Summary: There is no evidence of fault in the way the Council came to a decision to reduce Ms Y’s support hours. The Council properly assessed Ms Y before making the decision. As there is no evidence of fault in the process, I cannot comment on the merits of the decision reached.

The complaint

1. Mrs X complains the Council reduced her adult daughter’s support hours from eight hours per week to four.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. 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)
3. 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

4. I have:

• considered the complaint and discussed it with Mrs X;
• considered the correspondence between Mrs X and the Council, including the Council’s response to the complaint;
• made enquiries of the Council and considered the responses;
• taken account of relevant legislation;
• offered Mrs X and the Council an opportunity to comment on a draft of this document.

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What I found

Relevant legislation

5. The Care Act 2014 sets out local authorities’ duties in relation to assessing people’s needs and their eligibility for publicly funded care and support. Under the Care Act 2014, local authorities must:

• carry out an assessment of anyone who appears to require care and support, regardless of their likely eligibility for state-funded care
• focus the assessment on the person’s needs and how they impact on their wellbeing, and the outcomes they want to achieve
• involve the person in the assessment and, where appropriate, their carer or someone else they nominate
• provide access to an independent advocate to support the person’s involvement in the assessment if required
• consider other things besides care services that can contribute to the desired outcomes (e.g. preventive services, community support)

6. Eligibility determination must be made after the needs assessment.
7. Councils still have the power to meet needs that are not considered eligible in order to help maintain wellbeing and independence. Councils should consider risk factors which can include physical safety.
8. The Act gives local authorities a legal responsibility to provide a care and support plan. When preparing a care and support plan the local authority must involve any carer the adult has. The support plan may include a personal budget which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
9. Direct payments are monetary payments made to individuals who ask for one to meet some or all of their eligible care and support needs. They provide independence, choice and control by enabling people to commission their own care and support to meet their eligible needs.
10. The personal budget must always be an amount enough to meet the person’s eligible care and support needs. It can be administered by the Council, by a third party, or as a direct payment.

What happened

11. Mrs X’s adult daughter, Ms Y is in her forties. She is described as having a mild learning disability. She is deaf and lip reads. Ms Y has capacity to make day to day decisions but prefers the support of her sister for more complex decisions. She also needs support when attending medical appointments to ensure she has understood the information
12. Ms Y receives a direct payment to purchase support.
13. On 23 January 2019 the Council completed a review of Ms Y’s needs. Ms Y was present at the review along with Mrs X, Ms Y’s sister and Ms Y’s support worker. The review document sets out Ms Y’s typical weekly routine. She received 8.75 hours paid support per week, four hours one day and three hours another. One day was allocated for cleaning and managing Ms Y’s home, laundry, organising packed lunches and batch cooking meals. The other day was allocated for food shopping and accessing the local community. Ms Y does voluntary work two days every week, occasionally three. She travels independently by bus to the placements.
14. The reviewer noted Ms Y was not using her support hours for domestic tasks, shopping, cooking and personal care, instead she often met her support worker at an arranged venue for lunches/coffee.
15. I have seen copies of care records completed by Ms Y’s support worker. This confirms Ms Y accessed the community independently, she often met her support worker at various locations, and they went shopping and for lunch. Ms Y often ‘headed into town’ alone and was able to participate in community activities without support. The records also show Ms Y was also completing many household tasks independently.
16. Ms Y’s support worker encouraged her to join social groups. The reviewer noted “[Ms Y] is a sociable person who enjoys been out and about. It is important for [Ms Y] to have structure and routine to her week and to be busy to reduce the risk of historical gambling”. Ms Y has a tendency to hoard. She has, with the help of her family and support worker managed to reduce this. The risks are recorded as:

• [Ms Y] has a historical gambling addiction that puts her at financial risk
• [Ms Y’s] physical and mental health is at risk of self neglect without prompting
• Risk of abuse or neglect due to [Ms Y’s] vulnerability resulting from her mild learning disability

17. Ms Y’s sister supported Ms Y to manage her financial affairs. This reduced the risk of financial neglect and vulnerability.
18. Ms Y, her family and support worker told the reviewer they believed the level of support met Ms Y’s social care needs.
19. The reviewer believed Ms Y’s independence had increased and that a period of ‘community enabling’ would be beneficial in determining her need for ongoing support, and to promote independence with domestic and cooking tasks. The reviewer recommended that Ms Y’s needs should be reassessed at the end of the ‘community enabling’.
20. On 25 January 2019 the Council’s reviewing officer telephoned Ms Y’s sister to clarify some information and discuss the outcome of the review, that depending on the outcome of the enablement period, Ms Y’s formal support hours may be reduced. The reviewer said the current level of support hours would be maintained until Ms Y had been assessed by the Council’s enablement team. Ms Y's sister said she believed there was possible scope for Ms Y to be more independent in some areas and she would discuss the referral to the enablement team with Ms Y.
21. The officer sent a copy of the review documents to Ms Y on 30 January 2019. A copy was also sent to Ms Y’s sister.
22. The reviewing officer telephoned Ms Y’s sister again on 31 January 2019. Ms Y’s sister confirmed she had discussed a referral to enablement with Ms Y and “at the moment [Ms Y] is up for it”. The assessor said she would contact the enablement team to ensure it was aware of Ms Y’s hearing impairment and that officers should check Ms Y’s understanding of any discussions. Ms Y’s sister said Ms Y would need to be prepared for any reduction in support hours. The reviewer said she may visit Ms Y towards the end of the enablement period to discuss the outcome.
23. Ms Y was referred to the Council’s enablement team on 31 January 2019.
24. On 14 February 2019 the reviewing officer contacted the care agency to obtain the care records completed by Ms Y’s support worker. The officer received them on 7 March 2019. The support was summarised, “Wednesday indicate assistance with cleaning the flat, making one meal, Fridays indicate meeting for coffee, Wilko, Primark, Argos, Costa, Greggs, many cups of coffee, having lunch together out at MacDonald’s, Greggs, Costa or Sainsburys”. It appeared some support hours were not been used in accordance with the care plan.
25. On 26 April 2019 an officer from the enablement team contacted Ms Y to arrange to meet with her. Ms Y said she was unable to meet with the officer until 9 May 2019. The officer visited Ms Y at her voluntary placement on 14 May 2019, and at her home on 23 May 2019.
26. A risk assessment was completed. This identified possible risks and how they could be mitigated.
27. On 7 June 2019 the reviewing officer telephoned Ms Y’s sister to discuss the outcome of the enablement assessment. The officer explained Ms Y was independent in many areas, including travelling on public transport and socialising. That on one of the support days, Ms Y travelled independently to meet her support worker and they then went shopping, and this was not an assessed need. The officer said Ms Y’s eligible needs could be met with fewer support hours, and the allocated support hours would be reduced to 8.75 per week to 4 hours per week. Ms Y’s sister said she accepted the reduction but expressed her concern about Ms Y’s wellbeing. The officer said the reduced support would be reviewed after twelve weeks.
28. The officer said the reduction would take place from the following week, and “new paperwork would follow in the post, copy to [Ms Y] and [Ms Y’s sister] as agreed. I agreed with [Ms Y’s sister] that I will contact [Ms Y] directly”.
29. The reviewing officer telephoned Ms Y the same day. Ms Y said she was unable to speak to the officer because her mother, Mrs X, was visiting and asked the officer to telephone the following week when her support worker would be present. The officer agreed. Immediately after this Mrs X telephoned the officer to express her concerns about the reduction in support hours and how this was communicated to Ms Y. She asked when the enablement team had visited Ms Y because “she should have known about it”. Mrs X asked that her concerns be formally recorded. The officer agreed to send Mrs X a complaint form.
30. On 10 June 2019 Mrs X telephoned the enablement officer to request a copy of her report. Mrs X said she believed this had influenced the decision to reduce Ms Y’s support hours.
31. The reviewing officer telephoned Mrs X on 12 June 2019 to ask if she had received the complaint form, Mrs X confirmed she had. The officer confirmed Ms Y’s direct payment would be reduced the following week to reflect the reduced support hours, and that a review would be completed after six and twelve weeks.
32. Mrs X submitted a formal complaint to the Council on 19 June 2019. She complained the family had not been informed when the enablement observations had taken place. She said the Council should have reduced the support hours gradually, and that it had given very short notice about the reduction.
33. The Council responded on 27 June 2019. The author said Mrs X had been present at Ms Y’s review in January 2019 when Ms Y’s needs and possible reduction in support hours had been discussed. The author acknowledged Ms Y had received a telephone call informing her about the reduction in support hours, but this had already been discussed with Ms Y’s sister who agreed the officer should contact Ms Y directly. When the officer did, Ms Y said she could not speak because Mrs X was present, and the call was ended. Mrs X contacted the officer immediately and had a discussion. The author said Ms Y was assumed to be present. In respect of the enablement team’s observations of Ms Y, the author said Ms Y had capacity and could choose who she told. The author said Ms Y, or her family could contact the Council for a reassessment if it appeared her needs had changed, or they had concerns about her wellbeing.
34. The complaint was not upheld.

Analysis

35. It is not the Ombudsman’s role to decide if a person has social care needs, or if they are entitled to receive services from the Council. The Ombudsman’s role is to establish if the Council has assessed a person’s needs properly and acted in accordance with the law.
36. I have considered the documents provided by the Council which included Ms Y’s assessment, review document, risk assessment and case records. These show the Council properly considered all relevant factors in line with the requirements of the Care Act. This included how Ms Y utilised her paid support, her routine, and the risks of reducing formal support hours.
37. The Ombudsman cannot question the outcome of a needs assessment/review that has not been affected by administrative fault. It is the Council’s professional judgement as to how many hours of support Ms Y require and I cannot question it.
38. The Council referred Ms Y to its reablement service before reducing her support hours. This was good practice. The outcome concluded Ms Y’s independence had increased and supported the decision to reduce paid support.
39. Mrs X is unhappy she was not informed about the observations of Ms Y during the reablement period. The Council was not obligated to do so. The records show officers had discussed the reablement process with Ms Y and her sister. Both were at liberty to discuss this with Mrs X.
40. Both Ms Y and her sister were informed of the reduction in paid support on the same day, they were told paid support would reduce the following week. It was short notice, but I do not consider the notice period caused any injustice to Ms Y. She was aware of the possibility her support hours may be reduced and given her level of independence I cannot see that reducing the hours gradually would have benefited her. However, given Ms Y’s hearing impairment, an officer should have visited Ms Y to explain this and ascertain her understanding. This did not happen. This was poor practice. Ms Y told the officer Mrs X was visiting. Mrs X says she was not present at the time of the call, but she had told Ms Y she would be visiting her the following day, which she did. She was then able to ensure Ms Y’s understanding of the conversation. Because of this, I do not consider Ms Y was caused any injustice, however this was due to good luck, not good management.
41. Mrs X’s concern about Ms Y’s wellbeing is understandable, but that does not make the Council’s decision wrong.
42. I find no evidence of fault in the process. The Council followed the correct process before making a decision to reduce Ms Y’s support hours.
43. As there is no evidence of fault in the process, I cannot comment on the merits of the decision reached.

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Final decision

44. There is no evidence of fault in this complaint. The Council followed the correct process before reducing Ms Y’s support hours. It properly assessed Ms Y before making the decision. As such, the decision the Council has made is merits (see paragraph 2).
45. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman