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Shropshire Council (19 020 314)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 23 Nov 2020

The Ombudsman's final decision:

Summary: Miss X complains that the Council failed to move her mother to a home closer to her family. The Ombudsman finds the Council at fault. The Council has agreed to apologise and make a payment for the uncertainty and distress caused.

The complaint

Miss X complains on behalf of her mother, Mrs Y. She complains that the Council failed to move her mother to a home closer to her family in Stockport. She says the Council has failed to explain why no effective action was taken for five months. Because of the delay, Miss X believes her mother is now not well enough to move.

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The Ombudsman’s role and powers

  1. 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)
  2. 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

  1. I considered the correspondence Miss X sent to the Ombudsman. I wrote to the Council and explained what I intended to investigate and to ask for comments and copies of relevant records.
  2. I provided Miss X and the Council with a copy of my draft decision. I considered all the comments I received before reaching a final decision.

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What I found

Assessment of needs

  1. The Care Act 2014 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 they impact on their wellbeing and the results they want to achieve. The Act says the assessment should also seek to promote independence and reduce dependency. The Council must also involve the individual and where suitable their carer or any other person they might want involved.
  2. The Care Act provides councils with power to meet urgent needs where it has not completed an assessment of needs. When somebody asks the council, or is referred to the council for urgent needs, the council should provide an immediate response and meet that person’s care and support needs. The council should complete a more detailed assessment of needs, following the initial assessment.
  3. While there is no defined timescale for completing the care and support planning process, councils should complete plans in a timely fashion, proportionate to the needs to be met.

Mental Capacity Act

  1. The Mental Capacity Act 2005 applies to people who may lack mental capacity to make certain decisions. The Act sets out a Code of Practice (the Code) with the steps organisations should take to decide if someone lacks mental capacity.
  2. Both the Act and the Code start by presuming individuals have capacity unless there is proof to the contrary. The Code says councils should take all practicable steps to support people to make their own decisions before deciding they lack capacity. The Code says councils should not automatically treat people who make unwise decisions as not being able to make decisions. Someone can have capacity and still make unwise decisions.

What happened

  1. Mrs Y lived at home on her own. Her daughters hold Lasting Power of Attorneys for her health and welfare.
  2. In March 2018 Mrs Y’s daughter (Miss Z) called the Council and asked it for support for Mrs Y. The Council completed a social care needs assessment. It decided that Mrs Y should be, signposted to external agencies that could provide support around shopping, referred for a pedant alarm and bathing assessment. The Council also agreed to install some assistive technology in Mrs Y’s home to get a better understanding of her night time needs.
  3. On 20 May Mrs Y told the Council that she wished to move to Stockport so that she could live closer to her daughter, Miss Z. The Mental Capacity Assessment (MCA) completed at the time showed that Mrs Y had the capacity to decide where she lived. The Council says that because Mrs Y was looking to move into new housing and not residential accommodation, it was agreed that Miss Z would explore local social housing and services available in the area and visit the places identified.
  4. On 1 July the Council implemented a night time service for Mrs Y. A week later, Mrs Y had a fall at home and was admitted to hospital. The Clinical Commissioning Group arranged for Mrs Y to have rehabilitation at a residential nursing home, which I shall refer to as Care Home A.
  5. The Council spoke with Miss X on 21 August. Miss X said that the family wanted to move their mother to Stockport as soon as possible. The Council explained that a reassessment would need to be completed before any decisions were made. The next day the Council completed an MCA which showed that Mrs Y no longer had capacity to decide where she lived. The Council’s records show that Miss Z agreed to a transfer to a short-term reablement service, which I shall refer to as Care Home B.
  6. On 30 August Mrs Y was transferred from Care Home A to Care Home B. The Council completed another social care needs assessment and Miss Z was also present. The outcome of the reassessment was that Mrs Y required a nursing placement. The Council told Miss Z that her mother would be discharged from Care Home B to an interim nursing placement.
  7. On 30 September Mrs Y returned to Care Home A on the basis that it could meet her nursing needs and she was already familiar and content with the Home. The case records show that Miss X and Miss Z still wanted their mother to move to Stockport and subsequently Mrs Y was added to the Integrated Community Service (ICS) Team waiting list for an allocated social worker. Throughout October and early November, the family continued to chase the Council for a social worker. They explained that their mother’s health was deteriorating and the case records evidence this. The records state that Mrs Y “became withdrawn and non-compliant”. It was recorded that Mrs Y’s health had declined and whilst she initially had physical care needs, she now required psychological/cognitive care.
  8. On 20 November Miss X complained to the Council about the lack of support for Mrs Y. She asked for a social worker to “get the move sorted quickly and efficiently as a matter of urgency”
  9. The next day a social worker contacted Miss Z and explained that she will be completing another assessment of Mrs Y’s needs. The family were invited to attend but were unable to do so and a copy of the assessment was sent to Miss X on 4 December. Miss X told the Council that she was happy with the assessment but currently busy with work.
  10. On 8 January 2020 the social worker contacted Miss X and requested an update on their home preferences for Mrs Y and her move to Stockport. Miss X responded two months later and said the family were satisfied with the care their mother was receiving at Care Home A and that moving her mother now could be detrimental to her health and well-being.
  11. On 6 March the Council responded to Miss X’s complaint. It acknowledged that Mrs Y did not have a consistent social worker whilst she was under the care of the ICS team. The Council also acknowledged that the family had requested a social worker in October 2020 to support and facilitate Mrs Y’s wish to move to Stockport and accepted that there had been a delay in allocating the case. The Council apologised for the faults identified and for the delay in responding to the complaint.
  12. Miss X complained to the Ombudsman in March 2020. She said that the delay by the Council meant that her mother was now not well enough to move. Sadly, Mrs Y passed away in August.

Analysis

  1. My role is to decide if there has been any fault in the way the Council dealt with the issues under complaint. It is not to decide what Mrs Y’s care needs were or what services she should have received.
  2. The records show the Council considered Mrs Y’s needs and involved her family in the assessment process. It appropriately completed needs assessments and mental capacity assessments in accordance with relevant legislation and guidance.
  3. However, the Council accepts that there was a delay in allocating a social worker to Mrs Y when she returned to Care Home A at the end of September 2019. I note the Council’s explanation that the case was not considered a priority at the time because Mrs Y was safe and in a care home. My view is that this does not provide a satisfactory explanation as to why the Council made no progress on facilitating a move for Mrs Y to be closer to her family. The evidence shows that Mrs Y’s daughters had repeatedly requested a social worker for this purpose and the Council was aware that Mrs Y’s health continued to deteriorate. The Council also also knew Mrs Y wanted to live closer to her daughter.
  4. Miss X believes that Mrs Y may have been able to move sooner if there had not been a delay in allocating a social worker. It is not possible for me to say whether this would have been the case. Such decisions must rest on an appropriate assessment and finding a suitable placement, it would therefore be inappropriate for me to make my own judgement. I note the Council’s comments that it had previously agreed with the family that they would take the lead in locating suitable accommodation in the Stockport area. But the delay in allocating a social worker caused Miss X uncertainty of not knowing whether things might have been different but for the fault.
  5. The Council apologised for the length of time it had taken to reply to Miss X’s complaint. It accepted the delay had been unacceptable and this had added to her distress. It was appropriate for the Council to apologise for the delay in handling Miss X’s complaint. I have made an additional recommendation for the time it had taken to respond.

Agreed action

  1. The Council has agreed to my recommendations and within one month of my final decision it will:
  • Apologise to Miss X for the faults identified;
  • Make a payment of £100 for the uncertainly and distress caused by the delay in allocating a social worker;
  • Make a payment of £100 for the delay in responding to the complaint and the further distress this caused.

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Final decision

  1. I have completed my investigation on the basis there was fault by the Council which led to an injustice.

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Investigator's decision on behalf of the Ombudsman

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