Summary: The Council’s calculation of Mrs X’s contribution towards her care package was incorrect which led it to wrongly tell her she had a debt to pay, the Council failed to carry out a carer assessment for Mrs X’s husband and sent Mrs X communications which were not in accordance with her reasonable adjustments. That caused Mrs X distress, led to her feeling unable to reinstate her care package and left her with uncertainty. An apology, payment to Mrs X, completion of a care review to include a carers assessment, a breakdown of the Council’s calculations for the amount Mrs X overpaid and guidance to officers is satisfactory remedy.

The complaint

1. The complainant, Mrs X, complained the Council:
• provided her with incorrect and conflicting financial contribution figures, with no final breakdown ever confirmed which prevented her accessing care;
• delayed telling her about a debt and failed to properly explain how it had resolved that;
• failed to consider its safeguarding responsibilities when it became clear financial issues were undermining the care package;
• failed to provide her husband with a carer assessment when it knew he had to provide extra support when care arrangements broke down;
• failed to provide her with copies of care plans and care assessments;
• failed to implement reasonable adjustments; and
• failed to properly address her complaint.
2. Mrs X says the Council’s actions have resulted in a deterioration in her mental health, has had an impact on her husband and has left her feeling unable to reinstate her care package due to the outstanding concerns.

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The Ombudsman’s role and powers

3. 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)
4. 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)
5. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
6. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
7. 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(i), as amended)

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What I have and have not investigated

8. I have investigated what has happened in terms of Mrs X’s care arrangements since May 2024, which is 12 months before the complaint to the Ombudsman. I have not investigated any concerns about care provision for the earlier period because I see no reason why Mrs X could not have brought her complaint to the Ombudsman within 12 months given she put in her first complaint to the Council in 2023.
9. I have, however, investigated what has happened in relation to the financial issues since 2021. That is because I am satisfied Mrs X did not know about issues with the financial assessment before 2025.

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How I considered this complaint

10. As part of the investigation, I have:
• considered the complaint and Mrs X's comments;
• made enquiries of the Council and considered the comments and documents the Council provided.
11. Mrs X and the organisation 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

The Care Act and Care and Support statutory guidance

12. 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.
13. 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.
14. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
15. As part of the carer’s assessment, the Council must consider the carer’s potential future needs for support. It must also consider whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)
16. A council must make enquiries if it thinks a person may be at risk of abuse or neglect and has care and support needs which mean the person cannot protect themselves. An enquiry is the action taken by a Council in response to a concern about abuse or neglect. An enquiry could range from a conversation with the person who is the subject of the concern, to a more formal multi-agency arrangement. A council must also decide whether it or another person or agency should take any action to protect the person from abuse. (section 42, Care Act 2014).

The Council’s best practice guidance for care act assessments

17. This refers to the eight fundamental principles which a social care practitioner should demonstrate in their practice when undertaking an assessment and determining eligibility:
• strengths-based approach;
• transparency;
• whole family/holistic;
• maximise a person's involvement;
• recognise fluctuating needs;
• promote individual choice and control;
• appropriateness;
• proportionality.

The Council’s charging policy for adult social care non-residential (community-based) services

18. If a person has eligible needs for care and support and less than £23,250, the Council will undertake a financial assessment to determine how much the person is charged towards the cost of their care. The person will not be charged more than they can afford to pay as determined by the detailed regulations. They will also not be asked to pay more than the cost of their care.
19. A personal budget is money allocated to pay for a person's care services to meet their eligible assessed needs as identified in a Care Act assessment. A person's support plan shows the services they require to meet their eligible assessed needs and the outcomes that they want to achieve.
20. The amount a person will pay towards their personal budget is called their 'assessed contribution' and this is worked out via a financial assessment. If there is a shortfall between the person's assessed contribution and the full cost of meeting their eligible care needs, the Council will contribute to the personal budget to make up the difference.
21. When receiving care and support other than in a care home a person must retain a certain level of income to cover their living costs. Under the Care Act 2014, charges must not reduce a person's income below a certain amount, but the Council can choose to allow a person to keep more of their income. This amount is known as the minimum income guarantee (MIG).
22. The MIG is set by the Department of Health and Social Care and is reviewed annually. The amount a person will be entitled to will vary depending on several factors, such as a person's age, disability, relationship status and how many dependent children they have living with them.
23. The Council will write to the person to inform them of their weekly charge, even if it is zero. The person will be issued with a notification letter that documents the result of the financial assessment, showing how the assessment has been calculated from the information the person has given and the charge payable by that person.
24. Where a person chooses to receive a direct payment, their assessed contribution will be determined through a financial assessment in accordance with this policy.
25. The Council will pay the direct payment, less any charge the service user is assessed to pay, directly into the designated direct payment account. The service user is expected to pay their weekly contribution into their nominated direct payments account to ensure there is sufficient money available to meet their care needs. The payment of this contribution will be monitored through regular audits.
26. If a person disagrees with the outcome of their financial assessment, they can ask for it to be looked at again. A person can do this by telling the Council why they think the decision is wrong. In some circumstances this may mean completing a new financial assessment form to ensure all relevant details were considered in the initial assessment.

What happened

27. Mrs X began receiving a care package of 10 hours support from the Council for support with accessing the community in 2021. The Council assessed Mrs X as having to pay towards her care. Mrs X raised concerns about the Council’s calculation of her contribution as she said she could not afford it. The Council did not change the calculation.
28. Until 2024 the Council arranged the care package for Mrs X. From January 2024 Mrs X had a direct payment and used that direct payment to employ a PA to help her access the community.
29. In June 2024 Mrs X again queried the care contribution charges. Mrs X said she felt she should not be paying anything towards her care. The Council explained the contribution was right. Mrs X queried why she had been charged a higher rate previously and said although she had queried that she had not received a response.
30. In August 2024 the Council asked Mrs X for copies of her bank statements so it could complete a routine audit of her direct payment account.
31. In February 2025 the Council allocated Mrs X's case to a student social worker for an annual review. The student social worker contacted the direct payments team to see whether everything was up to date. The direct payments team said it had not received any monitoring forms and asked the student social worker to get those from Mrs X.
32. The student social worker visited Mrs X on 5 March to begin the review. At that point Mrs X explained she had not had a PA for some weeks due to issues with the previous arrangement. The student social worker provided Mrs X with a link to a site from which she could identify a new PA. The student social worker reminded Mrs X she needed to provide bank statements for her direct payment.
33. Mrs X provided bank statements to the Council on 11 March. When the direct payments department checked those bank statements it identified Mrs X had only made one payment into the direct payments account since January 2024. The direct payments department told the student social worker about that and about some expenditure for fuel and gardening which did not appear on the support plan.
34. The Council’s student social worker contacted Mrs X to discuss the issues raised by the direct payments department but could not make contact. Mrs X’s representative subsequently contacted the Council to ask for any further correspondence in writing as Mrs X was unwell and needed assistive software and therefore needed contact by email. Mrs X’s representative told the Council Mrs X did not feel comfortable attending in person meetings without the support of an assistant.
35. The Council emailed Mrs X on 24 March. In that email the Council explained Mrs X owed a little over £3,500 to reflect the contribution towards her care package from January 2024 onwards.
36. Mrs X put in a complaint on 14 April. Mrs X then contacted the Council on 13 May to ask it to put the direct payment on hold pending the outcome of the complaint.
37. When considering the complaint the Council identified its original financial assessment had not considered the fact Mrs X had one dependent child initially and later two. The Council carried out a further financial assessment to include the children. That assessment concluded Mrs X should not have had to pay anything towards her care since 2021. The Council emailed Mrs X to tell her that on 19 May. The Council explained Mrs X was due a refund for invoices she paid before she received the direct payment. The Council provided Mrs X with a copy of the new financial assessments back to 8 March 2021 which showed she did not have to pay towards her care.
38. The Council responded to the complaint on 30 May. The Council accepted it had not carried out the financial assessment properly and offered Mrs X £300. The Council also outlined various procedural improvements it had made to address the issues that had arisen in the complaint.
39. The Council contacted Mrs X on 12 June to ask whether she wanted her direct payment reinstated. Mrs X declined that option until the Ombudsman had considered her complaint.
40. The Council contacted Mrs X again in February 2026 to ask for her bank details so it could issue a refund for the amount Mrs X should not have had to pay. Mrs X asked the Council to provide a breakdown.
41. The Council says it has taken the following action in response to this complaint:
• carried out awareness and training about applying child premiums to financial assessments where appropriate;
• reviewed roles and responsibilities for contacting cases where there is a debt involved;
• reviewed its supervision processes to strengthen oversight and support across the service;
• addressed learning points with the officer involved to ensure they understand the importance of respecting communication preferences and contact times and methods;
• placed a note on the front of Mrs X's record stating that all communication should be by email.

Analysis

42. Mrs X says the Council provided her with incorrect and conflicting financial contribution figures with no final breakdown ever confirmed, which prevented her accessing care consistently. Mrs X says the Council delayed telling her about a debt of £3,500 and failed to properly explain how it had resolved that.
43. The Council accepts when it completed the initial financial assessment in 2021 it failed to apply the minimum income guarantee for someone with dependent children. The Council accepts because of that it told Mrs X she had to make a significant financial contribution towards her care package when she should not have had to contribute. The Council accepts it did not identify that error until 2025.
44. The Council’s failure to apply the right minimum income guarantee in 2021 is fault. I am satisfied that meant Mrs X had to make a significant financial contribution towards her care package between 2021 and 2025. I am also concerned the Council failed to identify issues with the financial assessment before 2025. That is despite the fact Mrs X repeatedly raised concerns about whether the Council had carried out the financial assessment properly. There were multiple opportunities for the Council to look again at the financial assessment it had completed between 2021 and 2025. Because the Council did not revisit those financial assessments until 2025 it meant Mrs X had to pay a large amount towards her care package for longer than she should have as she should not have had to pay anything.
45. It is unsurprising in those circumstances Mrs X has lost faith in the Council’s decision making. It is also clear that has undermined her confidence in accepting the Council’s explanation and in allowing the care package to continue. However, the documentary evidence I have seen satisfies me the Council has made clear to Mrs X the reason for the original error. I am also satisfied the Council sent Mrs X a copy of the revised financial assessments on 19 May 2025 which clearly set out she did not have any contribution to pay. I therefore could not say the Council failed to provide her with information about her calculation.
46. I understand Mrs X’s reluctance to reinstate the direct payment though until a third party considered the Council’s paperwork given the Council told Mrs X in March 2025 she had a debt of £3,500. Had the Council checked the financial assessment before writing to Mrs X about that debt it would likely have identified Mrs X’s children were missing from the financial assessment. The Council would then not have told Mrs X she had a debt to pay of £3,500. That is fault and clearly caused Mrs X significant distress.
47. Mrs X says the Council delayed telling her about the debt as it related to a period from January 2024 onwards. The evidence I have seen satisfies me the Council identified Mrs X was not making any payments into her direct payments account, other than one payment, when it carried out an audit of her direct payments in 2025. I am satisfied the Council originally intended to complete that audit in August 2024 as that is when it asked Mrs X for copies of her bank statements. I have seen no evidence Mrs X provided those bank statements to the Council until March 2025, which would explain the delay.
48. However, while I do not consider any delay telling Mrs X about the debt was caused by fault by the Council it is nevertheless clear if the Council had carried out the financial assessments properly or checked those financial assessments before writing to Mrs X it would not have told her she had a debt. That would also likely have meant Mrs X would have continued with her direct payments package.
49. I have found no evidence to suggest the Council used another person’s details on Mrs X’s financial declaration which falsely inflated her income and contribution. Instead, as I have made clear, I am satisfied the errors in the financial assessment were because the Council failed to include Mrs X’s children in the financial assessment which meant it used the wrong MIG.
50. Mrs X says the Council failed to provide her with a breakdown to show how it calculated the refund due to her. Mrs X says because the Council has not resolved that part of the issue she does not feel able to reinstate her direct payment.
51. I am satisfied the Council sent Mrs X a brief explanation of the amount it believes it owes her because of the wrong financial assessment. However, I have seen no evidence to show the Council provided Mrs X with a detailed breakdown of the amounts she has paid which should not have been paid, over what period, linked to previous invoices issued. Given Mrs X has made clear she does not feel able to reinstate her direct payment until she has a full picture of the financial issues I consider the failure to provide Mrs X with that information fault.
52. Mrs X says the Council failed to respond to her questions about mileage and expenses. I am satisfied Mrs X’s representative raised those issues in 2024. The evidence I have seen satisfies me the Council responded to that query to make clear mileage and gardener costs were not included in Mrs X support plan. I therefore could not say the Council failed to respond to those issues.
53. I recognise though those issues came up again during the review in 2025. At that point the Council identified Mrs X had paid for things which were not included in her support plan. I am satisfied the Council’s student social worker told Mrs X it would discuss those issues with her as part of the review. The evidence I have seen though satisfies me the Council put the review on hold when Mrs X put in her complaint and made clear she did not want her direct payments reinstating until after her complaint to the Ombudsman. In those circumstances I am satisfied the reason the Council has not discussed those outstanding matters with Mrs X is because the process is on hold. I would expect the Council to pick those matters up again when it completes the review following my investigation.
54. Mrs X says the Council failed to consider its safeguarding responsibilities when it became clear financial issues had undermined her care package. The Council says it did not consider it necessary to carry out any safeguarding action because Mrs X had capacity to make her own decisions and as the care package related to socialisation rather than daily care support.
55. There is no evidence in the documentary records to suggest the Council considered whether its safeguarding responsibilities were engaged. However, I do not consider it likely, on the balance of probability, if the Council had considered that it would have taken safeguarding action. That is because, as the Council has pointed out, Mrs X is assessed as having capacity to make her own decisions. The Council’s documentation also shows it did not consider it appropriate to contact Mrs X to seek to have the care package put back into place because the Council did not want to increase her anxiety. I have also seen no evidence to suggest Mrs X, her husband or her representative raised concerns with the Council about the impact of Mrs X not receiving a care package. In those circumstances and as the care package did not include the daily care I do not criticise the Council for not considering safeguarding action.
56. Mrs X says the Council failed to consider providing her husband with a carer’s assessment even though it knew he had to provide her with extra support when care arrangements broke down. As I say in paragraph 17, as part of a Care Act assessment the Council should carry out a holistic assessment which involves the rest of the family. I would therefore have expected the Council to consider whether a carer’s assessment for Mrs X’s husband was appropriate. Failure to do that is fault. That has left Mrs X and her husband with some uncertainty about whether they would have received more support if the Council had carried out the carer’s assessment.
57. Mrs X says the Council failed to provide her with copies of care plans and care assessments to help her understand what care should be in place. I have made clear I am not considering any period before May 2024 for this part of the complaint. The evidence I have seen satisfies me the Council has only completed one assessment and support plan since then. I am satisfied the Council sent a copy of the support plan to Mrs X at the time.
58. I recognise the Council has not yet sent Mrs X support plan following the March 2025 review. However, I am satisfied that is because the Council put the process on hold due to the financial issues when Mrs X stopped the direct payment. I would expect the Council to issue a new support plan once it has completed the review.
59. Mrs X says the Council failed to implement reasonable adjustments when she asked for correspondence by email only. I have seen no evidence Mrs X asked for that before March 2025. I am satisfied the Council acted on that and there is now a note on Mrs X’s file to ensure communication is by email. The Council accepts though there was one occasion when it sent an email through the secure platform and one occasion when a social worker contacted Mrs X by text late at night. The Council accepts that is inappropriate and has apologised. I consider that a satisfactory remedy for this part of the complaint, although I note that Mrs X has also provided evidence of other occasions when the Council sent emails through a secure portal that it knew Mrs X could not access. That is also fault.
60. Mrs X has raised concerns about the allocated social worker dealing with her in an abrupt and dismissive manner. I have to rely on the documentary records. I have found nothing in the documentary records to suggest the social worker dealt with Mrs X inappropriately. I therefore have no grounds to criticise it.
61. Mrs X says the Council, when responding to her complaint, failed to address key issues such as loss of care hours, financial manipulation and use of incorrect financial data. Having considered the complaint and the complaint response I am satisfied the Council responded to the complaint Mrs X put in. I am satisfied the complaint response acknowledged Mrs X had felt it necessary to stop care because of the issues that had arisen and addressed the issue of incorrect financial data. I have seen no evidence though Mrs X’s original complaint raised concerns about financial manipulation. As I have found no evidence of fault in how the Council responded to the complaint I have no grounds to criticise it.
62. Because of the fault I have identified I am satisfied Mrs X has not felt able to access her care hours since March 2025 and has experienced significant distress. It is also clear that has had a significant impact on the family. As part of the remedy for this complaint I recommended the Council apologise to Mrs X and make her a payment of £1,000 to reflect her distress and the uncertainty about whether the situation could have been resolved earlier and some of the issues avoided.
63. I also recommended the Council send Mrs X a clear breakdown of the amount it believes she has overpaid which it intends to refund to her. That should list the amounts she has paid and when and link those amounts to the invoices the Council issued so Mrs X has a clear understanding of the calculation. I further recommended the Council liaise with Mrs X to discuss putting the direct payment back into place given it has established Mrs X does not need to make a financial contribution towards her care. The Council should also complete the review it began in 2025. That should include a discussion with Mrs X and her husband about whether a carer’s assessment is required. If it is, the Council should carry that out promptly.
64. I recommended the Council provide guidance to officers dealing with Care Act assessments about the need to consider a carer’s assessment at the same time. I do not make any further recommendations for procedural actions because I am satisfied the Council has already carried out some action, which I refer to in paragraph 41. The Council has agreed to my recommendations.

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Action

65. Within one month of my decision the Council should:
• apologise to Mrs X for the distress/uncertainty/frustration and upset she experienced due to the faults identified in this decision. The Council may want to refer to the Ombudsman’s updated guidance on remedies, which sets out the standards we expect apologies to meet;
• pay Mrs X £1,000;
• provide Mrs X with a clear breakdown of the refund due to her. That should list the amounts she has paid and when and link those amounts to the invoices the Council issued so Mrs X has a clear understanding of the calculation;
• discuss with Mrs X reinstating her direct payment;
• complete the Care Act review the Council began in March 2025 and ensure that includes a carer’s assessment for Mrs X’s husband, should that be required;
• provide guidance to officers carrying out care assessments to make clear the need to consider whether a carer’s assessment is required.
66. The Council should provide us with evidence it has complied with the above actions.

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Final decision

67. I find fault causing injustice. The Council will take action to remedy that injustice.

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Investigator's decision on behalf of the Ombudsman