Summary: Mrs B complains about how a care provider commissioned by the Council dealt with matters relating to her son’s care and support. The Ombudsman finds no fault by the Council in these matters. There was however some fault in the investigation of Mrs B’s complaint, for which a remedy has been agreed.

The complaint

1. The complainant, whom I shall call Mrs B, complains on behalf of her adult son Mr C that a care provider commissioned by the Council:

• delayed in completing a form for Personal Independence Payment (PIP) for him;
• failed to promote and encourage Mr C to engage with leisure activities and to involve his family in promoting community activities, contrary to the care plan;
• failed to ensure Mr C had a working lock to his bedroom door for privacy and a safe place to keep his belongings (such as a locker or safe); and
• cancelled a GP visit to Mr C which Mrs B had requested due to concerns about his presentation.

2. Mrs B also complained that the lack of a safe place to keep his belongings resulted in several items going missing.

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What I have investigated

3. I have investigated all the matters referred to under point 1 above.

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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. 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)
6. The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)
7. 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

8. I considered all the information provided by Mrs B about this complaint. I made written enquiries of the Council and of the Department for Work and Pensions (DWP) and took account of the information and evidence provided in reply.
9. I provided Mrs B and the Council with a draft of this decision and considered all comments received in response.

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What I found

Background

10. Mr C, who has schizophrenia, lives in a care setting (‘the care home’) commissioned by the Council. He has capacity to make his own decisions.

The claim forms for Personal Independence Payments (PIP)

11. Mr C was receiving Disability Living Allowance (DLA), a benefit which for most recipients is being replaced by PIP.
12. Mrs B says that she received a PIP claim form in April 2018 which needed to be completed and returned to the DWP by 25 May 2018. She reports that there were a series of delays by the care home in completing the necessary information on the form for submission to the DWP. She also reports that a form she had handed in to the home for completion was not the same one she was subsequently given back, because it showed a different reference number. The DWP had to be asked for extensions of time for the return of the completed forms, and Mrs C believes that this led to delay in her son receiving the higher rate of benefit he eventually received when his claim was processed.

What the DWP says about the forms and the process

13. On 17 April the DWP received a letter from the care home requesting a Clerical PIP1 application pack. This is how a PIP claim is initiated if a claim is not made via the PIP claim telephone line and it can be requested by a third party. As Mr C was already getting DLA, the request was dealt with as a DLA to PIP re-assessment.
14. On 25 April, the records from the DWP show two clerical PIP1 application forms were sent out, to the care home to Mr C and to his representative, and the DWP treated this as the date of claim. The PIP1 is the initial claim and requires only basic details about the person for whom the claim is being made. On 16 May, the DWP received back a completed PIP1 form dated 15 May and apparently signed by Mrs B, together with two attachments: a medication administration record and a supporting letter from the home.
15. On 6 June, the DWP issued a PIP Part 2 questionnaire. This PIP2 form requires detailed information about how the customer is affected by their illness or disability. The DWP issued a reminder for the return of this form on 25 June. The following day the records note that a 14-day extension had been granted for the return of the questionnaire. A further extension was requested by Mrs B on 3 July, and the DWP noted the reason for this as being that Mr C’s support team were completing the form and had meeting arranged for this on 16 July. The extended deadline was 27 July. On the 4 July, the DWP says a call was received requesting a duplicate PIP Part 2 questionnaire, and this was duly sent out. Mrs B reports that she had not been informed that a second copy of PIP2 had been requested. The records held by DWP do not show who requested it.
16. The DWP received the completed form back on 27 July. The next stage in its process was a paper-based assessment which then informed the decision on the claim, which was finalised on 4 September. Mr C was awarded PIP from 3 October. The DWP can only start to pay PIP four weeks after a PIP reassessment decision has been made, and PIP cannot be backdated. Mr C’s benefit income increased by £239 a month.

Analysis

17. There appears to have been no significant delay in the completion and return of the PIP1 form, since as noted above this was issued by the DWP on 25 April and received back by that department on 16 May.
18. There is some confusion around the request for PIP forms and what happened to them. Mrs B says she had telephoned the PIP helpline at the DWP about changing her son’s benefit from DLA to PIP, while the DLA’s records show a written request for PIP1 was made by the home. In any event, two copies of the PIP1 form were sent out.
19. Insofar as form PIP2 is concerned, the original deadline date for the PIP2 form issued on 6 June was 6 July, subsequently extended to 20 July and then 27 July. Mrs B got the PIP2 form on 19 June, and as suggested by Citizens Advice then contacted her son’s social worker about changes she wanted made to the form, sending the necessary details in an email on 30 June 2018. She received a response on 2 July and an appointment was then made for a meeting at a local resource centre on 16 July, this being the first available appointment slot. Then, on or around 18 July, Mrs B attend a meeting at the care home and the form was signed by Mr C on 20 July and then returned to the DWP. It seems that the staff completing the forms had views of Mr C’s needs and abilities which differed from Mrs B’s views, and this led to difficulties in respect of what was being put on the form. It was not fault for those working with and caring for Mr C daily to express professional opinion in respect of his needs and abilities. On balance of probability the request for a second copy of form PIP 2 was made so that it could be completed with the information gathered as a result of the discussions referred to above. It was important to get the correct information submitted to the DWP in respect of the claim. The chronology and the supporting evidence do not show unnecessary delay by the care home leading to any financial loss to Mr C.

Leisure and community activities

20. Mrs B has raised concerns that her son’s care plans note that staff were to promote and encourage Mr C to engage in leisure activities. She also reports that his family was to be included, with home visits being promoted. Mrs B says when asked why he wasn’t visiting her and his father he said he had asked staff at the home on numerous occasions for a taxi to enable this but that his requests had been refused.

What the evidence shows

21. Mr C’s support plan from November 2016 noted funding was to be requested for an hour’s supported snooker or golf range activity, possibly time limited to two months to see if Mr C would engage with it. An action plan in January 2018 referred to this, setting out that staff at the home were explore meaningful activities with Mr C, to try to engage him in these. At the same time the care plan referred to participation in community-based leisure activities such as snooker or swimming; a personal budget of several hundred pounds being in place to cover the initial costs of community activities; and a mental health support worker and care coordinator to promote and encourage Mr C with this. Throughout 2018 there are several entries in the Council’s records which show the care co-ordinator attempting to engage Mr C’s interest in suggested leisure activities, without success.
22. Regarding the use of taxis, in April 2018 there was a meeting at the care home to discuss the January 2018 action plan. The record of the meeting includes the following: “Access to money made available via a direct payment for social interaction…..the money can be accessed to purchase items that would improve [Mr C]’s social needs and that family can also access it to pay for taxis and social activities that [Mr C] may go to.” Mrs B was present and advocated for her son, who had chosen not to attend. At some point after this, at Mrs B’s request and in her presence the home manager orally confirmed to Mr C that he could use a taxi but would need a receipt.
23. The Council has confirmed that the first occasion funds were used for a taxi was in mid-March 2019 at Mrs B’s request, when Mr C had asked to return to the care home. There had been an incident at the care home the previous evening and he had been removed from there to his parents’ home rather than being taken into police custody. After this, Mr C used the funds for taxis to his parents’ home each Sunday.

Analysis

24. Mr C has capacity to make his own decisions. The evidence shows that attempts to engage him in social activities were made but were unsuccessful. He had the right to choose not to engage and he exercised that right.
25. In respect of taxis, Mrs B says that requests were made orally. There is no documentary evidence that Mr C, or his mother acting as an advocate for him, requested taxis prior to March 2019. In the absence of such evidence, I make no finding of fault by the Council here.

Security of Mr B’s room

26. Mrs B says she voiced concerns over several months that Mr C did not have a key to lock his room within the home to give him privacy and security. When it responded to Mrs B’s written complaint on this point it said that Mr C would have been offered a key on admission, but on discussion he did not know where this was and so a new key was provided. Mrs B says that the first time she visited when he had a key was 24 December 2018.

What the evidence shows

27. A person-centred plan, from 2016, includes the following:

• a comment from Mr C which states: “I don’t have a key to my room. I’m not bothered about having one”;
• a note which reads: “[Mr C] feels safe in his room and in the home. He has been offered his own key but chooses not to in case he may lose it”; and
• Mr C’s response to the question of whether he feels safe within his home, noted as “Yes – I feel safe in my room”.

Analysis

28. Mrs B says that requests in respect of a key were made orally. There is no documentary evidence that Mr C or his mother raised the issue of Mr C being unable to lock his room before December 2018 when the complaint was made. In the absence of such evidence, I make no finding of fault. The evidence on balance indicates that Mr C elected not to have a key rather than supporting a contention that he wanted a key and was not given one. As noted previously in this statement, Mr C has capacity to make his own decisions, even where these might be considered unwise.

The request for a GP’s visit

29. Mrs B reports that on visiting her son on a hot summer’s day (in 2018). She found him anxious and pacing in the car park, heavily dressed in a jumper and coat. She says she sat and watched him for two hours during which time no staff attended to him or showed concern. She says that she asked staff to call a doctor and said she would wait as long as necessary. She says after many hours she asked a staff member what was happening and was advised the GP’s surgery had telephoned and the home’s nurse had cancelled the visit, but nobody had passed this information on to her.

What the evidence shows

30. The home’s records from the day in question note that Mrs B asked the registered mental health nurse (RMHN) on duty about her sons pacing back and forth and about his medication. The notes say that Mrs B demanded the doctor be called for her son, to which the nurse responded that she had no concerns about Mr C’s physical health at present which would lead her to do that but Mrs B could do so herself if she wished. Mrs B did call the doctor’s surgery and some 30 minutes later a practice nurse from the surgery called the home and spoke to the RMHN. After this all the RMHN spoke to Mrs B, who was angry that she had not had the opportunity to speak to the nurse during that call, and she still wanted a GP visit. A return call was made to the practice nurse who said that Mrs B’s concerns would be passed to the GP the following day. The home’s records state that Mrs B then reported she had made a GP appointment for her son for the following day. Mr C refused to attend. Notes relating to a subsequent appointment say that the GP agreed with the home’s staff that while Mr C had capacity to make his own decisions they could not restrict his rights and wishes.

Analysis

31. There was clearly a difference of opinion here between the home’s staff and Mrs B about what action if any was needed. It was not fault for nursing staff in the home to decide, exercising professional judgment, whether Mr C needed to see a GP. Neither was it fault to advise Mrs B she could call the GP herself if she wanted to do so. I have seen no documentary evidence to support the contention that Mrs B was left for several hours under the misapprehension that the GP would be attending that day as she had requested.

Other matters

32. After Mrs B made her formal complaint about these matters, the home provided the initial response and at the next stage the Council appointed an independent investigating officer (IIO). However, in the period with which this complaint was concerned, the Council’s adult mental health social care functions were delivered by an NHS Foundation Trust on its behalf. As a result of this investigation the Council established that information relevant to the complaint held on the Trust’s electronic recording system was not provided to the IIO, and some email exchanges between the allocated Social Worker and other council officers were not shared either. This means that Mrs B did not get the full and accurate investigation she was entitled to.
33. Even though the outcome in respect of the substantive issues would ultimately not have been different but for this fault, Mrs B was put to some time and trouble in pursuing her complaint and has a justified sense of dissatisfaction with the investigation which was undertaken.

Agreed action

34. In recognition of the injustice caused to Mrs B described at paragraph 33 above, I recommended that within four weeks of the date of the decision on this complaint the Council issues her with a formal apology and pays her £150.
35. The Council agreed to this recommendation.
36. I made no recommendation in respect of service improvements. The Council’s arrangements with the NHS Trust have already been changed, which should address the matter of information sharing, and the Council already confirmed it would be taking action to:

• remind adult social work staff that the Council retains responsibility and accountability for the actions of a provider it commissions, including complaint handling arrangements;
• provide adult social care staff with advice about recording contacts outside of the workplace relevant to service users;
• remind adult social care staff about the importance of accuracy and detailed information in case recording including in email communications; and
• explore whether any training or further resources are available around welfare benefit arrangements.

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Final decision

37. I have completed my investigation on the basis set out above.

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Parts of the complaint that I did not investigate

38. I did not investigate the loss of belongings referred to in paragraph 2 above. This is because if Mr C considered he had grounds for a claim against the Council in respect of lost belongings, that claim could be put to the Council’s insurer in the first instance. If liability for the loss was then disputed, that would be matter for the court to determine. There are no grounds in the circumstances for me to exercise discretion to investigate this point.

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Investigator's decision on behalf of the Ombudsman