Summary: Mr K complains the Council ignored his requests for an assessment of his care and support needs, refused to appoint an independent advocate and did not deal with his complaint. The Ombudsman has found some fault which has caused injustice. The Council has already apologised. It has agreed to make a payment to Mr K to acknowledge the uncertainty caused.

The complaint

1. Mr K complains the Council ignored two requests for an assessment of his care and support needs for almost a year. He also complains the Council refused to appoint an independent advocate for him and did not deal with his complaint.
2. Mr K says as a result he has lost confidence, is depressed and his anxiety has increased.

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The Ombudsman’s role and powers

3. 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)
4. 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)
5. 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

6. I considered the information Mr K sent, the Council’s response to my enquiries and:
• The Care Act 2014 (“the Act”)
• The Care and Support Statutory Guidance (“the Guidance”)
• The Autism Act 2009
• Statutory guidance for Local Authorities and NHS organisations to support implementation of the Adult Autism Strategy 2015 (“the autism statutory guidance”)
7. Mr K 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

Care and support needs assessment

8. The Act requires 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 determines what the person's needs are and whether the person has any needs which are eligible for support from the council. Where councils have determined that a person has any eligible needs, they must meet those needs.
9. The Act does not set any deadlines for completion of an assessment, but the Guidance says an assessment should be carried out over an appropriate and reasonable timescale taking into account the urgency of needs and a consideration of any fluctuation in those needs.

Support for people with autism

10. The Autism Act 2009 says that there has to be a Government strategy for improving services for autistic adults, and statutory guidance for councils and the NHS. The statutory guidance says councils:
• should provide autism awareness training for all staff
• must provide specialist autism training for key staff, such as community care assessors
• cannot refuse a community care assessment for adults with autism based solely on IQ
• must appoint an autism lead in their area
• must develop a clear pathway to diagnosis and assessment for adults with autism
• need to commission services based on adequate population data.
11. Councils must also ensure that any person carrying out a care and support needs assessment of a person with autism has the skills, knowledge and competence to carry out the assessment and is appropriately trained. Where the assessor does not have experience in the condition, the local authority must consult a person with that expertise.

Reablement

12. Reablement is a short-term period of intensive support which aims to help individuals regain skills, confidence and independence around their daily living skills, community access and integration.

Advocacy

13. The Act requires councils to arrange access to an independent advocate for individuals with autism. In particular where a person with autism would have difficulty in understanding the process of assessment including retaining that information, and or would not be able to meaningfully contribute their views, wishes or feelings and there is no appropriate person who knows them to support them in fully engaging in the process.

Complaints about adult social care

14. Councils should have clear procedures for dealing with social care complaints. Regulations and guidance say they should investigate a complaint in a way which will resolve it speedily and efficiently. The Council aims to respond within 20 working days, or up to 65 working days for complex cases. The Council should say in its response to the complaint how it has considered the complaint, what conclusions it has reached, what action it will take (if any), and how to complain to the Ombudsman. (Local Authority Social Services and National Health Service Complaints (England) Regulations 2009)

What happened

15. Mr K completed the Council’s online care needs assessment in June 2019. He said he was autistic and suffered with depression, anxiety and cognitive issues. Mr K said he was very socially isolated and needed help to access the community and other support. The form advised him he needed a care and support needs assessment and he was referred to the Council’s working age adult disability team.
16. In September 2019 the local NHS autism team submitted an online needs assessment on Mr K’s behalf. This said Mr K had had a recent diagnosis of autism and had sensory needs which were impacting on his functioning and daily living. He relied on a friend to help support him in the home as he had poor executive functioning.
17. Mr K complained to the Council in October 2019 that he had not heard anything, despite requesting an assessment in June.
18. The Council referred Mr K’s case to its mental health reablement team on 14 October. It says this was because this team could support people to access the community and become more independent within their home, and it did not have a waiting list. The mental health reablement worker contacted Mr K to arrange a visit. Mr K declined. He said the Council should assess his care and support needs and he was concerned the reablement worker was not properly trained in autism as required by the Autism Act. He also asked for an advocate to be appointed. His case was referred back to the working age adult disability team.
19. The Council replied to Mr K’s complaint in an email on 24 October 2019. It apologised he had not yet been contacted and said he remained on the waiting list for an assessment. The email did not set out the next steps of the complaint process. Mr K asked if the Council had received a referral from the NHS autism team but was advised it had not. Mr K later provided evidence of the NHS referral. He also asked about the advocate; in an email on 25 October the Council said he could self-refer to a charity or the assessor could do this once allocated. The Council again apologised to Mr K on 1 November 2019.
20. Mr K continued to chase up the matter until the Council had identified a worker with suitable training in late December 2019. It said the officer would start working with Mr K at the end of January 2020. Mr K remained dissatisfied. He said he had been ignored and the Council had not apologised. He asked about the worker’s training and for an advocate to be appointed. The Council made a referral to a charity on 21 January 2020 for an advocate.
21. In February 2020, the allocated worker arranged to assess Mr K with an advocate present. Mr K remained concerned about the worker’s training and experience. He eventually declined the assessment. Mr K complained to the Ombudsman in January 2020. The length of our investigation was affected by the coronavirus pandemic.

My findings

22. The Council has accepted there was a delay in dealing with Mr K’s request for a care and support needs assessment. Mr K asked for this in June 2019 but it was not arranged until January 2020. Whilst the Guidance does not set statutory deadlines, this was a significant delay and was fault. The delay has caused Mr K injustice as he does not know whether he could have had support in place to meet his needs.
23. In response to my enquiries the Council acknowledged the working age adult disability team’s waiting list had been large during 2019. The Council prioritised cases according to risk and had taken steps to reduce the waiting list, including holding weekly team case conferences and enabling different area offices to help each other out when necessary. The waiting list had reduced from about 80 people in 2019 to about 12 people in August 2020.
24. Mr K was concerned that the worker allocated in January 2020 did not have suitable training to assess people with autism. The Council has confirmed the worker had training which includes Autism in Practice: Working with Autistic Adults and Autism in Practice: Assessing & Care Planning with Autistic Adults. This fully meets the requirements of the autism statutory guidance, so I do not find fault here.
25. Mr K was entitled to decline the assessment offered in February 2020, but the lack of assessment then was not caused by fault by the Council. I have seen no evidence the Council has refused to carry out a care and support assessment.
26. Mr K also declined the mental health reablement worker’s offer to visit in October 2019. Mr K is right that the Council had a duty to carry out a care and support needs assessment. But whilst it would have been best for the mental health reablement worker to visit after a care and support assessment had determined Mr K’s needs, I do not consider there was fault by the Council. The Guidance and autism statutory guidance say councils must provide services to prevent or delay the development of care and support needs of adults, including for adults with autism. Whilst autism is not a mental health condition, Mr K had noted he had mental health conditions and my view is it was appropriate for the council to offer this. The worker had not had training in autism but was able to consult with a manager who had, which is in line with the autism statutory guidance.
27. Mr K complains the Council refused to arrange an advocate for him. I have seen no evidence of a refusal. In October 2019 the Council said Mr K’s worker could arrange an advocate if Mr K had not arranged one himself. The worker was allocated in January 2020 and contacted a charity to provide an advocate then. Mr K is concerned about the independence of the charity, but it is an independent organisation that is appropriate to provide advocates. I do not find fault.
28. There was fault in the Council’s 24 October response to Mr K’s complaint as it did not advise him of the next steps in the Council’s complaint process. I consider this caused some confusion, as Mr K remained unclear whether his complaint was being dealt with formally and whether he was able to bring his complaint to the Ombudsman until January 2020.
29. When we have evidence of fault causing injustice, we will seek a remedy for that injustice which aims to put the complainant back in the position they would have been in if nothing had gone wrong. When this is not possible, we will normally consider asking for a symbolic payment to acknowledge the avoidable distress, such as uncertainty, caused. But our remedies are not intended to be punitive and we do not award compensation in the way that a court might. Nor do we calculate a financial remedy based on what the cost of the service would have been to the provider. This is because it is not possible to now provide the services missed out on.

Agreed action

30. I note that the Council has already apologised to Mr K for the delay in arranging the care and support assessment. Within a month of my final decision the Council has agreed to pay Mr K £100 to acknowledge the uncertainty and distress the delay caused.

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Final decision

31. There was fault by the Council. The actions the Council has agreed to take remedy the injustice caused. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman