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Salford City Council (20 007 918)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 09 Jun 2021

The Ombudsman's final decision:

Summary: Ms C complained about the way the Council responded to her request for help and advice, when her main carer (her mother) potentially had Covid. We found fault with regards to the way the Council responded to this, which caused Ms C distress. The Council has accepted this and agreed to provide an apology to Ms C, pay her a financial remedy for distress, and share the lessons learned with staff.

The complaint

  1. The complainant, whom I shall call Ms C, complained about the way the Council assisted her when she needed help and advice, because there was a significant chance her mother (and main carer) had Covid. Ms C said:
    • She was unable to get through to Adult Social Care to speak to anyone, despite trying three times on 7 October 2020.
    • There was a delay in receiving a call back from Adult Social Care after she made contact on 8 October 2020 to obtain support with her care.
    • When she received a call on 12 October 2020, the Council failed to provide her with the advice she needed to solve her problem; i.e. to use (emergency) funds in her DP account to temporarily increase her support.
    • As a result of the above, her mother had to provide her support from 8 to 15 October 2020. As such, she was very concerned (being in the clinically extremely vulnerable category) that her mother may have Covid and she would get it from her during that period of time.
    • The Council failed to look into, and comment on, those three calls in its complaint response.
  2. Ms C says that, if she had been given the correct advice on 8 October 2020, she would have immediately been able to arrange a Personal Assistant to support her during the day and at night, until 15 October 2020.

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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 information I received from Ms C and the Council. I shared a copy of my draft decision statement with Ms C and the Council and considered any comments I received, before I made my final decision.

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What I found

The alleged difficulties getting through to Adult Social Care

  1. Ms C lives with her mother and has a need for frequent care support throughout the day. Her mother is her main carer, but she also receives some support from a paid Personal Assistant. With regards to Covid, she has been classes as “extremely clinically vulnerable” Ms C said that:
    • Her father tested positive for Covid on 1 October 2020. Her mother, who is her main carer, had been in direct contact with her father and was therefore at risk of having contracted Covid from him.
    • From 1 until 8 October 2020, her brother cared for her instead of her mother. However, he was no longer able to continue after that day. This meant her mother would have to step in again. This meant she, a vulnerable adult, would be potentially at risk of contracting Covid from her mother.
    • She tried to contact the Council’s adult social care team to get the help she needed with her situation. However, it was very difficult to get through and speak to anyone.
  2. The Council says that Ms C called the Adult Social Care Contact Centre on 3 October 2020. This means, she would have heard a pre-recorded message that the Contact Centre was closed. However, within this message there is advice to “Press 1) if the issue is urgent. This would divert the call to the Emergency Duty Team who covers the area outside of usual working hours. However, Ms C did not choose the option to speak to the Emergency Duty Team.
  3. Ms C called the Council three times on 7 October 2020. However, she says she was unable to speak to anyone. I have seen evidence she made the calls.
  4. The Council says that:
    • In response to the Ombudsman’s enquiry, it has checked the log of calls it received on 7 October 2020 and did not see Ms C’s number. As such, it has been unable to establish what may have happened on those three occasions. The Council is sorry for any difficulties Ms C has experienced contacting Adult Social Care and the associated distress this will have caused at a difficult time.
    • The investigator did not look into the calls on 7 October 2020, because Ms C did not specifically reference these when she discussed the complaint with her.

Analysis

  1. Ms C was unable to get through to Adult Social Care to speak to anyone on 7 October 2020, despite trying three times. I have seen evidence she has made these calls, but I have been unable to determine what happened on each occasion. This resulted in some distress to Ms C that day. However, she was able to talk to the Council the next day.
  2. The Council told Ms C that, as part of her complaint, it would look into any calls she tried to make before 8 October 2020. However, it did not look into the calls she made on 7 October 2020, because she did not specifically mention them and (in any case) these did not appear on the Council’s log of calls.

The alleged delay in receiving a call back:

  1. Ms C says she finally managed to speak to someone from Adult Social Care on 8 October 2020. However, there was subsequently a delay by Adult Social Care to obtain support with her care.
  2. According to the records, Ms C spoke to a Social Worker on 8 October 2020, who completed an initial assessment. It said:
    • Ms C advised she needed a review of her Direct Payment. She said her mum was filling in the shortfall for her care, but her mother was now isolating with Covid and therefore unable to carry out this support for the time being.
    • She therefore needed more hours per day to enable her to get her carers to cover her mother’s shortfall.
    • New changes in need require a review of her package of care to meet new need.
    • While Ms C’s mother is isolating, Ms C cannot support her daughter for the next 14 days. This means if Ms C needs to go to the bathroom, she cannot do this independently. Ms C has contacted DP and doesn't have enough money in her support plan to cover this. She has been told to request an urgent review.
  3. The social worker put a referral through to the relevant local electronic Duty clipboard the same day. The Council says that:
    • The call centre took the correct step as Ms C said she had already contacted DP and did not have enough money in her support plan to cover this. This was consistent with current methods of working, as the responsibility for undertaking an urgent review / reassessment in such circumstances sits with the neighbourhood adult social care teams.
    • At this point, the referral should have been screened by the Duty Worker on call that day to decide if immediate action was needed or if a response could be the following day.
    • However, the referral was only picked up by the Duty Worker on 12 October 2020 (after four days), for which the Council is sorry.
    • Ms C’s referral was missed due to the volume of referrals on the Duty Clipboard during this period of time. This made it difficult to see which referrals were new and required actions.
    • Learning took place following this incident, including that the Duty Workers need to go through the Duty Clipboard with a member of the management team at the end of each working day to ensure all referrals and call back requests have been actioned.
  4. Ms C says that, when she received a call on 12 October 2020, the Council failed to provide her with the advice she needed to solve her problem; i.e. to use (emergency) funds in her DP account to temporarily increase her support. She says she could have arranged additional support from her Personal Assistant 24/7.
  5. The record of the call on 12 October states that:
    • Ms C said she needed an increase in her DP. She has 18 hours DP support each morning, after which her mother supports her the rest of the day. Her mother is currently isolating due to having a positive covid result.
    • Ms C said her mother had been assisting her since 8 October, as there was no one else. Ms C asked for an urgent new assessment of her needs as she no longer wanted her mother to provide support during the day.
  6. The Council says that:
    • The on-call officer says she did not advise to use emergency funds because, based on the information she received, it was her understanding that her mother continued to work along the PA. Instead, she believed Ms C was asking for a review to permanently change the arrangement.
    • Based on a review of the information, the Council is satisfied that the use of emergency funds was not required in response to the issues presented. The advice Ms C received on 12 October 2020 was appropriate to the information discussed.
    • It is the Council’s position that emergency funds should only be used to provide immediate support that is otherwise unavailable and / or until such a reassessment can take place and there is evidence that the person would experience a risk to their independence without emergency support.
    • A GP to contact Ms C on 13 October 2020 and provided assurance to her that her mother could continue in her caring role, whilst being an asymptomatic household member.

Analysis

  1. Ms C told the Council on 8 October 2020 that her mother was unable to provide any support to her at the moment, because she was at risk of having Covid. Ms C was classed as “extremely clinically vulnerable”, as far as the risk of Covid was concerned. This meant there was an immediate potential shortfall in the care Ms C would receive; which should have been treated as an emergency. As such, the Council should have advised her to use any contingency funds in her DP account and/or advised her of (discuss with her) any other means to enable her to immediately be able to temporarily increase the paid for care support she was receiving.
  2. Ms C says that, if she had been given the correct advice on 8 October 2020 or had received a call back by the Duty Worker the same day as required, she would have immediately been able to arrange a Personal Assistant to support her during the day and at night, until 15 October 2020. Instead, her mother, who could possibly have Covid at the time, had to provide her care support after 8 October, potentially putting Ms C at risk
  3. Ms C told two things to the Council on 12 October 2020: 1) Her mother was currently unable to provide the care she needed due to Covid 2) she also wanted a review of her care package so her mother would no longer have to provide her care support going forward.
  4. Again, the Council failed to advise Ms C to use her emergency DP funds, because the Council failed to pick up the first issue. As a result, her mother had to continue to provide her care support after 12 October, potentially putting Ms C at risk.
  5. The above resulted in Ms C, being “extremely clinically vulnerable”, feeling distressed between 8 and 15 October 2020, as she felt at risk of potentially getting Covid from her mother, which could have endangered her life.

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Agreed action

  1. I recommended that, within four weeks of my decision, the Council should:
    • Provide an apology to Ms C for the faults identified above and pay her £300 for the distress she experienced.
    • Share the lessons learned with the relevant teams in adult social care.
  2. The Council has told me it has accepted my recommendations.

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Final decision

  1. For reasons explained above, I upheld Ms C’s complaint.
  2. I am satisfied with the actions the Council will carry out to remedy this and have therefore decided to complete my investigation and close the case.

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Investigator's decision on behalf of the Ombudsman

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