Summary: Miss X complained the Council failed to correctly identify her care and support needs and placed her in unsuitable temporary accommodation. She also said it failed to recognise her assistance dog. We find there was fault in how the Council completed the care needs assessment. That meant it is probable Miss X went 18 months without receiving the support she needed. There was no fault in the Council’s housing decision, however it did delay in considering the suitability of that accommodation after Miss X raised her concerns. It also incorrectly suggested Miss X register her dog as an assistance dog. The Council has agreed to make a payment to Miss X to remedy the injustice caused. It will also review its training on the Equality Act to ensure it includes information about assistance dogs. The Council has already made service improvements to its Adult Social Care Service including creating a Learning Disability and Autism Team to prevent a recurrence of the faults identified.

The complaint

1. Miss X complained that the Council failed to correctly identify her care and support needs when it completed a care needs assessment in September 2019. She said it also placed her in unsuitable temporary accommodation when she was homeless. She said the Council refused to complete a further care needs assessment until April 2021 despite her asking it to.
2. Miss X also said the Council has discriminated against her by failing to recognise her dog, Y, as an assistance dog.
3. Miss X said the unsuitability of the accommodation for her as a wheelchair user meant she has experienced difficulties entering the property and accessing the kitchen, bathroom and moving between rooms. Subsequently, the Council’s actions have caused a deterioration in her wellbeing and independence which has affected her mental health.
4. She wants the Council to review its systems to ensure it does not discriminate against disabled people.

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The Ombudsman’s role and powers

5. 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)
6. 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. When considering complaints, if there is a conflict of evidence, we make findings based on the balance of probabilities. This means that we will weigh up the available relevant evidence and base our findings on what we think was more likely to have happened.
8. 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)
9. I have used my discretion to investigate Miss X’s complaint from September 2019.
10. 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

11. I discussed the complaint with Miss X and considered evidence she provided.
12. I asked the Council questions and considered its response and the evidence it provided. That included Miss X’s Adult Social Care case records and her care needs assessments.
13. Miss X 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

Adult Social Care

14. Councils must assess anybody in their area who appears in need of care services. Following an assessment, the council must decide which needs are eligible for their support. If the council provides support, it must produce a written care plan.
15. Under the Care Act 2014 (the Act), there are three stages to the eligibility decision process, all of which must be met. They are:
• An adult’s needs must arise from or relate to a physical or mental impairment or illness.
• Because of the needs, an adult must be unable to achieve two or more of 10 outcomes listed in the Care and Support (Eligibility Criteria) Regulations 2014. These include outcomes such as managing and maintaining nutrition; maintaining personal hygiene and maintaining a habitable home.
• As a consequence, there must be, or likely to be, a significant impact on an adult’s wellbeing.
16. The Care and Support Statutory Guidance 2014 (the Guidance) states where a person has fluctuating needs, the council should consider their needs over a period of time when determining whether they have eligible needs. Councils should also complete care needs assessments over a “reasonable and appropriate” timescale and the assessment should collate a full picture of the adult’s needs.
17. Ensuring adults can effectively participate in the assessment process is central to the Guidance. It also states “The Act places a legal requirement on local authorities that all assessors must have the skills, knowledge and competence to carry out the assessment in question. Where an assessor does not have the experience in a particular condition (such as autism, learning disabilities, mental health needs or other conditions), they must consult someone with relevant experience. This is so that the person being assessed is involved throughout the process and their needs, outcomes and the impact of needs on their wellbeing are all accurately identified.”

Assistance dogs in the UK

18. The Equalities Act 2010 defines an assistance dog as a dog that has been trained to guide a blind person, assist a deaf person, or has been trained to assist a person with a disability. There is no register or certification process for assistance dogs in the UK and there is no legal requirement for the dog to be trained by a specific organisation. Only dogs that have been trained by members of Assistance Dog UK are issued an identification booklet.

The Equality Act

19. The Equality Act 2010 protects the rights of individuals and supports equality of opportunity for all. It offers protection in employment, education, the provision of goods and services, housing, transport and the carrying out of public functions.
20. The Equality Act makes it unlawful for organisations carrying out public functions to discriminate on any of the nine protected characteristics listed in the Equality Act 2010. They must also have regard to the general duties aimed at eliminating discrimination under the Public Sector Equality Duty.
21. We cannot decide if an organisation has breached the Equality Act as this can only be done by the courts. But we can make decisions about whether or not an organisation has properly taken account of an individual’s rights in its treatment of them.

Duties to the homeless and suitability of temporary accommodation

22. Councils must take reasonable steps to help to secure suitable accommodation for any eligible homeless person. This is known as the relief duty. When a council decides this duty has come to an end, it must notify the applicant in writing.
23. If a council is satisfied someone is eligible, homeless, in priority need and unintentionally homeless then it owes them the main housing duty. Generally, the Council carries out this duty by arranging temporary accommodation until it makes a suitable offer of social housing or private rented accommodation.
24. The law says councils must ensure all accommodation it arranges for homeless applicants is suitable for the needs of the applicant and members of his or her household. This duty applies equally to interim accommodation and accommodation provided under the main housing duty.
25. Homeless applicants may request a review within 21 days of being notified of the decision on their homelessness application. They also have the right to request a review of the suitability of temporary accommodation provided after the Council has accepted the main housing duty.

What happened

26. Miss X is a young adult. She has several medical conditions. She also has autism. This can make processing information difficult, and she needs information asked in a specific way.
27. In August 2019, Miss X’s parents contacted the Council and said that from 5 September, Miss X could no longer live at the family home.
28. The Council started a homelessness assessment. Miss X provided the Council with information about her medical conditions. This included a letter from her GP that explained she struggled to walk long distances and used a wheelchair once or twice a week and letters from her neurologist about other physical conditions.
29. The Council’s Housing Service wrote to Miss X on 5 September confirming it owed her the relief housing duty. It provided interim accommodation at a hotel for Miss X and her dog, Y. It also suggested Miss X register Y as an assistance dog. Miss X responded and explained there was no register for assistance dogs.
30. Alongside this, a social worker form Adult Social Care (Officer A) met with Miss X to complete a care needs assessment. In that initial meeting, Miss X told Officer A she struggled with parts of her personal care such as washing and brushing her hair and had been supported by friends to wash her hair on a regular basis. She also said she struggled with domestic tasks such as clothes washing and that she had little experience in cooking as there were risks of her falling or passing out. She said she did not know how to do these things as she had previously been supported by her parents.
31. Officer A did not assess Miss X as having eligible care needs, but recorded it was difficult to assess these because she was living in a hotel and was not in a home environment. They said Miss X needed a further assessment when in stable accommodation. The Council arranged for a care agency to provide Miss X with some support whilst staying at the hotel.
32. Officer A arranged for Miss X to attend an appointment with a Council Occupational Therapist (OT). In that meeting Miss X confirmed she had bought her wheelchair privately. She said she used a microwave with difficulty but could use a kettle to make instant noodle dishes. The OT assessed Miss X as needing a shower chair to assist with washing.
33. Adult Social Care contacted Housing Services with the outcome of its initial meetings with Miss X. It said her only housing needed was for a low-level property. Adult Social Care spoke to the care agency supporting Miss X whilst at the hotel. It said she could manage her personal care and dressing independently and the only assistance it had provided was with washing her hair.
34. Housing Services wrote to Miss X offering temporary accommodation in a one-bedroomed, wheelchair accessible flat. The flat was in a property for young people with housing needs and was staffed by housing support workers. Miss X moved into the flat on 10 September.
35. The following day, Officer A and Officer B visited her to complete a Care Needs Assessment. In that meeting the case records state Miss X said:
• The flat was accessible, however the doors were heavy to open.
• She had made “pot porridge” and “pot pasta” to eat.
• She had not used the shower at the property but had asked a worker to brush her hair for her.
• At times she forgot to take her medication.
• She did not need help with her care needs, other than washing her hair. However, her condition was variable and on bad days, she could not do anything for herself, such as getting out of bed, using the toilet or cooking or cleaning. Miss X said she did not know what support she wanted.
36. In that meeting, Officer A and Officer B told Miss X she was not eligible for support. They said she could visit a hairdresser to have her hair washed and set an alarm on her telephone to remind her to take her medication.
37. Between September and November, the Housing Service referred Miss X to three supported housing providers. It referred to Y as an unregistered assistance dog. The housing providers would not accept Miss X because Y was not a registered assistance dog.
38. Adult Social Care met with Miss X at the end of October. It told her it was closing her case, but she could contact it if her circumstances changed.
39. Housing Services wrote to Miss X at the start of November. It ended the relief housing duty and accepted it owed her the main housing duty. It set out her review rights about the suitability of the accommodation.
40. Around April 2020, Miss X moved in with Ms D (a family friend) following the start of the COVID-19 pandemic and lockdown. The Council also installed ramps to the front and rear of the flat, and lights to allow Miss X to access the property in the dark.
41. Miss X emailed Housing Services about the suitability of her temporary accommodation at the end of September. She said it was physically unsuitable because of high door locks, light switches, and kitchen counter tops.
42. Adult Social Care arranged a virtual meeting with Miss X and Ms D on 2 October. Miss X said she had not understood the care needs assessment process the previous year as she did not have an advocate. She said her accommodation was meant to be temporary. The Council said she was asked if she wanted representation when it met with her to complete the care needs assessment, but she had turned that down. It agreed to complete a further assessment of her care needs. It asked its Learning Disability and Autism Team to complete the assessment. It also referred Miss X for independent advocacy support. The case records state it was agreed that advocacy support would start first to ensure Miss X fully understood the care needs assessment process.
43. Miss X had a pre-existing worker supporting her from an advocacy service. They contacted the Council on 4 December stating the Council had not contacted Miss X about the care needs assessment. They also said Miss X had not heard from the independent advocate. The Council responded. It agreed to follow up the referral for the independent advocate. It said a further lockdown caused by the COVID-19 pandemic had impacted on services and as a result, it was responding first to those with the highest level of need. It did not class Miss X as having high needs because she had told the Council Ms D was meeting her care needs. It said if Miss X’s circumstances had changed it could look at a more urgent response.
44. The case records show the Council sent the referral for the independent advocate on 7 December.
45. A new Social Worker, Officer Q contacted Miss X mid-December. They agreed to meet at the start of January 2021 to complete the care needs assessment. Miss X cancelled that appointment, because of a further lockdown. Miss X said she had moved back into Ms D’s property for support with her care neds.
46. Officer Q had ongoing contact with Miss X through January and a virtual meeting took place in February. In addition, an OT contacted Miss X about her accommodation and support needs.
47. Officer Q contacted Miss X about a possible flat in supported accommodation in March 2021. Miss X visited the flat alongside the OT and Officer Q and she confirmed she wanted to live in the flat. Following that, Officer Q completed Miss X’s care needs assessment and contacted a care provider to commission the support Miss X would need. They assessed Miss X as needing 23 hours support a week to help her manage her medication; personal care and nutrition and develop independent living skills.
48. Miss X moved into the new flat on 10 May. Later that month Officer Q reviewed Miss X’s package of care. The Council agreed to increase it to 30.5 a week.

Miss X’s complaint to the Council

49. Miss X complained to the Council in December 2020 about her previous care needs assessment and the delay in arranging the reassessment. She said the support she was receiving from Ms D was not sustainable and that she had to have periods living with Ms D when she could not meet her care needs.
50. The Council responded in January 2021. It said it had discussed the outcome of the care needs assessment with her in 2019. It said based on the information available when it had placed her, it had assessed a ground floor, accessible flat with wet room as appropriate. It said it needed to complete a further care needs assessment, and if she were assessed as having care and support needs, there was a wider range of accommodation available.
51. Miss X emailed the Housing Service in January 2021 with several complaints including the suitability of accommodation, that it changed her housing officer without telling her, had nominated her for a two-bedroomed bungalow, despite knowing she would not be accepted for it and that it had failed to recognise Y as an assistance dog.
52. The Council provided a final response to Miss X’s complaint in May 2021. The Council apologised for not telling Miss X about the change in housing officer. It also apologised for any confusion around Y being an assistance dog and for any unnecessary distress that had caused. It said that once it had learnt of Miss X’s concerns the property was not suitable, it was appropriate for her to have a reassessment of her care needs to inform Housing’s decisions. However, at the time the accommodation was identified it was assessed as the most suitable option available.
53. Miss X remained unhappy with the Council’s response and complained to the Ombudsman.

The Council’s response to the Ombudsman’s enquiries

54. The Council said Miss X’s experience of its services in September 2019 fell short of the standard of practice it would expect. It apologised for not exploring her communication needs with her. It said at the time of Miss X’s adult social care assessment, it used generic teams to complete the assessments. However, since then, it had made significant changes to how it supported adults with autism. It had established a Learning Disability and Autism Team since March 2020 and employed an Autism Practice Lead to support developments in practice and with its commissioned providers.
55. The Council acknowledged that this was not in place when Miss X’s initial assessment was completed in September 2019. It said that may have impacted on the way her care needs assessment was completed, information shared and advice and support provided at the time.
56. The Council said neither social worker completing Miss X’s initial assessment had autism training. It said it was completing a training audit to ensure all staff had completed the autism training.
57. The Council provided information that it now provides to adults before their care needs assessments to help them understand the process and what information they will be asked.

My findings

The care needs assessment

58. The Guidance states there is a legal requirement on Council’s to ensure assessors completing care needs assessments have the relevant expertise in the adult’s condition and where not, to consult with someone with relevant experience.
59. When the Council completed Miss X’s initial care needs assessment in September 2019, neither social worker had autism specific training. They did not speak to an autism lead about Miss X’s assessment. In addition, the Council has accepted it did not consider Miss X’s communication needs when it first met with her. That was fault. It is probable that fault affected how well Miss X was able to participate in the assessment process, and to identify and communicate her support needs.
60. The Guidance states that assessments should be completed over a “reasonable and appropriate” timescale and provide a “full picture” of a person’s needs.
61. The Council finalised the assessment the day after Miss X moved into temporary accommodation. As Miss X had only lived in the flat for one day, that was insufficient time for the Council to properly gauge her eligible needs such as managing her nutrition, maintaining a habitable home and managing tasks such as laundry. The Council should have completed the assessment over a longer period or reviewed the assessment. Its failure to do either was fault.
62. In addition, Miss X told the Council that her condition was variable and that on bad days she faced significant struggles with her personal care. The assessment did not explore the frequency of Miss X’s bad days or the additional support that she would need on those days. The Council should have considered Miss X’s fluctuating needs over a period of time. It failed to do so. That was fault.
63. Given the above, my view is the Council failed to properly assess Miss X’s care needs. If it were not for the fault, it is probable Miss X would have got a care package earlier. The Council has agreed to pay Miss X £1000 to recognise the avoidable distress caused.
64. The Council has established a Learning Disability and Autism Team to support adults with autism needing care act assessments and developed an Autism Practice Lead. Therefore, I do not consider further service improvements are necessary.

The second care needs assessment

65. After the Council met with Miss X on 2 October 2020, it did not contact her until mid-December to arrange her care needs assessment. I have considered the impact of the COVID-19 pandemic on staff capacity and the need to arrange independent advocacy for Miss X before starting the care act assessment. However, the case records indicate the Council did not send the advocacy referral until 7 December. That was two months after Miss X met with the Council. This delay is fault.
66. After the Council contacted Miss X in December 2020, it completed the care needs assessment in April 2021. The case records evidence there was no unnecessary delay in the completion of that assessment. The Council was not at fault.

Suitability of temporary accommodation

67. The information Miss X gave the Council when she first became homeless included a GP’s letter that said she used a wheelchair one or two times a week and that she could not use a bath and required a shower with a seat.
68. The Council provided Miss X with a ground floor, wheelchair accessible flat, with wet room. There was no fault in the Council’s actions.
69. The Council wrote to Miss X accepting it owed her the main homeless duty in November 2019. That letter set out her right to ask for a review if she did not think the temporary accommodation offered was suitable. Miss X chose not to appeal. The Council was not at fault.
70. The Council did not install external ramps to the flat until April 2020, seven months after Miss X moved in. The Council’s delays in ensuring the proper adjustments were made to the building was fault. This caused Miss X avoidable frustration as she was reliant on staff to support her in accessing the building when using her wheelchair.

Review of the suitability of the accommodation

71. Miss X contacted the Council about the suitability of the accommodation in September 2020. The Council took three months to arrange an OT assessment. Given the accessibility difficulties Miss X had stated she was experiencing in the flat, the Council should have completed an OT’s assessment without delay. That would have provided the opportunity to assess whether there were any modifications the Council could make to her temporary accommodation whilst waiting to identify permanent accommodation. Failure to do that was fault.

Not recognising Y as an assistance dog

72. The Ombudsman cannot make a finding on whether the Council unlawfully discriminated against Miss X. Decisions about discrimination are for the Court’s. Therefore, I have considered the information and advice the Council provided Miss X and the housing providers about Y.
73. The Council suggested Miss X register Y as an assistance dog despite Miss X explaining there was no assistance dog register. That was fault. That caused Miss X avoidable frustration.
74. The Council also referred to Y as an unregistered assistance dog in its housing referrals. That was fault. That has caused Miss X avoidable uncertainty as to whether the housing providers would have provided accommodation, if the Council had not referred to Y as unregistered. However, I cannot say that fault prevented Miss X from getting alternative accommodation. It was for the housing providers to decide whether to give Miss X accommodation. The actions of the housing providers are outside of our jurisdiction, therefore I cannot investigate their actions.

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Agreed actions

75. Within one month of my final decision, the Council has agreed to apologise to Miss X and make a payment of £1,200 for the avoidable distress and uncertainty caused by:
• its actions when it completed its initial care needs assessments with her;
• incorrectly advising her to register Y as an assistance dog and referring to Y as an unregistered assistance dogs in its housing referrals; and
• the delays in arranging the reassessment and installing the ramps and not assessing the suitability of her accommodation after she made the Council aware she was struggling.
76. Within two months of my final decision, the Council has agreed to:
• review its training on the Equality Act to ensure it includes information about assistance dogs and the organisations responsibilities in respect of this.

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Final decision

77. There was fault in how the Council completed Miss X’s care needs assessment. It has agreed to my recommendations to remedy the injustice caused. Therefore, I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman