Summary: Miss H complains the Council reduced her direct payment, did not provide her with copies of reviews and was unreasonably seeking repayment of the direct payment. We uphold the complaint. The Council has accepted faults in the way it communicated with Miss H. The Council’s proposed personal remedy and action plan are suitable responses.

The complaint

1. The complainant, whom I shall refer to as Miss H, complains the Council:
• reduced her direct payment at the end of 2018 and did not explain why;
• did not provide her with copies of her reviews, or care and support plans;
• was unreasonably seeking repayment of some of the direct payment, without having explained what had been misspent.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. As part of the investigation, I have considered the complaint and the documents provided by Miss H’s representative. I made enquiries of the Council and considered its response.
5. I have considered responses to my draft decision from Miss H and the Council.

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What I found

Legal and administrative background

6. The 2014 Care Act introduced a single framework for assessment and support planning.
7. Sections 9 and 10 of the Act require local authorities to carry out an assessment for any adult with an appearance of need for care and support. The Act gives local authorities a legal responsibility to provide a care and support plan. The care and support plan should consider what 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.
8. Section 27 of the Care Act gives an expectation that local authorities should conduct a review of a care and support plan at least every 12 months.

Direct payments

9. Direct payments are payments to service users for them to purchase their own community care services they have been assessed as needing. The payment must be spent on services that meet the assessed need. Direct payments mean service users have greater choice in their care. But they mean recipients are responsible for employing people (for example, personal assistants).

What happened

10. Miss H receives a care and support package from the Council. Since 2008 she has had a direct payment budget to fund her care.
11. In 2015 the Council says it carried out a financial audit of Miss H’s direct payment. The purpose was to check Miss H was spending the direct payment in line with the agreed support plan. It says the audit found Miss H had made purchases that were not related to the care and support plan. But its records do not have any evidence of discussions then with Miss H about this. Miss H says she was not aware she had purchased good and services outside her care and support plan.
12. In 2016 the Council sent Miss H a questionnaire to review her services. The Council decided the direct payment continued to meet Miss H’s needs.
13. In 2017 the Council carried out a review. It says Miss H’s budget should have reduced, but it did not make the financial changes.
14. In February 2018 the Council wrote to Miss H, to advise her it wanted to carry out a financial audit to check she was spending the direct payment in line with the agreed support plan. It started the audit in March. In December 2018 it reduced Miss H’s direct payment.
15. In April 2019 the Council wrote to Miss H about the audit. The letter contained a table with payments that were still not accounted for. It carried out an assessment in June. In September, it wrote to Miss H about payments it was seeking to reclaim, as the direct payment had not been spent in line with the support plan.
16. In October, Miss H’s representative wrote to the Council. In December Miss H and her representative asked for a reassessment. They also complained, first to the Council and then to the Ombudsman.
17. Our investigation was delayed by a pause in our casework, due to the COVID-19 pandemic. When we did make enquiries, the Council responded to advise:
• It accepted it should have communicated better with Miss H.
• It noted an increase in Miss H’s direct payment after its most recent assessment.
• ‘We are committed to closer working with Miss [H] in the future. I have relayed my expectation in that future reviews will clearly evidence the consideration with Miss [H] about how well her budget has worked, including any support required in possible further areas of budget use uncertainty. In addition, that any future assessments, which may change Miss [H]'s budget, should be consultative and evidenced to reflect this has happened.’
• It outlined service improvements it had made. It would draw up an action plan in response to Miss H’s complaint.
• It also agreed to withdraw Miss H’s outstanding debt of £1692, as an apology for its failure of communications.

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Final decision

18. I uphold this complaint, as I agree with the Council about the faults it has identified. Its suggested personal remedy and action plan are suitable responses. So I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman