Summary: Mrs X and Miss P complained about the delay in making arrangements to assess and provide support to Mrs X. We have found the Council was at fault. To remedy the injustice caused, the Council has agreed to apologise, make a payment to Miss P in recognition of the financial losses she incurred whilst providing care for Mrs X and review its practices.

The complaint

1. Mrs X and Miss P complain about the Council’s failure to assess and provide support for Mrs X’s care needs since 2017.
2. They say this left Mrs X struggling to manage at home, putting significant stress on her family, especially Miss P. Miss P says she had to reduce her working hours to care for Mrs X and this had a significant impact on both her mental health and finances.
3. While the Council has already accepted some fault and offered a remedy, Miss P says this is inadequate and does not compensate her for the costs and loss of income she incurred in caring for Mrs X.

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What I have investigated

4. The restriction outlined in paragraph eight applies to this complaint because some of the events Miss P complains about took place over a year ago. The Ombudsman has discretion and can disapply this rule if there are good reasons.
5. I have decided not to exercise discretion to investigate events before November 2019 because the case records evidence that whilst there was some social work involvement with Mrs X prior to this date, both she and her family said they did not want formal support from the Council. I am also satisfied the Miss P’s main complaint is about what happened afterwards.

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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. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
8. 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

9. I spoke with Miss P and reviewed the information she provided.
10. I made enquiries of the Council, considered its response and reviewed the relevant law.
11. Miss P and the Council were given 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

Relevant law and guidance

12. Sections 9 and 10 of the Care Act 2014 require local authorities to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to all people regardless of their finances or whether the local authority thinks an individual has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
13. The Council must carry out the assessment over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Local authorities should tell the individual when their assessment will take place and keep the person informed throughout the assessment.
14. Direct payments are monetary payments a council makes to an adult who it has assessed as being eligible for care and support. Direct payments allow the adult to have control over their care and support. Generally, direct payments cannot be used to employ people who are relatives and who live in the same house as the disabled adult. A council has discretion to relax this rule in exceptional circumstances.

What happened

15. I have set out below a summary of the key events. But it is not meant to show everything which happened.
16. Mrs X was diagnosed with Alzheimer’s Disease in 2017. She was able to continue live at home with the support of her family. Over the next two years, her condition deteriorated.
17. In November 2019, safeguarding referral was made to the Council by the police after Mrs X was reported to have left home unsupervised and vulnerable. This had happened several times before and the reporting police officer was of the opinion Mrs X required more support at home.
18. In December 2019, Mrs X’s social worker met with Miss P to discuss the situation. Miss P explained her circumstances had changed and she needed more support.
19. Miss P says she was expecting the Council to assess Mrs X and make arrangements for her care but this did not happen.
20. Frustrated by further delay, in February 2020, Miss P identified a suitable carer and asked the Council to assist with this. She says the Council failed to respond again.
21. In March 2020, Miss P asked a national dementia charity to advocate on her behalf. The charity was reassured by Mrs X’s social worker that a direct payment was being arranged.
22. In June/July 2020, the Council was alerted to further concerns about Mrs X’s welfare by both the police and Mrs X’s GP surgery. The nurse suggested a care package of four calls per day may be appropriate and could fit in around the family dynamics.
23. Miss P says she struggled during this time to provide care, particularly as she lives many miles away and had to reduce her working hours to do so, causing financial hardship. This was compounded by the national lockdown.
24. In August 2020, Miss P complained to the Council about its failure to assess and support Mrs X. She explained the significant detrimental impact this had on her, including her own mental health and financially. She also sought the help from her MP.
25. In response, the Council apologised and accepted there had been a delay in making the necessary support arrangements for Mrs X. It offered £2000 to Miss P in recognition of the difficulties she experienced in her caring role.
26. As part of the support planning process, the Council also agreed to put in place a direct payment, backdated to September 2020, when the assessment had been undertaken.
27. Dissatisfied with this outcome Mrs X complained to the Ombudsman. She says direct payments should be further backdated. She also wanted clarification as to how the Council had decided on the figure of £2000.
28. In response to the Ombudsman’s enquiries, Council made the following points:

• In earlier discussions, Miss P was not identified as a formal carer and so it was not possible to make direct payments to her. The Council accepted its complaint letters had not explained the difference between informal and formal carers.
• The proposed payment of £2000 was in recognition of “expenses relating to her informal caring role, travelling etc”.
• Alternative support had been offered but refused by the family.
• It acknowledged there had been significant delay in making the necessary arrangements.
• Advice should have been given to Miss P in February 2020 about how to move forward with the direct payment when a suitable carer was identified.

29. Having reviewed the case records the Council has now agreed to reconsider the payment to Miss P. This would be equivalent to the cost of four daily care calls between March 2020 and September 2020 - £7919. This was in recognition of the delay and the additional care provided by Miss P during the national lockdown.

Analysis

30. The Council has a legal duty to carry out an assessment for anyone with the appearance of care and support needs and within a reasonable timeframe.
31. I am satisfied this duty was triggered in December 2019. It is disappointing that the Council carried out some preliminary enquiries, but then failed to follow this up.
32. Further opportunities were missed in February and March 2020 when:
1. Miss P told the Council she had identified a potential carer for Mrs X. This was an important development because Mrs X was resistant to receiving care from anyone she did not know; and
2. the dementia charity worker discussed the case with the social worker who said the matter was in hand.
33. The Council, in its response to my enquiries, has accepted the delay in carrying out the assessment was fault and in recognition of the injustice caused has offered an additional payment to Miss X. As fault has been accepted, I do not need to investigate this issue further.
34. I must now consider whether the Council’s suggested remedy is sufficient to remedy the injustice caused.
35. The Council has offered £2000 to Miss P to acknowledge the expenses she incurred in her caring role. It has now agreed to increase this amount to £7919, equivalent to four daily care calls for the six months from September 2020 to March 2020, based on the recommendation from the GP surgery.
36. I consider, taken as a whole, this is a proportionate financial remedy for the injustice caused to Miss P, both in terms of financial recompense and acknowledgement of the distress and frustration caused by the delay.
37. I do not consider it necessary to make any additional recommendations in respect of injustice to Mrs Y. I am satisfied her family, particularly Miss P, provided care in lieu of Council support.

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Agreed action

38. The Council has agreed to take the following action:
1. Send a written apology to Miss P and make a payment of £7919.
2. Review procedures to ensure the delays experienced by Miss P in carrying out assessments do not recur. The Council should explain to the Ombudsman the action taken to improve its practice in this area.
39. The Council should take the action at a) within one month of my final decision and the action at b) within three months of my final decision.

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Final decision

40. The Council was at fault by its failure to make to make timely arrangements to assess and provide for Mrs X’s care and support needs. The Council has agreed a suitable remedy.

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Investigator's decision on behalf of the Ombudsman