Summary: the Council was not at fault in its refusal to provide care and support to Ms B. There was no fault in how it made its decision, so we cannot question the decision itself.

The complaint

1. The complainant, whom I refer to as Ms B, complains that the Council decided she was ineligible for social care support following an assessment in February 2020.
2. Ms B says the Council failed to properly recognise the difficulties her condition (a form of dermatitis) causes her.
3. Ms B says she wants a care package in place, and wants a direct payment so she can arrange her own care.

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What I have investigated

4. I have investigated the Council’s decision, following an assessment in February 2020, that Ms B was ineligible for support.
5. I have not investigated any previous decisions because they are overridden by the 2020 eligibility decision. I have, however, included information dating back to 2018 for context.

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The Ombudsman’s role and powers

6. 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)
7. 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

8. I considered information from Ms B and the Council. Both parties 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

What happened?

9. In 2018 the Council arranged reablement care for Ms B. Reablement care is provided for a limited period to assist a person to regain the ability to live independently. In Ms B’s case, she had reported dermatitis, depression and anxiety.
10. Ms B then told the Council her carers could not wear gloves because she was allergic to them (as part of her dermatitis diagnosis). She said the carers could only wear gloves which did not contain methylisothiazolinone (MI) or nickel. She said she had a ‘type I delayed reaction’ – anaphylaxis – to nickel and MI, which she said were found in latex gloves
11. The Council sought medical evidence about Ms B’s condition, and her GP forwarded three consultant letters:
• The first, dated June 2017, said Ms B was sensitive to nickel sulphate (found in cheap metals) and allergic to MI (often found in cleaning products). She was not allergic to latex or nitrile gloves.
• The second, dated March 2018, said Ms B’s allergy to MI was level 4 (the lowest level).
• The third, dated November 2018, said Ms B had a ‘type IV hypersensitive reaction’ to nickel and MI. Type IV means it is delayed for a period of up to 2 or 3 days after contact. The letter said this would be completely different to anaphylactic shock and there was no risk of anaphylaxis to Ms B. It said there is no such thing as delayed anaphylaxis.
12. In May 2019 the Council gave Ms B information about the gloves its carers used. This confirmed the gloves contained neither MI nor nickel. However, Ms B continued to say the gloves would trigger her allergies, and refused to allow carers to visit. The Council said it would not agree a direct payment or ongoing care until its reablement team had been able to decide whether her needs were longer-term.
13. In November 2019, after further communication from Ms B, the Council agreed to conduct a new needs assessment with a new social worker. This assessment took place in February 2020 and was completed after a visit to Ms B’s home.
14. The Council decided that:
• Ms B’s view of her condition was contradicted by medical evidence.
• her dermatitis and personal care appeared well-managed.
• she managed to travel to the Philippines despite saying her condition prevented her leaving the house.
• she did not consider it necessary to check the ingredients in washing powder, despite saying carers could not come round because of the gloves they wear.
• although she had agreed to reablement care as long as carers wore gloves without certain chemicals in them, contacting every single glove manufacturer to find out the gloves’ ingredients would not be a proportionate use of the reablement team’s time.
• her needs could be met with low-level council, NHS and housing services without the need for social care support.
15. For these reasons, the Council decided Ms B was not eligible for any care or support services (including reablement).

My findings

16. It is not my role to decide whether Ms B should receive care or support. Nor can I decide how serious her medical conditions are. What I must decide is whether the Council acted properly in refusing to provide services, and whether its decision-making was consistent with the evidence at hand.
17. The medical evidence I have seen, as summarised above, supports the Council’s conclusions in its assessment. And the observations made by the social worker about the appearance of Ms B and her home during the assessment visit were a matter of professional judgement which I see no reason to question. Certainly,
    Ms B has not provided reasons why I should view the social worker’s observations as unreliable.
18. This comes down to a straightforward disagreement between Ms B and the Council about whether her dermatitis is serious enough to make her eligible for care and support. The Council made its decision, and adequately justified it. As a result, I have found no fault with how the Council acted in refusing to provide services.
19. As I have found no fault in how the Council made its decision, I cannot question the decision itself, so I have completed my investigation.
20. Since approaching the Ombudsman, it appears Ms B has commissioned an independent medical report and provided this to the Council (which, in turn, has sent it to me).
21. It is not for me to comment on the conclusions drawn by the report. If the Council feels the report justifies a reassessment of Ms B’s needs, then it should follow correct procedure in doing so. If not, then it should contact Ms B and explain why. If Ms B is dissatisfied with the Council’s decision, she can make a new complaint.

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Final decision

22. The Council was not at fault in its refusal to provide care and support to Ms B. There was no fault in how it made its decision, so I cannot question the decision itself.

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Investigator's decision on behalf of the Ombudsman