Summary: The Council was not at fault for refusing a COVID-19 Test and Trace payment to Mr X on the grounds his application was late. However, it was at fault for not making it clear to potential applicants that a deadline applied. It has since changed the information on its web-site.

The complaint

1. Mr X complained the Council wrongly refused a Test and Trace Support Payment. He said it imposed a 14 day deadline, which was not mentioned on its website or during the online application process.
2. Mr X also complained the Council’s complaint response did not respond to all the issues he raised and wrongly referred to him having had COVID-19.
3. Mr X said the refusal of the payment was insulting and caused inconvenience. He was also put to the frustration, and time and trouble, of pursuing the Council.

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The Ombudsman’s role and powers

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. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
6. 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

7. I considered:
• the information provided by Mr X and the Council; and
• relevant Government guidance, as set out below;
8. Mr X and the Council had an opportunity to comment on my draft decision and I considered their comments before making a final decision.

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What I found

Background

9. In September 2020, the Government introduced NHS Test and Trace Support Payments. A payment of £500 could be made to individuals who:
• were told to self isolate by NHS Test and Trace, either because they tested positive for COVID-19 or had recently been in close contact with someone who had tested positive;
• were employed or self employed;
• were unable to work from home and would lose income as a result; and
• were receiving certain means-tested benefits.
10. Version 2 of the Guidance (dated 16 October 2020), applicable at the relevant time, said eligible individuals could make a claim “up to 14 days after their period of isolation ended”.
11. Applications for payments are administered by councils. The Council’s online application sets out the evidence the applicant needs to provide when making a claim. For applicants who were self employed, this included:
• proof of self employment, for example, self -assessment returns or trading income;
• the most recent bank statement for the business; and
• proof that the bank account to which payment would be made is the applicant’s (for example, a bank statement).
12. Councils were also able to make discretionary payments to those individuals who:
• were told to self isolate by NHS Test and Trace, either because they tested positive for COVID-19 or had recently been in close contact with someone who had tested positive;
• were employed or self employed; and
• were unable to work from home and would lose income as a result.
13. The Guidance said the discretionary payment was for those not receiving the means-tested benefits necessary to qualify for the statutory payment, and who were on low incomes and would face financial hardship as a result of not being able to work while they were self isolating.
14. The Guidance said councils could introduce additional criteria for discretionary payments to determine eligibility, as long as they operated in addition to, rather than instead of, the above criteria.
15. This Council restricted the discretionary payment to persons qualifying under the criteria set out in paragraph 12 above and who also met one or more of the following:
• those awaiting the outcome of an appeal for one of the stipulated benefits;
• those who had recently applied for one of the stipulated benefits and were waiting for a decision;
• those with no recourse to public funds; or
• those not fitting the above categories but requiring assistance, subject to discussion with management.

What happened

16. On 24 October 2020 Test & Trace told Mr X, who is self employed, to self isolate for 10 days to 2 November 2020. Mr X explained that due to the nature of his job, this meant he had to stop working. Mr X applied to the Council for a test and trace payment on 28 November 2020, after obtaining copies of bank statements from his bank.
17. The online application asked for evidence as set out at paragraph 11. Mr X attached one document, which I understand was a bank statement. The record shows the system generated a response that said: “Sorry – you do not qualify” and provided links to other sources of help. The online application process then allowed Mr X to apply for a discretionary payment. Mr X did not provide any further supporting documents when prompted to do so but stated he endeavoured to be financially independent by working and being told to stop working by Track and Trace “financially impacted” him.
18. The Council refused the payment because it said he should have applied within 14 days of to the end of his period of self isolation. Mr X challenged this. He said:
• the information on the Council’s website and online application process did not say there was a 14 day deadline; and
• he needed to wait 3 weeks for bank statements to show he had no income during the period of self isolation, due to being paid one week in arrears.
19. The Council provided an extract of the relevant Guidance to show the time limit and confirmed the bank statement was required to confirm the bank details provided for the payment, not to confirm reduced earnings.
20. Mr X complained. In its complaint response dated 21 January 2021 the Council:
• apologised for the difficulty Mr X had contacting the department and said it was trying to provide the best service it could despite the impact of the COVID-19 pandemic;
• confirmed it had responded to emails about the decision on five separate days between 1st and 8th December 2020;
• said it had to follow Government guidelines when administering the scheme and Mr X had not applied on time; and
• said it hoped he had now fully recovered.
21. In a further complaint response on 1 March, the Council confirmed the information it had given Mr X was correct and the decision was in line with the relevant procedure.
22. Mr X remained unhappy and complained to us. He said he had a video of the online application process, which showed there was no mention of the 14 day deadline but the Council had not referred to this in its complaint response. He said the process had been very frustrating due to the Council not accepting it had made an error.
23. In response to my enquiries, the Council added that, even if the application had been made in time, Mr X had not provided all the information requested in the online application, namely proof he was self employed. Therefore, it could not say whether he would have been eligible for a payment.

My findings

Test and trace payment

24. The Council was operating a Government scheme and had to apply the relevant Guidance, which, at the time Mr X applied for the payment, said applications should be made within 14 days of the self isolation period.
25. I have not seen the information available on the Council’s website at the time but there was no mention of the deadline in the online form. Nor does the online form state that bank statements were needed only to confirm the bank details and establish the applicant was running a business. Therefore, Mr X could not tell from the information provided that he did not need to prove lost income and that, by the time he applied, he had missed the deadline. This was fault.
26. However, Mr X confirmed in his application that he was not receiving the stipulated benefits and did not provide evidence to show he met the criteria for a discretionary payment, as set out in paragraph 15. On the basis of the information I have seen, it appears unlikely he would have been eligible for a payment even if he had applied earlier. Therefore, he has not suffered a significant injustice.
27. By the time the complaint was investigated, the Council’s website had been updated to reflect later versions of the Government Guidance and clearly stated the deadline for applications.
28. The online application system provided an immediate response to the application, which was a refusal. Mr X asked the Council to consider a discretionary payment, which it refused. It informed him of its decision a few days later. In subsequent correspondence, it responded to the points Mr X raised.
29. Although the complaint response did not refer to the video, I am satisfied the Council provided appropriate information to show why it refused a payment.

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Final decision

30. I have completed my investigation. I have found fault but this did not cause significant injustice. The Council has already taken action to address the fault.

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Investigator's decision on behalf of the Ombudsman