Date of decision: 12 March 2026
Summary
An individual complained that the Council changed what expenditure was allowed under a long‑standing direct payment for her disabled sister’s care, without proper discussion or clear written explanation, then refused items it had previously accepted and sought repayment of around £4,500.
What happened
Miss W, an adult with care and support needs, had received support for her daily care funded by a direct payment from the Council for many years, with her sister Miss X managing the money.
In the 2024 care and support plan, the Council recorded that when the direct payment was first set up, Miss W and Miss X had been told it could be used in any way that met Miss W’s needs, and confirmed that her needs had not changed. The plan listed activities and services covered by the direct payment, including a clothes ironing and alteration service because Miss W could not iron and needed adjustments due to her body shape; stationery, ink and paper for record‑keeping, social activities such as cinema, bowling, meals out, theatre and pub visits, and a cleaner twice a week to keep Miss W’s home clean and tidy, noting this list was not exhaustive.
In mid‑January 2025 Miss X complained to the Council that it had removed items from Miss W’s care and support plan without proper discussion with the family. She said this only came to light when she completed the direct payment returns and found some items were now being refused, even though the Council had previously paid for them in earlier years, and she said there had been no change in Miss W’s needs since the February 2023 plan was agreed.
The Council responded in mid‑February 2025, referring back to a previous complaint Miss X had made in 2021 about direct payment returns being rejected after a change to Miss W’s care plan without her full involvement, which had been upheld in August 2021. At that time, the Council had agreed to continue funding social activities for Miss W as these had previously been in her support plan and said a more comprehensive plan would be completed; it then carried out a review in February 2023 and completed the updated support plan in 2024, confirming there was no change to the overall agreement.
In its February 2025 response, the Council explained that the items it now refused to fund in the direct payment returns were food items, podiatry, toiletries and meals out, which it said were not included in the plan. It reviewed the relevant receipts, highlighted which it would not fund, and accepted that the wording of the existing plan was vague. It told Miss X the annual review of the plan was now due and said that the use of the direct payment would be written in more detail to avoid further refusals, and it confirmed it had now agreed the previously refused returns because the plan had not been clear enough.
Miss X remained dissatisfied and, at the end of March 2025, asked for her complaint to be escalated to Stage 2 of the Council’s complaint procedure.
She welcomed the decision to allow all previously refused items but requested that a different social worker carry out the review of Miss W’s care and support plan and set out reasons why certain items should be allowed in future. In mid‑May 2025 the Council issued its Stage 2 response, agreeing to allocate a different social worker for the review. It explained that people were expected to use their benefits to pay for food shopping, toiletries and other personal items, and that Social Care funding could not be used to meet health care needs such as podiatry.
The Council said it had waived the amounts already spent on these items, but would seek to recover any such spending in future, or might reconsider the direct payment arrangement altogether.
In July 2025 the Council completed a further review of Miss W’s care and support plan. The plan noted that Miss W had long‑standing anxiety and other mental health needs which made it hard for her to cope with change and that she required support to manage her day‑to‑day life, including shopping, domestic tasks, paperwork and attending activities. The revised plan said the direct payment could be used for agreed outcomes such as accessing the community, support in the home, and maintaining personal hygiene, but it did not explicitly list all items or activities, and it repeated that the list was not exhaustive. The Council said it would provide more detailed written guidance to Miss X about what was allowed, and would consider other requested items as possibly distinct disability‑related expenditure in financial assessments.
However, Miss X continued to receive letters from the Council’s finance team chasing repayment of around £4,500 relating to past direct payment returns, even though she believed the issues were still under review. She felt harassed and distressed by the ongoing demands while she was trying to care for Miss W and to engage with the review process. She said the situation affected her own health, left her feeling overwhelmed and unsure what she could safely buy with the direct payment, and made her worry that she might lose the support arrangement altogether.
Miss X complained to the Ombudsman. She said the Council had changed the rules on what Miss W’s direct payment could be spent on after many years of accepting the same kinds of spending, without clear prior warning, proper explanation or an opportunity to discuss and agree any changes. She said she had never been given clear written information about what was allowed when the direct payment was first set up, and she felt the Council’s complaint responses did not fully acknowledge the impact on her as Miss W’s carer, especially given her own health conditions.
In its response to the Ombudsman’s enquiries, the Council said the direct payment arrangement was more than 20 years old and it no longer had a copy of the original agreement with Miss X or the information originally provided about how the scheme would operate. The Council accepted that, given the age of the arrangement, it may have previously told Miss X the direct payment could be used more flexibly for activities to meet outcomes, but it believed this flexibility had been misinterpreted to include ordinary eating of meals, which it said was not an eligible social care need and had never been intended. The Council confirmed it would give Miss X information about how to ask for other items to be considered as disability‑related expenditure under financial assessments.
The Ombudsman considered the relevant provisions of the Care Act 2014 and the Care and Support Statutory Guidance, which require councils to provide a care and support plan that includes a personal budget and to ensure direct payments are only used to meet eligible care and support needs identified in that plan. The Ombudsman also referred to the Ombudsman’s Principles of Good Administrative Practice, expecting councils to act fairly and consistently, be citizen‑focused by clearly explaining what people can expect, and to “get it right” by making reasonable and timely decisions.
What was found
The Ombudsman found that, although the core legal rule that direct payments can only be used to meet a person’s eligible care and support needs was clear and correctly stated by the Council, it had not met the expected standards in how it communicated and documented this rule over time.
The Council had failed to keep an adequate record of the original direct payment agreement and could not show it had ever given Miss X clear, comprehensive and timely information about how the funds should and should not be used, which was fault. The Ombudsman noted that direct payments are public money and the Council is entitled to question and refuse items that appear excessive or are not used to meet Miss W’s social care needs, so there were no grounds to require the Council to fund additional items in future. However, because the Council had for many years accepted returns for items it later questioned, without having provided clear written guidance at the point concerns first arose, its change to a stricter position was not open, accountable or citizen‑focused, and this lack of clarity amounted to fault.
This poor communication caused Miss X avoidable confusion and uncertainty about what was and was not permitted under the direct payment, which the Ombudsman recognised as an injustice impacting her and her caring role.
The Ombudsman did not find fault in how the Council had operated Stage 2 of its complaint procedure, because a different and more senior manager had reviewed the complaint in line with its policy, and any issues there did not cause significant additional injustice.
To remedy the fault and its impact, the Ombudsman recommended, and the Council agreed, that within one month it would write to Miss X with an apology for the lack of clarity, make a symbolic payment of £250 to acknowledge her confusion and uncertainty, give her clear and comprehensive written guidance on what the direct payment can and cannot be used for, and provide information on how to request that other items be considered as disability‑related expenditure.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
Where a direct payment arrangement has been in place for many years, councils should ensure they keep accessible records of the original agreement and any subsequent changes, so everyone involved can understand what has been agreed. Interpretation can change, where for instance, a financial monitoring exercise finds that money spent in a cafe on food has been spent for the person’s meal, as opposed to an enabler’s meal. Councils should provide clear, written information at the outset, and whenever they become concerned about how a direct payment is being used, setting out what can and cannot be funded and explaining any limits in plain language. Where a person has been allowed for some time to use a direct payment for certain types of spending that are later viewed as outside the scope of eligible needs, councils should not abruptly change their approach without prior discussion, clear reasons and, where appropriate, a phased transition to any new rules. Complaint handling about direct payments should be co-ordinated with finance processes so that repayment demands are paused while disputes about what was allowed are being fairly investigated, to avoid unnecessary distress for people using services and their carers.
The investigator does not seem to have grasped that whilst Podiatry may well not be part of social care (it is excluded from the regulations about registration for personal care), it is clearly able to be put forward as disability related expenditure or as essential for wellbeing if one is in a care home and one has nobody to do it and can’t manage it oneself and can’t get it met through the health service. Either way – in the plan or OFF the plan but privately arranged, the cost of it is going to impact on the council either through the charging system or through the budget setting process.
It is notable that Miss X had made a previous complaint about similar issues in 2021, which was upheld, but the same kind of difficulties remained. The Ombudsman’s ‘Principles of Good Administration’ includes a recommendation that public bodies should seek continuous improvement, including reviewing lessons learned from complaints.
The Ombudsman’s treatment of the “law and guidance” in this case is focused almost entirely on the rule that direct payments must be used only to meet eligible needs identified in a care and support plan, and on administrative fairness in communication and record‑keeping. Community care law and public law principles suggest that, given the facts recorded in the decision, at least three further legal issues are engaged more deeply than the Ombudsman explores: the scope of what can lawfully count as meeting eligible needs under the Care Act, the relationship between personal budgets, direct payments and reliance on informal carers, and the proper use of prevention and charging concepts instead of assessment and planning.
First, on the scope of what can lawfully be funded, the Ombudsman appears to accept without much scrutiny the Council’s assertion that ordinary food, toiletries and similar items are simply not “eligible social care needs” and therefore cannot properly be funded from a direct payment. That position sits uneasily with community care case law on what counts as meeting needs for outcomes such as maintaining family and personal relationships and making use of community and recreational facilities, where courts have rejected artificially narrow readings that exclude activities or ordinary‑looking expenditure just because they also resemble everyday living costs. In one leading appellate case about holidays and family activities for disabled adults, (BG v Suffolk CC) (and in a first instance decision, Windsor & Maidenhead) the court held that support could properly include funding for the activities themselves where, without financial help, the person would be unable to achieve the relevant outcomes at all; the fact that travel, accommodation or food are things everyone uses did not by itself disqualify them from being part of meeting eligible needs when the context was disability and family‑based support.
The Ombudsman does not test the Council’s “food is never an eligible need” position against that sort of reasoning, and does not ask whether some of the apparently ordinary items in Miss W’s returns were in fact an integral part of enabling her to participate in social activities or maintain wellbeing, as opposed to a separate, purely private direct consumption cost. On the Ombudsman’s own factual account, meals out were previously listed as part of social activities in the plan, and the ironing and alterations service was expressly justified by disability‑related difficulty and wellbeing; that should at least have prompted a more explicit analysis of whether a blanket refusal of similar items was consistent with community care law’s emphasis on outcomes, wellbeing and sufficiency, rather than simply with a budget‑driven view of what “should” be paid for from the person’s own benefit income.
Secondly, the decision gives relatively little attention to the legal structure around personal budgets, the transparency duties that go with them, and the way informal caring is factored into the duty to meet needs. Community care law has repeatedly stressed that a lawful personal budget must be transparent, show how assessed needs will in fact be met, and contain a reasoned link between needs, support, hours and cost.
The Ombudsman records that Miss W’s needs had not changed, that her sister had long been doing the management of the direct payment, and that the Council had once previously been found at fault for changing the plan without full involvement, but the legal discussion does not interrogate whether this later tightening of what could be bought amounted in practice to a reduction in what the personal budget would fund, with the shortfall effectively being picked up by Miss X through her own income or increased effort. Community care law would expect a council in that position to revisit the care and support plan itself, re‑specify the funded outcomes, and give a proper explanation of how the revised package, in money and content, remains sufficient, rather than just re‑labelling certain expenditure as outside scope and telling the family to use benefits. The Ombudsman treats the case largely as a matter of poor explanation and missing records rather than as a potential failure of the duty to secure a personal budget that is actually enough, and that difference of emphasis underplays the substantive legal protection around sufficiency and carer involvement which the courts have articulated.
Thirdly, the Ombudsman does not fully engage with the risk that prevention, charging and discretionary concepts are being used in place of straightforward assessment and planning duties. The Council’s description of some items as properly met from benefits, and its suggestion that other items might instead be raised as disability‑related expenditure in financial assessments, indicates that it is steering the family towards treating these things as part of charging calculations with scope for DRE disregards – or not – rather than as directly funded care and support. Community care law distinguishes clearly between the duty to meet eligible unmet needs through a care and support plan and personal budget, and the separate question of how much of that cost can lawfully be recovered through charges.
There ARE provisions for charging FULL COST regardless of what it does to one’s Minimum Income Guarantee, if a council wants to go that far, with items that can be called NON-CARE inputs, “such as the provision of meals on wheels, shopping or transport services or recreational activities”.
Public law principles would expect a council to articulate either that the disputed expenditure is now genuinely outside the needs being met, with reasons grounded in outcomes and wellbeing, or that it will be taken into account properly as disability‑related expenditure; the Ombudsman’s legal analysis stops short of examining whether the Council’s reliance on “benefits” and potential DRE has been used to avoid squarely facing the duty to set and explain a coherent, lawful budget for the same needs that were being met for years.
Taken together, these gaps mean that the Ombudsman’s decision, while rightly critical of record‑keeping and communication, does not use the full range of community care law and public law principles that could have been engaged by a long‑running direct payment, an unchanged pattern of needs, a heavily involved family carer under stress, and a sudden tightening of what counts as allowed expenditure.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s West Northamptonshire Council (25 004 420) 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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