Summary: Mrs X complained the Council failed to offer her a needs assessment following surgery and did not provide care or equipment she needed to stay independent. She said this caused her and her husband stress and inconvenience. There was no fault in the Council’s actions.

The complaint

1. Mrs X complained the Council did not offer her a needs assessment following foot surgery which left her temporarily unable to move around easily. She also said the Council did not supply equipment she needed to help her walk without assistance.
2. Mrs X said the Council’s actions put her and her husband to undue stress and upset.

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The Ombudsman’s role and powers

3. 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)
4. 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

5. I have discussed this complaint with Mrs X and considered her view of the case.
6. I made enquiries of the Council and reviewed the information it provided.
   This included Mrs X’s complaint form, correspondence shared between Mrs X and the Council, the Council’s records of contact made with Mrs X and the Council’s final response.
7. I wrote to Mrs X and the Council with a draft decision and considered their comments before making a final decision.

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What I found

Statutory Guidance

8. Sections 9 and 10 of the Care Act 2014 require councils to offer a needs assessment regardless of a person’s finances or whether they appear to have an urgent need for care and support.
9. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve.
10. An adult with possible care and support needs may refuse to have an assessment. In these circumstances, councils do not have to carry out an assessment.

Intermediate care and Reablement

11. Councils can make charges for care and support services they provide or arrange. Charges may only cover the cost the council incurs. (Care Act 2014, section 14)
12. Intermediate care or reablement is a programme of care provided for a limited period of time to assist a person to maintain or regain the ability to live independently.
13. Intermediate care and reablement must be provided free of charge for up to 6 weeks.
14. After the reablement period has finished, the Council can charge patients with over £23,250 in savings the cost of their care and support.

Council’s Reablement Service

15. To qualify for reablement at the Council’s residential facility, a person must:
• be assessed by a health or social care professional as requiring a period of reablement
• agree to pro-actively work towards achieving their outcomes and goals
• be unable to meet their needs in their usual place of residence.

What happened

16. In May 2019, Mrs X informed the Council she was having ankle surgery and would be bed bound for several weeks. She also confirmed she had over £23,250 in savings but believed she was entitled to 6 weeks free care. The Council informed her about its charging policy and referred her to its Community Support Team (CST).
17. CST contacted Mrs X to discuss her needs and Mrs X said her husband would support her at home.
18. Mrs X’s surgery took place in June 2019. She asked the Council to supply a wheelchair, glide commode, stool and toilet assist. The Council told Mrs X it was the hospital’s responsibility to provide this equipment.
19. Following Mrs X’s surgery, the Council informed the hospital that its primary reablement provider had no availability and could not assist Mrs X until her cast was removed. The Council offered to assess Mrs X at another residential facility or assist her in arranging private care. The hospital told the Council Mrs X did not want to go to the facility and was upset she was not receiving 6 weeks free care.
20. The Council contacted Mrs X directly and she advised she might need support once she left hospital. The Council provided her with a list of private care agencies and advised her to call back if she required further assistance.
21. After leaving hospital, Mrs X contacted the Council in late June 2019 to complain she did not receive reablement or support. The Council offered Mrs X an assessment and Mrs X declined. The Council explained Mrs X could self-fund her care with the Council’s assistance, but Mrs X was not happy with this.
22. Mrs X contacted the Council again in mid-July because her husband was struggling to care for her, and she felt the Council had failed to support her.
    The Council offered to visit Mrs X, but she said this was not necessary because she had already arranged the equipment she needed.
23. The Council explained it needed to conduct an assessment before it could supply specialised equipment. The Council offered to visit Mrs X again, but she declined this offer and raised a formal complaint shortly after this.
24. The Council responded to Mrs X’s complaint in August 2019. It did not uphold her complaint and referred her to the Ombudsman.

My findings

25. Mrs X is unhappy the Council did not provide equipment to help keep her independence following her operation. Typically, the hospital would bear the responsibility for arranging any adaptation or aids a patient may require. However, the Council informed Mrs X it could arrange specialised equipment for her subject to assessment. Mrs X told the Council she had sourced the equipment she needed and did not want an assessment. The Council was not at fault in how it responded to Mrs X’s request.
26. The law says the Council must offer an assessment to anyone who appears to need support. The Council needed to assess Mrs X before it could decide whether she was entitled to reablement. In line with the law and its own policy, the Council offered Mrs X an assessment on several occasions after her surgery. Mrs X declined. Therefore, the Council could not properly decide whether Mrs X was entitled to reablement, once her cast was removed. There was no fault in the Council’s actions.
27. Reablement is intended to assist a patient in regaining their independence. It is not an automatic entitlement; patients must be assessed as needing reablement. After offering Mrs X an assessment, the Council made her aware she was not likely to qualify for reablement whilst her foot was in a cast. The Council was not at fault for telling Mrs X this.
28. The Council also explained to Mrs X that she would need to pay for any care she received that was not reablement, as she had savings that were over the threshold. The Council was not at fault for making her aware of this.

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Final decision

29. There was no fault in the Council’s actions. I have therefore completed my investigation.

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Investigator's decision on behalf of the Ombudsman