Summary: Miss X complained the Council misled her into moving to her current residential placement. She said the placement does not meet her needs and the Council has not done enough to return her to her home area. The Council accepted it should have better prepared Miss X for the move to Home B and has apologised. There is no other fault in the Council’s actions.

The complaint

1. Miss X complained about her residential placement provided by the Council. She stated that:
1. the Council misled her into moving out of her residential placement at Home A into Home B;
2. that Home B does not meet her needs;
3. the Council has not done enough to return her to her home area; and
4. the Council delayed in giving her an outcome on her safeguarding concerns.
2. Miss X is unhappy in her placement. She wants to live closer to her family, friends and college.

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What I have investigated

3. I have investigated complaints a) – c) in paragraph one. The reason for not investigating complaint d) is given at the end of this decision.

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The Ombudsman’s role and powers

4. 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)
5. 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

6. I discussed the complaint with Miss X’s representative, Ms Y.
7. I made enquiries of the Council who provided Miss X’s case records and its complaint response to Miss X.
8. I visited Home B and read Miss X’s daily care notes between December 2018 and April 2019.
9. I referred to the Care Act 2014 and its supporting statutory guidance.
10. Miss X and the Council had the opportunity to comment on my draft decision.

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What I found

11. The Care Act 2014 requires local authorities to carry out an assessment for any adult who may need care and support. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve.
12. If the assessment finds the person does have care and support needs, the council has a legal responsibility to provide a care and support plan to show how these needs will be met. When preparing a care and support plan the local authority must involve any carer the adult has. The support plan may include a personal budget which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

Background

13. Miss X is a young adult with complex care needs. She has been looked after by the Council since she was 15. Since turning 18, Miss X has lived in adult care homes.
14. Miss X was living at Home A where she assaulted a staff member on 18 July 2018. Home A contacted the Council and said they could no-longer manage Miss X’s needs. Home A asked the Council to move Miss X to a new home immediately. The Council put in one-to-one staffing to support Miss X while it looked for a new placement.
15. The Council stated it contacted several providers for an emergency placement for Miss X. The nearest provider that could meet Miss X’s care needs was Home B. Home B was 35 miles from Miss X’s home town.
16. Miss X’s social worker met with Miss X on 26 July 2018 to tell her about Home B. Miss X moved to Home B on 30 July 2018.
17. Miss X met with the Council on 6 August 2018 and complained about her move to Home B. The main points of Miss X’s complaint were:
• the social worker had not kept her informed about the move;
• the social worker had told her she would get therapy at Home B but that was not true; and
• she would not be able to go to her choice of college while at Home B.
18. Miss X stated she wanted a different social worker and to move closer to home.
19. The Council investigated Miss X’s complaint and sent her a response within the month. It accepted it would have been better for Miss X to have viewed the new placement before moving. It partially upheld this part of the complaint and apologised to Miss X.
20. The Council stated there was no record of the social worker agreeing specific therapy would be put in place for Miss X on moving to Home B. It did not uphold this part of the complaint.
21. The Council partially upheld Miss X’s complaint about access to education. However, since it responded to Miss X, it has put in taxi provision, alongside the support of Miss X’s family, so she can go to her college of choice, three days a week.
22. Miss X complained to the Ombudsman at the start of December 2018 as she was unhappy she was still living at Home B.
23. Complaint a) the Council misled Miss X into moving out of her residential placement from Home A into Home B
24. Miss X, her mother and grandmother met with her social worker in July to talk about the move to Home B. The Council’s record of this meeting shows Miss X and her mother were both unhappy about her moving out of area.
25. The case records do not give any detail about what information the social worker gave Miss X about Home B. The meeting focussed on the reasons for the move and Miss X’s care needs. The social worker recorded telling Miss X she believed Home B would “support her to recognise and manage her difficulties”. The social worker agreed to review the placement after six weeks to see if there was anything available closer to home.
26. Miss X stated she agreed to move to Home B on the understanding it would be a short-term placement, where she would get the therapy she needed, before being able to return closer to home. She stated the social worker told her she would get 4 hours cognitive-behavioural therapy (CBT) and weekly art therapy at Home B.
27. Miss X looked at the care home’s website and understood it had facilities including a sensory room and swimming pool. However, the website explains these facilities are at a nearby care home which residents are free to use. Home B asked Miss X if she would like to use the swimming pool but she said no.
28. When I visited Home B, it confirmed Miss X can see the art therapist who comes to the home weekly. Miss X chooses not to.

My findings

29. Miss X says she was misled into moving to Home B by the Council after it said she would receive CBT and art therapy and that it would be a short-term placement. The social worker’s notes of the meeting do not record what information they gave Miss X about Home B. However, they show the social worker agreed to review the placement within six-weeks.
30. Miss X had to leave Home A, and Home B was the only available emergency placement that could meet her needs. However, the Council should have been clear when it explained the move to Miss X, that although it would review the placement, it did not mean another placement would be immediately available. The case notes should have recorded what information Miss X was given about Home B.
31. The Council was at fault for not ensuring Miss X fully understood the move to Home B or the support she would receive on moving. That led to her feeling misled by the Council.
32. The Council accepted it could have prepared Miss X better for the move and taken her to Home B before she moved in. It has apologised for this which is a satisfactory remedy

Complaint b) Home B does not meet her needs

33. Miss X said the care home is unable to meet her needs because:
• it does not arrange activities she is interested in;
• she has been bullied by another resident;
• she must pay for staff transport for activities in the community;
• it is too far from her family, college and friends; and
• it mismanaged her medication.

Activities

34. Miss X’s care and support assessment, says she needs twenty-four-hour support, including sixteen hours of one-to-one support daily. Home B says Miss X chooses which staff member provides her one-to-one support.
35. Miss X’s support plan shows she attends college three days a week. She also spends time with her family on a weekly basis. Home B is responsible for supporting Miss X with activities of her choice on evenings and weekends.
36. On 15 August 2018, Miss Y emailed the Council on Miss X’s behalf to tell them Home B was not offering Miss X any activities. Miss X’s social worker met with the manager of Home B on 22 August 2018. The Council records show Miss X was offered the opportunity to take part in several activities and had chosen not to.
37. I reviewed Miss X’s care records from December 2018 to April 2019. This showed Home B regularly took Miss X out on shopping trips and did cooking activities with her. When Miss X asked to go out, Home B would take her.

Bullying

38. On 21 January 2019 Miss X spoke to her social worker as she was unhappy how another resident at Home B was treating her. The social worker discussed this with Home B’s manager. The manager said Miss X was friends with the person she complained about, but they often fell out. This relationship is reflected in Miss X’s care records. Miss X states she is not friends with this person.
39. The care records showed Miss X was supported by staff when she fell out with the other resident.

Transport

40. Miss X states she pays for the care staff’s transport if she wants to go out on activities. The Council explained Miss X has a mobility car. The Council’s policy expects a person with a mobility car to use it for transport to activities. Miss X chooses for her car to remain with her mother when she is in placement therefore it is not available for staff to use.

Mismanagement of medication

41. Miss X stated Home B neglected to meet her care needs after she ran out of medication. Miss X said she was worried about not receiving her medication, and it may have impacted on her wellbeing at the time.
42. On 22 August Miss X met with her social worker after she had missed medication for two days.
43. The social worker spoke to Home B who explained it was unable to get Miss X an appointment with the doctor to register her as a new patient. It advised it had been in touch with the doctor who was sorting out a prescription for that day. Home B made a self-referral to the local adult safeguarding team to alert them that Miss X had not received two days medication. The safeguarding team was in a different area to the Council responsible for arranging Miss X’s care.
44. Miss X saw the doctor on 23 August 2018 as she felt unwell. Miss X believes this was because she had not taken her medication. The doctor prescribed Miss X antibiotics but she chose not to take them.
45. On 10 September 2018, the Council contacted the adult safeguarding team. It advised it was still investigating the alert and that Miss X would be given the outcome once it had been completed. If safeguarding had concerns about Home B, Miss X’s Social worker would be told. The Council passed this information to Ms Y on 14 September 2018.
46. The safeguarding investigation found the delay in getting medication was because of a communication error between Home B, the doctors and the dispensing pharmacy. Home B has since changed how it orders medication, doing this through an online process. It also orders medication earlier in case there are any difficulties getting medication in.
47. There have been no repeat incidents where Home B has failed to have a supply of Miss X’s medication.

My findings

48. Miss X complained Home B was failing to meet several care needs. I have reviewed each area of need individually. I am satisfied Home B meets Miss X’s assessed care needs. The Council is not at fault.

Complaint c) the Council is not doing enough to return Miss X to her home area

49. Miss X moved to Home B on 30 July 2018. The case records showed the Council were looking for alternative placements closer to her family from 22 August 2018.
50. On 18 September 2018, the Council gave Miss X a list of nineteen providers it had contacted in trying to find her a different placement. These providers had been either unable to take her or had not responded to the Council.
51. The Council continued to try and find alternative accommodation for Miss X. The Council’s case records showed it contacted more than thirty care homes or care providers. Miss X decided she did not want to live independently so the Council focussed its search on care homes. However, it was unable to find one with either the space or ability to meet Miss X’s care and support needs.

My findings

52. The Council’s records showed it has tried to find Miss X a different placement continuously, since August 2018. The Council is not at fault.

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Final decision

53. The Council was at fault for how it prepared Miss X for the move to Home B. It has already apologised for this. There is no further fault by the Council therefore I have completed my investigation.

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Parts of the complaint that I did not investigate

54. I did not investigate the delays in the safeguarding enquiry. That was because, the enquiry was completed by Home B’s local authority. Miss X would need to make a separate complaint to this Council if she is unhappy with how it dealt with her referral.

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Investigator's decision on behalf of the Ombudsman