Summary: Miss X’s representative complained the Council as Miss X’s financial appointee failed to ensure she claimed a personal independence payment. So, she missed out on benefit she was entitled to receive. There was a delay in Miss X receiving the benefits and some of this delay was due to Council fault. The Council has agreed to pay Miss X £500 to acknowledge the lost opportunity caused by the Council’s delays.

The complaint

1. Miss X’s representative complained the Council, as Miss X’s financial appointee, failed to ensure a claim for a personal independence payment was submitted. This meant Miss X missed out on benefits she was entitled to receive between November 2016 and April 2018, when the claim was finally awarded.

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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. When considering complaints, if there is a conflict of evidence, we make findings based on the balance of probabilities. This means that we will weigh up the available relevant evidence and base our findings on what we think was more likely to have happened.
4. 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

5. I have considered the information provided by Miss X’s representative and have discussed the complaint with them on the telephone.
6. I have considered the Council’s response to our enquiries on the complaint which includes the Council’s case records, records of phone calls and emails and letters.
7. I gave Miss X’s representative and the Council the opportunity to comment on a draft of this decision and I considered the comments I received in reaching a final decision.

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What I found

Appointeeship

8. When a council has concerns about someone’s ability to make decisions they must carry out a mental capacity assessment. The assessment must relate to the specific decision to be made at that particular time.
9. If someone does not have the capacity to manage their financial affairs they can agree to having an appointee. The appointee is responsible for managing a person’s benefits and for paying bills on their behalf.

Benefits

10. The Department of Work and Pensions (DWP) administers most welfare benefits. Employment and Support Allowance (ESA) is a welfare payment for those who have a disability or health condition that affects how much they can work.
11. Disability Living Allowance (DLA) is money for people who have extra care needs or mobility needs (difficulty getting around) as a result of a disability. Personal Independence Payments (PIP) are replacing DLA for adults under state pension age.
12. Housing benefit is administered by the Council, not the DWP. It helps people on low incomes to pay their rent.

What happened

13. Miss X has autism and other health conditions. For a number of years, Walsall MBC (Council A) acted as appointee for Miss X’s finances. However, Miss X now lives in another area of the country, in Council B’s area. Since 2014 Council B has had responsibility for meeting Miss X’s care and support needs.
14. In 2016, Miss X received support from a care provider, arranged by Council B. It helped her deal with correspondence including paying bills and dealt with a bank account on her behalf.
15. In March 2016 Council A wrote to Council B asking it to take over as appointee for Miss X’s financial affairs. Council B asked Miss X’s social worker to complete a mental capacity assessment.
16. Council A contacted Council B in November 2016, chasing progress of the change in appointee. Miss X’s social worker at Council B responded and advised Council A that Miss X had suffered a family bereavement and had gone to stay for an extended period with family in Council A’s area. Her support from the care provider had ended. They said they would look to carry out a mental capacity assessment when Miss X returned to Council B’s area. The social worker contacted Council A in December 2016 to report that Miss X had stopped receiving her weekly allowance and asked that this be sorted.
17. Miss X’s social worker from Council B then wrote to Council A in January 2017, enclosing some bills. The letter set out that Council B had ended the support provided by the care provider in November 2016 as Miss X had moved away for an extended bereavement period. They were in the process of reassessing her needs. The letter said her housing benefit had ended and this needed exploring. They had yet to carry out a mental capacity assessment for finances but would do so when Miss X returned to Council B’s area and was settled. They asked Council A to liaise with the care provider regarding management of Miss X’s finances. They attached copies of correspondence including a letter which set out why Miss X’s housing benefit had ended.
18. In March 2017 the social worker contacted Council A by email and asked it to contact the care provider about how best to progress with ensuring Miss X’s bills were paid and ensuring she had access to cash. Miss X returned to Councill B’s area in late March 2017.
19. In May 2017 Miss X’s support worker emailed Council A regarding unpaid bills and said Miss X was no longer receiving housing benefit. Council A telephoned the DWP in June 2017. The DWP advised that Miss X’s claim for DLA had stopped as she now needed to apply for PIP. It said it had sent the letter to her appointee however it did not have Council A recorded as Miss X’s appointee.
20. During June 2017 Council A liaised with the DWP to try and resolve the appointeeship issue. During this time Council B contacted Council A about outstanding bills which Council A paid.
21. In August 2017 a support agency agreed to support Miss X with a housing benefit claim. It requested information regarding her income and savings from Council A. Council A contacted the care agency that previously supported Miss X for information regarding the bank account it held for her. The support agency required evidence of Council A’s appointeeship. Council A received the money from this account in December 2017.
22. In August 2017 Council A contacted the DWP again as the appointee issue was still not resolved. The DWP agreed to accept information regarding Miss X’s ESA as evidence that Council A acted for Miss X. Council A provided this to the DWP mid-August. In early September Council A submitted a PIP claim form to the DWP.
23. In late September 2017 the DWP asked Council A to complete a further information form for Miss X’s PIP claim. Council A contacted Council B for support with this. Miss X’s social worker said they were unable to help. A support agency at Council B agreed to help but said Miss X would not engage with the process. Following a meeting with her social worker Miss X agreed to accept support with applying for PIP from the care agency. Council A contacted the DWP who agreed to extend the deadline for the return of the PIP form.
24. In October 2017 Council A asked Council B for assistance in obtaining bills and contacting service providers so it could manage these on Miss X’s behalf. It again asked that Council B take over as Miss X’s appointee as it was finding it difficult to get information for her due to the distance. Miss X’s social worker said Miss X was on a waiting list and it could take six months. They agreed to forward post to Council A and to ask her support worker if they would assist with transferring bills over.
25. The DWP wrote to Council A in November 2017 to arrange to assess Miss X for PIP. A worker from the support agency agreed to attend with Miss X. The DWP cancelled the appointment and offered three further dates which the Council passed to the support agency. The support agency worker contacted Council A to advise Miss X had not kept an appointment with them and so may not turn up for an assessment. They suggested Council A contact Miss X’s mum who could contact the support worker and rearrange the appointment.
26. Later that month, Council A contacted Miss X’s social worker to explain they were struggling to get Miss X to attend appointments and requested assistance with ensuring she made and attended a new appointment, or her claim would be terminated. The social worker advised they could not assist with benefit claims and it was unlikely Miss X would be allocated an appointee at Council B until the New Year. They suggested the Council contact Miss X’s mum to see if she could support her to attend the appointment.
27. In December 2017 Council A contacted Miss X’s mum who agreed to help whilst Miss X was staying there over Christmas but later changed her mind. Council A also contacted the DWP to rearrange the assessment appointment but DWP would not do so at that time.
28. In early February 2018 Council A contacted Council B again about it taking over as Miss X’s appointee. It said Miss X was not engaging with it as it was too far away and it was struggling to get assistance with benefit applications. Miss X’s PIP claim was stopped by DWP and she was only receiving ESA and was very vulnerable. Council A said it was in her best interests for Council B to take over. It re-sent the request in March 2018 as it did not receive a response.
29. In March 2018 Council B agreed to take over as Miss X’s appointee for finances. In April 2018 Council A reapplied for PIP for Miss X. Later that month it relinquished its role as appointee and Council B took over.
30. Later that year, following an appeal, Miss X received PIP backdated to April 2018.

Complaint

31. In October 2018 Miss X’s representative wrote to Council A and said its failure to claim for benefits in a timely fashion meant Miss X had missed out financially. Following a protracted exchange of correspondence, in which Council A offered to make some payment, the representative formally complained to Council A about its failure to perform its responsibilities as appointee which meant Miss X missed out on benefits she should have received.
32. Council A responded in February 2020. It referred to the delay in Council B accepting appointeeship and the difficulties it had getting support and information due to the geographical distance involved. It considered it did not have the information necessary to make a housing benefit and council tax support claim until December 2017. It referred to several contributory factors to the delay in claiming PIP including confusion with the DWP about the appointeeship. It referred to the support it sought from the support agency, Miss X’s mum and Council B with the PIP assessment, lack of support from Council B, with the PIP assessment and the rearranged appointments.
33. Miss X’s representative remained unhappy and provided further information to Council A. The Council responded in June 2020. It accepted it had failed to fully investigate Miss X’s capital and so failed to submit a housing benefit application in a timely manner which led to Miss X paying rent and accruing rent arrears when she would have been entitled to housing benefit. Equally Miss X had paid council tax when she should have received council tax support. It agreed to pay Miss X the equivalent sum.
34. With regards to PIP, it said it made numerous attempts to complete the PIP application in a timely manner once appointeeship details were confirmed in August 2017. It made every effort to complete the application but was unable to secure support from various parties to finalise the claim. It did not consider it was liable for the lack of PIP.
35. Miss X’s representative complained to us. They were satisfied with Council’s A’s consideration and response related to Miss X’s housing benefit and council tax support and so we have not investigated that issue but considered Miss X had missed out on £5,665 in missed PIP payments.

Findings

36. As Miss X’s financial appointee, Council A was responsible for overseeing Miss X’s finances, managing her benefits and paying her bills. I acknowledge this was a difficult situation as Miss X lived in a different geographical area to Council A and that Council A sought to transfer its role as appointee to Council B. However, until this happened Council A was responsible for overseeing Miss X’s finances.
37. In 2016, Miss X was supported on a day-to-day basis with managing her finances by a care provider who sorted her paperwork and managed her bills. The social worker wrote to Council A in January 2017 to advise the care provider was no longer supporting Miss X, so Council A needed to liaise with the care provider regarding managing Miss X’s finances. They also told Council A Miss X’s housing benefit had stopped and provided bills which showed Miss X was no longer receiving ESA. There is no evidence Council A contacted the care provider or Miss X at that time to clarify what was happening with her finances. This failure to take action is fault and resulted in around a four-month delay in Council A contacting the DWP.
38. When the support worker contacted Council A in May 2017, it contacted the DWP who advised Miss X’s DLA had stopped as it needed to change to PIP. The records show that between June and August 2017 the DWP questioned whether Council A was Miss X’s appointee and Council A tried to resolve this. Council A acted as Miss X’s appointee since 2009. I cannot say why the DWP questioned this. This caused delay in processing Miss X’s PIP claim but was not due to fault by Council A.
39. The records show that between August 2017 and December 2017 Council A made significant attempts to support Miss X with submitting a PIP claim. It arranged appointments and liaised with support workers to progress her application. Miss X did not engage. The delay between August 2017 and December 2017 was not because of fault by Council A.
40. Although Council A retained responsibility for Miss X’s finances, in early 2018 it was unable to progress Miss X’s PIP application due to her lack of engagement. It acted appropriately in contacting Council B to progress the transfer of appointeeship. When, in April 2018, Council B confirmed the transfer was taking place, Council A acted appropriately and submitted a new PIP claim. Council B supported her through the claims process and Miss X later received benefit backdated to that date.
41. I cannot say with any degree of certainty, even on the balance of probabilities, to what extent Miss X would have engaged had Council A taken action in January 2017 when Council B contacted it about managing Miss X’s finances. I therefore cannot say exactly what payments she may have missed out on. However, Miss X lost the opportunity to engage and to receive her PIP sooner. I have therefore recommended a payment to acknowledge this lost opportunity.

Agreed action

42. Within one month of the date of this decision, Council A has agreed to pay Miss X £500 to acknowledge the lost opportunity to claim DWP benefit caused by the Council’s delays.

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Final decision

43. I have completed my investigation. The Council was at fault leading to injustice which it has agreed to remedy.

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Investigator's decision on behalf of the Ombudsman