City of York Council (23 013 454)

Category : Adult care services > Direct payments

Decision : Upheld

Decision date : 26 Jun 2024

The Ombudsman's final decision:

Summary: The complainant (Mr X) said the Council had failed to update his wife’s (Mrs X) direct payments with the inflationary increase from April 2023. We found fault with the Council’s lack of action as well as with the inadequate communication with Mr X and its failure to respond to his complaint. The Council’s fault caused Mr X frustration. He spent much time contacting the Council and other organisations. The Council agreed to apologise and make symbolic payments to recognise Mr X’s distress and his time and trouble. The Council also agreed to carry out some service improvements.

The complaint

  1. Mr X complains the Council failed to increase his wife’s direct payment by 2.5% from April 2023 in line with the Council’s correspondence from May 2023.
  2. Mr X says the Council’s failure to adhere to its commitment caused him frustration and distress and affected his health. He has been dealing with all his wife’s care and financial affairs and after receiving the Council’s letter with the information on the uplift, he told the carers they would get it. Mr X started paying it from his own funds but after some time stopped. Mr X said he felt personally responsible for ensuring Mrs X’s carers received the increased payments.

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The Ombudsman’s role and powers

  1. 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)
  2. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
  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

  1. I spoke with Mr X and considered the information he provided.
  2. I made enquiries with the Council and considered the information it provided.
  3. I have referred to our guidance “Principles of Good Administrative Practice” and reviewed the Council’s Corporate Policy and Procedures for Complaints, Concerns, Comments and Compliments.
  4. 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

What happened

Background

  1. Mrs X has been receiving domiciliary care from the Council. She does not have mental capacity to manage her affairs. Mr X has been her nominated person. Mr X is in his nineties.
  2. At the beginning of June 2023 Mr X’s representative asked the Council to carry out Mrs X’s care and support plan review as the direct payment she had been receiving was not enough. The representative told the Council Mr X had been frustrated by the lack of the Council’s response to his communications. The complaint followed.
  3. The Council reviewed Mrs X’s care and support plan in July 2023 and agreed a new care package from the beginning of August.

Annual inflationary increase to direct payments

  1. In the second week of May 2023 the Council told Mr X it would be updating Mrs X’s direct payments by the annual inflationary increase of 2.5%. This increase was meant to be applied from the beginning of April 2023.
  2. Mr X told Mrs X’s carers about the increase of their fees and started applying the uplift from his own funds. As the Council failed to update Mrs X’s direct payments, after a few weeks Mr X stopped paying the extra fees to his wife’s carers.
  3. Mr X contacted the Council in mid-July, at the end of July and at the beginning of August 2023. In September Mr X tried to resolve the situation using the freedom of information legislation but the Information Commissioner referred him to us. Mr X also sought help from his local councillor.
  4. After receiving advice from us at the end of November 2023, Mr X complained to the Council’s about its failure to apply the inflationary uplift to his wife’s direct payments. He mentioned his age and the negative impact of the unresolved situation on his health.
  5. Mr X contacted us again at the end of January 2024 as the Council failed to respond to his complaint.
  6. The Council’s case notes show that only in the second week of February 2024 the Council noted Mr X’s complaint as outstanding. The Council also noted Mr X’s frustration at the lack of service and at the Council’s failure to respond to his complaint.
  7. At the beginning of March the Council decided it had owed Mrs X an inflationary uplift of 2.5% for her direct payments from the beginning of April until the end of July 2023. The extra payment amounted to £11.62 a week, a total of £199.86. The Council told Mr X of its decision and paid the overdue inflationary increase to him.

My findings

  1. Our “Principles of Good Administrative Practice” set up standards we expect from councils when providing their services. We expect councils to be service user focused by:
    • Ensuring people can access services easily, including those needing reasonable adjustments;
    • Keeping to commitments, including any published service standards;
    • Dealing with people helpfully, promptly and sensitively, taking account of their individual circumstances;
    • Responding to service users’ needs flexibly.
  2. In May 2023 the Council told Mr X it would be increasing direct payments for Mrs X by 2.5%. Mr X informed Mrs X’s carers it would happen and felt responsible for following this commitment.
  3. The Council’s failure to adjust Mrs X’s direct payment for the period from April to the end of July 2023 was fault. When the Council tells its service user it will do something it should follow up with the action. The failure to do so undermines confidence in the Council as a provider of public services and is contrary to the principles of good administrative practice.
  4. The Council’s failing caused distress to Mr X. Having told Mrs X’s carers of the proposed increase, Mr X felt personally responsible for ensuring it happened. Although the sum of the increase was modest, Mr X considered it was unfair to deprive his wife’s carers of this payment. He continued contacting the Council.
  5. The Council’s failure to respond to Mr X’s communication and clarify the situation is fault. On many occasions Mr X mentioned his vulnerability as an elderly person. He also made it clear he had been struggling to support his wife both when arranging her care and when dealing with her finances. As explained in paragraph 20 of this decision the Council should provide efficient services to all its service users and should also take into account people’s individual circumstances. This did not happen for Mr X.
  6. Mr X spent much time contacting various people and services trying to get the Council to honour its commitment to apply the inflationary increase. He contacted in error the Information Commissioner and sought help from the local councillor. This shows how important for him was to resolve this matter.
  7. The evidence suggests the Council failed to respond to Mr X’s complaint from the end of November 2023. I am aware, however, that the Council addressed the issue complained about at the beginning of March 2024.
  8. The Council’s failure to respond to Mr X complaint in line with its complaint policy is fault. Lack of response from the Council increased Mr X’s frustration at his inability to resolve the issue.
  9. Mr X told us the Council’s failings affected his health. We cannot, even on the balance of probabilities, verify this claim. It would be impossible to make a causal link between the Council’s actions or its failure to act and Mr X’s health. I do, however, consider that because of Mr X’s age and his responsibilities around making arrangements for his wife, the injustice caused to him by the Council’s failings was significant.

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Agreed action

  1. To remedy the injustice caused by the faults identified, we recommend the Council complete within four weeks of the final decision the following:
    • Apologise to Mr X for the injustice caused to him by the faults identified. The apology should follow our “Guidance on Remedies”;
    • Pay Mr X £50 to recognise his distress caused by the Council’s fault to communicate with him effectively;
    • Pay Mr X £50 to recognise his time and trouble spent on complaining.

The Council will provide the evidence that this has happened.

  1. We also recommend the Council within three months of the final decision:
    • Remind its Adult Social Care staff of the importance of timely communication with the service users and of taking their individual circumstances into account;
    • Review its complaint handling for the Adult Social Care complaints to ensure they are properly recorded and responded to in accordance with the Council’s policy.

The Council should provide us with evidence it has complied with the above actions.

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Final decision

  1. I uphold this complaint. For the reasons explained in the Analysis section I found fault in the Council’s failure to apply inflationary increase to the direct payments for Mrs X, to communicate with Mr X and to respond to his complaint. The Council’s fault caused injustice to Mr X. The Council has accepted my recommendations, so this investigation is at an end.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman

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