Essex County Council (18 007 402)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 02 Jan 2019

The Ombudsman's final decision:

Summary: We uphold this complaint because the Council failed to consider reasonable adjustments when placing contact restrictions on Mr B. And it also delayed in completing a care assessment and care and support plan and in commissioning home care for Mr B. This was fault and caused Mr B avoidable distress and inconvenience. To remedy the injustice, the Council will, within one month, take the action described in this statement which includes a payment (offset against outstanding care charges) and apology.

The complaint

  1. Mr B complains about Essex County Council (the Council). He says:
      1. the Council placed restrictions on the way he can contact it. It says he has to write or email. But he cannot write or email because of his disabilities and so he cannot contact his social worker or other officers
      2. the Council only responded to one of his six verbal complaints and the response was unsatisfactory
      3. he is not receiving any care because the Council has not carried out its financial assessment.
  2. Mr A says he has not been able to bathe or shower and would like to be able to contact his social worker by phone.

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The Ombudsman’s role and powers

  1. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
  2. 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)

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How I considered this complaint

  1. I considered Mr B’s complaint, the Council’s responses to his complaints and documents described later in this statement. A colleague discussed the complaint with Mr B on the phone. I took into account both parties comments on a draft of this statement.

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What I found

  1. The law requires public bodies, including councils, to make reasonable adjustments to ensure people with disabilities can use services as closely as is reasonably possible to the standard offered to people without disabilities. Disabilities include cognitive impairments as well as physical ones. (Equality Act 2010, section 20)
  2. A council must carry out an assessment for any adult with an appearance of need for care and support. (Care Act 2014, section 9)
  3. If a council decides a person needs support, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether they meet any eligibility criteria and sets out how the council is going to meet them. It should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
  4. The council must carry out assessments and support planning over a suitable and reasonable timescale considering the urgency of needs. Local authorities should tell the individual when their assessment will take place and keep the person informed throughout the assessment.
  5. A council has a duty to meet a person’s eligible unmet needs. (Care Act 2014, section 18)

Key facts

  1. Mr B has physical disabilities. He lives in a private property with his mother.
  2. The Council told us it did not know Mr B could not write and said it had previously received written communication from him, including emails. However, one of its social care assessments said ‘Mr B is able to read and write. He struggles to write due to pain in his hands. He has access to a computer although he has chosen not to use his email…… Mr B informed me he has arthritis in his hands and is unable to write or type’
  3. A social worker and an occupational therapist carried out an assessment of Mr B’s care and support needs in May 2018 and decided he was eligible for care and support. They drew up a care and support plan in November 2018. I summarise these documents below:
    • Mr B was eligible for care services. He could not maintain personal hygiene, make use of the home safely or maintain a habitable home;
    • Adaptations to bathing facilities and small pieces of equipment could meet most of Mr B’s care needs around toileting and showering, but the landlord of his property would not consent to adaptations;
    • He needed support to wash his feet which could be achieved using a long handled loofah (which Mr B could buy himself). He could buy a sock aid which would enable him to put on and take off socks. He said one of his relatives helped him with this;
    • A bed lever would assist with getting in and out of bed, but Mr B refused this;
    • Mr B did not need a specialist bed or mattress and the Council would not provide standard ones;
    • Carers were to clean Mr B’s bedroom, support him to change bed linen and help him to wash and dry his feet.
  4. The Council carried out a financial assessment in August and advised Mr B of his weekly charge for care.
  5. The Council commissioned a care agency to support Mr B. Services were due to start in October, but the agency had staff problems. Mr B then asked for a different agency, but the Council could not find one that would work with him. Officers asked the agency commissioned to provide care for Mr B’s mother to provide him with care. Care services to Mr B started at the beginning of November.
  6. The Council has records of two complaints from Mr B about his mother’s care and not about the issues he raises with us. The Council’s March 2017 complaint response said:
    • There was concerns about his contact with social care which was too frequent and could be intimidating and aggressive;
    • All communication should be in writing through one of three officers. If his behaviour did not improve, officers would consider additional restrictions on his contact.
  7. The Council responded to a second complaint in June 2017 saying:
    • Mr B’s excessive contact continued and he could communicate with one senior officer only;
    • This would not affect services to his mother who had a social worker who met with her and another relative regularly;
    • Two agencies had refused to provide care to his mother because of his behaviour
    • He should treat carers and social workers with respect.
  8. The Council told me it was in the process of reviewing the contact restrictions with Mr B. Mr B said he wanted a senior officer to be his main contact. The Council has also identified a second senior officer if the first officer was not available. The Council said Mr B was happy with this arrangement.

Was there fault and if so, did this cause any injustice?

Complaint a: The Council placed restrictions on the way he can contact it. It says he has to write or email. But he cannot write or email because of his disabilities and so he cannot contact his social worker or other officers

  1. The Council told me it was unaware Mr B could not write. Yet its social care assessment noted he could not write/type due to arthritis. It appears his ability to type/write may vary. The Council is required to make reasonable adjustments to ensure its services are accessible to disabled people, including those who have fluctuating conditions. It was fault of the Council to restrict Mr B’s contact to be in writing when this effectively prevented him, or made it very difficult to get in touch with the single point of contact. The Council has now reviewed the contact arrangements with Mr B who is reported to be happy with them. This remedies any injustice to him.

Complaint b: The Council only responded to one of his six verbal complaints and the response was unsatisfactory

  1. The Council has records of two complaints and responses. There is no evidence of any other complaints. There is no fault in the responses I have considered.

Complaint c: Mr B is not receiving any care because the Council has not carried out its financial assessment

  1. The Council has carried out a financial assessment and this is not the reason for the delay. The delay is because of (1) a six-month gap between starting the assessment and completing the care and support plan and (2) difficulties finding an agency that will work with Mr B. Although there are no statutory timescales for completing an assessment and care and support plan, taking six months is too long, is not a reasonable time frame in the circumstances and is fault. The Council is under a duty to meet Mr B’s eligible needs and its failure to identify and put in place an agency is fault. I have taken into account that Mr B’s behaviour is likely to be known to some local care agencies because of his mother using them and that at least two have refused to work with Mr B because of his behaviour when carers were looking after his mother. This does not absolve the Council of its responsibilities to meet Mr B’s eligible needs.
  2. Mr B says he has not had a bath/shower because of the failure to commission care. The Council’s assessment concluded he could do most personal care independently and needed help with washing his feet only. There is not enough evidence to conclude Mr B has been unable to bathe or shower. But I am that the failure to commission care sooner has caused him avoidable inconvenience and distress.

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Agreed action

  1. Within one month of this statement, the Council will:
    • Apologise to Mr B;
    • Pay him £250 to reflect the avoidable inconvenience and distress caused by the delay in starting home care. This payment will be offset against Mr B’s outstanding care charges;
    • Confirm the current contact arrangements for Mr B in writing, ensuring it has taken into account my comments on reasonable adjustments and gives Mr B a date for reviewing them to see if they are still needed.
  2. I will require evidence of compliance.

Final decision

  1. We uphold this complaint because the Council failed to consider reasonable adjustments when placing contact restrictions on Mr B. And it also delayed in completing a care assessment and care and support plan and in commissioning home care for Mr B. This was fault and caused Mr B avoidable distress and inconvenience. To remedy the injustice, the Council should, within one month, take the action described in this statement which includes a payment (offset against outstanding charges) and apology.

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Investigator's decision on behalf of the Ombudsman

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