Summary: Z complained the Council failed to adequately assess their care and support needs and this left them without the care and support they required. The Council was not at fault in the way it assessed Z’s needs.

The complaint

1. Z complains the Council has failed to adequately assess their care and support needs and this has left them without the care and support they need.

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The Ombudsman’s role and powers

2. 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)
3. 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/care provider has done. (Local Government Act 1974, sections 26B and 34D, as amended) I have considered what has happened since the Council assessed Z’s needs in February 2020.
4. 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

5. I have considered the information supplied by Z and have spoken to them on the telephone. I have considered the Council’s response to my enquiries including copies of Z’s needs’ assessments and the relevant law and guidance.
6. I gave Z and the Council the opportunity to comment on a draft of this decision. I considered any comments I received in reaching a final decision.

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What I found

Assessing needs

7. 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.
8. To have needs which are eligible for support, the following must apply:
1. The needs must be due to a physical or mental impairment or illness.
2. Because of the needs, the adult must be unable to achieve two or more of the following:
1. Managing and maintaining nutrition;
2. Maintaining personal hygiene;
3. Managing toilet needs;
4. Being appropriately clothed;
5. Being able to make use of the adult’s home safely;
6. Maintaining a habitable home environment;
7. Developing and maintaining family or other personal relationships;
8. Accessing and engaging in work, training, education or volunteering;
9. Making use of necessary facilities or services in the local community including public transport, and recreational facilities or services; and
10. Carrying out any caring responsibilities the adult has for a child.
3. Because of not achieving these outcomes, there is likely to be a significant impact on the adult’s well-being.
9. Where local authorities have determined that a person has any eligible needs, they must meet these needs. When a local authority has decided a person is or is not eligible for support it must provide the relevant person (the adult or carer) with a copy of its decision.

What happened

10. Z has PTSD and atypical autism. Z has made frequent contact with the Council about their concerns. The following does not detail all contact and does not show everything that happened but provides an overview of key events.
11. In February 2020 Z met with a social worker along with a friend and two housing support workers from a charity. The social worker noted Z said they were struggling to cope. Z wanted support to move to another council area to a residential community. The social worker advised the support workers could assist with the move. Z stated they were victimised as they were unable to attend a support group, group B, they had attended previously. (Z had attended group B in 2018 but had been banned from attending). Z wanted an investigation into the ban. The social worker advised the Council had considered this in 2018 when it occurred but was satisfied it was not a safeguarding matter. It was a private organisation and the Council could not get involved in its decision.
12. The social worker noted Z had been referred to the personality disorder network for an assessment and that Z stated they self-harmed. The social worker advised Z to speak to the crisis team if they felt suicidal or were going to self harm. The social worker provided Z with a copy of the Leeds care directory to consider if there was other support they may want to consider accessing.
13. The personality disorder clinical network completed an assessment of Z in July 2020 to determine whether it could offer Z suitable support. It noted at the outset Z did not feel the service was the right service for them as they did not identify with a personality disorder diagnosis and the assessment did not consider it was a suitable intervention for Z. It noted ‘there was a growing reality that an agency or individual equipped to meet [Z’s] needs in quite the way they hoped was unlikely to exist’. It noted Z described a need for someone to fulfil a personal assistant role and this might be helpful but would need to be structured carefully.
14. In October 2020 the Council received a referral from an agency for personal care support for Z. It telephoned Z who said they did not need personal care support but requested support from a social worker. In a further phone call Z said the crisis team had referred them to the ambulance service and later to adult social care. Z said they were scared to go to their flat due to flashbacks following a previous abusive relationship. They said they left the flat in the early morning and did not return until late. The Council agreed to allocate the case to a social worker.
15. The social worker visited Z in October 2020. They found Z’s flat clean and tidy with secure windows and door. They noted Z wanted to move flat and was being supported by housing support workers and a worker from a charitable organisation. Z felt a house move would help them recover. The social worker decided Z did not have care and support needs. They noted Z wanted to be able to attend support group B. The social worker agreed to contact support group B to clarify the position.
16. The social worker met with Z in early November 2020 to assist with preparing a list of things they needed help with which the charitable organisation may be able to assist. The social worker updated Z they had spoken to group B which would not overturn the ban. The social worker spoke to the allocated worker from the charitable organisation. The social worker noted the worker was trying to assist Z but Z refused to engage in any meaningful way and so they were not able to provide Z with support.
17. Group B wrote to Z in November 2020 to reiterate that it could not support Z. It said it staff were not effectively qualified to meet Z’s needs and it did not have the supervision ratios to support their attendance at group B.
18. Z called the Council distressed and tearful on several occasions. It advised Z to contact the crisis team or an ambulance if they were going to hurt themselves. Z wanted to meet face to face to discuss their safeguarding concerns. The social worker met with Z in late November 2020. Z again raised concerns about their ban from group B and the lack of support. The social worker referred Z to an agency to provide privately funded support. Z says they did not have the skills to set this support up.
19. In December 2020 the social worker arranged for a personal assistant who could provide some privately paid support to Z. In late December, Z called the Council distressed when the personal assistant failed to attend. The social worker contacted two other agencies to try and identify support and one agreed to contact Z.
20. The social worker arranged to meet Z in January 2021 and completed an assessment, taking into account information from other agencies, contacts over the previous months and their meetings with Z. They noted Z had received support from a worker at the charitable organisation but it was unable to sustain that level of support in future. Z wanted support with accessing the community, everyday tasks such as shopping and appointments and activities to keep them busy. They noted Z was very anxious and of low weight as Z found the process of eating ‘complicated’. Z struggled to go to the shops to buy food and struggled to plan meals. Z managed their own personal care but said they struggled to shop to buy items needed to complete these tasks.
21. The social worker noted Z’s flat was safe but Z did not feel safe there because of noses from outside or within the complex. Because of this Z went on long walks and felt more calm in open spaces in nature. They discussed Z using a firm to support with domestic tasks but Z declined as they said they could not be in the flat in the day time. Z managed their own finances using internet banking.
22. Z wanted to be able to go shopping and complete tasks with someone as this made them feel more secure in enclosed spaces. The social worker noted Z was able to go to certain supermarkets alone. They noted Z wanted to challenge the ban from support group B even though the group had explained the reasons for the ban. They noted Z had support from workers from two charities. They noted Z was offered a personal assistant by the Council in March 2019 but had declined to engage with workers as Z would not allow them in the property so this ended after two months.
23. The social worker concluded Z was independent with all daily tasks. Z was able to shop independently, was fully mobile, was able to access public transport and attended a walking group. Z could access services such as the GP, ambulance service and the voluntary sector without support. Z could manage their own finances and could communicate by phone and vocalise their concerns.
24. In the case notes, the social worker noted they had tried to assist Z to resolve their housing issue and Z had support to bid for properties but a house swap had not gone ahead. Z had also turned down two offers. They had referred Z to a support service which declined to support Z due to Z’s mental health. They referred Z to an agency to provide a private support package which may be able to assist. They noted they had not identified any care and support needs and felt able to discharge Z by signposting them to other services. The social worker emailed Z to confirm they had ended their support.
25. At the end of the meeting Z said they had a panic attack outside the building and the social worker left them on the floor. The police attended.
26. Z contacted the social worker’s team manager a few days later. Z said they had back pain and an ambulance had taken them to the GP. Z was also upset about the meeting with the social worker and felt it unfair that they had ended their involvement. The manager explained Z could make a complaint if they were unhappy. The Council also texted Z to reiterate the information provided by the social worker including details of the care provider they had suggested, the details of the crisis team and that Z should contact the GP about the back pain.
27. The Council received a referral for an assessment from Z’s GP. It advised the GP it had assessed Z earlier that month and found no role for adult social care at that time. Z also made a self referral to the Council. It telephoned Z and reiterated what it had previously advised. The Council received several other referrals and noted there was no new information in the referrals.
28. In February 2021 Z complained to the Council about their social worker and the lack of support they had received from the Council’s social care services. The Council responded in March 2021. It noted the social worker had assessed Z’s needs in October 2020 and did not identify any unmet care needs. The social worker had agreed to contact support group B to see whether it would accept Z following the previous ban. However, support group B advised the social worker this was not possible. It noted the social worker suggested referrals to other organisations but Z declined these. It referred to the incident following the meeting in January 2021 and that the social worker’s recollection was different to Z’s. The social worker’s team manager also phoned Z to discuss the response.
29. Z remained unhappy and asked to escalate the complaint. Z was unhappy they continued to be banned from the support group. The Council responded at the next stage of its procedure in early May 2021. It reiterated it had not identified Z had any eligible needs for care and support. The social worker had provided details of an agency who could support Z privately if they wished to pay for support. It reiterated it could not influence the decision of support group B to ban Z. The Council explained the social worker closed the case as they had covered the issues Z had raised. It noted Z was unhappy the social worker had left them on the floor after the January meeting and acknowledged this must have been stressful. It noted Z had support from other agencies to assist with a housing move and a nominated contact with a local charitable organisation. Z remained unhappy and contacted us.
30. In August 2021 an officer from the Leeds Autism Diagnostic Services contacted the social worker. They advised Z had autistic traits and wanted to refer Z for support. The social worker noted the officer was unable to identify what specific support or service could be put in place for Z.

Findings

31. It is not the Ombudsman’s role to decide what, if any, care and support a person needs. That is the Council’s role. The Ombudsman’s role is to consider if the Council has followed the correct process in assessing a person’s needs.
32. The social worker assessed Z’s needs over four months. They considered information from other professionals and concluded Z did not have eligible needs for care and support. There is no evidence of fault in the way they reached that decision. They signposted Z to other agencies, which was appropriate.
33. The Council received referrals from other agencies. However, the Council had already assessed Z’s needs and was satisfied the referrals did not contain new information or raise new issues it had not already considered. It decided Z did not require a new assessment. This was a decision the Council was entitled to make and there was no evidence of fault in the Council’s actions.
34. Z wants to attend support group B and repeatedly sought assistance from the Council with this. It was the decision of support group B to ban Z, not the Council. Support group B is outside the jurisdiction of the Ombudsman and I cannot investigate its actions. The social worker supported Z by contacting support group B to explore if this could be lifted. Support group B remained of the view it could not meet Z’s needs. Support group B is independent of the Council and the Council cannot alter the support group’s decision no matter how much Z disagrees with it. The Council was not at fault.

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Final decision

35. I have completed my investigation. There was no evidence of fault by the Council.

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Investigator's decision on behalf of the Ombudsman