Summary: The Ombudsman finds fault with the Council for reducing support for Mr X’s eligible care needs without discussing this with him, and for delaying reassessing his needs. This caused Mr X avoidable distress and uncertainty. The Ombudsman also finds fault with the Council for not assessing Mr X’s parents support needs, for not considering Mr X’s previous history in decision making, and for poor complaint handling. The Council has agreed to apologise to Mr X, and pay him and his parents in recognition of the distress and delay caused. The Council has also agreed to reinstate Mr X’s previous support until it can reassess his eligible care needs and assess his parents for support. The Council will also review its procedures for reviewing eligible care needs, recording information and how it communicates with service users where their case is being transferred.

The complaint

1. Mr X complains the Council did not properly discuss a cut in support hours with him and his family and delayed re-assessing him. He complains the cut in hours left him without appropriate care.
2. Mr X complains the Council has delayed addressing his concerns about the cut to his support and did not communicate with him about the matter for long periods of time. Mr C complains this caused him stress and ongoing uncertainty.
3. Mr X complains the cut in his support has also had an impact on his parents and feels the Council should have provided them more support.
4. Mr X complains the Council did not consider his experiences of hate crime from previous personal assistants and the trauma this caused in the request to allow his father to be his personal assistant.
5. Mr X also complains about the poor communication and delay from the Council during the handling of his complaint.

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The Ombudsman’s role and powers

6. 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)
7. 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

8. Mr X was supported to make his complaint using an advocate, whom I shall refer to as Mr A. I considered the complaint and documents provided by Mr A, and information provided by the Council. I provided Mr X and the Council with copies of my draft decision and considered any comments before writing my final decision.

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What I found

Legislation

Assessment and review of eligible care needs

9. Section 27 of the Care Act 2014 gives an expectation that local authorities should conduct a review of a care and support plan at least every twelve months. The authority should consider a light touch review 6 to 8 weeks after agreement and signing off the plan and personal budget. It should carry out the review as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. As well as the duty to keep plans under review generally, the Act puts a duty on the local authority to conduct a review if the adult or a person acting on the adult’s behalf asks for one.

Carer’s Assessments

10. Where an individual provides or intends to provide care for another adult and it appears the carer may have any needs for support, local authorities must carry out a carer’s assessment. Carer’s assessments must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.

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What happened

11. Mr X has a disability and was previously assessed by the Council as having multiple eligible care needs and requiring a package of support from the Council.
12. In May 2018, the Council visits Mr X and identified that he needed to be reassessed due to a change in his needs. It also identified Mr X was accumulating money from his direct payments which was then being reclaimed by the Council. Council notes show the Council believed Mr X was not accessing support services and therefore did not require the funds.
13. In October 2018, the Council visited Mr X and his parents to complete a reassessment of his needs.
14. In December 2018, the Council visited Mr X and his parents to go through the results of the reassessment and care plan. The Council recorded that because the reassessment, it had agreed reducing the support package for Mr X with him and his parents. The Council send a letter to Mr X telling him about the costs for the new, reduced support.
15. The reassessment documents the package Mr X was previously receiving was working well for him and meeting his needs. It does not identify the Council were recommending that his support be reduced.
16. In January 2019, the Council made attempts to contact Mr X and his family to discuss the care plan and if it was working for him. They could not contact Mr X. Mr X’s father contacted the Council to advise that Mr X and his family were unhappy with the change in support as this had not been agreed and requested details of how to appeal.
17. In February 2019, Mr X was referred to an advocate, Mr A. Mr A contacted the Council and advised that Mr X and his parents felt they had not been told about the change in support. Mr A requested a reassessment of Mr X’s needs with the presence of an advocate. The Council advised that it had agreed the change of hours with the family and that an advocate was offered, but was declined by Mr X.
18. A meeting took place in March 2019 with Mr X, his parents, Mr A and the Council. Mr X voiced his concern about the reduction in support and the impact it was having on him and his parents.
19. The Council remained of the view that the reduction in the care and support plan had been previously agreed by Mr X and his parents, and there had been opportunities to discuss this in follow up home visits. The Council also felt that Mr X’s father could not be a suitable personal assistant due to his own needs, and that he was already carrying out other support to Mr X.
20. In April 2019, a new worker was allocated to Mr X by the Council, who would be meeting with the family to discuss the reassessment and any amendments to the care plan.
21. Mr A again requested a new reassessment be completed by the Council. Mr A also advised that Mr X’s parents had taken on a lot of responsibility and would benefit from some support and respite.
22. There are case notes from the Council indicating that a new assessment was to be arranged in April 2019.
23. In May 2019, the Council advised Mr X that he would transfer to another team that specialised in adults with learning disabilities and autism.
24. There is correspondence between Mr A and the Council trying to establish a worker in the new team and arrange a visit to Mr X between May and September.
25. In September 2019, a new worker visited Mr X and his parents, with the support of Mr A. The new worker advised she would explore reinstating Mr X’s reduced hours but submitting a request to the funding panel.
26. There are records to show ongoing correspondence for 4 weeks between Mr A and the Council to establish the outcome of the application to the funding panel for Mr X. Council records show that an application was not submitted to the panel until 6 weeks after the visit to Mr X where the worker advised she would do this.
27. At the end of October, the new worker advised that she was leaving and suggested another meeting to discuss the funding, as well as a carers assessment for Mr X’s mother.
28. Mr A continued to ask for an update on the funding for Mr X, and for a decision about whether his father could be his personal assistant.
29. In November 2019, the new worker left her position in the Council without updating Mr X, his family or Mr A.
30. Mr X was not allocated a new worker until February 2020. There are no records to show that any contact was made with Mr X during this period to advise him of what was going on, or if any actions had been completed.
31. The new worker attended a home visit in February 2020, however he later advised that Mr X had been allocated to his team wrongly and did not meet the criteria for this team.
32. Mr X did not have a worker between February 2020 and July 2020, when he was allocated a new worker. Records from the Council show there was no communication with Mr X during this time.
33. In July 2020, Mr X’s case was heard at an internal funding meeting, to review the request to reinstate his hours. The minutes from this meeting show that the Council agrees there was no evidence to show why Mr X’s support was cut initially, and that it should be reinstated. However, the outcome of the meeting was that Mr X’s needs should be reassessed.
34. Also in July 2020, the Council met with Mr X, his parents and Mr A via video call to reassess Mr A’s eligible needs. Mr A then followed up with the Council about how the family felt about the cut to support. The Council informed Mr X that his support would remain the same, and previous support would not be reinstated. The social worker told Mr A “It is difficult for me to justify an increase in support for someone who I have not actually met (all be it virtually)”.
35. Upon reviewing the reassessment, it is identical to the assessment and care plan created in 2018 and contains the same information. It did not include up to date information about Mr X or his circumstances and relied on information from the 2018 assessment. The reassessment and care plan for Mr X was not recorded on the Council’s system until 19th November 2020, the day after the Ombudsman requested a copy of it. Mr X was not provided a copy by the Council.
36. Mr A says that Mr X was told to expect a review in September 2020. This did not take place and Mr X has not heard from the Council since the video meeting in July 2020.
37. Mr X says that he wishes to be reallocated to the previous team that he was under, as he felt he was treated better when allocated to the previous local team rather than the current team.

Analysis

38. The Council records show that it acknowledged there is no evidence why Mr X’s hours were cut initially. Therefore, I uphold Mr X’s complaint that the cut to support was not appropriately discussed with him and his family. This was fault and caused Mr X significant injustice and distress.
39. The outcome of the meeting was that Mr X’s needs should be reassessed. This is what Mr X and Mr A had been requesting since the cut to his hours. The Council said it reassessed Mr X in July 2020. However, I am of the view the reassessment in July 2020 was not carried out adequately, and the Council still has not completed a robust and transparent reassessment. This was also fault by the Council, causing Mr X distress and uncertainty.
40. The Care Act 2014 sets out expectations for Council’s to carry out reviews every twelve months, and a light touch review within 6-8 weeks after agreeing and signing off a care and support plan. This did not happen in Mr X’s case. The Council felt that Mr X agreed and signed off his support plan in 2018, however from what I have seen, Mr X continually voiced that he was unhappy with the outcome. If the Council had followed the expectations set out for reviews, it is likely that Mr X would have had a decision about a reassessment and his hours carried out significantly earlier.
41. It is also clear that Mr X has experienced significant injustice because of poor communication and delay occurring from staff leaving. In the period of these issues arising, Mr X was unallocated to a worker for three months and then five months, as well as allocated to a team that he was not eligible for. Mr X was subject to poor communication from the Council. This was fault by the Council causing injustice, as Mr X experienced long periods of time with no update on his care or any outcomes that had previously been agreed.

Support for Mr X’s parents

42. Mr X’s mother had taken on the role of managing Mr X’s finances due to his eligible needs. The Council initially discussed an accumulation of funds in Mr X’s account with Mr X and his parents in May 2018.
43. Between November 2018 and September date, the Council reclaimed multiple payments from Mr X for accumulation of funds. The Council initially seemed to use this information as an indicator that the Mr X did not need the provision he was receiving, and it possibly contributed to the cut in support. However, there are several notes from the Council and discussions with the family which show the Council were aware that Mr X’s mother was struggling to manage paying invoices for his care. This appears to explain why there was an accumulation of funds in Mr X’s account.
44. In March 2019, there are several records to show the Council was aware that Mr X had run out of direct payment money, shortly after it had been reclaimed by the Council. The Council documented that Mr X’s mother was struggling to manage outstanding invoices and requires more support with this.
45. The Council discussed a carers assessment with Mr X’s mother and provided information to her. Council records also show workers planned to follow this up with her but did not do so.
46. There are also notes to show that both Mr A and Mr X’s father approached the Council to request respite and support for Mr X’s parents, in particular over their 50th wedding anniversary. The Council did not follow this up and as a result, Mr X’s parents did not access respite or further support. The Council apologised for this in the complaint response but did not provide a further remedy.

Analysis

47. There is a history of payments being reclaimed and professionals recording that Mr X’s mother was struggling to pay outstanding invoices. It is my view the Council should have followed up with Mr X’s mother about a carers assessment and what support she may need when it identified this issue.
48. The Council partially upheld Mr X’s complaint for this issue. Whilst it offered an apology to Mr X’s parents for this, it failed to offer a remedy to Mr X’s parents that would assess any ongoing support needs.
49. It is also my view that Mr X’s parents request for respite should have been considered and provided with a response.

Mr X’s father acting as Mr X’s personal assistant

50. In March 2019, the Council told Mr X and his family the Council would no longer be providing a direct payment for a personal assistant. This was because Mr X’s father was fulfilling this role, and the funds could not be used to pay someone living in the same household.
51. Mr X explained to the Council his history with poor personal assistants that had resulted in him unable to build trust with agencies for this role.
52. Mr A also supported this information to the Council in several emails.
53. Council records show this issue was discussed each time the case was transferred to a new worker. Records from the Council show that when this was discussed, Mr X’s history was often not included in the conversation to provide his reasoning for wanting his father to fill the role.
54. The Council advised workers that it did not pay for family members to be personal assistants except in extreme circumstances.
55. Mr X complains that he has previously experienced hate crime from his previous personal assistants which had been reported to the police and caused him trauma. Mr X felt the Council did not consider this information when reviewing if his father could be his personal assistant.

Analysis

56. Having reviewed Council records, it is my view the Council did not communicate information about Mr X’s previous experiences when discussing if his father could be his personal assistant.
57. It is not for the Ombudsman to decide whether the Council’s decision not to pay Mr X’s father to be a personal assistant is wrong. This is a merits decision for the Council.
58. However, if Mr X’s historical circumstances had been included in initial discussions, a decision may have been made at an earlier point. This would have removed the need for each worker to ask for the same advice and could have changed the decision made.
59. The poor communication about this issue is fault, causing injustice to Mr X, as he has spent 2 years without a consistent answer about who can support him.

The Council’s complaint handling

60. The complaint responses from the Council were delayed on multiple occasions.
61. In its final response, the Council upholds the parts of Mr X’s complaint about the carer’s assessment and delay. The Council told Mr X that it hoped a consistent case worker and apology were suitable remedies.

Analysis

62. At the time the complaint was submitted to the Ombudsman, Mr X had not received an adequate reassessment or decision about the support for his eligible care needs.
63. I do not agree that a consistent case worker and an apology were a suitable remedy. This did not remedy the injustice that Mr X had experienced. The Council should have provided a remedy for the parts of the complaint that were upheld. The Council should also have completed a reassessment for Mr X, and a carers assessment for Mr X’s mother.

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Agreed action

64. Within 4 weeks of this decision, the Council has agreed to:

• Apologise to Mr X and pay him £1000 for the avoidable distress and uncertainty he has experienced by not having his eligible needs adequately reassessed.
• The Council will also pay Mr X £300 for the delay experienced in not reassessing his needs in a timely manner, and for the continued injustice caused by poor complaint handling.
• The Council will reinstate Mr X’s support package that was in place before the 2018 assessment until the Council has completed a fresh reassessment. The Council will also discuss with Mr X whether he can be reallocated to his previous team.
• The Council will pay Mr X’s mother £300 in recognition of not providing adequate support.
• The Council will pay Mr X’s parents £200 in recognition for not exploring the request for respite support for their anniversary.
• The Council will also carry out a carer’s assessment for Mr X’s mother and review if Mr X’s parents are eligible for respite support.
• The Council should review its decision on whether Mr X’s father can be personal assistant and include his previous experiences and his reasons for requesting this. It should tell Mr X and his father the Council’s decision and its reasons for this. If the Council decides Mr X’s father is not eligible to be his personal assistant, it should consider whether he is eligible for a carer’s assessment.

65. Within 12 weeks of this decision the Council has also agreed to:

• Review how it monitors that reviews of eligible care needs are carried out every year.
• Remind workers of their responsibilities when carrying out assessments and recording information and provide training on information recording.
• Review how staff manage case transfers and handovers, and how it communicates with service users when they do not have a worker.

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Final decision

66. I find fault with the Council for reducing support for Mr X’s eligible care needs without discussing this with him, and for delaying reassessing his needs. This caused Mr X avoidable distress and uncertainty. I also find fault with the Council for not assessing Mr X’s parents support needs, for not considering Mr X’s previous history in decision making, and for poor complaint handling.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman