London Borough of Hackney (20 006 369)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 18 May 2021

The Ombudsman's final decision:

Summary: Ms C complained about an occupational therapy assessment done in September 2019 and the subsequent delays in carrying out minor adaptations to her kitchen to enable her to use it independently. We found fault with the Council. The Council has agreed to finalise the proposals within one month and complete the work within three months. It has also agreed to carry out a reassessment of Ms C’s needs and pay her £750.

The complaint

  1. Ms C complained that the London Borough of Hackney (the Council):
    • made errors in the occupational therapy assessment report from September 2019, which it refuses to correct;
    • referred her to two external organisations without her consent; and
    • delayed carrying out a reassessment and the recommended work to her kitchen.
  2. This has caused Ms C significant frustration and inconvenience in addition to the time and trouble of chasing the Council for a prolonged period. Ms C has been unable to use her kitchen properly throughout this period.

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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 have considered the complaint and the documents provided by the complainant, made enquiries of the Council and considered the comments and documents the Council provided. Ms C 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

  1. An Occupational Therapist visited Ms C in September 2019 to carry out an assessment of her needs. Ms C says she was very late and went to the wrong flat initially. The assessment states that:
    • Ms C did not give verbal consent to liaise with other relevant individuals to obtain information.
    • Ms C self-referred to the Council for an OT assessment of her kitchen on 12 August 2019.
    • Ms C was in receipt of disability living allowance and a pension.
    • The assessment notes she has scoliosis in her spine and osteoarthritis in her hips and knees which affects her ability to reach into top and lower cupboards in the kitchen and makes standing difficult.
    • The OT advised that lowering her kitchen cupboards would not be possible due to the position of electric sockets and switches just below the existing cupboards. Instead she proposed drop-down or pull out storage shelves within the cupboards.
    • The OT also recommended a perching stool so Ms C could sit while preparing food. But Ms C rejected this as there was not space underneath the worktop for her legs.
    • Ms C terminated the assessment and asked the OT to leave as she did not feel the OT was being receptive to her needs. She emailed Ms C the following day with the suggested proposals for the kitchen.
    • The OT had posted a blank attendance allowance form to Ms C to complete and send back to the DWP.
    • Ms C informed the OT of her new diagnosis: Muscular degeneration and Chronic Kidney Stage 3.
  2. Ms C complained by telephone in September 2019 to the Council about the OT’s visit. She said the OT was late, the assessment was inaccurate (she disputed she had asked the OT to leave, her GP had referred her to the OT and she had macular degeneration, not muscular) and the Council had referred her to organisations without her consent. She said she had received a letter from a housing support group offering help with completing an attendance allowance form and was then offered a home visit by the DWP. She said she did not request or need this help and had not consented to the referrals.
  3. Mrs C, with the help of her representative said she sent an email to the Council in December 2019 asking for another assessment and providing possible dates in January 2020. She said the Council did not respond.
  4. The Council responded to Ms C’s complaint in May 2020. It apologised for the OT being late in September 2019 and noted that the OT had apologised the following day by email. It agreed there were some factual errors in the assessment regarding her health condition and the manner of the referral. It also noted Ms C disputed that she had terminated the assessment but said it could not amend an assessment once it had been completed. It apologised for the errors, said that the OT had been spoken to and another assessment had been done in March 2020, with which Ms C was satisfied.
  5. In respect of the referrals, it said the Council had referred Ms C to the housing support organisation because Ms C had said she was struggling financially and wanted support when applying for attendance allowance. So it concluded Ms C was aware of the referral and the purpose of it. It said the Council did not refer Ms C to the DWP.
  6. The Council said it had not received Ms C’s email in December 2019 requesting another assessment. It asked Ms C to provide the email address she had sent it to so the Council could look into this further.
  7. In respect of Ms C’s request for a copy of all her assessments and reports it said it had passed her request to the Subject Access Request Team.

Kitchen works

  1. Following the second OT assessment in March 2020, the OT recommended some kitchen adaptations under the minor works scheme (for work under £1500). The OT panel approved these in May 2020 and the OT sent the proposals to the Council’s contractor in early August 2020. Ms C had not seen a copy of the plans and was not aware what was being proposed.
  2. The contractor asked a kitchen company to visit Ms C and provide a quotation for the work based on the OT recommendations. The kitchen company visited Ms C in September 2020 and drew up some plans following this visit. Ms C’s neighbour, Mr D (who was an architect) offered to help her with the project but he was not present at the meeting with the kitchen company. The kitchen company said the plans were based on the OT’s recommendations and suggestions Ms C had made during the visit. In October 2020 Mr D contacted the kitchen company to see if the washing machine could be moved. It replied saying the matter was back in the hands of the Council’s contractor. The contractor said to Ms C and Mr D that the work was more than that requested by the OT so it was referring the matter back to the OT.
  3. Mr D queried what the increase in work was given he had only requested moving some of the base units. In November 2020 the contractor said the kitchen company’s plans would cost more than the minor works limit of £1500 so it had referred the plans back to the OT for a possible disabled facilities grant. Mr D asked for information from the kitchen company to see if he could suggest a solution to bring the work back under the £1500 limit. The contractor referred him back to the OT.
  4. Mr D chased the OT at the Council on five occasions between December 2020 and February 2021 but did not receive a response. Following the sixth attempt the OT contacted Ms C to ask if she gave her consent for the Council to communicate with Mr D. She said yes.
  5. During February and March 2021, Mr D communicated with the OT. He did not understand when and how the project went from minor adaptations of less that £1500 to a full kitchen refurbishment at £4500. Mr D sent his drawings for the £1500 project and requested to go back to these proposals. At the beginning of March 2021, the Council said it had expected to get a quotation based on the original OT recommendations. But instead, it had a quotation for a full refurbishment costing £4500. It proposed asking the contractor for a quotation based on the original recommendations. Ms C agreed to this and the Council requested another quotation.
  6. The contractor and the OT visited Ms C and Mr D on 10 May 2021 to agree a way forward.

Cyber attack

  1. In April 2021 Ms C requested a copy of her assessment from March 2020 but the Council could not provide one: In October 2020 the Council was the victim of a significant and widespread cyber-attack which affected many of its databases. It has been unable to recover any information form its social care records system. So, it has been unable to send Ms C a copy of her assessment or provide many records in respect of this investigation. Ms C has provided her email records including the emails sent to the Council in December 2019 (which the Council acknowledged) and a copy of the original assessment from September 2019.


September 2019 assessment

  1. The Council acknowledged there were faults in the assessment, including the manner of the referral and the nature of Ms C’s conditions. It apologised for the errors but did not amend them or place a note on the file. It said it was unable to amend the assessment once it was recorded on the system. This is unsatisfactory, as a significant error relating to one of Ms C’s health conditions remained on her record which could have caused confusion and further errors in the future. This was fault and I consider the simple errors could have been corrected as soon as Ms C raised them.
  2. There is a wider question over the accuracy and completeness of the assessment. The assessment appears to be unfinished: the OT said this was due to Ms C terminating the visit, while Ms C says this was untrue and the OT was very late. This issue should have been resolved at the time Ms C first complained in September 2019 and another OT visit arranged to complete the process. This eventually happened in March 2020.
  3. Given the incompleteness of the first assessment in addressing Ms C’s difficulties using the kitchen, I consider the Council should have arranged a second visit within two months, by the middle of November 2019. The failure to do so caused a four-month delay in identifying the changes she needed.
  4. The Council should also have responded to Ms C’s emails requesting another assessment. She has provided evidence they were received by the Council. Th failure to do so was fault and contributed to the delay in arranging a further assessment.

Referral to external organisations

  1. The Council said it referred Ms C to a housing support agency in August 2019 because she was struggling financially and needed help completing an attendance allowance form. Ms C denies she ever requested such help as she is in receipt of disability living allowance and does not need attendance allowance.
  2. In the absence of the Council’s records, I cannot reach a safe conclusion on this issue. However, I am concerned that advice has been given to claim a benefit a person does not need apparently without her consent.
  3. I can conclude that the Council did not refer Ms C to the second organisation, the DWP because that was done by the housing support group.

Kitchen work

  1. In addition to the delay in carrying out the OT reassessment to identify the required kitchen adaptations, the Council has delayed in ensuring the alterations have been done.
  2. The Council approved the work in May 2020 but took three months to refer the case to its contractor. I consider this should have been done within one month of the approval as it was a small kitchen needing only minor alterations.
  3. The kitchen company visited within a month of receiving the referral but then drew up plans for a different kitchen not based on the OT’s recommendations. It says Ms C and Mr D were responsible for the significant amendments, but Mr D denies this and says it only involved moving a few units. Even if Ms C and Mr D did suggest additional work, I consider the contractor should have ensured the kitchen company provided a quotation for the original work in line with the OT recommendations. It did not do so and the Council failed to notice or act on this omission between October 2020 and February 2021 despite persistent chasing by Mr D. I acknowledge that this coincided with the cyber-attack. But I consider the Council should have taken control of the situation by December 2020 (two months after the contractor referred the plans back to the OT). The failure to do so has caused another three-month delay.

Copy of March 2020 assessment

  1. Following the cyber-attack, the Council does not have a copy of the assessment done in March 2020. Neither do Ms C nor her representative have a copy. This means the only assessment now available is the inaccurate and incomplete copy from September 2019.
  2. I note Ms C requested a copy of the March 2020 assessment as part of her complaint, but the Council treated the matter as a subject access request. I do not know if it sent Ms C a copy of the assessment after this referral, but I see no reason why it could not have sent Ms C a copy as part of its complaint response. It should have been shared with her as part of the assessment process. In the absence of any records showing what happened here I cannot say if the Council is at fault, but it is an unsatisfactory situation which needs resolving.


  1. Ms C has not been able to use her kitchen properly since August 2019. Even accounting for the impact of the cyber-attack, I consider the Council should have been able to progress these works much more quickly. I consider there was a four-month delay in identifying what Ms C’s needs were and how they could be met, followed by a five-month delay in producing a workable proposal to meet those needs. In addition to the inconvenience and distress, she has been put to significant time and trouble in trying to resolve the matter.

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Agreed action

  1. In recognition of the injustice caused to Ms C, I recommended the Council within one month of my final decision:
    • finalises the plans and obtains an acceptable quotation for the kitchen adaptations. Then within a further three months ensures the work is completed.
    • in consultation with Ms C, arranges a further OT assessment to ensure there a is a current and correct record of Ms C’s needs on file.
    • pays Ms C £750.
    • ensures OT staff are aware of the need to record accurate information as part of the assessment process and to share the assessment with the service-user to ensure any mistakes or misunderstandings can be corrected promptly.
  2. The Council has agreed to my recommendations.

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Final decision

  1. I consider this is a proportionate way of putting right the injustice caused to Ms C and I have completed my investigation on this basis.

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Investigator's decision on behalf of the Ombudsman

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