Summary: Mr X complains the Council was at fault in the way it provided support services to him to help with daily living skills and his hoarding habit. The Ombudsman has found no evidence of fault in the way the Council considered these matters so has completed his investigation.

The complaint

1. The complainant whom I shall refer to as Mr X complains about the support services the Council provided to help him with daily living skills and his hoarding habit. In particular Mr X says:
• He did not know how long the support would last for and the Council failed to tell him it was only for 12 months ending in February 2019.
• He has not received help with daily living skills and support with his hoarding after the 12 months of help ended. Mr X says the Council considers it has addressed his habit, but it is still an issue for him.
• He faces a risk of eviction as he is a hoarder. Mr X says he was told he could reapply for support again after six months. When he did so in September 2019 the Council delayed making a referral, so he has been without support for many months causing him distress and worry.
• The Council then delayed carrying out an assessment on him in December 2019.

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What I have investigated

2. I have investigated Mr X’s concerns about the length of time the support would last for, the lack of support with his hoarding and daily living skills and the delay in making a referral in September 2019 . The final part of my statement explains my reasons for not investigating Mr X’s complaints about the delay in carrying out an assessment in December 2019.

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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 read the papers submitted by Mr X and spoken to him about the complaint. I considered the Council’s comments on the complaint and the supporting documents it provided.
6. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Statutory Guidance

7. Sections 9 and 10 of the Care Act 2014 require local authorities to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to all people regardless of their finances or whether the local authority thinks an individual has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
8. The Council must carry out the assessment over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Local authorities should tell the individual when their assessment will take place and keep the person informed throughout the assessment.
9. The Care Act 2014 gives local authorities a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. 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.
10. Section 27 of the Care Act 2014 gives an expectation that local authorities should conduct a review of a care and support plan at least every 12 months. The authority should consider a light touch review six to eight weeks after agreement and signing off the plan and personal budget. It should carry out the review as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. As well as the duty to keep plans under review generally, the Act puts a duty on the local authority to conduct a review if the adult or a person acting on the adult’s behalf asks for one.

Background information

11. The Council says Mr X has complex and ongoing mental health needs causing him to hoard items at his home. It says he has issues with daily living and fears being left with no support as he has no family. Mr X wants to live a different way but finds it difficult to move forward and let go of his hoard. This is because he has chronic issues with hoarding and OCD which makes progress difficult.
12. Mr X has a care plan drawn up by the Council and updated each year. Mr X receives support from officer K, a senior mental health social worker and officer L a senior day care mental health practitioner at a day centre Mr X attends. Officer K is Mr X’s care coordinator, and she contacts Mr X weekly and sees him once a month. Officer K referred Mr X to a day centre, and he sees a doctor for psychological input. Mr X attends psychiatric outpatient appointments.
13. The Council assessed Mr X as needing extra support with daily living skills and his hoarding habit. Mr X had previously received help from two other support providers arranged by the Council between 2014 and 2017. The Council’s support services went out to tender in 2017 and awarded to a different support provider I will refer to as B Company. The services are usually to provide for one to one support at day centres, or home support, groups, and meetings and for a limited period of six months.
14. In 2017 Mr X lived in a flat but the Council moved him to a bungalow in January 2018. The Council says the bungalow was close to his flat and large enough for him to bring his hoard with him. Officers K and L helped Mr X move from the flat and sort through his hoard. Both officers K and L continued to provide Mr X with support following his move with physically moving belongings, help with rent and housing issues as well as emotional support.
15. The Council says officers have shown Mr X how to operate things in the bungalow such as a washing machine, but he struggles to do this when on his own. He feels unable to manage the heating at the bungalow and wants officers to turn it on and off for him. The Council says Mr X finds it difficult to decide such things as buying home furnishings. And he has refused help to assemble a bed, so he sleeps on cushions on the floor.
16. In commenting on the draft decision Mr X says some of the Council’s comments are incorrect such as sleeping on cushions. Mr X says he sleeps on a mattress. Mr X says he has mental health difficulties with daily living skills and buying things he never has had.

Support plan with B Company

17. The Council drew up a support plan for Mr X for the extra services starting in February 2018. This involved B Company supporting Mr X with his hoarding and helping to fill a black bin bag each week for collection on Fridays. The Council confirms the service provided by B Company was usually for six months support with the offer of attending the various groups they provide after that. The Council no longer has a specific hoarding service in the borough. So, it agreed with B Company it could extend the support to 12 months where hoarding was an issue. Therefore, the Council commissioned support for Mr X for 12 months to recognise his needs.
18. Mr X signed a contract with B Company, but it does not specify the timescale of the support.
19. The Council assigned officer K to help Mr X to transfer to B Company’s services as he was unsure about doing so due to his good relationship with a previous provider. Officer K helped Mr X meet the worker from B Company assigned to help him.
20. The Council says Mr X found it hard to engage with B Company as a new service provider due to his difficulty in accepting new workers. However, Mr X began to work well with the support worker but then cancelled appointments when he was upset or overwhelmed. In commenting on the draft decision Mr X says appointments were cancelled by both parties.
21. The Council has provided the support history notes from B Company’s electronic service user records. This records the goals set and when they are met. The notes show Mr X successfully met his goals of filling bin bags when possible. Mr X also received help with bills and made progress in clearing the bungalow.
22. In February 2019 Mr X and officer K met with B Company and they advised the support plan was ending as due to being commissioned for 12 months. B Company said clients then stepped down to their hubs and groups for support. B Company advised Mr X and officer K he could attend the groups and be referred to them again after six months. The Council considers Mr X then became preoccupied with the support ending rather than making the most of the support while it was there.
23. Mr X also had an annual care plan review in April 2019 with officer K. Mr X expressed concern the service from B Company had ended although it was a time limited service. It was noted he could access some of their activities. Officer K sent Mr X a timetable of the activities Mr X could join but Mr X did not engage with the activities.
24. It was agreed at the review officer K would aim to meet Mr X once a week when possible to offer support at home. And Mr X could attend the day centre to help him move forward and gain support. The Council says this proved unrealistic although records show officer K met with Mr X at least four times each month from April 2019 to January 2020.
25. The Council says Mr X also met with officer L at the day centre when he called in unexpectedly. Mr X often preferred sessions at the day centre rather than home and want help with writing letters. Mr X has also attended the day centre for sessions and the Council provided records of his visits in 2019. These vary between five and 10 times a month from January 2019 to January 2020. Mr X can attend group meetings at the day centre, but the Council says he rarely attends although does enjoy them when he does. Mr X has officer K’s phone number so she can contact him when he does not attend for some time as he will not answer the phone to unknown numbers.
26. In commenting on the draft decision Mr X says he has attended groups and used the day centre groups for more practical help. Mr X says he finds it difficult to attend group meetings due to his ongoing needs and mental health problems.

Re-referral to B company

27. The Council confirms once the 12 months support ended, Mr X continued to receive support from other agencies and had the choice to keep support with B Company through the groups. But Mr X considered his needs were long term and could not be met through short term intervention. In September 2019 after six months, officer K contacted B Company asking if she needed to fill in a new referral. B Company did not respond so officer K emailed again in October 2019.
28. Mr X complained to B Company in October 2019 about the lack of contact and referral. B Company advised the referral was not made through its usual procedure. It responded to Mr X in November 2019 the referral from officer K had been sent to an officer who no longer worked at B Company. So, it could not confirm whether any action was taken. B Company said it had been in contact with officer K and arranged an assessment at his property in December 2019 as Mr X asked for help again with his hoarding.

The Council’s comments on the complaint

29. The Council acknowledges Mr X has an ongoing need to address his hoarding as well as daily living skills. But at the end of the 12 months he did not present with any new needs. It says it did not leave Mr X without support as he could access support from officers K and L, the day centre, the psychiatrist, and psychiatric outpatients. The Council considers there has not been a gap in service. Officers K and L offered to visit Mr X at his home to help with sorting out his hoard and other practical issues.
30. The Council considered B Company successfully addressed Mr X’s hoarding issues during the contract. Although the Council acknowledges hoarding is still an issue for Mr X. It reports staff involved with Mr X believe he was advised the support was for 12 months but have been unable to find evidence to confirm this.
31. The Council says while Mr X was told he had to wait six months before B Company would be able to reassess him for ‘floating support’, it would have conducted an assessment sooner or supported him with a one off piece of work if he had advised of any other or new needs. This is through a ‘touchbase’ service he can use for a further 12 months. The Council says he could have raised any issue with officers K and L whom he had a close professional relationship.
32. The Council says Mr X has asked officer K to apply to the Funding panel for funding with his preferred support service. Or to get a personal budget for him so he can fund his own support with that provider. Officer K advised Mr X it was likely he would have to contribute financially towards this option. The Council has referred Mr X to a charity support network to see if they can help.
33. The Council arranged for a Multi-Disciplinary Team case conference to take place in 2020 to discuss Mr X’s concerns and how best to support him. Meanwhile, the Council agreed to a worker from B Company working with Mr X for six months while officer K investigated other options for more long-term support. The outcome is for officer K to apply for a direct payment for Mr X so he can arrange his own care.

My assessment

34. The Council’s documents show Mr X has been receiving support from the Council since 2014 under a care plan. The support is ongoing with two officers with one acting as a care coordinator to ensure Mr X receives appropriate support. Mr X also receives support from medical practitioners for his hoarding issue.
35. The support from B Company was an additional service to the one he receives from the Council. The documents show the Council considered Mr X had achieved the goals set to put out a black bin back for collection. The support from B Company is usually for 6 months but Mr X received 12 months due to his complex needs. So, Mr X has received the benefit of a further six months of support.
36. It is unfortunate there is uncertainty over whether Mr X was advised of the length of the contract, but I do not consider it amounts to fault by the Council. The length of contract is not specified in the documents but that is with B Company, not the Council. The Council’s documents show officers advised Mr X in February 2019 the 12-month contract was coming to an end. While Mr X was unhappy with that and the need to wait to be re-referred, he was still receiving support from the two officers, day care centre, a doctor, and psychiatric services. It was also open to Mr X to engage with group activities for support, but he chose not to. So, I am satisfied Mr X was not without support during that time.
37. I suggested the Council could contact B Company to ensure it makes the length of contract clearer in its agreements. In commenting on the draft decision the Council confirmed it had spoken to B Company who advise that following Mr X’s complaint, they now make sure everyone is aware of the time limit of the service when they begin to receive support.
38. It is unfortunate there was a delay with the re-referral in September 2019, but the documents show Mr X was still receiving support. So, I do not consider it is an issue I should pursue any further. In addition, the Council arranged additional support for Mr X again with B Company after the reassessment in December 2019 while it considered the best way forward to help him. The outcome is for Mr X to receive a Direct Payment so he can buy in support with his preferred provider.
39. I note Mr X’s concerns about being evicted from his bungalow due to hoarding. But there is no indication from documents I have seen to show this was an option being considered by the Council.

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Final decision

40. I am completing my investigation. I have found no evidence of fault by the Council in the way it provided support to Mr X to help him with daily living skills and his hoarding habit.

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Parts of the complaint that I did not investigate

41. I have not investigated Mr X’s concerns the Council delayed in carrying out an assessment in December 2019 or the outcome of the assessment . This is because it is a new issue Mr X raised during the investigation. So, Mr X needs to complain to the Council about this issue first. Once he has completed the Council’s complaints procedure it is open to Mr X to pursue a complaint with the Ombudsman if he remains unhappy with the Council’s response.

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Investigator's decision on behalf of the Ombudsman