Summary: Ms X complains the Council delayed in carrying out an agreed increase in her son’s (Mr Y) care package and, despite accepting its fault, has failed to remedy the injustice this caused. The Council accepts it initially failed to respond properly to Ms X’s complaint and that it delayed in carrying out the agreed increase in Mr Y’s care package. It has offered to reduce an outstanding debt arising from the historic mismanagement of Mr Y’s direct payments by £5,150, to remedy the injustice caused by having to provide extra support for him. The Council needs to pay £9,000 to the family (Ms X and Mr Y’s siblings) and £150 directly to Ms X, without reducing the outstanding debt.

The complaint

1. The complainant, Ms X, complains the Council delayed in carrying out an agreed increase in her son’s (Mr Y’s) care package and, despite accepting its fault, has failed to remedy the injustice this caused.

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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 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)
3. 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

4. I have considered evidence provided by Mr Y’s Solicitor and the Council, as well as relevant law, policy and guidance.
5. Ms X, via the Solicitor, 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

What happened

6. Mr Y has significant needs for care and support. He lives at home with his mother and siblings. He has a care package, which until last year was jointly funded by the Council and the NHS. In May 2024 he qualified for full NHS Continuing Healthcare, which now funds all his care. His mother and siblings meet the care needs not met by his care package.
7. The Council reviewed Mr Y’s care and support plan in September 2022. The review said Mr Y’s incontinence resulted in a significant amount of additional washing, which his family was struggling to cope with. It recommended support from a cleaner twice a week for up to four hours a week, to help with laundry.
8. In October the Council provided a copy of the review, which included an updated care and support plan. According to this, the care package in place at that time comprised 145 hours of support with personal care a week (although the times identified in the plan provided for 148 hours), plus 60 hours of support a week from a specialist provider to address behavioural issues. The updated plan proposed 207 hours of support with personal care, plus 60 hours of support with behavioural issues. The extra hours were for support at weekends (32 hours) and three nights a week (27 hours).
9. In December the Council’s funding panel agreed, at least in principle, to increase Mr Y’s care package to 288 hours a week. Mr Y’s solicitor says around this time the Council agreed the family could use the 27 hours for overnight flexibly. The family wanted to use these hours during the day for support with cleaning. But they could not do this, as the Council did not set up the increased personal budget.
10. On 11 January 2023 the Council said, despite having considered the proposed increase in Mr Y’s care package at the funding panel’s meeting in December 2022, it would consider the proposed increase again at its meeting on 17 January.
11. On 14 March the Council told Ms X it had agreed to increase Mr Y’s care package to 288 hours a week. But it did not set up the increase.
12. In April the Council provided an updated care and support plan review document (dated September 2022). This recommended support from a cleaner for four hours a day, five days a week (20 hours). It included an updated care and support plan, which referred to 207 hours (plus 60 hours of behavioural support). Although the plan broke the hours down by time periods, it did not identify any specific provision for cleaning. The Council did not set up the increase.
13. In June the Council provided a further updated care and support plan review dated September 2022. This confirmed the need for support from a cleaner for four hours a day, five days a week (20 hours). The care and support plan provided for 260 hours a week, which included 60 hours of support with behavioural issues and 20 hours of support with cleaning. It no longer included overnight support. It said the funding panel agreed:
• an increase in September 2021 “with the expectation that family members will provide additional care and support to facilitate their request for [Mr Y] to remain cared for in the family home”;
• agreed 20 hours of support with cleaning in December 2022, subject to a review in six weeks following a referral to the bladder and bowel service.
14. Mr Y’s solicitor complained to the Council in December.
15. When the Council replied to the complaint on 19 January 2024, it said
• Its transition team (children and young people with disability team) had dealt with Mr Y until October 2023, when he transferred to adult social care.
• It apologised for the delay in commissioning support from October 2023. It said this was because it had been waiting to finalise decisions with NHS colleagues.
• The increased funds would be available soon.
16. As Ms X was not satisfied with the Council’s response, the solicitor pursued the complaint further in February.
17. When the Council replied to Ms X’s complaint on 17 May, it said:
• Mr Y’s care and support plans had not made it clear which team was dealing with him.
• Adult social care’s transition team had been responsible for him since he turned 18, and had assessed him under the Care Act 2014.
• The Council’s funding panel agreed to increase Mr Y’s care package to 288 a week on 22 December 2022.
• Mr Y’s care package actually increased to 288 hours a week from 1 October 2023.
• It had delayed by two months in telling Ms X the 17 January funding panel’s decision. It put this down to a delay in receiving confirmation from the NHS.
• It apologised for the inadequacy of its previous response to Ms X’s complaint and offered to pay her £150.
• It offered £5,000 for the delay in increasing Mr Y’s care package.
• It said it would use the £5,150 to reduce Mrs X’s outstanding debt to the Council.
• It apologised for the delay in responding to Ms X’s concerns.
18. I understand the debt relates to the historic misuse of Mr Y’s direct payments by his mother when she used to manage them.
19. When the Council reviewed Mr Y’s needs in May, his care package comprised 208 hours a week, plus 60 hours of behavioural therapy and 20 hours of support with cleaning.
20. Later in May Mr Y qualified for full NHS Continuing Healthcare, which means the NHS now funds all his care.

Is there evidence of fault by the Council which caused injustice?

21. There is no dispute over the fact there was a long delay in setting up increases to Mr Y’s personal budget. The need to increase his personal budget was first identified in September 2022 but not set up until October 2023. The Council has offered to pay £150 for the inadequacy of its response to Ms X’s initial complaint and a further £5,000 for the delay in increasing Mr Y’s care package. It has also said it will offset these payments against Ms X’s debt to the Council.
22. There is nothing to suggest Mr Y suffered injustice himself, as his family ensured all his care needs were met. However, the Council’s offer fails to take into account that the delay in setting up the increased care package had an impact on Mr Y’s siblings, as well as his mother. It left the family providing support for up to 80 hours a week, which should have been funded by Mr Y’s personal budget. This prevented them from doing other things they had wanted to do with their lives. That is an injustice which needs a remedy for the three of them. It is also not appropriate for the Council to use the remedy to reduce Ms X’s debt, as that would prevent it from working as intended.

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Action

23. I recommend the Council within four weeks:
• pays Mr Y’s family £9,000 to remedy the injustice arising from the delays in setting up his increased personal budget; and
• pays Ms X £150 for the distress caused by failing to respond properly to her initial complaint.
24. The Council should provide us with evidence it has complied with the above actions.

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Decision

25. I find fault causing injustice which requires a remedy. The Council has agreed to take the action I recommended to remedy the injustice.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman