Decision Date: 7th October 2024
Summary
Mr and Mrs X approached the Ombudsman with complaints about their carers’ personal budget assessments and budgets. Mrs X’s personal budget for her support needs was reduced without four weeks’ notice and inconsistencies were found within their carers’ support plans.
What happened
Mr and Mrs X cared for their sons, Mr P and Mr Q, who each had eligible care needs under the Care Act 2014. Mr X has been appointed by the Court of Protection as Mr P’s deputy for health and welfare and finances.
Mrs X
Mrs X’s carer’s assessment, from April 2020, identified her as the main carer for Mr Q but acknowledged that both parents cared for both sons. The assessment noted that her caring role had a significant impact on:
– Providing care to other persons for whom the carer provided care.
– Maintaining a habitable home.
And that it had a very significant impact on:
– Developing and maintaining family or other significant personal relationships.
– Making use of necessary facilities or services in the community.
– Engaging in recreational activities.
Subsequently, she was provided with a personal budget of £76.26 a week from the Council. It said the money could only be used for:
– Maintaining a habitable home (garden and household maintenance).
– Paying for recreational activities including meals for them both and other recreational activities such as going to the cinema.
– Spending time with Mr X to sustain their relationship.
– Paying for therapies to assist with physical wellbeing.
In July 2023, Mrs X was reassessed by the Council. The assessment said:
– Mrs X’s caring responsibility for Mr Q did impinge on the care she now provided for Mr P.
– The family struggled to pay heating bills due to the costs arising from having a son with significant disabilities.
– Mrs X could manage food shopping and preparing meals for herself and the family.
– Due to her caring role, Mrs X could not take part in work, training, education or volunteering as much as she wanted.
– She found it difficult to maintain family relationships due to time constraints resulting from her caring role.
– She was unable to access facilities in the community.
– As Mr Q had gone to university, Mrs X was no longer providing him with daily support, other than speaking to him daily to provide prompts – so she had more time to maintain relationships with friends and family.
– Mrs X supported Mr Q by visiting him roughly every three weeks.
– Mr P did not need a second carer but required additional support when travelling to unknown places and when attending medical appointments due to becoming distressed.
It was noted that Mrs X’s caring role (still, we assume) had a significant impact on:
– Providing care for other persons for whom the carer provides care.
– Maintaining a habitable home (garden and household maintenance)
– Managing and maintaining nutrition.
– Developing and maintaining familial or other significant relationships.
– Engaging in recreational activities.
As a result of the July 2023 reassessment, the Council reduced Mrs X’s personal budget to £12.71 a week. The personal budget was to cover the cost of therapies, to assist with her physical and emotional wellbeing and to engage in recreational activities.
The reduction in budget was attributed to:
– Mrs X providing less support to Mr Q, so she had the opportunity to develop relationships.
– Mr X’s own caring role for Mr P would reduce the amount of time Mrs X could spend with him, but they refused respite when offered.
– Mrs X being referred to a ‘warm homes’ scheme by the Council.
Mr X
In October 2020, Mr X was identified in his carer’s support plan as Mr P’s main carer. The plan said that:
– Mr X’s caring responsibility did not impact on the care he provided to others.
– Mr X could manage food shopping and preparing meals for himself and his family.
– Mr X spent over 16 hours a day caring for Mr P, so it became difficult to develop and maintain family relationships due to time constraints.
– He had had to retire early to care for Mr P.
– It was difficult for Mr X to engage in community/recreational activities, as he and Mrs X were anxious about leaving Mr P with other people due to past experiences.
– Accessing social groups and local facilities was difficult for Mr X. He would either have to be accompanied by Mr P or to go when Mr P was attending day services twice a week.
Subsequently, the plan had provided Mr X with a personal budget of £76.26 per week to:
– Maintain a habitable home (garden and household maintenance).
– Spend time with Mrs X to sustain their relationship.
– Avail himself of therapies to assist with his physical wellbeing.
– Engage in recreational activities.
In October 2022, the Council reassessed Mr X’s needs as Mr P’s carer. The assessment noted that Mr P needed Mr X to help with:
– Dressing, washing and bathing.
– Preparing food and eating.
– Household tasks.
– Travelling.
– Getting out and about.
– Managing medication.
– Dealing with paperwork/correspondence.
– Keeping him company, checking he was alright, listening and offering emotional support.
The Council did not make any changes to Mr X’s personal budget leaving it at £76.26 per week. The care and support plan confirmed that it could be used to:
– Maintain a habitable home (garden and household maintenance).
– Spend time with Mrs X to help sustain their relationship.
– Avail himself of therapies to help with physical wellbeing.
– Engage in recreational activities.
However, it was noted that:
– It was not ‘appropriate’ to use it for funding housing maintenance and repairs.
– It referred Mr X to the Citizens’ Advice Bureau about the need for a power shower.
– It referred him to a Warm Homes scheme for advice on managing high utility bills.
– Mr X would have to complete a new direct payment agreement.
The Council proposed that it should provide the personal budget via a direct payment card to monitor expenditure. If Mr X refused, then he would have to provide information on how the money was spent on a weekly basis. If he did not account for his expenditure, then he would have to reimburse the Council for it.
The Complaints
Mr and Mrs X complained to the Council in August 2023 about the reassessment of their needs and (separately) the changes in their sons’ personal budgets as a result of their own assessments.
In October 2023, the Council replied to their complaint, which said:
– Due to Mr Q’s increased independence and reduced needs, this had implications for Mrs X’s role as his carer.
– Under its Direct Payment Policy, they could not be used for food. Between April 2020 and April 2022, Mr X has used his personal budget to buy takeaways.
– On 4 July 2023, Mr and Mrs X were invited to contact the social worker to discuss their review. They did not respond.
– On 5September 2023, Mr and Mrs X were contacted via phone and email with an offer to review their assessments. Mrs X declined the offer.
– They should retain receipts to record their expenditure from their carers’ direct payment accounts from April 2023.
– It had failed to give them four weeks’ notice of changes to their carers’ personal budgets as they had reduced them on 10 July, 6 days after having informed them of the changes on 4 July. It would remedy this by reimbursing the amounts owed up to 6 August into their direct payment accounts.
In November 2023, when the Council had responded to Mr X’s complaint it said:
– It had offered to commission an independent social worker to assess the whole family’s needs. As Mr X had rejected all the people offered, it would assign one of its own social workers to reassess the family’s needs.
– The social worker would review Mrs X’s receipts for the expenditure from her carer’s personal budget since April 2023.
– It may also need to review Mrs X’s support needs, depending on the outcome of the review of Mr Q’s needs.
– The social worker would also review Mr X’s receipts of his expenditure from his carer’s personal budget since April 2023
What was found
The investigator acknowledged the strained relationship between Mr X and Mrs X on the one hand, and the Council on the other, as a result of long standing disputes. They had used a solicitor to pursue concerns, then employed an independent advocate to support them in their contact with the Council. The advocate acted as an intermediary and attended meetings between the Council and the family. Mr X believed the Council should reimburse them for the costs incurred from employing the advocate. The investigator stated that there were no grounds for this and that the cost arose from the choice of the couple to engage that support.
The Council accepted its failure to give four weeks’ notice in making changes to Mr and Mrs X’s personal budgets, and the investigator noted that this made no sense because no change had been made to Mr X’s personal budget! The Council’s decision to backdate the payment as a remedy for Mrs X was found not to be sufficient, as Mrs X would not have known that she could continue spending at the higher rate during the three weeks for which no notice was given. For that, the Council should apologise and make a symbolic payment for the distress caused.
The Council was not found to be at fault for the way it reassessed Mr and Mrs X’s needs as carers for their two adult offspring. Mrs X’s carer’s personal budget was reduced to reflect Mr Q’s increased independence following his move to university. As he had now returned home, a further review of Mrs X’s carer’s support plan would be necessary.
The investigator noted inconsistencies in the carers’ support plans. They referred to household maintenance, despite the Council saying it was no longer something the money could be used for. It was unclear how Mr and Mrs X could use their personal budgets to spend time together when Mr P no longer attended day services, yet could not be left alone.
The Council had been open to reviewing Mr and Mrs X’s carers’ support plans, but they did not want to engage with the Council. The investigator stated that if they had engaged with the Council, the inconsistencies could have been addressed. It was also said that it was an unrealistic expectation to have no contact with the Council if they wanted to receive public money.
As carers’ support plans need to be reviewed at least every 12 months or when there is a change in need, the family’s reviews were now overdue, but not because of the Council’s approach. The Council was entitled to review the use of direct payments and to expect Mr and Mrs X to keep receipts of expenditure.
The Council offered to commission an independent social worker, yet Mr X rejected those put forward. Therefore, it was not the Council to withdraw their offer.
The investigator recommended that within 4 weeks of the final decision that the Council send Mrs X a written apology for failure to give four weeks’ notice before reducing her carer’s personal budget and that it also pays her a symbolic payment £150 for the distress caused. The Council agreed to this and to provide the Ombudsman with evidence of its compliance with the recommendations.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
We find it odd that the investigator does nothing to hold the council to account with regard to the reasons behind the reduction in support to the specific amount of £12.71 a week for Mrs X. We say that, because there is clear principle in the case law regarding the budget for the disabled person that the amount must rationally relate to the means by which the need is to be met or the impact is to be reduced to something less than significant. We don’t think that much therapy or recreation can be obtained for £12.71 a week.
Similarly to what we assume are reports regarding the budgets for their sons, Leicestershire County Council acknowledged fault for failing to provide 4 weeks’ notice. But in none of the reports, was there any reference to a direct payment agreement specifying 4 weeks’ notice as a minimum that the Council was binding itself to provide. There are no minima in the direct payment regulations. However, we would agree that 4 weeks should BE a minimum for the simple reason that most people deserve 4 weeks’ notice when their job is being brought to an end.
The inconsistencies between the outcome of the reassessment did not only involve the prohibition on using the money for household maintenance whilst allowing it on the face of the support plan, but also a prohibition on meals, whereas Mrs X had been specifically allowed to spend it on the consumption cost of relaxing with her husband.
We are not surprised that the investigator declined to recommend reimbursement of the cost of the solicitor and private advocate. The Council offered engagement and an independent social worker, which were either ignored or declined. The ombudsman’s organisation would not want to encourage recourse to formal outsider advice and assistance in such situations.
But IF an investigator had found wider fault in this or any other complaint under consideration, and a person has had to go to the Ombudsman to get that acknowledgement, we do not think it’s unreasonable for a complainant to make the point that it seemed impossible to get the Council to engage and that they had lost trust and confidence in the system and could not waste any more of their lives as carers, at that point, and needed to put distance between them and the Council.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Leicestershire County Council (23 021 493) report.
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