Summary: Ms X complains about the Council’s actions following Y’s transition into adult social care. We found the Council underfunded direct payments and failed to provide clear care and support plans. It also delayed providing a complaint response. This is fault. It caused undue distress to Ms X and disrupted the care Y was entitled to receive. The Council agreed actions to remedy the injustice caused.

The complaint

1. Ms X complained about the Council’s actions following her child Y’s transition from children’s services to adult social care. She said the Council underfunded Y’s direct payments, failed to provide clear care and support plans, and delayed in responding to her complaint. She said this affected the level of care Y received, caused financial loss for having to pay for care and distress, time and trouble for having to chase the Council.

Back to top

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

Back to top

What I have and have not investigated

5. Ms X complained to the Ombudsman in June 2025. Some of the events complained of date back to 2023, which is outside the normal 12-month period for bringing a complaint as detailed in paragraph 3
6. However, I exercised discretion to investigate matters from 2023 onwards. The complaint concerns a continuing course of action relating to the funding and administration of direct payments, which continued into 2025. The Council has accepted there was underfunding during this period. The Council did not provide clear or consistent information about Y’s entitlement, which limited Ms X’s ability to understand the extent of the problem or to complain earlier. I therefore consider it reasonable to investigate the earlier period.

Back to top

How I considered this complaint

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

Back to top

What I found

Guidance and legislation

Care Plan

9. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs 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. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

Personal Budgets

10. Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. It should confirm the final amount of the personal budget through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person’s care and support needs. The personal budget can be administered as a direct payment.
    (Care and Support Statutory Guidance 2014)

Direct payments

11. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.

Background

12. Y is a young adult with learning disabilities who requires support to meet their assessed needs. Ms X is Y’s mother and main carer.
13. The Council received a transition referral in September 2021, when Y was 16. This confirmed Y was receiving 8 hours per week of direct payments from children’s services. The referral recommended continuation of the existing package, subject to review.
14. An adult needs assessment was completed in January 2023. The Council completed Y’s first adult care and support plan in March 2023. The plan recommended 5 hours per week of direct payments at £17.60 per hour during term time and 8 hours a week in the school holidays. The proposal was agreed by the Best Outcomes panel in early May 2023.
15. Direct payments started from May 2023 onwards, but system setup issues meant payments did not align with the agreed hours.
16. Ms X raised concerns about inconsistent payments and asked for clarification.
17. A review of Y’s care and support plan took place in May 2024, with a recommendation to increase support. The Best Outcomes panel agreed in June 2024 for an additional 10 hours during school holidays and an additional 3 hours at weekends during term time. It declined further weekday term-time hours on the basis that school attendance was considered respite.
18. A social worker emailed Ms X confirming Y’s support as 8 hours during term time and 18 hours during school holidays in August 2024. But the care plan was not promptly issued, and payment systems were not corrected to reflect these changes.
19. Ms X made a formal stage one complaint in early February 2025. The Council responded in late May 2025. The Council accepted underfunding between 8 May 2023 and 21 February 2025, acknowledged shortcomings in recording and clarity, apologised, and offered £500 for distress and inconvenience. The Council also asked Ms X to provide evidence of any out-of-pocket care costs before considering reimbursement.
20. Ms X complained to the Ombudsman in June 2025.

Analysis

Care and support planning

21. The Council did not provide Ms X with a clear, accurate and timely care and support plan setting out Y’s entitlement following their transition to adult social care. The March 2023 care and support plan did not clearly explain how support would operate during term time and school holidays or how it related to the support previously provided by children’s services. The changes to support hours were not consistently reflected in updated care and support plans. Ms X did not receive a clear care and support plan setting out Y’s entitlement until April 2025. This was fault.

Administration of direct payments

22. The Council accepted there was underfunding of Y’s direct payments between May 2023 and February 2025. This happened because payment systems were not aligned with the agreed care and support plans and errors were not identified or corrected in a timely way. This was fault.
23. Direct payments are intended to fund specific care services and are not a financial benefit. Where a council’s fault has caused a complainant to incur extra care costs, the appropriate remedy is to reimburse evidenced costs that should have been covered by direct payments, provided it is consistent with the agreed care and support plan.
24. Ms X said she paid for additional care to cover the shortfall. The Council rightly asked her to provide evidence of this expense before reimbursing her. Ms X did not provide this. I cannot recommend an amount for reimbursement of additional care costs at this stage due to the lack of evidence. Subject to Ms X providing suitable evidence, the Council should reimburse the cost of care Ms X paid for which should have been covered by direct payments.

Complaint handling

25. The Council took over three months to issue its final complaint response and did not take timely steps to resolve the underpayment once identified. This was fault.

Injustice

26. As a result of the faults identified, Ms X experienced uncertainty and was put to avoidable time and trouble in seeking clarification about Y’s entitlement. Ms X reports using her own funds to pay for additional care, although this has not yet been evidenced. Y did not consistently receive support at the level the Council accepted was required to meet his assessed needs. The injustice occurred over an extended period and was avoidable.

Back to top

Action

27. Within 4 weeks of our final decision, the Council should:
• Issue a formal apology to Ms X for 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.
• Subject to Ms X providing suitable evidence, the Council should reimburse the cost of care Ms X paid for which should have been covered by direct payments.
• Pay £500 to Ms X for distress and time and trouble incurred as a result of the faults identified.
• Pay £300 to Ms X, on behalf of Y, for the disruption to his care as a result of the faults identified.
28. Within 3 months of our final decision, the Council should:
• Review its procedures for recording and communicating care and support plans for adults transitioning from children’s services, with particular regard to cases involving direct payments. The review should ensure that payment systems are checked against agreed care and support plans to ensure direct payments align with approved support levels.
29. The Council should provide us with evidence it has complied with the above actions.

Back to top

Decision

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

Back to top

Investigator's decision on behalf of the Ombudsman