Summary: Mr R, complains the Council did not carry out an assessment of his care needs before his discharge from hospital. The Ombudsman upholds the complaint. Our view is the Council has made a suitable offer of a remedy.

The complaint

1. The complainant, whom I shall refer to as Mr R, complains the County Council (which I shall refer to as the Council) did not carry out an assessment of his care needs before his discharge from hospital.

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The Ombudsman’s role and powers

2. 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)
3. 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)
4. 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

5. The information I have seen includes:
• the documents Mr R supplied with his complaint;
• the Council’s responses to the Ombudsman’s enquires; and
• documents from the NHS’s occupational therapy service;
6. I also sent my draft decision to Mr R and the Council and invited their comments.

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What I found

Legal and administrative background

7. Schedule 3 to the Care Act 2014 and the Care and Support (Discharge of Hospital Patients) Regulations 2014 make provisions on the discharge of hospital patients with care and support needs.
8. The NHS must issue a notice to the local authority where it considers a NHS hospital patient receiving acute care may need care and support as part of a transfer from an acute setting. The NHS should try to give the local authority as much notice as possible of a patient’s impending discharge.
9. On receiving an assessment notice, the local authority must assess the person’s care and support needs to determine whether it considers the patient has needs. The local authority must then decide whether any of these identified needs meet the eligibility criteria. If so, it should confirm how it proposes to meet any of those needs. The local authority must inform the NHS of the outcome of its assessment and decisions.

What happened

10. Mr R was in hospital after an accident that led to mobility changing disabilities. Mr R could not return to his previous home – a furnished, privately rented sector, flat – as it was not wheelchair accessible. In effect, this meant Mr R was homeless, as he had nowhere to stay on discharge from hospital.
11. On 5 February the hospital sent a notice of assessment to the Council’s adult social care (ASC) department, advising Mr R was ready for discharge. It noted he was capable of caring for himself, but that his old flat was no longer suitable.
12. The Council says it did not carry out an assessment, or any planning, before Mr R’s discharge. It says this was because the hospital had informed it Mr R was independent and did not have any care needs.
13. The hospital also referred Mr R to the District Council for re-housing. The referral noted Mr R would need a wheelchair accessible property for the rest of his life. The report noted he would need ‘extensive help from Social Services’ to achieve being able to live independently. We are investigating a separate complaint about the referral for housing to the District Council.
14. On 6 March Mr R moved to a new flat, arranged on a temporary basis by the District Council. That day, Mr R’s friend contacted the Council to advise he was concerned the flat was not suitable. And this was having an affect on Mr R’s mental health. The Council’s records note it decided Mr R urgently needed an occupational therapy (OT) assessment.
15. The local NHS Trust had arranged for its own OTs to visit Mr R. Their records show an OT contacted the Council’s ASC team on 7 March. The OT advised the Council Mr R would benefit from care as soon as possible.
16. On 14 March, officers requested authorisation for 30 minutes of daily personal care for Mr R and an extra two hours’ flexible care provision. An officer met Mr R on 19 March and agreed to provide this care beginning 20 March.
17. Later, the Council had input into responding to a complaint Mr R made to the NHS about his discharge from hospital. It accepted it should have visited Mr R in hospital to carry out an assessment. It apologised that this had not happened.
18. In response to my enquiries the Council reiterated its view about not carrying out an assessment:

‘We are of the view this is not acceptable and after reflecting on their practice, Mr [R] should have been visited by our Social work team and an assessment should have been made and not relied on information from other agencies.’

19. The Council offered to apologise and make Mr R a payment of £250, in recognition of the distress the delays in assessment caused him.

Analysis

20. Mr R first complained to the Health Service Ombudsman about events in the hospital, but also the issues that this complaint is about. That Ombudsman alerted our joint working team in October 2018. We then asked the Council to look at the complaint, as it had not done so. Mr R then came back to us. The events are about matters from February 2018. So Mr R did start to complain about the issues within 12 months. Although he did not, strictly, come to us within 12 months, my view is Mr R’s complaint is one we can consider. There have been delays in considering it because of our backlog and a pause in our casework during the COVID-19 lockdown.
21. We have also delayed issuing this statement, to produce it at the same time as a revised decision on Mr R’s complaint about the District Council.
22. The Council has accepted fault in the way it dealt with a notice from the hospital advising Mr R needed assessment before discharge. To its credit, once Mr R’s friend contacted it on the day of his discharge, it recognised then the need for an assessment and began the process of arranging one.
23. The Council began providing services from 20 March. On the balance of probabilities, if it had acted without fault, it would have arranged some services before Mr R left hospital. So that care would have begun on 6 March. So for two weeks Mr R was left without services the Council later assessed him as needing.
24. The Council recognises that delay is an injustice that demands a remedy and has made an offer of £250. The Ombudsman’s Guidance on Remedies says that a payment for unavoidable distress will often be a moderate sum of between £100 and £300. So my view is the Council’s offer fits with the remedy the Ombudsman would have recommended.

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Final decision

25. I uphold this complaint. The Council’s offer of a remedy is satisfactory. So I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman