Summary: Mrs Y complained about the Council’s assessment of her support needs. We have found fault by the Council in its delay completing one of the assessments. The Council should remedy this by making a payment to reflect the distress this caused Mrs Y.

The complaint

1. The complainant, who I am calling Mrs Y, complains about the way the Council carried out its assessments of her care needs and responded to her requests for support. She is also unhappy about the way in which its social care teams dealt with her case. She says:

• Her children’s social worker denied she needed physical support to care for her baby.
• Her social worker handled her case irresponsibly and lied in responses. This led to a Child Protection Plan being put in place.
• The Council’s Adult Social Care team discriminated against her.
• She did not hear from Children’s Services about support provision.
• The Council’s complaint response did not address her points 6, 9, 11 and dismissed her rights at point 12 – to have an advocate at her assessment.

2. Mrs Y says the Council failed to provide her with the support she needs, as a disabled parent, to care for her children. Because of this, she has been unable to achieve her desired outcomes in daily life, impacting her physical and mental health. She has had to pay for essential support herself.

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The Ombudsman’s role and powers

3. 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)
4. 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)

5. 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

6. I spoke to Mrs Y’s representative, made enquiries of the Council and read the information Mrs Y and the Council provided about the complaint
7. I invited Mrs Y and the Council to comment on a draft version of this decision. I considered their responses before making a final decision.

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What I found

Relevant law and guidance

Adult social care

8. Councils must carry out an assessment for any adult with an appearance of need for care and support. 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 involve the individual and where suitable their carer and any other person they may want to involve. (Care Act 2014, Sections 9 and 10)
9. A council must carry out the assessment over an appropriate and reasonable timescale considering the urgency of needs and any variation in those needs. It should keep the person updated throughout the assessment. (Care and Support Statutory Guidance 2014, Paragraph 6.24)
10. If the needs assessment identifies eligible needs, the council will provide a support plan setting out what services are required to meet these needs.

Concerns about a child’s welfare

11. The Children Act 1989 and statutory guidance Working Together to Safeguard Children set out councils’ responsibilities for safeguarding children, and that the child’s needs and welfare are paramount.
12. In response to concern a child may be at risk of ‘significant harm’ (which can include emotional abuse) a council must make enquiries to establish the child’s situation and whether protective action is required. (Children Act 1989 section 47)
13. Once a council has gathered information, which may involve all agencies who work with a child and the family, it must decide what action to take. This may include a Child Protection Conference.

Greater Manchester Safeguarding Children Procedures

14. The Council has adopted the Greater Manchester Safeguarding Children Procedures (GMSCP) based on the Working Together guidance. This sets out the approach which all those working to safeguard and promote the welfare of children must ensure their practice reflects.
15. The GMSCP says the initial Child Protection Conference should bring together family members, the child where appropriate, supporters/advocates and those professionals most involved with the child and family. Its purpose is to share information, assess risks and formulate an agreed plan of management and services with the child’s safety and welfare as the paramount aim.

Equality and discrimination

16. The Equality Act 2010 protects the rights of individuals and supports equality of opportunity for all. It 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. The ‘protected characteristics’ include disability.
17. Direct discrimination occurs when a person or service provider treats another less favourably than they treat or would treat others because of a protected characteristic. Direct discrimination is generally unlawful.
18. Indirect discrimination may occur when a person or service provider takes the same approach to decision making or service provision for everyone. This may then put people sharing a protected characteristic at a particular disadvantage.

What happened

19. I have set out a summary of key events below. It is not meant to show everything that happened.

December 2019 to June 2020

20. Mrs Y’s first contact with the Council’s Adult Services team was in December 2019. Mrs Y told the team she suffered chronic pain due to fibromyalgia. She was experiencing pain in her neck and back, affecting her ability to carry out daily tasks, including lifting. Mrs Y was a single parent with a young child and expecting a baby.
21. The Council’s Early Intervention Service carried out an assessment. Mrs Y was provided with support from an Occupational Therapist.
22. Mrs Y was concerned about her physical ability to manage the care of a new baby. She was referred to the Council’s Adult Social Care (ASC) Team.
23. An ASC social worker completed a supported self-assessment of her needs with Mrs Y in March and agreed a support plan. This provided Mrs Y with two hours of support a day to help with meal preparation, maintaining the home, shopping and attending appointments. The Council commissioned a care agency to provide the support.
24. Mrs Y stayed with family when her baby was born. The support package resumed when she returned home in June.

June to December 2020

25. In addition to the ASC social worker, a number of other professionals worked with Mrs Y before and after her baby’s birth, including a public health midwife, the Perinatal Mental Health Team and its consultant psychiatrist, Occupational Therapists, a Home-Start volunteer and a Children’s Services (CS) social worker. A specialist community public health nurse began visiting Mrs Y after the midwife’s role ended. The Council’s records show the professionals were in regular contact with each other and with Mrs Y about her support needs.
26. The ASC social worker arranged for a reassessment by an Occupational Therapist now Mrs Y was at home with her child and new baby. She also referred Mrs Y to the Chronic Fatigue Team and Chronic Pain Service for help with pain management. Additional hours were added to the support plan to support Mrs Y transferring her baby upstairs.
27. The Occupational Therapist completed her assessment in June 2020. She considered Mrs Y’s issues with fibromyalgia, chronic widespread pain syndrome, depression and anxiety. She recommended equipment and strategies to help Mrs Y manage and carry out practical day-to-day tasks and ordered appropriate equipment for her.
28. The ASC social worker carried out a review of her needs with Mrs Y on 30 July. Mrs Y had said she was having to spend time in bed because she was in a great deal of physical pain, making it very difficult for her to mobilise. She was struggling with meal planning and preparation and food shopping. They discussed changes already made to the support plan to provide more structure with daily plans, menus, shopping. They also discussed the evening visit, put in place temporarily to support Mrs Y carrying the baby upstairs, while work with Mrs Y was ongoing to help her do this herself. Mrs Y said the evening visit provided her with routine emotional and practical support.
29. Following the review, a new support plan was agreed increasing the support from two hours to three hours every day, with the hourly evening visit being made permanent as Mrs Y had requested.
30. Children’s Services put a Child in Need plan in place. It also referred Mrs Y to its Family Group Conference Service to identify family support available to supplement the support commissioned by ASC. A number of Family Group Conferences, with Mrs Y and her family, were held from September to December 2020.
31. The care agency providing support since before the birth of Mrs Y’s baby, told ASC it could no longer meet the needs of the support package, which now included carrying and bathing children. This was because it was not registered to provide support to children. It agreed to continue to support Mrs Y until a new provider was commissioned.
32. Another agency was able to take over the support package in September. Shortly after this, it contacted ASC to ask for an urgent increase in the care package. It told ASC Mrs Y had hurt her back, was bedbound, struggling with pain and could not hold the baby. The ASC social worker discussed additional support with Mrs Y and also suggested she contact her GP about pain relief. ASC agreed to provide a further three hours of support a day, in addition to the three hours already being provided (a total of six hours a day) as a temporary measure, pending a reassessment of Mrs Y’s needs.
33. The ASC social worker visited Mrs Y on 28 September to begin the reassessment of her needs. Mrs Y’s advocate and a friend were there with her. A supported self-assessment was completed with Mrs Y. This identified a number of changes and noted what Mrs Y said about struggling more with pain and managing daily activities, and also that her older child was worried about Mrs Y and had been upset. They discussed specialist input and support for pain management to help Mrs Y move forward and engage in functional tasks and daily life. The ASC social worker followed up the referral to the Pain Clinic. She told the clinic Mrs Y was really struggling with pain which was having a massive impact on her daily living tasks. She contacted Mrs Y’s GP about her pain and its impact on Mrs Y.
34. The ASC social worker sent Mrs Y the draft reassessment on 30 September. On 5 October Mrs Y confirmed she was happy with the assessment and wanted to thank the social worker. She also noted a few points she wanted to check and update. Mrs Y and her advocate then corresponded with the social worker about parts of the assessment and Mrs Y’s ability to achieve certain outcomes.
35. As at 21 October, the reassessment had not been agreed. The social worker confirmed the temporary additional hours (giving Mrs Y a total of six hours of support a day) would continue while the assessment process was completed. The social worker proposed a further visit to discuss the reassessment with Mrs Y and her advocate.

December 2020 to February 2021

36. Mrs Y’s ASC social worker was away from work from the end of October. In December, when, the Council says, it became clear her return to work might be delayed, another ASC social worker was asked to complete the reassessment. The new social worker was not able to speak to Mrs Y but spoke to her advocate. The advocate said the delay in completing the reassessment had caused Mrs Y worry and upset. The social worker explained she would need to carry out her own assessment, as it had been some time since the previous social worker’s visit at the end of September.
37. The social worker proposed a home visit with Mrs Y and her advocate in early January 2021. She said she would be assessing Mrs Y’s level of needs in her own right as an adult and her ability to meet the needs of her children would be considered as part of a joined-up approach with Children’s Services
38. The ASC social worker visited Mrs Y at home in January. Mrs Y’s advocate and two friends were also there. They discussed the carers’ role of supporting Mrs Y with her parenting tasks. Mrs Y said the pain prevented her from carrying out tasks such as lifting the baby and giving him breakfast.
39. The social worker discussed the assessment with Mrs Y by phone and sent her the completed supported self-assessment and proposed support plan on 18 January. The plan was for 15 ¼ hours of support a week. This provided two hours of support every day with carrying the baby downstairs in the morning and upstairs in the evening, preparing meals at breakfast, lunch and tea, and one and a quarter hours every week for an online shop. The social worker’s view was this met Mrs Y’s identified needs under the Care Act, taking into account the information she had provided.
40. Mrs Y disagreed with the needs assessment and support plan. She told the Council on 1 February she was unhappy at the way she had been treated by its social workers. She had a non-visible disability of constant pain and had not been provided with the support she needed. There had been no action since the re-assessment was started in September 2020. Support had been withdrawn without completing the needs assessment and Children’s Services had moved her case to Child Protection without telling her why. The Council treated this as a complaint.
41. On 26 February Children’s Services held a multi-agency initial Child Protection Conference with a number of professionals working with Mrs Y and her family. Mrs Y and her cousin were also at the meeting. Concerns were raised about the impact on Mrs Y’s children of observing her health needs and the possibility of them becoming young carers.
42. The professionals at the conference concluded there was a risk of harm to the children, under the category of emotional abuse. Children’s Services put a plan in place to support Mrs Y and the children. This included funding for after school clubs and a family support worker to work with Mrs Y. Further reviews have taken place since then and based on the progress made since February, I understand it is planned to step the case back down to Child in Need or Early Help support.

March to April 2021

43. The Council responded to Mrs Y’s complaint on 24 March 2021. It said it had investigated her concerns and found no evidence to suggest Children’s Services or ASC had discriminated against her or dismissed her health conditions. Its ASC social workers had worked with her to properly assess her eligible needs under the Care Act and commissioned adequate support to meet her identified needs.
44. On 30 March Mrs Y asked for a new social worker who would carry out a fair and accurate needs assessment. She said her health had deteriorated because of an unfair assessment based on false information.
45. Mrs Y moved in early April. She asked for her case to be transferred to the Council’s ASC team for her new area. This was arranged by the Council.
46. Mrs Y complained to us on 26 April.

Analysis – was there fault by the Council causing injustice?

The social care teams’ work with Mrs Y

47. There were discussions about Mrs Y’s health issues and conditions, the impact of these on her ability to carry out some of her parenting tasks and how best to support her. It is part of the role of a professional, such as a social worker, to consider relevant information and come to a view about the impact of health issues on a person and their ability to carry out certain tasks, and appropriate support. I do not consider there is evidence the Children’s Services social worker denied Mrs Y needed physical support to care for her baby.
48. The records I have seen show a number of professionals had concerns in early 2021 about the impact of Mrs Y’s health issues on her children. The discussions about these concerns, as well as the positive aspects of Mrs Y’s parenting, are in the minutes of the Child Protection Conference. The minutes confirm the Child Protection Plan was put in place because of the concerns of all the professionals. I have not seen any information indicating either the Children’s Services or ASC social workers handled Mrs Y or her children’s case irresponsibly or lied in responses.
49. In my view, the information I have seen shows the ASC team went to great lengths to understand Mrs Y’s health issues and source appropriate help and support for her, including pain management, practical help with parenting tasks, as well as commissioning the support package.
50. It arranged a significant temporary increase in her support package in September 2020, in response to what she had told her ASC social worker about the increase in her pain levels. This was kept in place until an updated assessment was completed in January 2021.
51. My view is the evidence shows the Council had due regard to its duties under the Equality Act when considering Mrs Y’s needs as a disabled person. Its assessments included a section about the help Mrs Y needed to play a full role as a parent or carer and these needs were considered as part of her assessment and the support plan. I have seen no evidence the ASC team discriminated against Mrs Y.
52. I have not found fault in the way the Council’s social care teams dealt with Mrs Y.

ASC support

53. I understand Mrs Y felt at times she was not provided with enough support. It is not my role to decide what Mrs Y’s needs were or the level of support which should have been provided. My role is to look at how the Council dealt with Mrs Y and whether, in my view, it carried out proper assessments of her needs and proposed support plans after proper consideration of her identified needs.
54. The ASC team carried out self-supported assessments with Mrs Y before her new baby was born, and again in July after the baby had arrived, together with a full assessment by an Occupational Therapist. The information I have seen shows Mrs Y was fully involved in the discussions and provided with details of the assessments and the support plan. Her comments about the support provided by the temporary evening visit were considered and included in the new support plan.
55. The ASC social worker responded immediately to the urgent request in September 2020 for a temporary increase in support because of a change in Mrs Y’s condition. She promptly began the reassessment process, and Mrs Y arranged for her advocate to be present at the first home visit.
56. There was a delay of some eight weeks – from October to December 2020 - in the re-assessment process, because the social worker was away from work unexpectedly. I have not seen any evidence the Council took steps to review the position or update Mrs Y before allocating her case to another social worker in December. I consider this was fault by the Council.
57. Although the extra temporary support remained in place, I appreciate the uncertainty due to the delay caused Mrs Y additional worry and upset during this period.
58. I consider the new ASC social worker completed the assessment promptly. She carried out a home visit at which Mrs Y’s advocate and her friends were present, obtained information from Mrs Y’s GP, and considered information provided by Mrs Y and her advocate. She discussed the assessment with Mrs Y by phone, before completing this, and provided Mrs Y with a copy of the assessment and proposed support plan.
59. I appreciate Mrs Y disagreed with the proposed level of support. But, based on the evidence I have seen, my view is the Council followed the proper process and procedures, taking into account its duties under the Care Act, when assessing Mrs Y’s needs and proposing the support it decided was appropriate for her identified needs.
60. Save for the delay referred to in paragraph 56, I do not consider there was fault in the way the Council assessed Mrs Y’s needs and proposed support plans.

Children’s Services support

61. The information I have seen shows a Children’s Services (CS) social worker worked with Mrs Y and her children from the outset, in response to Mrs Y’s concerns about the impact of her health issues on her physical ability to carry out certain parenting tasks. The CS social worker made regular home visits, there were regular Child in Need meetings, and Family Group Conferences, with which Mrs Y was involved. Support plans were put in place following these meetings, and the Child Protection Conference with which Mrs Y was also involved.
62. In my view, the information shows Children’s Services properly followed the safeguarding procedures, taking into account its duties under the Children’s Act. It consulted with professionals, Mrs Y and others involved with the family and considered the children’s needs, safety and welfare when making decisions about appropriate support for them.
63. I have not found fault by the Council in the way it made decisions about the support provided by Children’s Services for the children and Mrs Y.

Council’s complaint response

64. I have reviewed the Council’s response of 24 March 2021 to Mrs Y’s complaint. The response was from a service manager who confirmed they had examined the social care teams’ records and interviewed the ASC and Children’s Services officers involved. I note Mrs Y considers it did not fully address some of her points but in my view, it provided a substantive reply to her concerns, including an apology for the delay in completing the re-assessment at the end of 2020.
65. I do not consider there was fault in the way the Council responded to Mrs Y’s complaint.

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Agreed action

66. To remedy the injustice caused by the above faults, and within four weeks from the date of our final decision, the Council has agreed to:

• pay Mrs Y £100 to reflect the avoidable distress and worry its delay in completing the assessment at the end of 2020 caused her.
• This figure is a symbolic amount based on the Ombudsman’s published Guidance on Remedies.

67. The Ombudsman will need to see evidence this action has been completed.

Final decision

68. I have found fault by the Council, as set out in paragraph 56 above, causing injustice. I have completed my investigation on the basis the Council will carry out the above action as a suitable way to remedy the injustice.

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Investigator's decision on behalf of the Ombudsman