contribution. She also experienced avoidable distress, frustration and time and trouble pursuing the matter.
27. During this investigation the Council acknowledged shortcomings in its communication and offered to carry out a fresh review of Ms X's Disability Related Expenditure. That is an appropriate step towards remedying the injustice. But it does not fully remedy the injustice because it does not recognise the avoidable distress, uncertainty and time and trouble caused by the faults identified, nor does it make clear the review will consider the relevant historic period. Further recommendations have been made.

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Action

28. Within one month of our final decision, the Council agreed to:
• Apologise to Ms X for the injustice caused by the faults identified. 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 I have recommended in my findings.
• Pay £300 to Ms X to recognise the avoidable distress, uncertainty, frustration, and time and trouble caused by the faults identified.
29. Within two months of our final decision, the Council agreed to:
• Complete a fresh assessment of Ms X's request for Disability Related Expenditure covering the period from August 2025 onwards. As part of that assessment, the Council should give Ms X an opportunity to provide any further supporting evidence, consider each claimed expense individually, and issue a reasoned written decision. If the Council concludes any additional Disability Related Expenditure should have been allowed, it should recalculate Ms X's assessed contribution from the relevant date and refund or credit any overpayment.
30. The Council should provide us with evidence it has complied with the above actions.

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Decision

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

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Investigator's decision on behalf of the Ombudsman