Summary: Mrs X complains about the Council’s failure to arrange a permanent residential placement for her adult son and the emergency placement it organised was unsuitable. The Ombudsman has found no evidence of fault in the way the Council considered these matters.

The complaint

1. The complainant whom I shall refer to as Mrs X complains there were failings in the way the Council responded to her request for a long-term residential placement for her adult son Y. Mrs X says the Council gave her the option of two places but then vetoed her choice. Mrs X says she made her request in June 2018 and the Council has failed to find a long-term placement for Y.
2. Mrs X also complains there were failings by the Council when providing an emergency respite placement for Y in August 2018 causing both Mrs X and Y distress. Mrs X says the Council arranged for Y to live at his overnight respite home despite her concerns about its ability to cope with him. The respite home then offered Y a full-time placement.
3. Mrs X says the Council did not consult her about the emergency placement and forced it on her as there was no alternative. Mrs X says the Council agreed the permanent placement at the respite home could be for a two-week trial period. But the placement lasted two days and she removed Y to live back with her. Mrs X says she raised safeguarding concerns about Y’s stay and the Council has not investigated her concerns.

Back to top

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’. We provide a free service but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• it is unlikely we would find fault, or
• the fault has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify our involvement, or
• it is unlikely we could add to any previous investigation by the Council, or
• it is unlikely further investigation will lead to a different outcome.

(Local Government Act 1974, section 24A(6), 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)

Back to top

How I considered this complaint

6. I have read the papers submitted by Mrs X and spoken to her about the complaint. I have considered the Council’s comments on the complaint and the supporting documents it provided. I have explained my draft decision to Mrs X and the Council and considered the comments received.

Back to top

What I found

7. Mrs X acts as carer for her adult son, Y who has severe Autism. Y lives with Mrs X and attends day care services during the week with three nights respite a month at a place I shall call Home B. Mrs X says Home B only provide three nights a month as they cannot cope with Y’s behaviour. Y has been to Home B for residential respite 18 times from April 2017 to November 2018.
8. Mrs X became unwell during June 2018 needing long-term treatment. Because of her ill health and Y’s behaviour, she asked the Council to find a suitable long-term residential placement for him. An officer from the Community Learning Disability team (CLDT) and a Community Nurse discussed suitable placements with Mrs X. The Council consulted with Mrs X and made a Best Interest decision for Y to go to a permanent residential placement.
9. The CLDT officer suggested two possible respite places for Y. One was at a place I will call Home C and a second at a place I will call Home D. Mrs X visited the homes and chose Home D as her preferred choice. The Council asked Home D to send costings for the placement. When received in August 2018 the Council’s Brokerage team prepared a costing and care plan for the Joint Working Panel (Panel) to consider and agreed funding.
10. Officers advised Y ‘s case needed priority to prevent him being admitted to a hospital. The Council identified an emergency respite placement at Home B as the least restrictive alternative for Y.
11. The Council was changing the way it sourced residential placements from social workers independently sourcing placements to a Dynamic Purchasing System (DPS) in 2018. The DPs is run by the Brokerage team. Social workers complete a residential checklist for any residential placements including respite. Brokerage send out the specification via the DPS to service providers to tender for the placement. The Council requires service providers to be registered for the DPS and respond to tenders within 24 hours. Brokerage send any responses to social workers to consider. The DPS opened in April 2018 with care providers invited to register. The Council activated the DPS on 16 July 2018.
12. Brokerage placed a specification on the DPS for a permanent placement for Y. This closed on 15 August 2018, but no providers tendered for the placement. The Council says Home D did not respond as it had not signed up to be on the DPS and it could only go with registered providers.
13. Due to the urgent need for a respite placement for Y the Council contacted Home B for a respite placement. Home B said it could offer a few nights of respite. It then said it could offer Y a permanent placement from the end of August 2018. A social worker met with Mrs X to discuss the respite and permanent placement at Home B.
14. Mrs X raised some concerns about Home B managing Y and the social worker contacted Home B for a response. The social worker emailed Mrs X with Home B’s replies to her concerns. The social worker included in her response that Y ‘will live there permanently’ and ‘Y will be classed as a permanent Residential’.
15. Mrs X emailed the social worker the next day asking for a two-week trial of Home B in September 2018 when Y did not attend day care to see how he settled. The social worker agreed to the two-week period in September without day services. The social worker said they needed to see how Y managed without going to day services. The social worker said she agreed ‘we do need to know it is the right place for Y both for him and yourself’. The social worker said she would review the placement after six weeks anyway.
16. The Council referred the offer to the Panel on 17 August 2018 who agreed a permanent place for Y at Home B. The Council’s records show it provided support for Mrs X until Y went to Home B. Home D applied for registration on the DPS in August 2018 and its application accepted by the Council on 21 August 2018.
17. Y started the permanent placement at Home B on 22 August 2018. Mrs X removed Y from Home B on 24 August 2018. Mrs X says Y needed a regimented timetable and Home B did not do this as it stopped Y’s daytime and evening activities. So Y was spending most of the day in dirty pyjamas. She says Home B staff telephoned her claiming Y was agitated and distressed. Mrs X says staff at Home B contacted Y’s day care provider to find out how to take him out for a walk.
18. The Council’s records show Y’s social worker contacted Home B about Mrs X’s concerns. Home B said they considered it was a trial period. Y’s social worker had been on leave during this time and questioned the placement being a trial period. The Council says Mrs X was aware it was a permanent placement. But the social worker found while she was away Mrs X arranged with Home B for it to be a two-week trial and not the planned permanent placement.
19. In September Mrs X requested Y continued to use the day care services and Home B for respite while she was in hospital. The Council agreed to the provision. So, Y attended day care services for five days a week with support to access different activities in the community. Y also received three nights of respite at Home B a month. The Council says Mrs X declined its offer of more frequent respite.
20. In October 2018 Mrs X confirmed she was managing Y at home with day services during the week and support from family. Mrs X complained to the Council about her concerns over the emergency respite provision at Home B. The Council acknowledged Mrs X’s complaint.
21. The Council looked at other respite choices for Y and held a Best Interest meeting for him in December 2018. Home B confirmed it could not provide a permanent place for Y. Officers visited Mrs X to discuss choices for Y and advised the Council had not been able to find a further placement.
22. The Council arranged for a worker to provide extra support for Y to minimise the risk of carer breakdown. So, as well as day services during the week Y received extra support at home on Saturdays. Mrs X occasionally paid for a private support worker to provide extra support on Sundays.
23. The Council made a Best Interest decision on Y in February 2019 for a permanent residential placement and assigned Y’s case to Brokerage. Brokerage entered a placement request for Y on the DPS and discussed the choices with Mrs X. Mrs X agreed to a permanent placement but did not want Y to go to certain placements. Officers advised this would limit choices for Y.
24. The care provider for Home D responded to the DPS tender by offering a placement at a different home – Home E. Mrs X accepted an offer for two weeks respite only while she returned to hospital again. The Panel agreed a funding package in February 2019 for Home E. In March 2019 Mrs X said she was recovering well and wanted Y to return home. Mrs X confirmed she did not need any extra support for Y, and he was attending day care services. Mrs X stated she would then look at placements and contact a social worker when she found a suitable one.
25. The Council became concerned about the delay in finding Y a placement and arranged a Multi-Disciplinary Team meeting in May 2019 to discuss the care and support he needed. The Council involved Mrs X and the meeting aimed to agree on what was best for Y. The result was a permanent placement for Y. After the meeting Y’s social worker offered Mrs X three residential placements the Council considered could meet Y’s needs. Mrs X asked for time to consider the placements and possible alternative arrangements.
26. A social worker contacted Mrs X in June 2019 to try and make arrangements for Y. In July 2019 Mrs X confirmed she no longer wanted a permanent care placement for Y as she was feeling well. Mrs X said she felt able to care for Y at home with five days of day care a week with the extra respite previously offered by the Council.
27. In commenting on the draft decision Mrs X confirms she now wishes Y to attend a permanent residential placement.

The Council’s response to Mrs X’s complaints

28. The Council says Mrs X confirmed Home B was a place she knew when the option of Y going to Home B was raised. Mrs X said it was a nice place and the staff already knew Y. The Council reported Mrs X was aware Y did not get on with a client at Home B and felt it could be a problem. But Home B considered this could be resolved. The Council’s records show the manager of Home B spoke to a social worker about the placement and answered Mrs X’s concerns.
29. The Council accepted issues arose about the care Y received, so Mrs X decided to end the placement. The Council says diary notes and consultation with Home B show it made efforts to ensure Home B was aware of Y’s needs. It says Mrs X was consulted throughout the procedure and unfortunately the problems could not have been foreseen. The Council considered the placement at Home B was a permanent one and not a trial.
30. The Council considered Mrs X’s complaints about safeguarding issues following Y’s placement at Home B. It says it did not carry out any safeguarding action as Home B documented a different version of events from Mrs X’s concerns. It says Mrs X alleged Y continually asked staff at Home B to ring her. The Council says Y has limited speech. The manager at Home B says Y would not be able to demand to go home. And staff would not have been ringing Mrs X up about him returning him as it was not the usual respite.
31. The Council says it placed a permanent placement tender for Y on DTS through Brokerage in September 2018. But no service providers came forward to offer Y a placement.
32. The Council continued to work on finding a long-term placement for Y and arranged a placement it considered suitable for Y’s assessed needs in February 2019. Mrs X declined this and a respite placement for Y during February and March 2019. The Council Mrs X agreed to the placement with a view for the long term. But Mrs X decided on her discharge from hospital Y should live back at home with her.
33. The Council says Mrs X declined help from Y’s social worker to arrange a placement as she wished to do it herself. It reports Mrs X wanted to look at different placements in the area and chose a suitable one for the Council to consider. Officers remained in contact with Mrs X, but she declined any social work involvement. It says Mrs X suggested Home D again for Y and wanted to wait until a room became available.
34. The Council says Mrs X complained in September 2018 and it was passed to the Brokerage manager to respond to. The Council appointed a new Brokerage manager in November 2018 and the officer received an email from Adult Social Care chasing up the outcome of the complaint. The new manager found no response to the complaint so allocated it to a senior officer to consider.
35. The officer responded to Mrs X’s complaint in December 2018 explaining the Council could not offer a placement at Home D due as the service provider had not registered for DPS. And so, it did not respond to the tender expressing an interest. The officer said there was an urgent need for a placement for Y, so it the Council chose Home B as he was familiar with the home.
36. The officer explained it the social work team made the decision and not Brokerage. The social work team make the best Interest decision using the Mental Capacity Act when appropriate and after consulting with the family and other people involved in the person’s life.
37. The Council says the delay in dealing with Mrs X’s complaint in September 2018 was due to key staff taking unplanned long-term leave. And regrettably not being passed to another officer to deal with. The Council considers it responded to the complaint appropriately and ensured all other professionals involved in Y’s care and support were aware of Mrs X’s situation, her wishes and feelings. The Council has reviewed how it handled complaints. It now ensures it stores all information securely but accessible for better continuity should a key person be absence at short notice.
38. The Council has provided an update and advised it has held a Best Interest meeting for Y in August 2019. Mrs X attended along with an advocate. It was agreed to find a residential placement for Y and a different respite placement. This is ongoing.

My assessment

39. The documents I have seen show that despite the Council’s DPS system going live in April 2018 the care providers at Home D did not register until August 2018. This meant the Council could not offer Mrs X the permanent placement for Y she preferred as Home D was not registered for the DPS at that point. And so Home B did not respond to the tender to provide a place. While it is unfortunate that Home D did not sign up for the DPS until August 2018 I cannot say it was due to fault by the Council.
40. The Council’s records show it consulted with Mrs X over the placement at Home B in August 2018. Mrs X responded it was a nice place and staff knew Y well. The documents show the Council was aware Mrs X had concerns and liaised with Home B to respond to her. Mrs X considered that the placement at Home B in August 2018 was for a two-week trial period. The Council disagrees and says the placement was a permanent one.
41. The Council’s documents refer to Y living permanently at the home and being classed as ‘permanent residential’. The social worker also stated there would be a review of the placement after six weeks. So, the Council’s records do indicate it considered the placement was a permanent one and gained funding for the placement. However, the social worker advised Mrs X that they needed to see whether it was the right place for Y and Mrs X. And the responses to Mrs X’s request for a trial were unclear whether it was a trial permanent placement or a trial without day care.
42. So, I consider the lack of clarity over what had been agreed about Y’s stay at Home B in August 2018 caused some confusion for those involved. But I do not consider it is proportionate for the Ombudsman to investigate this matter further as Y was only at the placement for two days. In addition, Mrs X has been able and willing to care for Y at home with support and day care services. Mrs X advised she could manage Y’s care at home with this support.
43. It is unfortunate the placement broke down and Mrs X removed Y from Home B. Mrs X disagrees with the Council’s decision not to carry out a safeguarding investigation about the concerns she raised. But the decision is a matter of officers’ professional judgement. The Ombudsman cannot question the merits of the decision itself without evidence of fault in the way it was made. I do not consider there was fault in this case.
44. This is because officers raised Mrs X’s concerns with Home B but decided not to pursue them further due to the differing accounts about what happened. This is a decision the officers are entitled to make. There is no evidence of fault in the way the Council reached this decision from the documents I have seen. And Mrs X has remained happy for Y to continue to receive respite care at Home B.
45. The Council says it had been difficult to find another permanent placement for Y as there were no responses to the DPS tender until February 2019. The Council offered Mrs X a place at Home E. Mrs X accepted and then declined the placement wanting to keep Y at home and to lead on finding a suitable placement for him herself.
46. The Council’s records show it offered Mrs X a choice of three placements for Y in May 2019 after a Best Interest meeting. Mrs X has declined the placements and advised she wished to care for Y at home. Although Y has not taken up a permanent placement since June 2018, I cannot say it has been due to any fault by the Council. It has offered placements it considers suitable, but Mrs X has not taken these up. This is due to changes in circumstances for Mrs X and Y and Mrs X’s views about a permanent residential placement for Y. However, Mrs X has recently agreed to Y moving into a permanent residential placement once a suitable home becomes available. The Council is currently seeking a suitable placement.
47. Mrs X made her complaint to the Council in September 2018 about the emergency placement. The Council did not respond until November 2018 due to an officer leaving and the complaint not assigned to someone else. I consider the Council delayed when responding to Mrs X’s complaint and I would expect it to do so within its published timescales. The delay was unfortunate, but I do not consider it caused a significant injustice to Mrs X to warrant my pursuing the matter further. This is because the documents show officers were in contact with Mrs X during this time about Y and her concerns. So, there was no lack of communication between the Council and Mrs X during September to November 2018.

Final decision

48. I am completing my investigation. I have found no fault by the Council in the way it dealt with Mrs X’s request for a permanent residential placement for her son Y and arranged emergency respite care.

Back to top

Investigator's decision on behalf of the Ombudsman