Date of decision: 10 December 2025
Summary
A disabled woman with long‑term physical and mental health conditions complained that the Council stopped her direct payments, failed to arrange care and support at home, insisted on a deep clean of her unsafe property, and did not help her secure white goods or mortgage support. She said years of delay and refusals left her without care, at risk of self‑neglect and losing her home.
What happened
Ms Y is an adult woman with physical and mental health conditions who had been in contact with the Council for many years for adult social care support, including a 12‑hour‑per‑week care package and help with cleaning because she struggled to maintain a habitable home.
Her preference was to employ a personal assistant using direct payments, and the Council agreed, with an advocate supporting her in contacts with organisations. The Council’s records showed she struggled to find and retain care providers, to allow access to her property, and that it had already funded three deep cleans to remove rubbish and thoroughly clean surfaces.
In October 2022 the Council reviewed her care and support plan, which officers completed in January 2023, confirming she had eligible needs and needed a care package including cleaning support and help to obtain a working fridge. The Council noted a charity‑funded fridge could not previously be delivered because debris, items and furniture blocked access in her home. It agreed to use care provider Company B to help her recruit a personal assistant to support a further deep clean and fridge delivery.
In March 2023 the Council attempted a deep clean to clear the hallway so a fridge could be delivered, but this could not be completed due to differing expectations between Ms Y and the provider, and she did not succeed in finding a personal assistant through Company B.
In March 2023 Ms Y complained to the Council about the service, made negative comments about her social worker and requested a new one. A senior officer, disagreeing with her comments, wrote to explain that future visits would be made by two social workers so everyone felt confident, and offered to meet to discuss concerns; Ms Y declined the meeting.
In June 2023 the Council’s complaint response explained that paired visits were needed because her statements about the social worker could be professionally damaging, and that it would not reallocate the case due to service pressures. It set out Company B’s account that it had offered her several potential personal assistants in early 2023, but that opportunities had “fallen through” due to lack of response, and that the agency had closed the file after sending seven profiles when it would normally send three, while acknowledging Ms Y disputed being uncooperative and reported practical recruitment difficulties.
In September 2023 the Council reviewed her arrangements and concluded the existing approach—packages of care, direct payments for personal assistants and cleaning support—was not working, partly because six previous providers had ended involvement due to relationship breakdowns, so it would not continue to support her in that way. The Council explained its decision to her, said the social worker would review it regularly and that it would reconsider if her circumstances changed. It noted it had assessed her needs, offered a deep clean, several packages of care, and direct payments for her to recruit a personal assistant, but she had declined all options, so it had to consider whether any further support options were viable, given finite resources.
The Council acknowledged it retained a duty to support her wellbeing and agreed, at her request, to communicate by email only. A senior officer opened a safeguarding enquiry about potential harm from self‑neglect and environmental risks in her home and wished to meet her to discuss risks and support options; the Council also arranged a new advocate for her. The senior officer then met Ms Y and her social worker in December 2023 to discuss the safeguarding enquiry.
In January 2024 officers reviewed her care and support plan again at her request before progressing any package. They recorded that, despite sustained efforts by Ms Y, the Council and community providers, she still had no package of care, and attempts to recruit a personal assistant via Company B had failed. The Council had opened a section 42 safeguarding enquiry for self‑neglect due to concerns about the habitability of her home, her ability to engage with services and to carry out daily living activities. Ongoing social work focused on exploring further care options, arranging a deep clean, ensuring access to white goods, and facilitating pest control when needed. Brokerage was asked to identify a care package that could start before a deep clean, as Ms Y preferred, and the review noted her additional concerns about noisy neighbours, her car and the property management company.
In March 2024 the Council agreed a 12‑hour‑per‑week package of care. The social worker contacted the direct payments team to explore whether Ms Y could again use direct payments and approached a charity for funding a fridge freezer. Care records showed further difficulties because Ms Y did not provide necessary information and measurements for the fridge.
In April 2024 the direct payments team raised concerns about her capability to manage direct payments and did not support renewed use of them. The Council noted she wanted care and support to start before a deep clean, but explained most providers would require a deep clean first for staff safety. The social worker offered to search for a provider willing to provide care first, warning this would cause delays, and in May 2024 Ms Y confirmed she wanted such a provider. The social worker sent her the review as requested and she asked for further help with fridge delivery because she struggled to take measurements.
In June 2024 the senior officer proposed a further safeguarding meeting with Ms Y and her advocate, but she needed more time to prepare, so the Council agreed she would come back with dates.
In July 2024 the social worker delivered a microwave to her and suggested arranging a firm to take the fridge measurements, and reported having located an alternative provider, Company C. Ms Y later reported difficulties because the firm came to measure the fridge without phoning ahead. In August 2024 she agreed to proceed with Company C; the company visited, assessed her, and by September 2024 the social worker could offer a funded package of support through Company C, while again chasing her about choosing a fridge. She signed with Company C in October 2024 but said previously discussed fridge options were unsuitable. Company C told the Council it had staff ready to support her but would not begin regular care until a deep clean had taken place, though it could provide staff to attend the deep clean to support her. In October 2024 the social worker updated her, suggested she contact the fridge firm directly, and asked her to confirm the deep clean, as Company C was ready to start.
In November 2024, after she did not respond, the social worker contacted her again. In December 2024 Ms Y replied that she had a foot injury and could not have the deep clean before, or as a condition of, starting home care or support. She said she no longer wished to have a Council‑commissioned community care package and instead wanted to employ her own personal assistant using direct payments, and she refused any deep clean until either a community package or a personal assistant was in place. The Council told her it would not provide direct payments to employ a personal assistant and that the property needed a deep clean before Company C could provide regular care, to protect the health and safety of visiting professionals.
In December 2024 Ms Y’s advocate, Mx X, made a further complaint to the Council on her behalf. The Council replied in January 2025, explaining the steps taken to secure a care package and confirming it would not reinstate direct payments. It set out the four statutory Care Act conditions for direct payments—capacity, willingness, ability to manage and appropriateness—and said Ms Y had previously mismanaged direct payments and failed to pay invoices, even when supported for a year with a managed bank account. The direct payments team therefore considered she did not meet the “ability to manage” and “appropriateness” conditions, and discontinued her direct payments in June 2023 on that basis, confirming it would not provide care via direct payments in future.
A senior officer contacted Ms Y and Mx X in April 2025 for an update on whether she intended to accept the support offered, and reported that Company C could no longer keep support open due to the time spent waiting for her response. The officer chased her again and warned that, without a response, the case would be closed. In May 2025 the senior officer closed the safeguarding concern, recording that Ms Y had been seen several times and communicated with by email, phone and through her advocate. The safeguarding report found no concerns about her ability to understand, retain, use information or communicate her views, and concluded that she understood she had eligible care and support needs that were not being met, that this adversely affected her physical and mental wellbeing, and that her situation amounted to “self‑neglect”. The enquiry aimed to explore the risks, identify outcomes she wanted and support her to mitigate risk of harm.
The safeguarding officer assessed Ms Y as having capacity to make informed choices, supported by advocates and advice from multiple other bodies, including independent legal advisers. Ms Y wanted personalised home‑based care for daily living and domestic tasks, but the officer did not consider she was at immediate significant risk of harm due to environmental hazards. The officer felt Ms Y understood that her needs and risk could be addressed via a deep clean and community care package, but that she had chosen not to accept these because she disagreed with how the Council proposed to meet her needs. The officer concluded she had capacity to make that decision, even though the result was that her property remained neglected and she received no care or support. The Council closed her adult social care case in June 2025 after she failed to respond, recording that it could not put in place the care package because she would not accept the condition of a deep clean before care.
What was found
The Ombudsman found the Council had lawfully applied the Care Act 2014 criteria for direct payments, taking into account Ms Y’s historic mismanagement of payments and failure to pay invoices even with a supported account, and was therefore entitled to stop and not reinstate her direct payments. The investigation found Company B had made more than the usual number of offers of personal assistants and had adapted to her preferences, so the difficulty recruiting was not caused by Council fault. The Ombudsman was satisfied the Council had carried out Care Act assessments, produced care and support plans, offered multiple care packages, commissioned safeguarding enquiries into self‑neglect and explored options for deep cleans, pest control and white goods, but that Ms Y repeatedly declined or did not engage with key parts of these offers, particularly the requirement for a deep clean. The Ombudsman also found the Council made considerable efforts over time to secure a fridge and other white goods through charities and suppliers, and any delay was not due to fault but to practical obstacles and Ms Y’s difficulties providing measurements and agreeing options. There was no evidence of unreasonable delay in contact, and the decision to send social workers in pairs after her damaging comments was a defensible response to staff‑safety concerns rather than maladministration. The Ombudsman therefore found no fault and did not recommend any financial remedy or changes to direct payments or care arrangements.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
The Ombudsman’s handling of law and guidance in this decision gives rise to several legal issues under community care law as a sub-topic of public law.
The treatment of the deep clean as an effective gatekeeping condition because it was what any provider doing right by its staff would require, needed to be very clearly explained to this woman, so that she could make an informed decision about saying no to the deep clean and no to the fridge measurement attempts or just insisting that she be given direct payments, when they had been terminated with reasons that would not be judicially reviewable. It is everyone’s right to refuse services, if they have capacity, but to have capacity one needs to have had the legal truth told to one kindly but firmly. The legal truth, since the Muriqi Kujtim case established that capacitated refusal to agree to reasonable conditions, making it impossible to meet needs, practicably, can amount to refusal of a service. She needed a social worker combined with the legal department or an advocate who understood public law principles and who could explain that the choices she needed to make all have consequences, and that that is lawful.
If nobody explains this concept, people get distressed about what might seem to some as the most unpalatable feature of the Care Act – but one that it is essential given it all comes out of taxpayers’ money: the State is the decision-maker, subject only to judicial review for an indefensible or unlawful decision – although it does have to be person-centred in arriving at the decision.
This decision contains only limited engagement with the distinctive due‑process and participation rights that arise in long, contested care planning where advocacy is involved.
Public law principles and community care law stress that, where there is substantial difficulty in being involved and no-one appropriate to support a person, Care Act advocacy rights and broader participation duties are not discretionary extras, but integral to the lawfulness of assessment, planning, review and any revision in the way needs are to be met.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Brighton & Hove City Council (24 023 076) 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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