Summary: There was no fault in the way the Council carried out social care assessments for Mr and Mrs X.

The complaint

1. Mr and Mrs X complained there was fault in the way the Council assessed their social care needs in 2021. They said this meant they have not been getting the care they need.
2. Mr and Mrs X also complained about matters that happened several years ago including:
• Not getting care or advice since 2006
• A problem with their wet room
• Being forced to take out loans
• Their children’s health problems in 1979 and 2006

Back to top

What I have investigated

3. I investigated the complaints at paragraph one. My reasons for not investigating the complaints at paragraph two are at the end of this statement.

Back to top

The Ombudsman’s role and powers

4. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
5. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
6. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

Back to top

How I considered this complaint

7. I considered the complaint to us, the Council’s response to the complaint and documents described in this statement. A colleague discussed the complaint with Mr X
8. Mr and Mrs X and the Council now have an opportunity to comment on my draft decision. I will consider their comments before making a final decision.

Back to top

What I found

Relevant law

9. A council must carry out an assessment for any adult with an appearance of need for care and support. The assessment must be of the adult’s needs and how they impact on their wellbeing and the outcomes they want to achieve. It must also involve the individual and where appropriate their carer or any other person they might want involved. (Care Act 2014, section 9)
10. An adult’s needs meet the eligibility criteria if they arise from or are related to a physical or mental impairment or illness and as a result the adult cannot achieve two or more of the following outcomes and as a result there is or is likely to be a significant impact on well-being:
• Managing and maintaining nutrition
• Maintaining personal hygiene
• Managing toilet needs
• Being appropriately clothed
• Making use of the home safely
• Maintaining a habitable home environment
• Accessing work, training, education
• Making use of facilities or services in the community
• Carrying out caring responsibilities.

(Care and Support (Eligibility Criteria) Regulations 2014, Regulation 2)

What happened

11. A social worker completed a social care assessment for Mrs X in April 2021. An occupational therapist (OT) was also present at the social worker’s visit. I have summarised the main points below:
• Mrs X could express her views and make decisions with no support needed
• She was in a lot of pain. Despite her disabilities she was very independent
• Mr X felt all members of the house were entitled to care because they have disabilities. The social worker explained they were entitled to a social care assessment but not necessarily entitled to care and support.
• Mrs X did not have eligible unmet needs around any of the domains listed in paragraph nine. Other members of the household supported her; she had equipment which she used for bathing/showering, she could complete laundry herself, she could use the toilet independently, could dress and undress, could use the home safely, another remember of the household did household chores, and she could access the community, maintain relationships and had no needs around work and training. She drove and owned a car.
12. On 15 April, the social worker sent Mrs X a letter with a copy of the completed assessment. The social worker also wrote to Mrs X’s GP, with her consent, about pain management. The letter explained Mrs X did not meet the criteria for social care support because she could achieve all the outcomes described in paragraph ten with support from her family.
13. The case records include a note at the start of May 2021 which says the Council put in place a temporary reablement care package for Mr X. Mr X told an officer he was going on holiday for two weeks. This short-term care was therefore cancelled and the plan was for a social worker to do a social care assessment when he got back from holiday.
14. A social worker completed a social care assessment for Mr X at the end of May 2021. Mr X’s advocate was present at the assessment. The assessment said:
• Mr X had a head injury
• He wanted a direct payment (money to organise his own care)
• He could move from a sitting to a standing position, use stairs, use the toilet independently upstairs and he could use a urine bottle at night
• Social services would provide a commode to keep downstairs to deal with when he needed to use the toilet urgently. Mrs X agreed to empty it
• He did not have any eligible care needs in any of the domains. Mrs X provided occasional assistance with personal care on a bad day (on average three days a month). Family helped with meal preparation, accessing the community, housework
15. After the assessment, the social worker wrote to Mr X sending him a copy and explaining he was also not eligible for social care support. The letter went on to explain that an OT had identified equipment to help with moving around the home and getting to the toilet – a commode for downstairs, a handrail and a ‘handihelp’ to assist with dressing. The OT ordered the commode and handrail and suggested a shop where Mr X could buy the ‘handihelp’. The records indicate the equipment supplier tried to deliver several times, but Mr and Mrs X would not arrange a time for delivery.
16. In response to letters from Mr X about his care, the Council offered to put in place a 30-minute care call every morning to assess him in his home. Mr X said he did not want this at the moment.
17. Mr and Mrs X complained to the Council about the issues they raised with us. The Council did not uphold their complaint, explaining they did not meet the criteria for care under the Care Act 2014. So Mr and Mrs X complained to us.

Was there fault?

18. We are not an appeal body. This means we do not take a second look at a decision to decide if it was wrong. Instead, we look at the processes an organisation followed to make its decision. If we consider it followed those processes correctly, we cannot question whether the decision was right or wrong, regardless of whether the person affected disagrees with it.
19. There was no fault in the Council’s assessments of Mr X or Mr Y. The social worker took into account the eligibility regulations described in paragraph ten and applied them to what Mr and Mrs X told them during the assessment visit or what they observed in the home. It was reasonable to suggest the use of a commode and a urine bottle to meet any need Mr X had for care around toileting. The Council does not have to provide care funding where equipment will do the job. As there was no fault, I cannot criticise the decisions that Mr and Mrs X did not have eligible needs. To clarify, the Council is not saying Mr and Mrs X do not have disabilities or serious health problems, just that they do not have needs arising from those disabilities and health conditions that require the Council to provide care funding under the eligibility regulations described in paragraph ten. My view is the Council responded appropriately when Mr X continued to raise concerns by offering a short period of care to assess their needs in more depth. So there was no fault.
20. Mr X told us they did not receive copies of the assessments. However, the Council’s records show that the social worker posted copies with covering letters. So I do not consider there was fault by the Council.

Back to top

Final decision

21. There was no fault in the Council’s social care assessments of Mr and Mrs X. I have completed the investigation.

Back to top

Parts of the complaint that I did not investigate

22. I did not investigate the second complaint as it was late. Mr and Mrs X gave no reason for failing to complain to us within 12 months of the matters.

Back to top

Investigator's decision on behalf of the Ombudsman