Date of decision: 10 November 2025
Summary
A family complained that the Council failed for years to review their adult son’s direct payment account properly, to explain what it could be spent on, and to keep his care and support plan up-to-date. During that time, the holder failed to pay the charge into the direct payment account, which was invoiced for in one large bill for £5K, leading to anxiety about debt, and loss of clarity over his needs, while his parents struggled on with limited carer support.
What happened
Mr Y is an adult with a learning disability who lived with his parents until moving to a Council-arranged supported living setting in September 2024.
His needs whilst at home were funded in part through a direct payment (DP) managed on his behalf by his mother. Mrs X was responsible for paying his assessed client contribution (the social care charge) into the DP account from 2019 onwards.
In April 2019, the Council had completed a financial assessment (FA) for Mr Y, allowed £35pw disability related expenditure (DRE) for replacement clothing, entertainment and laundry, and wrote to Mrs X explaining that Mr Y’s client contribution had to be paid into his DP account. That FA recorded no DRE for equipment, fuel, utilities, hobbies, leisure, or the claimed legal charges [unspecified in the report, but potentially deputyship or appointeeship charges].
Each year when it reassessed the charges, it reminded her to inform it if DRE changed, but there was no evidence that she provided new DRE information over those years.
In December 2023, a group of Council managers met to review DP finance information and noted three issues: non‑payment of Mr Y’s client charge of just over £5K; transfers from the DP account into Mrs X’s personal bank account which she said was reimbursement for money she had spent on food and drink while Mr Y was out with his Personal Assistant; and that the DP account was low because of the unpaid charge and large expenses. [The report does not explore how it was in the black at all, if £5K of charges was missing!]
Managers decided to pursue recovery apart from the money that had already been spent on food and drink.
In February 2024, a further review of Mr Y’s financial assessment occurred after Mrs X supplied additional information, and finance managers considered both that information and Mr Y’s care and support plan in the round.
Mortgage contributions were not allowed because the mortgage of the property in which Mr Y was living was in Mr and Mrs X’s names. [Housing benefit may have been in payment and would thus have offset any payment that he would have made in rent had any tenancy been formalised].
It did allow further DRE for laundry, replacement clothing, glasses, swimming, parking at the leisure centre, a coffee shop “treat” for socialisation, and magazines to encourage exercise.
The revised DRE breakdown, which followed later on, included specified amounts for “getting around”, “health and wellbeing”, “help in the home”, and “hobbies and leisure”, and confirmed that additional DRE would be backdated to August 2023.
In April 2024 she wrote a detailed letter to the Council’s finance team stating she had been unaware which expenses counted as DRE, arguing that if she had been properly informed Mr Y would not now face a £5,000 bill because his DRE profile had not changed since 2019, criticising the Council’s poor up‑front information, saying Mr Y’s care and support plan had not been reviewed “for several years”, and asking the Council to consider the family’s special housing circumstances while they rented and then bought a property while waiting for supported housing.
The Council would not move from its stance.
Mrs X also complained that the Council had not progressed a supported housing application dating back to 2016 and that respite care had not been provided for some time, but the Ombudsman later treated those parts largely as late or so late as to be inappropriate for investigation because records about available placements so far back and their suitability for Mr Y would not now exist.
Mrs X had raised concerns about respite for herself and her husband as carers at some point early on, but in August 2024, the social worker’s case notes recorded that a carer’s assessment had been offered to Mrs X twice, but she had declined on each occasion.
In September 2024, Mr Y finally moved from the family home into a Council‑arranged supported living house and the Council drew up a new care and support plan at the point of the move, reviewing it shortly afterwards; this plan described his needs, set out how they would be met through commissioned services and the DP managed by Mrs X, made clear that food and mileage costs were not included in the DP, and directed any DP‑use queries to the social care team.
On 30 September 2024, the Council issued its complaint response. It accepted it had failed to provide clear advice about whether meals and refreshments could be paid for from the DP and acknowledged this should have been resolved earlier, apologising for the confusion and confirming it would not seek to recover those costs and that the new care and support plan now clarified the issue.
In the same complaint response, the Council accepted it had failed to review Mr Y’s DP in line with Guidance (CSSG) and accepted that if reviews had taken place, the meals and refreshments issue would have been resolved sooner and the unpaid charge would likely have been identified earlier.
It noted Mrs X had signed the DP agreement in 2014 confirming her obligation to pay client charges into the DP account and that Mr Y first became liable to pay a contribution in April 2019, when it wrote to her with the client charge, saying this put her on notice that payment was required, and it maintained that none of its failures removed her responsibility to pay the charge.
The Council also stated that where a DP recipient is personally liable for housing costs, it includes these in the financial assessment, because that is the law, but that this did not apply to Mr Y because he was not the person liable for the home mortgage, and parents’ mortgage responsibilities could not be included in his FA. [There is an argument that they were providing him with necessaries and could have reimbursed themselves, but in fact, there was no evidence that he was paying any contribution or loan repayment as far as we can tell.]
It admitted Mr Y’s care and support plans had not been updated as regularly as required, apologised if there were errors, accepted that the service had not met its expected standards, and said it had reduced the outstanding invoice for the charges by about half (around £2,500) to reflect that.
At the end of November 2024, the Council provided a further complaint‑stage letter after Mrs X asked for a review of its response, stating that adults were not permitted to use their DP to pay for their own lunches when out with a Personal Assistant, which it described as Council policy. By this stage, the Council had written off part of the historic DP debt and confirmed it would not seek to recover the food and drink expenditure, because it agreed Mr X’s previous care and support plan was poorly drafted in relation to food and drink costs. [We would add that it was STILL unclear as to whether the policy was only about the person’s own food and drink, or that of their PA as an enabler.]
However, the remaining outstanding client contribution remained payable.
During the Ombudsman’s investigation, it was confirmed that Mr Y lacked capacity to complain and that Mrs X complained on his behalf; Mrs X had not complained earlier about supported housing progression or historic respite because of her own health difficulties, bereavement, and a belief that finding a suitable placement would take years; and she first contacted the Ombudsman about respite loss for herself, only in February 2025.
The Ombudsman decided to investigate only certain parts of the complaint (monitoring of the DP, DRE and financial assessment issues, care and support planning, and limited aspects of respite between February 2024 and February 2025), while treating other parts as late, premature or already appropriately remedied (including failure to give complaints information, which the Council had already apologised for on 30 September 2024).
What was found
The Ombudsman found the Council at fault for failing to monitor Mr Y’s direct payment annually, contrary to Care and Support Statutory Guidance [and Regulations] which require councils to monitor DP usage at least once a year, and concluded that if annual reviews had occurred the non‑payment of charges would probably have been identified by 2020 instead of building up to about £5,000.
This failure caused avoidable distress, including shock to the family when a very large backdated invoice arrived, and also allowed DP spending on items not genuinely required to meet assessed care and support needs (such as meals and refreshments, in light of the Council’s line on this sort of consumption expense) to continue unchecked for several years.
The Ombudsman accepted the Council’s approach to DRE as lawful: it had properly assessed DRE in 2019 on the basis of information Mrs X provided, reminded her annually to report any changes, and only increased and backdated DRE from August 2023 once she submitted additional evidence, in line with Care and Support Statutory Guidance Annex C paragraphs 39 and 41.
The decision not to include parental mortgage or housing costs in Mr Y’s financial assessment was found to be in line with charging rules, because there was no evidence that Mr Y himself was contractually liable for those costs.
The Ombudsman found fault in the Council’s failure to act on Mrs X’s request for respite care in February 2024 through not offering and conducting a timely carers assessment, as required under the Care Act duty to assess carers who may have needs for support. However, because the social worker did later offer a carer’s assessment twice in August 2024 and Mrs X declined, the Ombudsman decided this earlier omission did not create a significant outstanding injustice requiring further remedy.
The Ombudsman also found fault in the Council’s failure to review Mr Y’s care plan annually, contrary to the expectation in the Guidance (paragraph 13.32). This caused uncertainty about whether Mr Y’s needs were accurately captured and how best to meet them, but there was insufficient evidence on the balance of probabilities that he lost specific services as a direct result of the missed reviews.
In recognising its failings, the Council had already apologised to the family, decided not to reclaim historical food and drink spending from the DP, and reduced the historic charge by approximately 50% (about £2,500): there was no separate financial compensation award beyond this reduction.
The Ombudsman considered that the apology, partial debt write‑off, and decision not to claw back unauthorised food and drink expenses together provided an appropriate and proportionate remedy for the avoidable distress and uncertainty caused, and therefore confirmed the complaint as upheld but already satisfactorily resolved.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
Councils should treat annual monitoring of direct payments, and timely review of care plans in the context of direct payment clients’ plans, as core legal duties rather than optional good practice, because the regulations require the financial review as a matter of law and one may as well do the care review at the same time as the financial review, especially if the latter flags up concerns. Delays can lead to large backdated debts and prolonged use of funds for non‑care expenditures that are harder to unpick later.
Councils should also ensure that explanations of what direct payments and disability related expenditure can legitimately cover are clear, written, and revisited at each review, so that families are not left to guess what counts as allowable spending or DRE.
Carers who manage direct payments need to be supported to separate the cared‑for person’s funds from their own, both to avoid accusations of misuse and to ensure that any disability‑related expenses that genuinely arise are captured and evidenced for financial assessment purposes.
Where a person lacks capacity, councils should be explicit about who is the authorised decision‑maker for finance and care planning, and should avoid relying on informal arrangements that blur the line between acting as an authorised person and simply helping as a family carer.
The question of whether an enabler’s expenses should be allowed as part of the budget, and if not, as part of DRE, is not properly explored by the investigator here, in our opinion. If the plan is responding to an assessed need regarding getting out and about, it is not unreasonable to expect that an enabler will need to sit down in a café with the client as part of delivering the work. If the café or other venue manager will not allow sitting there without a spend, it seems obvious to us that that expense is able to be seen as part of sufficient funding of the budget, or if not, then definitely as DRE.
From a public law standpoint, it is important that councils do not treat internal policies (for example, on what food or refreshments can be purchased from a direct payment) as if they were the law, and that any such policies are tested against the Care Act framework, statutory guidance and human rights considerations before being applied in individual cases.
For carers themselves, the statutory right to a carer’s assessment, when there appears to be a risk of significant impact on their wellbeing, should be triggered promptly when respite or similar support is requested, not deferred until the situation reaches a crisis point or until multiple offers have been declined. Councils should be careful not to treat a later refusal of a carer’s assessment as retrospectively curing earlier failures to respond lawfully to clear requests for support or review. The carer in question may have no idea of their role in the legal architecture for whose duty it is to meet the needs, and no idea that they can simply refuse to meet needs that they’ve previously shouldered, whether eligible needs or not.
From a community care law perspective, duties around assessment, eligibility, care planning, review and charging form a single integrated pathway, and failures in one part (for example, delayed review of a direct payment) can quickly undermine lawful charging, the sufficiency of the care plan, and the fairness of debt recovery action. Public law principles require that decisions about DRE, recoverability of historic charges, and responses to complaints are reasoned, consistent with guidance, and transparent enough for families to understand and, if needed, challenge through complaints, advocacy or legal routes.
In addition, community care law emphasises that reviews and revisions of care plans should be grounded in a fresh look at needs, outcomes and wellbeing, not just financial housekeeping, and that councils cannot lawfully allow an inadequate or outdated plan to drift on simply because family carers are coping. Where capacity issues arise, public law and mental capacity principles require careful attention to who is being consulted, how their wishes are taken into account, and whether any financial or care planning decisions might expose an incapacitated person or their carer to avoidable risk or unfair liability.
Community care case law also stresses that where a council’s breaches of statutory duty (for example in relation to reviews, personal budgets or charging) have caused a quantifiable financial shortfall or loss, the appropriate remedy may include repayment or write‑off of sums that would not have arisen but for the unlawful conduct, particularly where carers have been filling gaps in care without that being transparently recorded or negotiated. Public law therefore supports a more rigorous approach to identifying, explaining and, where necessary, compensating for the consequences of missed reviews, mis‑stated guidance references, and opaque decisions about which historic spending will or will not be recovered.
Community care law would also expect that when councils acknowledge systemic failings—such as years‑long lapses in DP monitoring—they consider wider service changes, training and audit, not just one‑off remedies, to reduce the risk of similar injustices for other families.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Suffolk County Council (24 021 093) report. If you are affected by the issues in this report, please consider asking a free, one-off question, anonymously, at a level of principle, here. Our experts’ response will give you an opinion which may then help you and the broader community, when posted.
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