Birmingham City Council (05C18474)

Adult care services                      Maladministration causing injustice

04 March 2008

Birmingham City Council failed utterly in its duty towards ‘Miss D’, a deaf young woman with learning disabilities who was in its care. The Ombudsman said that the management and supervision of Miss D’s care by Birmingham Adult Learning Disability Service was “woefully inadequate”.

Among the many examples of failure were its long delay in allocating a social worker, who was instructed to do reviews by telephone even though Miss D was deaf and had learning disabilities, and who only saw Miss D once and then without a signer to enable her to communicate.

Miss D moved out of the Birmingham area with her childhood foster family, but she remained in Birmingham City Council’s care. When she was a teenager her first foster mother became unable to look after her and she was placed in her second foster home through a private fostering agency. When Miss D was 18 Birmingham’s Adult Learning Disability Service took over responsibility for her. Miss D remained with the second foster family and Birmingham continued to pay fees to them, even though they failed for eight years to register as a small home providing board and personal care to vulnerable adults.

Miss D’s foster sister from her first foster family (called ‘Mrs B’ in the report) had become increasingly concerned about Miss D’s welfare. Among her concerns were that Miss D was:

• obstructed from contact with her first foster family;
• not allowed to use sign language – her preferred means of communication;
• treated like a child (for example being sent to bed at 7pm);
• prevented from developing a relationship she desired with a young man at her work placement, and encouraged to form an inappropriate relationship with an older man acquainted with the family; and
• punished for private sexual expression and prescribed drugs to reduce her libido that made her overweight and sluggish.

Mrs B was so disturbed by the situation and Birmingham’s lack of response to her concerns that she involved MENCAP and the local Social Services. After eliciting no sensible response to the situation from Birmingham, at the end of 2004 the local Social Services initiated an Adult Protection Investigation. This led to Miss D moving to a new placement.

Mrs B made formal complaints to Birmingham on behalf of Miss D. An Independent Investigating Officer and a Review Panel upheld almost all the complaints. The Panel said it was “…appalled at the poor practices and indifference which had permitted [Miss D] to be placed and remain in a placement that was questionable from the beginning” and “The evidence… is that Birmingham failed dismally to exercise adequate care and responsibility for more than 10 years…”

The Council delayed for six months before writing to Mrs B with its response to the Review Panel’s findings. The response was inadequate and gave Mrs B every justification for believing that the Council did not take the issues seriously.

Miss D was now settled in a new placement where she could communicate by signing and had regular contact with Mrs B. Only the care and vigilance of Mrs B had achieved this after more than five years of vigorous campaigning on Miss D’s behalf. She was ignored by Birmingham Social Services, had good cause to doubt its ability to fulfil its obligations, and felt, with justification, that she had been ‘fobbed-off’ with platitudes.

The Ombudsman found maladministration causing injustice in that the Council:

• failed for eight years, after Miss D became an adult, to assess and review her needs and only acted when forced to do so by an Adult Protection investigation;
• placed Miss D with people who were only approved as foster carers for children and who resisted registering as a small home;
• failed to respond to concerns expressed by Mrs B and professionals that Miss D’s placement was inappropriate and damaging;
• delayed in providing funding for an advocate and alternative placement for Miss D;
• delayed in responding to the Review Panel findings, and disregarded them; and
• failed to review Miss D’s new placement.

The Adult Learning Disability Service did not function as it should have done and was in crisis with two thirds of its posts vacant. The Ombudsman said “In these circumstances there is little point in criticising the staff and management.” 

She said “Birmingham must ask itself how such a crisis could develop and endure for so long and how the Council, as a corporate body and a Social Services authority, could fail so seriously to ensure adequate resourcing and performance of its services to highly vulnerable adults.”

Remedy

In accordance with the Ombudsman's recommendations, the Council:

• paid Miss D £5,000 compensation (to be used for social outings and holidays);
• paid Mrs B £1,250 and donated a further £1,250 to MENCAP to recognise her time and trouble in pursuing the complaint;
• commissioned an independent audit of a representative sample of adults with learning disabilities to establish whether proper arrangements for their care were now in place; and
• reported the outcome of this audit to a meeting of the appropriate scrutiny panel that was open to the public.

LGO satisfied with Council's response: 4 August 2010

Date Updated: 05/08/10