Summary: Mr X complains the Council have not dealt properly with his Housing Benefit. The Council is at fault because it did not properly notify Mr X about changes to eligibility in relation to his benefit. Mr X suffered avoidable distress. The Council should apologise, pay Mr X £500, review its decision letters and provide guidance to staff.

The complaint

1. The complainant, whom I shall refer to as Mr X, complains the Council did not deal properly with his benefits because:
• He was given a letter saying that his housing benefits had stopped without any explanation.
• had Mr X been supported to set up a Universal Credit claim 6 months prior to turning pension age, none of this would have happened, and he would have continued to receive his money.
• The Council have not taken proper account of his learning disability and reasonable adjustments required.
2. Mr X says he has suffered financial loss and avoidable distress.

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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 an injustice, 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(i), as amended)

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How I considered this complaint

5. I considered Mr X’s complaint and offered to speak with him or his representative. I made enquiries of the Council and considered its response and the supporting documents it provided.
6. Mr X and the Council 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

Law, guidance and policies

7. The Government changed the eligibility rules for Housing Benefit under certain circumstances where one half of a couple was past retirement age. This is called a Mixed Age Couple (MAC) and means that eligibility for Housing Benefit may stop and a new claim has to be made through Universal Credit.
8. As of 15 May 2019, mixed age couples are no longer able to choose whether they claim Universal Credit or Pension Credit and pension-age Housing Benefit. Instead, mixed age couples can only claim Universal Credit until they both reach State Pension age.
9. The Housing Benefit Regulations 2006 say that an authority shall notify in writing any person affected by a decision made by it:
• in the case of a decision on a claim, forthwith or as soon as reasonably practicable thereafter;
• in any other case, within 14 days of that decision or as soon as reasonably practicable thereafter.
10. The Universal Credit, Personal Independence Payment, Jobseeker's Allowance and Employment and Support Allowance (Claims and Payments) Regulations 2013 say that Universal Credit claims can be backdated for up to one month.

What happened?

11. This is a brief chronology of key events. It does not contain everything I reviewed during my investigation.
12. In March 2022, the Council identified that Mr X would be affected by the MAC rules outlined above in paragraph 8.
13. In early December the Council sent a letter to Mr X stating that his Housing Benefit (HB) would be stopped in a week.
14. Mr X’s support worker called the Council in early January to discuss the issue and was told that Mr X needed to make a claim for Universal Credit.
15. Mr X made a Universal Credit (UC) claim effective from 10 February 2023. The Council received notification of UC awards but Mr X was not entitled to UC as his income was too high. In August 2023 Mr X’s UC claim was stopped.

Analysis

Stopping of benefits

16. The Council says it provided notification to Mr X about the changes to his benefit entitlement in March 2022 and December 2022. I have seen copies of the letters.
17. The Council says, “On the 22 March 2022, Mr X’s HB claim was amended, which added an end date of 18 December 2022 to the claim. This amendment triggered an automated benefit decision notice to Mr X. The only regulation regarding notification is that changes to the claim are notified, and the automatic letters fulfil this obligation.”
18. The Council was aware that Mr X’s housing benefit would be ended in December back in March 2022. The automatically generated benefit decision notice does not make clear that Mr X’s Housing Benefit would be terminated in December 2022. It also does not include any information about what action he may need to take as a result of the decision.
19. A claimant can request a written statement of reasons. However, in order to know they may want that, they need to know what the decision actually is. The letter sent to Mr X in March 2022 says, “..your benefit has changed. The reason for this is we have made an administrative amendment to your claim. Details of the changes and how we worked out your weekly benefit are shown in the following pages of this letter. It is your responsibility to check all information included in these pages is correct.”
• The letter says Mr X’s benefit has changed, not that it will be stopped;
• The use of the words ‘administrative amendment’ implies that it is not a major or significant change; and
• There are no further details of any changes and how they have been worked out included with the letter.
20. The Council was aware that Mr X had significant learning difficulties. There is no evidence to show that it considered whether or not it was necessary to provide more information than the standard auto-generated letter.
21. The Council says it, “provided advance notification of the change in March 2022. It is difficult for an auto-generated letter to cover every individual circumstance, but it does include an email address to contact the Council if the recipient has any questions.”
22. The Council wrote a bespoke letter to Mr X in early December 2022 which did explain the decision, the consequent impact and what action he may need to take as a result.
23. The Council did not follow the Housing Benefit Regulations 2006, because the first letter did not clearly identify or explain the decision that it was supposed to inform Mr X about, and the second letter was sent 11 months after the decision had been made. This is fault by the Council. Mr X was not made properly aware of the changes to benefit entitlement that would subsequently affect him. Mr X did not suffer financial loss as his UC claim was closed as his income was too high, but did suffer avoidable distress as a result.

Earlier Universal Credit claim

24. Universal Credit applications may only be backdated for up to one month, as identified in paragraph 11 above. Mr X could not have applied for UC six months before the change.
25. The Council only provided a detailed letter explaining the decision one week before Mr X’s benefits were stopped. It takes five weeks to UC to start to be paid. This means that in order for Mr X to have any chance of making a successful claim for UC, he would have had to make that claim almost immediately.
26. The Council was aware that Mr X had significant learning disabilities, that he needed to be supported with benefits decisions and that it was the Christmas period, when people and services are less likely to be available. It did not give Mr X sufficient notice or time in which to deal with the decision to stop his benefits. This is fault by the Council. Mr X could have been aware of the impending changes and made the necessary arrangements to make a UC claim in good enough time.

Reasonable adjustments

27. I have not seen any evidence that Mr X or anyone on his behalf requested any reasonable adjustments from the Council.
28. The Council says in 2020 it offered Mr X the opportunity to give permission for the Council to speak directly to his support worker to discuss any claim on his behalf. This offer was not taken up by Mr X. This is not fault by the Council.
29. The Council says it has no records to show that a reasonable adjustment for Mr X was requested and that his claim was not flagged as vulnerable. It says it was aware Mr X had significant learning difficulties and that his support worker had acted on his behalf on previous occasions. This is fault by the Council. It should have considered whether Mr X’s claim should have been flagged as vulnerable given the history it was aware of.

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Agreed action

30. To remedy the outstanding injustice caused by the fault I have identified, the Council has agreed to take the following action within 4 weeks of this decision:
• Apologise to Mr X;
• Pay Mr X £500 in respect of avoidable distress;
• Review its auto-generated benefit decision notices to ensure that they clearly identify the nature and specific details of the decision they are intended to advise a claimant about; and
• Provide guidance to staff to consider whether or not claims should be flagged as vulnerable where there is knowledge or evidence that a claimant has required support in the past.
31. The Council should provide us with evidence it has complied with the above actions.

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Final decision

32. I have found fault by the Council, which caused injustice to Mr X. I have now completed my investigation.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman