Summary: Mr B complained about the way in which the Council dealt with his request for adaptations and about the Council’s decision to stop his Direct Payments. We found there was an unreasonable delay in carrying out Mr B’s OT assessment, following a request from Mr B’s GP. This resulted in distress to Mr B for which the Council has agreed to apologise.

The complaint

1. The complainant, whom I shall call Ms C, complains to us on behalf of her brother, whom I shalll call Mr B. Ms C complains about several different aspect in relation to the Council’s support to her brother:
• The way in which the Council responded to Mr B’s request for an Occupational Therapist (OT) to assess the suitability of his current property and carry out adaptations.
• The Council’s decision to stop his Direct Payment.
• The unreasonable long time it took to change his social worker.
• The Council’s decision to reduce his care support hours.
• The Council’s failure to respond to safeguarding concerns that have been raised about her brother in 2020.
• The Council’s refusal to provide a hoist in 2020, even though this was recommended by a doctor.

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What I have investigated

2. I have investigated the first three complaints above, because these were the only complaints where there was evidence that Ms C has already made a complaint about them to the Council, which the Council had subsequently looked into and responded to through its complaints process.

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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. The law says that, before investigating a complaint, we must normally be satisfied that the complainant (or their representative) has made a formal complaint to the Council, and that it has been given an opportunity to consider it and reply.
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 I received from Ms C, Mr B and the Council. I shared a copy of my draft decision statement with Mr B and the Council and considered any comments I received before I made my final decision.

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What I found

Mr B’s request for an OT assessment

7. In August 2019, Mr B found and moved into a flat within a sheltered accommodation plus scheme, after living in temporary accommodation at a hotel. The scheme has staff on site day and night and consists of individual flats that have many adaptations to support independent living, such as automatic doors, widened corridors and wet rooms.
8. Ms C says the Council refused to assess the suitability of this new property. In response, the Council told me that:
• It (an OT) did not assess the suitability of Mr B’s new property before he moved in, because Mr B chose the property without involving the Council. He independently applied to move to this property.
• The manager of this scheme said Mr B was very independent when he moved into the property and there were no concerns about the suitability of the scheme. However, after Mr B moved in, he told the housing provider about some adaptations that he felt he would need.
9. Ms C says the Council has also failed to put the adaptations in place that her brother needed and asked for. Ms C says her brother and his GP contacted the Council to ask for adaptions to his property. Ms C says the GP said her brother could not properly access the shower and was struggling to cook.
10. In response, the Council told me there are no cooking facilities in the individual flats, because the main meal is provided by an outside caterer and served to all residents at lunchtime. This meal is provided as part of the contract and the charges Mr B accepted when he decided to move to his flat. As such he did not need adaptations to cook.
11. The records state the Council received a letter from Mr B’s GP in October 2019, to ask for an OT assessment for a wet-room adaptation. The Council said:
• It had been made aware that Mr B’s health had allegedly deteriorated since August 2019. As such, it felt it would be best if the OT assessment would be done by a Health OT, so the (Health) OT could also consider and discuss any health angle and longer-term deterioration aspects of Mr B’s deterioration with health colleagues as part of the assessment.
• As such, the social worker told the GP practice that: “The GP can refer to the Health OT service for this. Mr B selected this accommodation, and it is his health and physical impairment needs that means he needs the report for the housing provider to consider any adaptations”.
12. The social worker left a message with Mr B in November 2019, to say she had told the GP to make the referral for a Health OT. The record says: “This was discussed with him at the review meeting and Mr B was happy with this”. The social worker called the GP later that same day to ask for an update on the referral. The GP surgery said they had made the OT referral, but would check the outcome of this.
13. The GP surgery told the Council on 13 December 2019 that the Health OT team (Community Therapy Team) said the Council should deal with this referral. Two weeks later, the Community Therapy Team contacted Mr B’s social worker to explain it could not accept the referral from the GP, because: the equipment / adaptations requested were for long term needs, but the team is not commissioned to supply those.
14. The Council subsequently made a referral to its OT service, which it received on 21 January 2020.
15. Mr B received an OT assessment at the end of February 2020. It concluded that he did not need adaptations at the time, but Mr B would receive a replacement shower chair (he was using a commode to sit on) and his drop-down rail would be replaced.

Analysis

16. In October 2019, the Council received a request for an OT to assess if Mr B’s flat should be adapted. Rather than allocating this case to one of its own OTs, the Council decided the GP should request a Health OT to do this. The Community Therapy Team has clearly explained why the Council’s OT service should have dealt with this request at the time: because it does not deal with long term adaptations / equipment issues.
17. This resulted in a delay in the OT assessment taking place. This delay resulted in some distress to Mr B, for which the Council should apologise.

The Council’s decision to stop Mr B’s Direct Payments

18. Ms C says her brother is unhappy the Council stopped his Direct Payments (DPs), which he used to employ two Personal Assistants (PAs).
19. The Council told Mr B in September 2019, that it would carry out a review of his DP. As such, it asked Mr B to ensure that all financial statements and receipts would be available to facilitate this.
20. The Council also sent a letter to Mr B in September 2019 confirming the outcome of his financial assessment. It said his weekly contribution would be £101.50 per week. The Council also provided a copy of the letter to Mr B during its visit in mid-October 2019.
21. The Council received an email early January 2020, which said Mr B had not been paying the contribution he should pay for his care, into his DP account. As such, there was a shortage of funds in his DP account. The Council says it also became clear that Mr B had made requests for money to be paid from his Direct Payment account into his personal account to pay his PAs, between April to July 2019. This was not in line with the agreement, which was for the DP Support Service company to receive the PA’s timesheets and pay the PAs accordingly. The Council says that Mr B’s instructions to the Company to reimburse him for this period was irregular and would have made the expenditure more difficult to audit. 
22. Further concerns were raised about Mr B’s DPs at the end of January 2020, when one of Mr B’s PAs told the Council he had not been paid for the support he had provided to Mr B. He said he had been told there was not enough money in Mr B’s DP account to pay him. The PA said that if he would not receive his payment, he would have to look for alternative work.
23. The Council says it subsequently tried to contact Mr B to discuss this. However, he did not engage. The records I have seen provide evidence the Council tried to contact Mr B by telephone and leaving voice messages.
24. The Council wrote a letter to Mr B in February 2020, which said it had been unable to contact him over the phone to discuss the status of his DP account. Later that same day, Mr B told the DP brokerage team that both his PAs had left due non-payment of wages.
25. The Council says this meant that Mr B did no longer have the care support he needed. As such, the Council stopped his DPs and commissioned his support instead. This ensured, in the absence of his PAs, that Mr B had the care support in place to meet his needs. The Council kept the same level of support in place that Mr B had received from both PAs.

Analysis

26. The Council was not at fault for its decision to stop Mr B’s DP and change it to commissioned support. After Mr B’s PAs had left, this was the only option to ensure he could continue to receive the support he needed.
27. The Council identified concerns about the way in which Mr B managed his DP. It has told Mr B that it will keep his case under review to see if Direct Payments can become an option again with regards to his support package.

Mr B’s request to change his social worker

28. Ms C says:
• Her brother has asked for a different social worker for a long time. This was, because he lost confidence in his social worker’s ability to effectively support him and his social worker’s attitude / behaviour towards him.
• The Council initially decided it would not change his social worker, but subsequently changed its mind. He now has a new social worker.
• However, she and her brother are unhappy the new social worker is still from the same team as the previous one, as they have also been unhappy with the team manager.
29. The record states that Mr B contacted the Council in September 2019 to say he permanently moved to a different area in Essex. He stated he needed a new start and wanted to be transferred to a new local area team with a new social worker. The officer reminded Mr B that he had previously requested a transfer to another team, which was turned down because his circumstances were regarded as “not stable”. The record says that: Action agreed: The social worker would support with a handover process to the local team. Title:
30. The Council says it discussed his request to transfer in March 2020 with senior management and decided against it, because Mr B’s case was complex and it would be better to wait until it had ‘settled down’.
31. The Council told me that:
• Mr B does not have a new social worker. The ‘new social worker’ Ms C referred to, was a senior social worker within the Physical and Sensory Impairment, who only provided temporary cover when Mr B’s social worker was on annual leave.
• Mr B has in the past, made requests to change his previous allocated social workers when they haven’t agreed with his requests. The Council has actioned this previously. However, there is no justification or plans at this time to change the Social Worker for Mr B.

Analysis

32. The Council has considered Mr B’s request but decided there is no justification to change his social worker and it would be better to wait as his case until it settles down. I have found no fault with regards to this; the Council is entitled to come at such a decision.

Agreed action

33. I recommended that, within four weeks of my decision, the Council should provide an apology for the delay in providing an OT assessment, after October 2019.
34. The Council has told me it has accepted my recommendation.

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Final decision

35. For reasons explained above, I found fault with the Council’s response to the GP’s request for an OT assessment.
36. I am satisfied with the action the Council will carry out to remedy this and have therefore decided to complete my investigation and close the case.

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Parts of the complaint that I did not investigate

37. I did not investigate Mr B’s complaint about the Council’s decision to reduce his care support hours, the way the Council dealt with concerns being raised and the decision about the hoist. There is insufficient evidence that Mr B has already made a complaint about these issues to the Council, giving the Council an opportunity to looked into them and respond through its complaint procedure.

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Investigator's decision on behalf of the Ombudsman