• The complaint
• What I have investigated
• The Ombudsman’s role and powers
• How I considered this complaint
• What I found
• Final decision

The Ombudsman's final decision:

Summary: Mr X complains about his care needs assessment, care plan, and the Council’s handling of his financial assessment. He also complains about the Council’s role in his disabled facilities grant application to the district council and that the Council would not complete a continuing healthcare checklist for him. The Ombudsman finds some fault with the Council’s actions regarding its role in the continuing health care checklist. However, the fault did not cause Mr X a significant injustice.

The complaint

1. Mr X complains about the following:

• The Council’s care needs assessment and care plan. Mr X is not happy with the support the Council has allocated to him. The Council’s handling of his financial assessment. Mr X says the Council delayed in completing the financial assessment as it would not allow him to send evidence by email. Mr X said the delay meant the implementation of the care package was also delayed.
• The delays in the Council submitting his disabled facilities grant application. Mr X says he thought he had submitted his application in October 2018 but only found out in April 2019 that there was no application.
• The Council did not allow him to provide his own quotes for soundproofing works and did not allow him to choose the contractor. Mr X says he was forced to use the preferred contractor of his housing association.
• The Council has refused to complete a continuing healthcare (CHC) initial checklist assessment

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What I have investigated

2. Mr X also complains about the Council’s actions with regards to the noise reduction works that are ongoing. These matters have not concluded and relate to the actions of his housing association and the district council. Therefore, I will not be investigating this complaint.

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The Ombudsman’s role and powers

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. 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)
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)
6. We investigate complaints about councils and certain other bodies. We cannot investigate the actions of bodies such as housing associations. (Local Government Act 1974, sections 25 and 34A, as amended)

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How I considered this complaint

7. I considered the information provided by Mr X.
8. I made enquiries with the Council and considered the information it provided.
9. I sent two draft decision to Mr X and the Council and considered their comments.

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What I found

Care Act 2014

10. Section 9 and 10 of the Act require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to all people regardless of their finances or whether the council thinks an individual has eligible needs.
11. The assessment must be of the adult’s needs and how they impact on their wellbeing and the outcomes they want to achieve. The assessment must involve the individual and, where suitable, their carer or any other person they might want involved.
12. Statutory guidance highlights that care and support planning should be person centered, with an emphasis on the individual having every reasonable opportunity to be involved in the planning. This requires the local authority to ensure that information is available in a way that is meaningful to that person, and that they have support and time to consider their options. (Care and support statutory guidance, paragraph 10.33)
13. Where councils have determined a person has eligible needs, they must meet those needs. Councils must provide a care and support plan. The care and support plan should consider what the person has, what they want to achieve, what they can do by themselves or with existing support, and what care and support may be available in the local area.
14. The support plan must include a personal budget which is the money the council has worked out it will cost to arrange the necessary care and support for the person. Councils can charge for care and support it provides or arranges. Councils must assess a person’s finances to decide what contribution they need to make towards their care and support.
15. Local authorities must take all reasonable steps to reach agreement with the person for whom the plan is being prepared. Wherever possible, local authority sign off should occur when the person and the local authority have agreed on the factors within the plan, including the final personal budget amount, and how the needs in question will be met. (Care and support statutory guidance, paragraph 10.83)
16. Section 27 of the Care Act 2014 gives an expectation that local authorities should conduct a review of a care and support plan at least every 12 months. As well as the duty to keep plans under review generally, the Act puts a duty on the local authority to conduct a review if the adult or a person acting on the adult’s behalf asks for one.

Disabled Facilities Grant (DFG)

17. Disabled Facilities Grant (DFG) are provided under the terms of the Housing Grants, Construction and Regeneration Act 1996. There is also detailed guidance on good practice.
18. Councils have a statutory duty to provide grant aid to disabled people for certain adaptations.
19. Councils will need to check the proposed works are:

• Necessary and appropriate to meet the disabled person’s needs.
• Reasonable and practicable depending on the age and condition of the property.

20. Councils will often consult an occupational therapist (OT) from the social services department to carry out an assessment. If the occupational therapist decides an adaptation to a person’s home is necessary and appropriate to meet their needs, they will send their recommendation to the district or city council. The district or city council then helps the applicant complete the grant application form.

Continuing healthcare (CHC) assessment

21. Continuing healthcare is a package of care for people who have been assessed as having a primary health need. It is funded by the NHS.
22. Determining whether a person is eligible for CHC is a two-stage process. The first stage is to have an initial assessment called a Checklist. This can be completed by a nurse, doctor, social worker or other qualified healthcare professional, who carries out a brief evaluation of your care needs. Anyone can ask for an assessment at any time.
23. If the Checklist shows the person may be eligible for CHC, then a full assessment will be completed.

Background

24. Mr X has a diagnosis of Autism. Mr X was occasionally supported by a friend, Mr Y. At the time of my investigation, Mr X had withdrawn consent for Mr Y to represent him.
25. The Ombudsman has previously considered a complaint by Mr X that the Council did not complete his care needs assessment in January 2018 properly. We did not find fault with how the Council completed Mr X’s care needs assessment and our investigation considered matters up to April 2018.
26. With regards to Mr X’s complaint about the Council’s care needs assessment and support plan, I have only considered the care needs assessment completed by the Council after January 2018. I have not reinvestigated the Council’s actions with regards to the January 2018 care needs assessment.

What happened

27. In February 2018, the Council sent Mr X a financial circumstances form for him to complete. This was to allow the Council to complete the financial assessment to work out how much Mr X had to contribute towards his care and support services.
28. Mr X did not return the form and the Council asked Mr X if he would like help with completing the form. Mr X told the Council he had raised a complaint and was not receiving any care and support.
29. In April 2018, the Council offered to meet with Mr X at his home to help him with the financial assessment. Mr X declined this and asked the Council to stop contacting him.
30. In August 2018, the Ombudsman issued his final decision on Mr X’s complaint, finding no fault with the way the Council completed the care needs assessment.
31. In early September 2018, Mr Y contacted the Council to advise Mr X now wanted help to complete the financial forms. The Council sent Mr Y the financial forms. Near the end of September 2018, Mr X told the Council Mr Y had completed the financial assessment forms. Mr X said he would not sign the completed form. Mr X also rejected the Council’s offer of support to complete the financial assessment form.
32. In November 2018, the Council visited Mr X to complete the financial assessment. Mr X was not present for the meeting, but the Council was able to complete the financial assessment with Mr Y. Mr Y also asked the Council for an occupational therapist assessment for Mr X for a DFG. The Council confirmed it had referred Mr X for an occupational therapist assessment.
33. Mr Y asked the Council to provide Mr X with the personal budget from his February 2018 care needs assessment. The Council explained Mr X’s care needs assessment would need to be reviewed and updated if he wanted support. Mr X said he did not want a reassessment as his needs had not changed.
34. Between December 2018 and January 2019, the Council had continuous contact with Mr X about his care needs assessment. The Council sent Mr X a draft assessment in January 2019. Mr X was unhappy with the draft as he said some of the information contained within the assessment was wrong. The Council sent a further assessment near the end of January 2019. Mr X signed and agreed to this assessment.
35. At the end of January 2019, the Council provided Mr X with his draft support plan. The Council sent a further amended draft support plan in February 2019. Mr X signed and returned this support plan.
36. In April 2019, the Council allocated Mr X to an occupational therapist. The Council explained to Mr X the occupational therapist needed to visit his property to start the DFG application. Mr X was unhappy at this as he thought a DFG application had already been submitted.
37. Between April 2019 and May 2019, the Council tried to arrange for the occupational therapist to visit Mr X’s property. The occupational therapist visited Mr X in June 2019. The Council wrote to Mr X to confirm it had written to the district council and his housing association recommending they consider him for a DFG for soundproofing works.
38. In August 2019, Mr X’s housing association provided a quote from a contractor for the soundproofing works. The district council approved this quote and the contractor started the soundproofing work in September 2019. At this point, Mr X had not asked the Council if he could source his own contractor.
39. The Council explained it had no role in the process of choosing what contractor to use for the soundproofing works. The Council explained it was for Mr X’s housing association to identify an appropriate contractor and the district council reviewed and approved the contractor quote.
40. In September 2019, Mr X asked the contractor to stop as he was unhappy with the material being used and the work being completed. The Council told Mr X the district council was happy for him to obtain his own quotes. The Council said it would put his quotes forward to the DFG funding manager at the district council. The Council also explained to Mr X that if his quote was accepted by the district council and an alternative contractor appointed, his housing association would have to agree to the new contractor.
41. Mr X provided the Council with some quotes for materials he had obtained. The Council requested the current contractors provide a quote for fixing the soundproofing system Mr X wanted.
42. In October 2019, the Council told Mr X the contractor had provided a quote and the quote had been approved. Mr X told the Council to stop all soundproofing works as he was unhappy with the amount the contractor had quoted. He told the Council he would source his own quote. Mr X provided his quotes to the Council in October 2019. In November 2019 the Council asked the district council and his housing association to consider using an alternative contractor. The housing association agreed to this on 20 November. The Council updated Mr X on 27 November. It said it would ask the housing association to get quotes from his preferred contractor. In January 2020, the district council approved the disabled facilities grant for soundproofing based on the quotes from the company Mr X preferred.
43. Mr X asked the Council about a CHC. The Council said Mr X refused to meet with anyone to complete the checklist and asked whether he could complete the checklist himself. The Council said it had checked whether the CHC checklist needed to be completed by a professional. The Council confirmed the CHC checklist would not be accepted by the clinical commissioning group if it was completed by Mr X.
44. The Council told Mr X he should contact his doctor about completing a CHC checklist because his doctor knew him better than his social worker and had a better knowledge of his health issues.

Analysis

Financial assessment delays

45. It is clear from the evidence there has been a delay in the completion of the financial assessment. However, the evidence shows the delays are because of Mr X’s actions and not because of any fault by the Council.
46. Between February 2018 and April 2018, the Council had sent Mr X the relevant financial forms for him to complete but Mr X did not complete them. Further, the Council made several offers to help Mr X with completing the form, but he declined all offers.
47. In April 2018, Mr X told the Council he did not want any contact from it. This meant the Council could not complete the financial assessment because it could not contact Mr X to request the required information. Again, this delay was caused by Mr X’s actions, not the Council’s.
48. Mr X said the Council had refused to accept information by email. However, there is no evidence to support this.
49. Therefore, I do not find fault with the Council for the delay in completing Mr X’s financial assessment.

DFG application

50. Mr X said he thought he had made a DFG application in November 2018. However, the evidence shows that Mr X’s friend, Mr Y, had only asked the Council for a referral for a DFG and for an occupational therapist assessment in November 2018.
51. The Council has an information leaflet, available on its website, which sets out the DFG process. However, there is no evidence the Council had explained to Mr X the process for making a DFG application. Given Mr X’s needs, it may have been useful for the Council to explain the process to him or to directly provide him with the information leaflet.
52. Therefore, it is possible Mr X had mistakenly thought that by requesting a referral for a DFG and for an occupational therapist assessment, this meant he had submitted his DFG application.
53. While the Council could have provided Mr X with further information, I do not consider this to be fault. This is because at no point did the Council tell Mr X it had submitted a DFG application. Further, if Mr X was uncertain about the application process, he could have asked the Council to clarify matters.

Social care assessment

54. The Council completed a review of Mr X’s care needs assessment in January 2019. It is clear from the evidence Mr X did not agree with a review because he felt his needs had not changed since January 2018. However, the law states councils should review care plans at least every 12 months. Therefore, there is no fault by the Council for reviewing Mr X’s care plan and care needs in January 2019.
55. It is clear the Council was not able to meet with Mr X in January 2019 to complete the review of his care needs assessment. It is good practice for councils to do so as it ensures the process is person centred and it allows the person to be involved in the planning. However, in this case, Mr X had refused to engage with the Council to complete the care needs review. Therefore, I do not find fault with the Council for completing the review without initial input from Mr X.
56. Further, the evidence shows that while the Council was not able to get input from Mr X during the review, it was able to update its assessment with information where available. The Council considered information provided by Mr X through various emails and from information provided by his friend, Mr Y. This was appropriate in the circumstances as it demonstrates the Council was aware of the need to capture Mr X’s views during the review.
57. The Council sent Mr X a draft assessment in January 2019. Mr X told the Council he was not happy and wanted amendments made because some of the information contained was wrong. This shows Mr X could engage with the care needs assessment and had the opportunity to provide the Council with his views. The Council provided Mr X with an amended assessment at the end of January. This shows the Council had taken note of Mr X’s views. This is in line with the principles of a good care assessment as set out within the statutory guidance.
58. The evidence shows Mr X signed and agreed to the Council’s care need assessment. Mr X also signed and agreed to the care plan in February 2019. This suggests Mr X was happy with the assessment completed by the Council and with the support offered.
59. Therefore, I do not find fault with how the Council completed Mr X’s care needs assessment. This is because the Council has followed the correct process and considered all relevant information.

Contactor quotes

60. Mr X said the Council did not allow him to source his own contractor quotes. However, there is evidence Mr X provided quotes to the Council in September and October 2019 and it passed them on to the housing association. The district council approved the revised grant in January 2020.
61. Therefore, there is no fault with the Council as it is clear it did allow Mr X to provide quotes for his preferred contractor. It was for the district council, not the County Council, to approve the grant based on the new information.

CHC assessment

62. A social worker can complete a CHC checklist; it does not need to be completed by the person’s doctor. I can understand why the Council felt Mr X’s doctor was better placed to complete the CHC checklist. Therefore, there is no fault by the Council for suggesting to Mr X that he should ask his doctor to complete the CHC checklist.
63. However, when Mr X refused to contact his doctor and asked the Council to complete the CHC checklist, it should have done so rather than refusing to. This is fault.
64. I do not find the fault identified caused Mr X any significant injustice. This is because Mr X can approach the NHS directly to request it to complete a CHC checklist.

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Final decision

65. I find fault with the Council for not completing a CHC checklist. However, the fault did not cause Mr X any significant injustice. I do not find fault with the Council’s other actions. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman

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