Summary: Ms X complains the Council placed her in a care home, even though she did not belong there, and failed to subsequently move her to more appropriate accommodation. The Ombudsman found fault with the way in which the Council carried out some if its mental capacity assessments. As such, the Council has agreed to review this and share the lessons learned with its staff in adult social care.

The complaint

1. The complainant, whom I shall call Ms C, complains to us on behalf of her sister, whom I shall call Ms X. Ms C complains that:
• The Council failed to place her sister in more suitable / appropriate accommodation in September 2017. Instead it placed her in a dementia care home. Living together with residents who had dementia was very distressing to Ms X.
• The Council failed to discuss this placement with Ms X in advance, failed to ask her to sign a contract and failed to discuss how the placement would be paid for.
• Once placed in the dementia care home, the Council failed to move her to more suitable / appropriate / affordable accommodation, in a timely manner
• The involvement of the first social worker was haphazard. She cancelled many appointments and there was a lack of engagement.
• The care home provided unreasonable restrictions on her movements.
• On two occasions money disappeared from her room.
• The care home failed to provide her with the special diet (organic food, brown bread/rice etc) that she wanted.
• The Council froze her bank account in December 2018, as a result of which she had to loan money from others.

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The Ombudsman’s role and powers

2. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint or others. I have used the term fault to describe such actions (Local Government Act 1974, sections 34B and 34C)
3. 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)
4. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), 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 considered the information I received from Ms X and the Council. I also carried out a telephone interview with the Council. I shared a copy of my draft decision statement with Ms X and the Council and considered any comments I received, before I made my final decision.

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What I found

The way in which the Council placed Ms X in the care home

7. Ms X is in her 70s and suffers from Obsessive Compulsive Disorder (OCD). She has a history of poor mental health and has been detained under the Mental Health Act (MHA) on at least two occasions, most recently in February 2017.
8. Ms C says the Council failed to move her sister into suitable / appropriate accommodation in September 2017. Instead, it moved her into a dementia care home, even though her sister did not have dementia or physical care support needs. Living together with residents who have dementia was very distressing to her sister.
9. Ms C says her sister now lives in the same place that was available to her in September 2017. The placement is much more suitable for her sister than a dementia care home. However, the Council failed to place her there in 2017, because it wrongly believed at the time, that her sister would not like it because the other people who live there are too young and noisy. As such, the social worker failed to take her sister there and let her sister decide if she wanted to move there.
10. Furthermore, Ms C says the Council failed to discuss this placement with her sister in advance, it failed to ask her to sign a contract and failed to discuss how the placement would be paid for.
11. Ms X lived for several years rent free with a friend, who gave her notice to leave in February 2017. The Council says this was due to her deteriorating Obsessive Compulsive Disorder (OCD) and her hoarding behaviour. This was traumatic for Ms X who was subsequently detained in hospital under the Mental Health Act. The Mental Health Crisis Team referred Ms X to STEPS. STEPS provide a free housing support service, to help people aged over 60 to stay living independently. The service offers a range of support, including looking into more suitable accommodation. STEPS met with Ms X in February 2017 and it explained it could help her to look for alternative accommodation and get onto the housing register. Ms X agreed to work with them.
12. When Ms X was discharged at the end of February 2017, Rother District Council Housing (hereafter referred to as ‘Housing’), who had a duty to provide (interim) accommodation to Ms X, provided her with accommodation at a Bed & Breakfast (B&B) in East Sussex. She was also registered with Housing and was in band A (urgent).
13. Between March and August 2017, those supporting Ms X regularly asked her to explain in what type of accommodation she wanted to live and in which location / area. However, Ms X was unable to answer this at times and said she felt she could not move on from her temporary B&B accommodation. On other occasions, her answers were not clear or consistent. The following options were raised:
• Rented independent accommodation (Private/Housing Association): It appears this was Ms X’s preference. However, stakeholders involved with Ms X (the social worker, STEPS, Housing) all expressed doubts if she could manage a tenancy on her own. She did not have experience with this (paying bills etc), had issues with regards to hoarding etc. The shared view was that Ms X was not at a stage where she could manage a tenancy independently and could therefore become homeless again. Furthermore, Ms X did not have supporting references from previous tenancies and did not support efforts by STEPS to obtain an ID, complete housing benefits forms, provide information about her income/savings etc. Ms X did also not pay a contribution towards the cost of her B&B. All of this hindered any efforts to pursue this option. Ms X was free to pursue private rented accommodation. She did not want support from a personal assistant with any of the above.
• Sheltered Accommodation: In this type of accommodation, residents have their own independent flat, but have a scheme manager on hand if needed. Ms X regularly said she was not happy with this option. Housing made one specific offer before Ms X moved into the care home. However, Ms X refused this because she was afraid she would become the victim of anti-social behaviour in that specific area. At a subsequent meeting in June 2017, it was reported that Ms X would not have been eligible for a placement at this scheme anyway. Although the social worker asked Housing to offer a placement at another scheme, this did not happen.
• Supported Accommodation: The social worker suggested this to Ms X, which is a room (with additional facilities) within a larger building, along with on-site support. It is arranged via adult social care, not Housing. However, Ms X declined this.
• Live with her sister: Ms X mentioned on several occasions that she had a sister and would try to call her and perhaps live with her. She did not want the Council to become involved with this.
14. There was a lack of clarity with regards to Ms X’s capacity to make decisions about where she wanted to live:
• At a meeting in March 2017 it was agreed to carry out an assessment of Ms X’s capacity to make decisions about her accommodation. It was noted that Ms X had a long history of anxiety, depression, OCD, self-neglect and hoarding. The social worker subsequently recorded that she completed a mental capacity assessment, which concluded that Ms X lacked capacity due to her mental health conditions to make decisions about where she should live and lacks capacity regarding her care needs. She has no insight. However, I have not seen a copy of this assessment.
• However, a mental capacity assessment (MCA) from July 2017 recorded that:
1. Ms X's mental health impacts her ability to understand and process the actions she needs to do to ensure her housing needs are met. Due to her feelings of loss and anxiety she is unable to move forwards.
2. Ms X can understand the information given to her but is then unable to progress with any actions to reduce risks to herself. Her mental health and anxiety have reduced her ability to process this information and make decisions based on the information. She lacks insight into her current needs and is unable to make plans.
3. She can understand info given and can retain it. Has capacity.
15. The records show the social worker had regular meetings with Ms X and actively liaised with STEPS and Housing during this time, to try and move Ms X’s case forward. She also organised regular multi stakeholder meetings. Ms X also had support from an advocate.
16. Following problems at the B&B with regards to Ms X not cleaning her room (keeping more than 60 bags) and not paying a contribution, the B&B told Ms X in July 2017 she would have to leave. Ms X had said she did not feel she could afford the B&B contribution, but she refused help from STEPS to try and maximise her benefits. She also refused support with cleaning her room. Housing agreed to extend her placement on the basis that Ms X would agree to apply for Shared Lives accommodation. In this type of accommodation Ms X would live with an approved carer in the carer’s home, paying rent etc. The social worker referred her for this mid-July 2017, but there were no vacancies.
17. The Council was told mid-September 2017 that, due to the problems referred to above (see para 16) the B&B decided that Ms X would have to leave on 20 September. The Council said it made concerted efforts with Housing to find alternative B&B provision and told Ms X to look for one as well. However, one B&B did not accept Ms X and she refused another one.
18. As such, to avoid Ms X becoming homeless on 20 September 2017, the Council decided to make emergency arrangements to allow Ms X to go into a care home for two weeks. At the time, there was no other option available. The Council says it made this decision to safeguard Ms X, at very short notice.

Analysis

19. There was no fault in the way in which the Council supported Ms X in finding accommodation between February and September 2017. The social worker referred Ms X to STEPS so she would get the support she needed. However, there are several references to Ms X not engaging with the actions recommended by STEPS to enable her to move forward. Ms X did not want to pursue the option of supported accommodation and said she did not like sheltered accommodation. However, if Ms X is unhappy that she did not receive a suitable offer of sheltered accommodation from Housing, between February and September 2017, she can make a complaint to Rother District Housing.
20. Ms X appeared to prefer independent living, either privately rented or social housing. For reasons explained above, those involved with her felt this would not be suitable for her. Nevertheless, Ms X was free to pursue the option of privately rented accommodation during this time. If Ms X is unhappy that she has not been offered social housing accommodation, she can make a complaint about this to Rother District Council.
21. I did find there was a delay by the Council in pursuing the option of Shared Lives. However, I am unable to conclude this resulted in an injustice to Ms X. It is not possible to determine now if a suitable vacancy would have been available before July 2017, or if Ms X had accepted this.
22. I also found there was a lack of clarity around Ms X’s capacity to make decisions about accommodation. A mental capacity assessment in March/April2017 concluded Ms X did not have capacity, whereas an assessment in July 2017 concluded that, despite Ms X having a “reduced ability to process information and make decisions based on the information”, that she did have capacity to make these decisions. It is unclear from the records if Ms X had capacity at the time to make decisions about accommodation and if it therefore asked Ms X if she agreed to be placed in the home on a temporary basis, of if the Council placed her in the home in her “best interest” (which meant it made the decision on behalf of Ms X because it believed she did not have capacity to make the decision). This is fault.
23. Based on the information the Council received on 15 September 2017, it was clear the Council had very little time to ensure Ms X would not become homeless. It asked Ms X to look for a B&B to move to and tried to support Housing with finding alternative B&B accommodation. When this was not possible, it placed Ms X within a care home to avoid a vulnerable person from becoming homeless. I found there was no fault in the Council’s decision to do this to safeguard a vulnerable person.
24. The Council acknowledged to me that, even though it made the placement in an emergency situation, it should have told Ms X at the time that the weekly fee of the care home would be £750 a month and there would be a financial assessment to determine what contribution she would have to pay towards this. The Council would like to apologise for this.

The alleged failure to move her to more suitable accommodation quickly

25. Ms X says that, after the Council put her in the dementia care home:
• It failed to move her to more suitable and affordable accommodation in a timely manner.
• As such, she should not have to contribute anything towards the cost of the placement.
• During this time, the involvement of the first social worker was very haphazard. She cancelled meetings and there was a lack of engagement.
26. The first social worker continued to be Ms X’s allocated worker until June 2018. During this time:
• She asked Ms X in which area she would like to live. However, she was unable to answer this. The officer explained to her that if she would accept an offer from Housing, she would be able to leave the home. Ms X told the social worker that the fear she had due to her OCD prevented her from accepting ideas and moving forward. Housing offered a placement in September 2018 (a flat with its own facilities) at a retirement sheltered housing scheme. However, Ms X did not accept this, as a result of which Housing discharged its duty to provide Ms X with accommodation. Ms X told me she does not remember being offered this property but would not have wanted to go there anyway.
• The officer regularly encouraged Ms X to work together with STEPS to try and find a property. However, Ms X declined the offers.
• The Council explained to Ms X in November 2017 that it would have to carry out a financial assessment to determine how much she would have to pay for the cost of the placement at the care home. However, since then, Ms X has refused to provide enough information to enable the Council to complete her financial assessment. Ms X says that she did not complete the financial assessment because it made her very anxious. Furthermore, she continued to disagree with her being placed at the home and believed she should not have to pay anything because she was forced to stay there. The Council explained to Ms X that, as a result of her refusal to engage with the financial assessment, it would have to charge her for the full cost of the placement (£750 per week).
• The social worker asked the Council’s funding panel in November 2017 to make Ms X’s placement permanent. However, the panel did not agree and told the officer to further explore supported or sheltered accommodation as well as a transfer to the mental health team.
27. Ms X’s case was referred to the mental health at the end of 2017. However, it declined the referral in January 2018, saying Ms X did not meet its criteria.
28. Ms X continued to indicate she wanted to move on from the care home. She said in January 2018 that she did not like the care home. She did not like the rules and felt it was like an institution. The officer advised Ms X that she was able to leave if she finds other accommodation.
29. The Council says it carried out another Mental Capacity Assessment (MCA) in March 2018. However, the form related to this assessment showed that most of the text was copied from the previous assessment of July 2017. Again, it was unclear what decision the assessment was about and how the assessor reached their conclusion.
30. The social worker had a range of discussions and meetings between April and June 2018 with Ms X and her advocate. During these meetings:
• Ms X said she wanted her own home and would not accept any care support. The social worker advised Ms X again that she did not have to stay at the home and could go out to look for accommodation.
• The officer explained the Council had limited options once Ms X declined the offers from Housing.
• Ms X continued to decline support from a Personal Assistant (PA) and STEPS to help her move.
• The Council offered support to apply for an increase in her benefits, which Ms X declined saying she was "not bothered".
• The officer encouraged Ms X to attend a meeting with Housing to review her options. However, she did not meet with Housing because “she felt distressed about the current situation” and did not speak to Hastings Council about housing options, because “she didn't feel able to emotionally”.
• The officer asked if Ms X wanted to move to another residential home, which she declined.
31. At the end of June 2018, the social worker moved to a different team and the case was allocated to a new social worker. The Council decided in June 2018 that Ms X would have to pay for the entire cost of her care (£750/week) because she refused to assist with her financial assessment. It explained to her and her advocate that this would mean her placement at the home would be at risk because the care home could issue an eviction notice for non-payment of fees.
32. Between July 2018 and 25 October 2018, when Ms X was placed in supported accommodation, the Council invested a significant amount of time and effort to move the case forward. During this time:
• It was explained to Ms X that Housing had taken her off its waiting list because Housing felt it had offered her "appropriate" choices of accommodation. Ms X did not agree the offers had been appropriate.
• Ms X continued to say she would like to live somewhere where she could be more independent, make her own food, and not have to ask and inform staff when she wanted to leave. She would ideally like to find somewhere to rent privately. However, she was unable to say how she would achieve this as she had no references and was unwilling to engage with STEPS to find a property. The social worker advised Ms X to visit some letting agents to get ideas on accommodation. Ms X seemed unable to weigh up that an alternative accommodation would be more suitable for her and more cost effective.
• Ms X appeared not to understand why it would be in her benefit to participate in a financial assessment. It could potentially significantly reduce her care home fees and could facilitate the process of finding other accommodation. Ms X was convinced that if she declared her savings, the Council would go into her bank account and take all her money.
• The Council organised several multi stakeholder meetings. Participants agreed that Ms X showed insight into certain steps that need to be taken to get what she wants. However, she did not want to engage in these processes. It was therefore not clear if this indicated a lack of capacity or an attitude and lack of regard for the consequences. All agreed it was important to determine if Ms X had capacity to make decisions about her finances and accommodation.
33. Two mental capacity assessments by the social worker in July 2018, and an independent assessment by a medical consultant in September 2018 found that:
• It has been suggested to Ms X that supported accommodation would be a good idea to provide her with skills to manage her own tenancy in the future, but she immediately says no when the word 'supported' is mentioned. She was unable to weigh up the pros and cons of supported accommodation, as she could not see past the word ‘support’. She did not see herself as a person in need of support of any kind.
• Ms X seemed unable to weigh up that by complying with a financial assessment and engaging with STEPS, she would greatly increase her options and potential to move on from the care home. Ms X lacked the capacity to weigh up the pros and cons of engaging with services to move into a suitable and affordable property.
• Ms X had very poor insight into the severity of her illness and the impact it has on her daily life. Due to her poor insight she was not able to participate in rational discussions about her care needs and placement. Her plans for the future were flimsy and contradictory. She was not able to discuss what kind of placement or which area she would prefer to live in. She was not able to discuss the financial aspect of finding accommodation. She does not have the capacity to take decisions on those matters.
34. Following the assessments, the Council appointed an Independent Mental Capacity Advocate (IMCA) to support Ms X and organised best interest meetings. The meetings agreed Ms X did not have capacity to make decisions about accommodation and finances. All agreed the least restrictive option in terms of accommodation would be supported accommodation. The advocate agreed this would be the safest option.
35. The Council identified a placement on 5 September 2018, which was the only supported accommodation remaining as Ms X refused to even consider two other options given to her. Ms X visited the placement with her advocate but was not happy with moving there:
• The price for the room was approximately £140 a week but would be half if she applied for housing benefit.
• She was very close to the shops she likes to go to daily.
• It was explained to her that it could be a temporary placement whilst the Council looks further in finding her somewhere else
36. The care home told the Council at the end of September 2018 that Ms X owed £19,897.50 and the home had given her four-week notice to leave on 25 October 2018.
37. The Council applied to the Court of Protection in October 2018, to ask the Court to agree that it would be in Ms X’s best interest to obtain information about her finances (to enable the financial assessment to be completed) and move her to supported accommodation. To avoid a potential conflict of interest with regards to finances, the Council asked the Court to appoint an Independent Panel deputy to act as her Deputy for Property & Affairs.
38. Ms X told the Council in October 2018 that she had some options to move to. She said she could live with a friend, rent a room she had seen advertised, or book into a hotel. The Council said she could do this if she wanted to and asked her why she had not done this in the past 12 months. Ms X was unable to answer this question.
39. The CoP decided later on in October 2018 that there was reason to believe Ms X lacked capacity to make decisions about where she should live and about her property and affairs. It would therefore be in her best interest to move to the proposed accommodation. Ms X moved two days later. I have not seen evidence to support Ms C’s view (see para 9) that the Council had also identified this specific accommodation for her in 2017 but decided not to offer it to her then.
40. A Court order from January 2019 said it was in Ms X’s best interest to remain at the placement. If she wanted to move elsewhere, she could apply to the Court, which would consider if this would be suitable.
41. The Council has paid the home £13,655.93 in February 2019 and has invoiced Ms X accordingly.

Analysis

42. Overall, there is enough evidence in the records that the Council continued to try and support Ms X in moving her to more suitable accommodation. This was after Ms X turned down a second offer of sheltered accommodation by Housing, only a few days after she moved into the care home:
• The Council explained to Ms X that she would have to pay a contribution to the cost of the care home placement, for as long as she stayed in the care home. It explained to her that she was free to find and go to other accommodation, including B&B etc, if she wanted to.
• Ms X said she wanted to move into independent rented accommodation. The Council continued to encourage Ms X to work with STEPS and/or a Personal Assistant to achieve this. However, she declined those offers and I did not find evidence she tried to pursue this during her stay.
• The Council offered Ms X to move her to another less restrictive non dementia care home, which she declined
• Ms X continued to refuse the option of moving to supported accommodation, which the Council explained to her would be more suitable and affordable for her.
43. Once it became clear in mid-2018 that Ms X would be at an increased risk of being served with a notice by the care home to leave, and a new social worker was allocated, there was an increased urgency to move Ms X into more suitable accommodation. As Housing had discharged its duty to support Ms X, the Council’s options were limited.
44. All stakeholders involved with Ms X had increasing doubts if Ms X had capacity to make decisions about finances and accommodation. As such, I did not find fault with the Council’s decision to carry out mental capacity assessments in July and September 2018. Once the assessments, including an assessment by an independent expert, concluded Ms X did not have capacity to make decisions in both areas, all stakeholders involved agreed it would be in Ms X’s best interests to move into supported accommodation and complete a financial assessment. As such, the Council had to apply to the Court of Protection to agree this.
45. If Ms X is unhappy that she did not receive any offers from Housing for sheltered accommodation or a housing association flat, between September 2017 and September 2018, she can make a complaint to Rother District Housing.

Ms X’s complaint that the Council froze her bank account:

46. A Court order from mid November 2018 said it authorised the Council to investigate Ms X’s assets, income and liabilities and report back to the Court of Protection at the earliest opportunity. It also authorised the Council to freeze her bank account, while doing this.
47. The Council was told on 21 November 2018 that Ms X was extremely anxious yesterday as she had tried to withdraw money but had been told her account had been frozen. She called the helpline and was told it was frozen due to the Court Order.
48. The Council realised that it had made a mistake as it had written to the bank account provider: “she needs access to the account for her daily spending needs so please DO freeze the account”. It should have read ‘DO NOT’. The Council immediately contacted her bank account provider, who said it would probably not have made a difference because its standard procedure is to freeze the account. The provider told the Council to submit a request in writing to unfreeze the account. The Council immediately provided this and chased it up on 26 November and 7 December. The provider said on 7 December that its legal department had approved the request.
49. In the interim, the Council says it made arrangements with the care placement to loan funds to Ms X, as this was the quickest and most practical way for her to receive funds as and when she required them.

Analysis

50. The Council made a mistake when it instructed the account provider to freeze the account. However, the provider says it would probably have done this anyway. It immediately requested the provider to unfreeze the account and put an arrangement in place to ensure Ms X had access to funds in the interim.

Ms X’s complaint that the care home provided unreasonable restrictions on her movements

51. Ms X says the care home put restrictions on her movements. They told her there was a curfew time and she always had to tell the home when she would be back. The home had a ‘locked door policy’ and she was unable to return to the home at a time she wanted. The home told her it would involve the police if she did not comply with these rules. She only found out the code a few months before she left when she saw it being entered. As a result, Ms X says she felt she was no longer her own person and had lost her independence.
52. Ms X’s care plan said she would generally leave the home between 2-4 pm and agreed to return before 10pm. If she wanted to stay out beyond 10pm she would have to inform the home, as otherwise staff will have to alert the home manager.
53. The home says it has tried to work with Ms X to balance her need for independence with the care home’s duty and responsibility to ensure the safety of all its residents, including Ms X. At first, the home asked Ms X to return by a certain time and explained the home would need to contact the Police if it didn't know where she was. The home says it tried to explain this numerous times.
54. In November 2017, the Council offered to move Ms X to a non-locked door residential home, which Ms X declined saying she did not want to move somewhere else. Ms X did not raise this as an issue anymore, until April 2018. She was advised that she could go away for a few days but would have to tell the home for her safety where she would go and for how long. Ms X was unhappy with this condition. The home also said it had offered her the door key code on several occasions, which she refused. Ms X says she did not receive the code of the door to go out when she wanted. The care home was unable to provide a record to show when it first offered this and/or that Ms X refused it. Ms X subsequently stayed away over weekends and had a door key code.

Analysis

55. I found that the care home reached a reasonable compromise with Ms X, enabling her to leave when she wanted but asking her to tell the home where she would go and when she would return. If Ms X decided to stay longer, she would have to tell the home.
56. The Council offered Ms X to move her to a less restrictive care home environment, which Ms X declined. This would have addressed this issue.
57. In the end, this was a matter for the care home to decide, in light of its duty to ensure that Ms X, who was vulnerable, was safe. There was no fault with the way in which the home dealt with this and the Council offered Ms X an opportunity to move to a less-restrictive care home.

The two incidents when money disappeared from her room

58. Ms X said that money disappeared from her room twice. She asked the Council to look into this, but it asked the care home to investigate it instead. Ms X said the outcome of the investigations was a whitewash. The first incident involved £130 that disappeared from her room, four days after she arrived. The second incident was in 2018 and involved £5. Ms X said these experiences of theft from her room left her extremely distressed and she was finding it very difficult to cope.
59. I have not received evidence to show the care home or the Council investigated the first incident, and I am therefore unclear about the circumstances of this incident.
60. The Council says that Ms X was given a key to her room (this is confirmed in a meeting from November 2017) and no one could enter without her permission. Cleaning of the room and any maintenance was only done with her consent. Ms X declined an offer to keep her money in the home’s safe.
61. The incident report of the second incident (dated 5 April 2018) said £5 had gone missing a few weeks ago (date unknown). Ms X believed a specific staff member had gone into her room and taken it. The care home and the Council investigated this but did not find evidence to substantiate the allegation. The home again offered Ms X to keep her money in the home’s safe. In future, staff members would only enter Ms X’s room in twos.

Analysis

62. The Council failed to carry out an investigation into the first incident, which is fault. It is unlikely that any investigation now would be able to determine what happened. As such, the injustice to Ms X is that she was deprived of an opportunity to try and find out if and how her £130 went missing.

Ms X’s complaint about the food offered by the home

63. Ms X said she bought her own food because the home failed to cater to her personal diet.
64. Ms X’s Eating and Drinking Care Plan states that she did not eat a lot at the home, preferring to get her food in the town. She liked to eat free range and wholesome food. She did not eat meat but would eat some fish. Staff offered her a meal each day, at breakfast and lunch, but she declined. The home offered to buy special and organic food of her choice, which she declined.
65. The records do not show that she raised this with the Council until April 2018. When she raised it, it was not in relation to a complaint that the home was refusing to cater to her dietary preferences. It was about her view that she should not have to pay for all the cost of the placement, because she was buying her own food.

Analysis

66. According to the records, the home offered to provide Ms X with the food she wanted, but Ms X preferred to arrange this herself.

Agreed action

67. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), as amended).
68. I recommended that, within four weeks of the date of my decision, the Council should:
• Apologise for the fault identified in paragraph 21, 24 and 51.
• Review the MCAs carried out in July 2017 and March 2018 to identify and share lessons learned about these, and the forms, should be completed to make it clear what decision the MCA is about and how the conclusion on capacity was reached.
69. The Council has told me it has accepted my recommendations. It also added that:
• It has Mental Capacity Assessment and Best Interest decision making guidance in place. It will share the lessons learned with the staff members who are currently reviewing and updating the guidance. Once the practice guidance document is updated, it will be shared with all Adult Social Care staff.
• It has shared the learning from this case with its Training Team and reviewed its training to ensure it appropriately covers what decision the Mental Capacity Assessment is about and how the conclusion on capacity was reached.

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Final decision

70. For reasons explained above, I found there was fault with regards to some of the actions of the Council. I am satisfied with the actions the Council will carry out to remedy this and have therefore decided to complete my investigation and close the case.

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Investigator's decision on behalf of the Ombudsman