Summary: There was fault by the Council for the time taken to process Ms X’s direct payment application. This meant Ms X had to wait longer than she should have to start to receive the payments. To remedy the injustice caused the Council agreed to apologise and make a payment to Ms X to recognise the distress caused by the delay.

The complaint

1. Ms X complains about the time taken to process her application for direct payments.
2. Ms X said she had to pay privately for some care as a result of the delays.

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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 suggest 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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What I have and have not investigated

5. I have investigated matters up until August 2025, which was the end of the complaints process. If Ms X has any concerns about events which have taken place after this time she would need to make a complaint to the Council in the first instance.

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How I considered this complaint

6. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
7. 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

Law and guidance

8. 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.
9. The gateway to receiving a direct payment must always be through the request from the person. Councils must not force someone to take a direct payment against their will. They should not place someone in a situation where a direct payment is the only way they can get personalised care and support.
10. Councils must tell people during the care planning stage which of their needs direct payments could meet. However, councils must consider requests for direct payments made at any time and have clear and quick procedures in place to respond to them.
11. After considering the suitability of the person requesting direct payments against the conditions in the Care Act 2014, the council must decide whether to provide a direct payment. In all cases, the council should consider the request as quickly as possible.
12. The council must provide interim arrangements to meet care and support needs to cover the period in question. Where accepted, the council should record the decision in the care or support plan. Where refused, the council should explain its decision in writing to the person who made the request. It should also tell the person how to appeal against the decision through the local complaints procedure. (Care and Support Statutory Guidance 2014)

What happened

13. Ms X was receiving care at home from a care agency commissioned by the Council. In March 2025, Ms X told the care company who were providing her home care that she had instructed another provider to deliver the care package.
14. In late March 2025, a social worker spoke to Ms X about the new provider she instructed as they were not registered with the Council. The social worker discussed the possibility of direct payments to offset some of the costs of the provider, however Ms X would need to pay a top up.
15. In early April 2025, the Council discussed direct payments with Ms X. Ms X said her mother would pay the top up needed to use the care provider she wanted. The Council agreed to visit Ms X in mid-April 2025 to discuss direct payments further and decide if Ms X’s mother could afford to pay the top up fee.
16. On 17 April 2025, the Council visited Ms X and her mother and told them the top up they would need to pay. The Council then made a request to change Ms X’s care package to a direct payment and confirmed it was satisfied the top up was affordable.
17. In early May 2025, the Council’s local area co-ordinator took Ms X to the bank to open a new account for the direct payments. The Council then sent Ms X the direct payment agreement which she signed and returned.
18. The direct payments were put in place from late July 2025. In late July 2025, Ms X contacted the Council as she only had direct payments for 7 calls per week and not 14. The Council told her the support plan was for 7 calls per week.
19. Ms X made a complaint to the Council in late July 2025 about how the Council had handled her direct payment application.
20. In early August 2025, the Council responded to Ms X’s complaint. The Council apologised for the delay setting up the direct payments. The Council said there was a difference between the care provider’s rate Ms X wanted compared to the agency rate so the Council had to make sure the top up was affordable. The Council said Ms X’s direct payments were in place and it had backdated these to May 2025, when she opened the bank account. The Council said it discussed the direct payment process with Ms X twice in April 2025, and twice in July 2025. The Council said it would now review Ms X’s direct payment as she had raised concerns about her mother being able to afford the top up.

Analysis

21. Ms X initially asked for direct payments in late March 2025, however it took until late July 2025 to set these up. This delay was fault. The Council approved direct payments, sent Ms X a direct payment agreement and helped her open a bank account by early May 2025.
22. While the Council said it wanted to make sure the top up was affordable, the case notes showed it was satisfied Ms X’s mother could afford the top up after it visited her in April 2025.
23. Ms X said she has had to pay privately for her care provider because of this delay. The Council has backdated her direct payment, therefore I do not consider she has lost out financially. The delays have caused Ms X distress and anxiety as she spent time pursuing the direct payments with the Council.

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Agreed Action

24. Within one month of my final decision the Council agreed to carry out the following:
• Apologise to Ms X for the injustice caused by the delay processing her direct payments. 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 Ms X £100 to recognise the distress and anxiety the delay processing her direct payments caused to her.
25. The Council should provide us with evidence it has complied with the above actions.

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Decision

I find fault causing injustice. The Council agreed to the above actions to remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman