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Bracknell Forest Council (18 008 782)

Category : Adult care services > Assessment and care plan

Decision : Not upheld

Decision date : 29 Mar 2019

The Ombudsman's final decision:

Summary: Mr X complains about the occupational therapy service provided by the Council. He says this caused delays in meeting Mrs Y’s needs in this area. The Ombudsman finds no fault in the Council’s actions.

The complaint

  1. The complainant, whom I shall refer to as Mr X, complains on behalf of his mother, Mrs Y, that the Council:
    • failed to provide accurate information and signpost to the relevant services in relation to mobility issues including adaptations to the property and equipment.
    • removed direct contact with the occupational therapist which caused delays and difficulties.
    • delayed dealing with his complaints about this.
  2. Mr X and Mrs Y say the Council provided the wrong information and did not signpost to relevant services. The lack of direct contact caused delays. The lack of a ramp caused a risk to Mrs Y as she could not leave the property independently. They would like to make sure the Council deals with them properly.

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The Ombudsman’s role and powers

  1. 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)
  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 information from the Complainant and from the Council.
  2. I sent both parties a copy of my draft decision for comment and took account of the comments I received in response.

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What I found

  1. The Care Act 2014 sets out local authorities’ duties around adult social care. The Care and Support statutory guidance sets out how the Care Act should be applied
  2. The guidance says the local authority must not charge for certain types of care and support which must be arranged free. This includes community equipment (aids and minor adaptations). Aids must be provided free of charge whether provided to meet or prevent/delay needs. A minor adaptation is one costing £1,000 or less.

Disabled Facilities Grants

  1. Disabled Facilities Grants (DFG) are for people with a qualifying disability who need adaptations in their home to help them remain in their home. They are mandatory and must be awarded if the applicant meets the qualifying conditions.
  2. The maximum amount of a grant is £30,000. The council does a means test to work out how much it can award. If the applicant’s contribution would be more than the cost of the work then the council will not pay a grant. In these cases the council must issue a nil assessment decision.

What happened

  1. In September 2016, while Mrs Y was in hospital, an occupational therapist (OT) visited twice to assess what she needed when she returned home. The OT recommended she should take some equipment home with her to help with transfers. He also discussed a specialist wheelchair assessment and advised this could take 12 weeks.
  2. Mrs Y needed some adaptations to the bathroom. The Council had assessed Mrs Y as needing to contribute over £46,000 towards a DFG. Since this is more than the maximum grant, she was not eligible for a DFG.
  3. The OT visited the family at home and advised about a sliding door, portable shower screens, a slide board, and a self-propelling shower chair. He put in a funding request for a toilet riser and a hospital bed to be joint funded with the health service. He also discussed car transfers, access to the property, ramps, rails, transfers from bed and wheelchair and wheelchair use. Mr X said Mrs Y did not want any adaptations that would make the house “look disabled”. She did not want portable shower screens or a slide board. Mrs Y was to use a commode to strip wash in the kitchen until the bathroom was completed. Mr X planned work to begin at the start of October 2016 and told the OT it was unlikely to be complete before discharge. The OT also completed a carer’s assessment for Mr X’s daughter, Ms Z, who was her main carer.
  4. When Mrs Y returned home from hospital in October, the OT visited again to assess. He advised Mr X that there were potentially some problems with his plan for a temporary wooden ramp. Mrs Y had not brought the equipment to help with transfers, home with her so the OT ordered this urgently. Mrs Y’s family planned to build temporary ramp for her to access the front door. The OT advised Mrs Y that he would order the shower screens and shower chair once the bathroom was complete. A financial officer advised Mrs Y and Ms Z about their applications for Attendance Allowance and Carer’s Allowance.
  5. At the end of October, when the bathroom was complete, the OT visited to trial the shower chair. Mrs Y fell and the OT visited again. He recommended she use the lifeline alarm system but Mrs Y declined. The OT sent Mrs Y and Mr X information about suitable contractors to ask for quotes for the ramp.
  6. In November, the OT visited to trial the toilet riser seat but Mrs Y refused it. The IT showed her a toilet lift which she agreed to try, also an extended seat for the existing commode which she trialled. The OT also visited to take measurements for the ramp.
  7. Towards the end of November, a demonstration of the toilet lift and ramps was unsuccessful because the family were not at home.
  8. In December 2016, Mrs Y advised the OT she had been in hospital and said she had left him a message. He had not received the message but Mrs Y refused to speak to him. Mrs Y said she no longer wanted the shower chair so the OT arranged for collection. Mrs Y asked again from the funds to replace the toilet.
  9. The OT asked the Council to pay for the £375 to change the toilet.
  10. Mrs Y saw a private physiotherapist who advised against the toilet riser arranged by the OT. Mrs Y decided she did not want the toilet riser but wanted a higher toilet. Her GP referred her for a powered wheelchair.
  11. During January 2017, Mrs Y’s new wheelchair arrived. Mr X complained about a letter from the OT which he said was rude and unprofessional.
  12. Mrs Y discussed the toilet with the OT and said she wanted the Council to pay for the work to replace the toilet. The OT explained that it was unlikely the Council would pay as he had recommended the standard toilet for use with the toilet riser and commode. However, it did fund this as a minor adaptation (under £1,000). The OT visited, apologised, and discussed the ramps as Mrs Y’s preferred option was not possible. The OT also suggested three options for wheelchair accessible vehicles.
  13. The OT visited the property with a technical officer to look at the possible options for a ramp; the technical officer advised on this.
  14. In February, the Council refused the request to fund the ramp.
  15. In April, the OT visited Mrs Y to introduce his replacement. The (new) OT arranged for a replacement chair for Mrs Y and arranged a visit from a stair lift provider, and a builder to advise on the ramp. Mrs X went back into hospital so the visit was delayed.
  16. When Mrs Y was discharged in May, the OT visited her at home and the builder also came to assess the threshold and ramp access. The OT visited again with the technical officer, as the builder refused to visit again until the ramp design was agreed; they had visited six times. When the OT advised Mrs Y and Ms Z about this, the conversation became heated and Ms Z was unpleasant towards the OT.
  17. A few days later, the quote for the stair lift was given to Ms Z.
  18. In June, the OT rang the builders to discuss a quote for access at the side of the property. Mrs Y advised she was undecided about the stair lift as she was considering moving.
  19. Between June and September, the OT visited a few times to discuss a perching stool, a grab rail for the bathroom and the ramp. The contractor due to fit the ramp was delayed because of staff sickness.
  20. Mr X complained to the Council about the delay with the ramp.
  21. Towards the end of September, the contractor attempted to install the ramp. The contractor had difficulties with the threshold and could not install the ramp as planned. Mrs Y and Mr X were unhappy with the alternative suggestions.
  22. In October, the OT visited with the contractor but Ms Z was verbally abusive to the OT and the Council wrote to Mrs Y advising that he was no longer working with her.
  23. In April 2018, a team manager at the Council received abusive calls from Ms Z and ended the calls. The Council advised the family contact would be by email only.
  24. In June 2018, the Council says Mrs Y and Ms Z were verbally abusive to the OT when they saw him out in the community. This resulted in the OT lodging an anti-social behaviour complaint.
  25. The Council accepts that it delayed significantly in responding to Mr X’s complaint and apologised for this.

Was there fault which caused injustice?

  1. It is unfortunate the relationship between the OT and the family deteriorated to such a degree. In fact, the family had received considerable support from the Council over an extended time. I consider the information, direct support and signposting was evidence of good practice by both OTs, who, despite difficulties, continued to offer support. The Council was not responsible for the ramp, it had only offered advice and information and was not funding the works. I found no fault here.
  2. I have concluded the Council removed direct contact with the OT with good reason, and in line with the Council’s policies. It had provided most of the support needed and was not responsible for the ramp. I found no fault here.
  3. The Council delayed responding to Mr X’s complaint about the delay in the ramp. This was fault. However, throughout the period of the delay, the Council continued to work with Mrs Y and Mr X, and it was not responsible for the delay in the works. It apologised for the delay responding to the complaint, and I am satisfied this was enough to remedy any injustice caused.

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Final decision

  1. I have completed my investigation and have not upheld Mr X’s complaints that the Council:
    • failed to provide accurate information and signpost to the relevant services in relation to mobility issues including adaptations to the property and equipment.
    • removed direct contact with the occupational therapist which caused delays and difficulties.
    • delayed dealing with his complaints about this.

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Investigator's decision on behalf of the Ombudsman

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