The Ombudsman's final decision
Summary: Mrs X complained the Council failed to properly comply with some of the recommended actions it agreed to complete following the Ombudsman’s investigation into her original complaint about disability related expenditure requests. The Council was at fault for its delays and failure to properly complete the agreed actions. It was also at fault for its poor communication with Mrs X. This caused Mrs X and Mr Y injustice. The Council will take action to remedy the injustice caused.
The complaint
Mrs X complained on behalf of herself and her adult child, Mr Y. She has a court appointed deputyship.
Mrs X complained the Council failed to properly comply with some of the recommended actions it agreed to complete following the Ombudsman’s investigation into her original complaint about disability related expenditure requests. As a result, Mrs X said she was not satisfied the Council took her complaint seriously and that the recommendations remain unresolved.
The Ombudsman’s role and powers
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) 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)
How I considered this complaint
I considered the information Mrs X and the Council provided about this complaint in line with our compliance guidance.
I sent Mrs X and the Council a copy of my draft decision and considered all comments received before reaching a final decision.
What I found
In November 2023, we issued our final decision statement on Mrs X’s original complaint 22013512 about disability related expenditure (DRE) requests. We made recommendations which the Council agreed to complete within one month of our final decision. This was to remedy the injustice caused to Mrs X and Mr Y by the Council’s identified failings in that complaint.
In early December 2023, the Council wrote to Mrs X. The Council said it had reviewed Mr Y’s support worker DRE and his day care provision DRE. The Council said it agreed to pay the costs for both DREs. The Council said it would arrange to complete an assessment for Mr Y. This was to consider Mr Y’s DREs for the current financial year with the view to increasing his direct payment which it said it would clearly set out in Mr Y’s support plan.
In mid-December 2023, the Council reassessed Mr Y’s care and support needs. Mrs X said she asked the support worker what date the Council would backdate Mr Y’s Day Care provision DRE to. Mrs X said the social worker told her day services were not allowed as DREs because cheaper council’s services were available. Mrs X said she was concerned about the social worker’s response because it was contrary to what the Council said in its early December 2023 correspondence to her.
Mrs X said she received five separate financial re-assessments dated 21 December 2023 from the Council which considered Mr Y’s support worker and Day Care provision DREs. Mrs X said she also received 31 separate credit notes from the Council in January 2024 with an estimated total of £1,500.
In late January 2024, Mrs X said the Council issued Mr Y with a full amount invoice which suggested the Council had not refunded Mr Y with the DRE credit notes.
In February 2024, Mrs X contacted the Ombudsman. She raised concerns that the Council had not properly completed the agreed actions contained in the final decision of her original complaint. The agreed actions she raised concerns about were for the Council to: review Mr Y’s DRE request for the cost of the support worker hotel accommodation and the top up cost for his Day Care provision or consider if these should be met by an increase to Mr Y’s direct payments. The assessment should include a detailed explanation of the reasoning behind any decision taken.
review and provide clear information about Mr Y’s direct payments in his support plan and clearly set out the agreed direct payment for his Day Care provision.
Mrs X also said the Council had not provided her with any information about the direct payments in Mr Y’s support plan. She also questioned whether the Council had backdated Mr Y’s Day Care provision DRE.
In March 2024, the Council sent a cheque of £1,601.46 payable to Mr Y. Mrs X said the Council did not explain what the payment was for. She said the 31 credit notes she had previously received came to a total of approximately £1,500. Mrs X said she was confused with the difference in figures.
In response to my enquiries, the Council confirmed it had applied Mr Y’s assessed contribution to his four weekly invoices. It confirmed it had backdated Mr Y’s Day Care provision DRE to 23 May 2022 as requested by Mrs X. The Council also said after it completed Mr Y’s DRE reassessment, it issued him with credit notes and it refunded Mr Y with a £1,601.46 cheque.
To support its response to my enquiries, the Council provided the following evidence. A copy of: a notification of Mr Y’s assessed contribution letter. The Council re-assessed Mr Y’s contribution from April 2021 until July 2023 which it will subsequently review every year.
an invoice of £548.96 dated 26 February 2024 of the assessed contribution applied to Mr Y’s weekly contribution. This covered the period from 15 January 2024 to 11 February 2024.
the breakdown of Mr Y’s credit notes with a total of £1,601.46. This covered the period from 5 April 2021 to 13 November 2023.
Mr Y’s support plan dated 22 March 2024.
After we issued the initial draft decision statement on this complaint, Mrs X raised additional concerns about some information in Mr Y’s support plan. She said the support plan contained an incorrect direct payment for Mr Y’s Day Care and that the Council incorrectly backdated his Day Care DRE to May 2022 instead of May 2021. Mrs X also maintained the Council did not send her the notification of Mr Y’s assessed contribution letter.
We put those concerns to the Council. It confirmed: the Day Care rate in Mr Y’s support plan which covers the period from 1/5/2023 to 14/12/2023 was correct because the difference was covered by the DRE. The Council explained it had continued to pay the Day Care DRE since then. It confirmed the DRE will be increased to £50 per session and it will be included in Mr Y’s new support plan once his new direct payment agreement is signed. The Council said the increased £50 Day Care DRE will be reflected in Mr Y’s new support plan and it will hand deliver the new plan to Mrs X.
it should have backdated Mr Y’s Day Care DRE to May 2021. It apologised and said it will arrange a further refund for Mr Y.
and provided evidence it sent the notification of Mr Y’s assessed contribution letter to Mrs X on 21 December 2023.
Analysis Based on the additional information and evidence provided by the Council in response to my enquiries, I find fault by the Council for its failure to complete the actions in paragraph 12 within the agreed timescale. We issued our final decision on case reference 22013512 on 1 November 2023. The Council agreed to complete the actions one month after we issued the final decision. This meant the Council should have completed the agreed actions by 1 December 2023.
The Council did not complete its assessments for Mr Y until 21 December 2023 and it did not issue Mr Y’s support plan until 22 March 2024. These were faults. The Council’s delays caused further distress to Mrs X.
I also find the Council failed to comply with the recommended actions listed in paragraph 12. First, the Council failed to properly review and backdate Mr Y’s Day Care DRE to May 2021 which it only acknowledged when Mrs X raised additional concerns to the Ombudsman. This was fault. And as a result, it meant the Council failed to correctly backdate and refund Mr Y with an additional one year’s worth of Day Care DRE. The Council has agreed to arrange the additional one-year refund to Mr Y.
Similarly, I find the Council failed to clearly set out information about Mr Y’s agreed direct payment for his Day Care provision in his support plan. It was after Mrs X raised her concerns with the Ombudsman that the Council provided a clear explanation about Mr Y’s Day Care DRE as set out in paragraph 18(a). This was fault and it caused confusion and frustration to Mrs X.
I note the Council had sent some credit notes to Mrs X in January 2024. But I find the Council failed to properly explain to Mrs X how it calculated and reached the £1,601.46 figure on the cheque it sent to Mr Y in March 2024. This was fault and it caused further confusion to Mrs X.
As regards notification of Mr Y’s assessed contribution letter, additional evidence provided shows the Council issued the letter on 21 December 2023. This was not fault.
Agreed action
To remedy the injustice caused by the faults identified, the Council has agreed to complete the following within one month of the final decision: apologise in writing to Mrs X and pay her £150 to acknowledge the further distress and confusion caused by the Council’s failings as identified above. The apology should be in accordance with our guidance, Making an effective apology provide the Ombudsman with evidence to show the Council has issued Mr Y’s new support plan which shows the increased £50 per session for his Day Care DRE evidence to show the Council has backdated Mr Y’s Day Care DRE to May 2021 and refunded him with the additional one-year outstanding DRE cost.
The Council should provide us with evidence it has complied with the above actions.
Final decision
I find evidence of fault by the Council leading to injustice. The Council will take action to remedy the injustice caused.
Investigator’s decision on behalf of the Ombudsman
Investigator's decision on behalf of the Ombudsman