Summary: Miss X complains about the care needs assessment completed by the Council. She says the assessment was flawed and did not consider correct information. She also complains the Council did not provide her with an advocate or make reasonable adjustments. The Ombudsman finds fault as the Council’s assessment was likely not an accurate record of what was discussed with Miss X. We do not find fault with the Council’s decision not to appoint her an advocate or to make reasonable adjustments.

The complaint

1. Miss X complains:
• the care needs assessment carried out in October 2019 was flawed and did not consider correct information;
• that the Council did not provide her with an advocate when she asked for one; and
• did not make reasonable adjustments for her to engage with the service.

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The Ombudsman’s role and powers

2. 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)
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. 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 spoke with Miss X and considered the information she provided.
6. I made enquiries with the Council and considered the information it provided.
7. I sent two draft decisions to Miss X and the Council and considered their comments.

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What I found

Legislation and guidance

8. 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.
9. The Care and Support (Eligibility Criteria) Regulations 2014 sets out the eligibility threshold for adults with care and support needs. The threshold is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing. To have needs which are eligible for support, the following must apply:
1. The needs must arise from or be related to a physical or mental impairment or illness.
2. Because of the needs, the adult must be unable to achieve two or more of the following:

• Managing and maintaining nutrition;
• Maintaining personal hygiene;
• Managing toilet needs;
• Being appropriately clothed;
• Being able to make use of the adult’s home safely;
• Maintaining a habitable home environment;
• Developing and maintaining family or other personal relationships;
• Accessing and engaging in work, training, education or volunteering;
• Making use of necessary facilities or services in the local community including public transport, and recreational facilities or services; and
• Carrying out any caring responsibilities the adult has for a child.
3. Because of not achieving these outcomes, there is likely to be, a significant impact on the adult’s well-being.

10. Where local authorities have determined that a person has eligible needs, they must meet these needs. When a local authority has decided a person is or is not eligible for support it must provide the person to whom the determination relates (the adult or carer) with a copy of its decision.
11. The reasonable adjustment duty is set out in the Equality Act 2010. It applies to any body which carries out a public function. It aims to make sure a disabled person can use a service as close as it is reasonably possible to get to the standard usually offered to non-disabled people. When the duty arises, the body is under a positive and proactive duty to take steps to remove or prevent obstacles to accessing their service. If the adjustments are reasonable, they must be made.
12. The care and support statutory guidance note local authorities should consider whether the individual would have substantial difficulty in being involved in the assessment process and if so, consider the need for independent advocacy.

What happened

13. In October 2019, the Council completed a care needs assessment with Miss X. The care assessment noted Miss X suffered from depression, low mood, and some mental unwellness. The assessment also noted Miss X could take medication without support.
14. The care assessment noted Miss X had needs in accessing and engaging in work, training, education or volunteering and in the use of public transport and/or recreational facilities or services in the local community.
15. For accessing work, the care assessment detailed Miss X was in paid work and was provided with a taxi service to help her get to and from work. For use of public transport, the care assessment noted Miss X did not use public transport and instead used taxis.
16. With regards to developing and maintaining personal relationships, the care assessment noted Miss X has had major trauma in her life. The assessment did not provide any further details on what this was or how this affected her ability to develop and maintain personal relationships. The Council also did not note whether Miss X had an eligible need in this area.
17. For all other areas, the care assessment noted Miss X did not have needs.
18. The care assessment noted the Council would provide Miss X with some financial support to help her access further training. It also noted the Council referred Miss X to the sensory impairment team and signposted her to other organisations that could continue to assist her.
19. The Council provided Miss X with a draft copy of the assessment in October 2019. Miss X provided some comments and noted the areas where she felt the Council had not properly recorded the information discussed.
20. Miss X told the Council she was not fit for her job and could not continue in the job she had. Miss X also told the Council she took medication.
21. The Council updated the care assessment to include some of the information provided by Miss X. The Council did not update the information about Miss X’s medication or her job.
22. In November 2019, the Council sent Miss X a copy of the amended care assessment and told her it had closed the case. The Council said Miss X did not contact it after this.
23. In response to my first draft decision, Miss X provided evidence that she did contact the Council after it sent her the amended care assessment. In her email, Miss X told the Council she felt the care assessment still contained inaccurate information and that information had been left out, such as the fact she took medication.
24. Miss X told the Ombudsman she told the social worker she would sometimes forget to take her medication or occasionally take too much. Miss X said she told the social worker she needed help with this.
25. Miss X also told the Ombudsman she told the social worker she was on sick leave at the time of the assessment. She said she told the assessor she was losing her job and was trying to change job as she could not do the job she had. She said she told the assessor she wanted to retrain for a new job and needed support with this.
26. Miss X said she asked the Council to provide her with an advocate to help her. She said she could not remember if she specifically asked the Council to provide one to help her complete the care assessment. The Council said it did not provide an advocate as Miss X did not have any significant difficulty in taking part in the assessment process.
27. The Council also said while it did not feel Miss X needed an advocate to take part in the assessment process, it did provide Miss X with information about advocacy services available in the community. The Council said Miss X declined these advocacy organisations as she knew people who worked in the service.
28. Miss X said the Council did not provide her with reasonable adjustments to help her engage with adult social care services. Miss X said she could not remember if she had asked the Council to provide her with any specific adjustments. The Council said it had considered all possible help and support available to Miss X.

Analysis

Care assessment

29. The law requires local authorities to carry out an assessment for any adult with an appearance of need for care and support. The assessment must be of the adult’s needs and how it impacts on their wellbeing and the results they want to achieve.
30. The care assessment shows the Council explored Miss X’s needs in the outcome areas and considered whether her needs meant she could not achieve those outcomes.
31. The care assessment set out that Miss X had needs in two areas: accessing and engaging in work, training, education or volunteering, and in the use of public transport and/or recreational facilities or services in the local community. This meant Miss X was unable to achieve those outcomes without support.
32. The information set out in the care assessment suggested Miss X already had the support in place to meet her needs. For example, Miss X required support to get to work but these needs were met by the fact she received a taxi which took her to and from work. This meant Miss X’s needs did not have a significant impact on her wellbeing.
33. However, Miss X said the care assessment did not consider correct information and that not all information had been recorded.
34. The evidence shows there is a large discrepancy between what Miss X says she discussed with the Council compared to what is recorded in the Council’s assessment. Therefore, there is a conflict of evidence here.
35. However, there is evidence the Council made some changes to the care assessment when Miss X first asked it to make changes. This would suggest the Council accepts the care assessment was not an accurate reflection of the information Miss X had discussed with the assessor during the assessment.
36. There is also new evidence Miss X raised concerns with the Council that the amended care assessment was still not an accurate record of what was discussed. Therefore, on balance, I am of the view the Council’s assessment was likely not an accurate record of what was discussed with Miss X. This is fault.
37. Further, while the Council did make some amendments, it has not explained why it did not make other changes which Miss X requested. For example, the amended care assessment did not record what medication Miss X took. This is despite the fact the evidence shows Miss X told the Council what medication she took.
38. Therefore, this suggests the Council has failed to include relevant information in the care assessment. This supports my view that the Council’s assessment was not an accurate record of what was discussed with Miss X.
39. I consider the fault identified caused Miss X some distress and uncertainty. This is because I cannot say what the outcome of the care assessment would have been had the Council accurately recorded the information.

Advocate

40. The statutory guidance sets out when councils should consider involving an independent advocate.
41. The Council said it did not appoint an independent advocate for Miss X as it did not consider Miss X had substantial difficulty being involved in the assessment process. There is no evidence to suggest Miss X struggled to take part in the assessment.
42. Therefore, I do not find fault with the Council’s decision. This is because this decision was in line with statutory guidance.

Reasonable adjustments

43. The reasonable adjustment duty aims to ensure a disabled person can use a service as close as it is reasonably possible to get to the standard usually offered to non-disabled people. Therefore, the Council needs to ensure its services are accessible to everyone.
44. There is no evidence to suggest the Council’s services were not accessible to Miss X. The Council’s records show Miss X was able to engage with the assessment process and, as noted above, the Council did not consider Miss X had substantial difficulty in being involved in the assessment process.
45. As the Council had no reason to believe Miss X could not access its services without adjustments, I do not find fault with the Council for not making any reasonable adjustments for Miss X.

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Agreed action

46. To remedy the injustice caused by the fault identified, the Council has agreed to complete the following:
• Apologise to Miss X for not accurately recording all information provided during the care assessment.
• Pay Miss X £150 in recognition of the uncertainty and distress caused.
47. The Council should complete the above remedy within four weeks of the final decision.

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Final decision

48. I find fault with the Council as its assessment was likely not an accurate record of what was discussed with Miss X. I do not find fault with the Council’s decision not to appoint Miss X an advocate for the care assessment or for not providing any reasonable adjustments.

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Investigator's decision on behalf of the Ombudsman