Decision : Not upheld
Decision date : 24 Nov 2020
The Ombudsman's final decision:
Summary: Mr and Mrs X complain the Council refused to revise their adult daughter, Ms Y’s, care and support plan, despite evidence that a reduction in her care and support package had negatively affected her health and wellbeing. The Council was not at fault. It appropriately reviewed Ms Y’s care and support plan and considered all relevant information in its decision making.
- Mr and Mrs X complain the Council refused to amend their adult daughter, Ms Y’s, care and support plan, despite evidence from themselves and health professionals that a reduction in her care and support package had negatively affected her health and wellbeing. They say the Council’s refusal to re-instate her previous level of support has caused Ms Y unhappiness and distress. They want the Council to accept the current support plan does not meet her needs and re-instate her previous level of support.
The Ombudsman’s role and powers
- 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)
- 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)
How I considered this complaint
- I read Mr and Mrs X’s complaint and discussed it with them on the phone.
- I considered information provided by Mr and Mrs X and the Council.
- Mr and Mrs X and the Council had the opportunity to comment on the draft decision. I considered their comments before making a final decision.
What I found
Legal and background information
- The Care Act 2014 gives councils a legal responsibility to provide a care and support plan for a person with eligible needs for care and support. The care and support plan should set out how the council will meet the identified needs.
- Section 27 of the Care Act 2014 gives an expectation that councils should conduct a review of a care and support plan at least every 12 months. The council should consider a light touch review six to eight weeks after agreement and signing off the plan and personal budget.
- When conducting a review, a council should consider whether the care and support in the plan is meeting the person’s needs. They should involve the person needing care and their carer(s) where appropriate. They should also consider advice from other health and care professionals who may be able to inform the council of any concerns about the plan’s ability to meet needs.
- The Independent Living Fund (ILF) was a Government-funded discretionary scheme which helped people who had both day and night care needs and who were getting the high rate care component of Disability Living Allowance. Those helped under the scheme were able to receive a joint ILF/council funded care support package to help them live independently in the community rather than in residential care. The ILF has been closed since 1 July 2015
- Ms Y is an adult who has health conditions and a learning disability. She has received care and support services for many years. Until 2015, this support was funded through the ILF. Following the ILF’s closure, the Council took over the funding and provision of Ms Y’s care.
- Ms Y lives with her parents, Mr and Mrs X. Mr and Mrs X provide care and support Ms Y with decision making. Ms Y’s relative, Mr Z, has been Ms Y’s main carer for many years. After the ILF closed in 2015, this arrangement continued with Ms Y employing Mr Z through a direct payment from the Council. In 2019, Mr Z provided care for Ms Y during the day and three nights respite care per week, when Ms Y would stay at his house. Ms Y also attended a supported work placement three days a week.
- In March 2019, the Council reviewed Ms Y’s needs under the Care Act 2014. As part of its assessment, the social worker met with and gathered information from Ms Y, Mr and Mrs X and Mr Z. They also considered information from Ms Y’s GP and from staff at her work placement. The assessment showed Ms Y had eligible needs and records show that Mr and Mrs X told the social worker they felt the assessment was a true reflection of Ms Y’s current needs.
- The social worker completed the care and support plan. The plan reduced the number of paid hours Mr Z would provide from 43.5 to 40 hours per week. It reduced the number of nights paid respite care from three nights a week to one. It removed the transport service to/from the work placement but advised that Ms Y would be entitled to a Motability vehicle, as she received a qualifying benefit. Mr and Mrs X agreed to look into this further. It made no changes to Ms Y’s work placement. The social worker advised there would be a three-month notice period before the changes took place and recommended the plan be reviewed after 6-8 weeks. Although Mr and Mrs X had expressed concern a change in care package may lead to increased negative behaviours, there is no evidence they contested the care and support plan at this time. The care and support plan came into effect in July 2019.
- In August 2019, the social worker contacted Mr and Mrs X to arrange a review. Mrs X told the social worker Ms Y had been unhappy since the changes.
- The social worker contacted Ms Y’s work placement. The manager told the Council Ms Y’s checking routines had become more obsessive to the point where, at times, she was extremely distressed. They said they would contact Mrs X to discuss their concerns when Ms Y had a particularly bad day.
- The Council held the review meeting in September 2019. Mr and Mrs X told the Council Ms Y had been unsettled and was not coping with the changes. They asked the Council to re-instate the previous level of care and support. The Council did not agree to this. Instead, they recommended Mr and Mrs X refer Ms Y to the local NHS community team for support to adjust to the changes and to manage the changes in behaviour. Mr and Mrs X did not agree to this, as they said previous experience with this team had not been helpful.
- Mr and Mrs X contacted their MP, who contacted the Council on their behalf. The Council corresponded with the MP but said the current offer of care and support was in line with the Care Act 2014.
- In November, Ms Y’s GP wrote to the Council. They said since the changes to her care support, Ms Y’s obsessive-compulsive traits had become more apparent, more difficult to manage and she was more tearful and sad. She was also waking more at night and wandering downstairs at night, which was becoming problematic for Mr and Mrs X. They asked the Council to take this information into account when reviewing Ms Y’s case.
- In December, Mr and Mrs X agreed for Ms Y’s work placement to refer her to the local NHS community team. The NHS team considered the referral but decided Ms Y did not have an unmet health need that required their specialist input. Instead, they recommended the Council review the care and support and that Ms Y visit her GP to check for any underlying health issues.
- In January 2020, the Council visited Mr and Mrs X again to review Ms Y’s care and support plan. Mr and Mrs X told the Council the reduced care and support was still impacting negatively on Ms Y’s behaviour and they wanted the Council to re-instate the previous level of support.
- The Council considered Mr and Mrs X’s views, the letter from Ms Y’s GP, the decision letter from the NHS team and feedback from Ms Y’s work placement. It decided the current care and support plan met Ms Y’s assessed needs.
- Mr and Mrs X remained unhappy and complained to the Council.
- In its complaint response, the Council said it had carried out its duties in line with the Care Act 2014, and changes to Ms Y’s care and support had been phased in to reduce their impact. It said it had considered the information from Ms Y’s GP, her work placement and the NHS team as part of its decision making but considered its current offer of support appropriate and proportionate.
- Mr and Mrs X remained unhappy and brought their complaint to us.
- It is not the role of the Ombudsman to decide Ms Y’s need for care and support but to investigate how the Council has considered it.
- I have reviewed information provided by Mr and Mrs X and the Council and have found no fault in the way the Council assessed Ms Y’s needs and formulated the care and support plan. When it reviewed the care and support plan in September 2019, it appropriately considered all the relevant information and decided the care and support plan met her needs. I have found no fault in how the Council reached this decision, so cannot question the decision reached.
- When the Council completed a further review in January 2020, it considered all the information provided by Ms Y’s relatives, the GP, the NHS team and Ms Y’s work placement. It met with Mr and Mrs X to discuss their concerns. It decided the current care and support plan met Ms Y’s assessed needs. Although Mr and Mrs X disagree with this decision, there was no fault in how it was reached. The Ombudsman cannot criticise decisions made without fault.
- I have completed my investigation. The Council was not at fault.
Investigator's decision on behalf of the Ombudsman