Bolton Metropolitan Borough Council (21 002 888)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 25 Apr 2022

The Ombudsman's final decision:

Summary: Ms X complains that the Council did not take account of her fluctuating needs when it assessed her care needs. There was fault by the Council because it did not provide her with information she requested as a reasonable adjustment, despite a commitment to do so. However, we do not find this fault caused a significant injustice that warrants a remedy.

The complaint

  1. I refer to the complainant here as Ms X. Ms X says the Council did not take account of her fluctuating needs when it assessed her care needs. Ms X also says the Council failed to make reasonable adjustments to allow for her disabilities and sight conditions and imposed unreasonable deadlines for her to respond to it.
  2. Ms X wants the Council to provide a needs assessment which is truly reflective of her needs. She also wants reasonable adjustments to be made to take account of her disabilities.

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The Ombudsman’s role and powers

  1. The Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or may decide not to continue with an investigation if we decide:
  • there is not enough evidence of fault to justify investigating, or
  • any fault has not caused injustice to the person who complained, or
  • any injustice is not significant enough to justify our involvement, or
  • we could not add to any previous investigation by the organisation, or
  • further investigation would not lead to a different outcome, or
  • we cannot achieve the outcome someone wants, or
  • there is another body better placed to consider this complaint,
  • it would be reasonable for the person to ask for a council review or appeal.

(Local Government Act 1974, section 24A(6))

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How I considered this complaint

  1. I considered the complaint and background information provided by Ms X and the Council. I discussed matters with Ms X by telephone. I sent a draft decision statement to Ms X and the Council. I considered the comments of both parties on it. I revised my draft decision statement. I again revised my draft decision statement following further comments from both sides. I considered Ms X’s further comments.

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What I found

The Care and Statutory Support Guidance

  1. The guidance sets out how local authorities should go about fulfilling their responsibilities under the Care Act 2014.
  2. The Guidance says that an assessment should be carried out over an appropriate and reasonable timescale, taking into account the urgency of needs and considering any fluctuation in them.
  3. With regards to fluctuating needs, paragraphs 6.58 states that “As the condition(s) of the individual at the time of the assessment may not be entirely indicative of their needs more generally” and that “In establishing the on-going level of need local authorities must consider the person’s care and support history over a suitable period of time…”
  4. Paragraph 6.59 goes on to state that “The assessment should also include a consideration of the individual’s wider care and support needs. This may include types of care and support the individual has received in the past and their general medical history, which may be indicative of their current care and support needs.”

The Ombudsman’s own guidance

  1. We expect councils to complete assessments in a timescale that is proportionate to the complexity of the issues, and normally within 28 calendar days. Councils should tell the individual how long their assessment will take and keep them informed about this throughout the process.
  2. If it is a particularly complex assessment then the council should tell the person how long it is likely to take. If, during the course of an assessment, it becomes clear more time is needed, the council should explain this to the person.

Background

  1. The Council started a needs assessment of Ms X in 2019. Ms X felt the social worker did not include her fluctuating needs in the main body of the assessment and so she challenged the draft produced by the social worker.
  2. Ms X also challenged further drafts produced by the social worker because of errors in the documents or the continuing failure to note her fluctuating needs. This culminated in an appeal in late 2020.
  3. The Council provided us with a chronology of its dealings with Ms X. Its integrated services manager met with Ms X at the start of the assessment to explain the assessment would be conducted over several sessions so the Council could get an accurate picture of her needs and how she was affected.
  4. Ms X asked the Council to include information from her GP and other consultants who had been involved in her case. This took some time for the Council to gather information from them. The Council also obtained input from an occupational therapist and physiotherapist.
  5. Ms X required 21 to 28 days to review any draft of the needs assessment produced by the social worker. When Ms X disputed how information about her needs was documented, in particular where reference to her fluctuating needs was put. The social worker explained why the information was recorded in that way. There were five versions of the needs assessment produced before the Council proceeded to a final document.
  6. Ms X appealed against the outcome of the needs assessment. The Council did not uphold Ms X’s appeal. It considered the assessment of Ms X’s needs was satisfactory. However, it accepted there was a considerable disagreement on the matter and so it offered Ms X the option of a new assessment to be done by external assessor independent of the Council.
  7. Ms X asked the Council to provide her with an audio recording of the appeal hearing. This was requested as a reasonable adjustment under the Equality Act 2010, to support Ms X’s visual impairment. The Council said it would do so but it later told Ms X there were technical reasons why it could not provide her with a recording.
  8. Prior to the appeal hearing, Ms X had asked the social worker to provide correspondence in large print and to ensure attachments such as pdfs were not attached to emails sent to her because she had difficulty accessing them. Ms X says the social worker still wrote to her with attachments which she was unable to read.

Finding

  1. I do not find fault with the Council’s conduct of the needs assessment. It is clear the Council took the necessary steps to ensure it understood Ms X’s needs before it completed the assessment. The assessment took time but the time was necessary to ensure it responded to Ms X’s various requests.
  2. Ms X is now due to be assessed again. It is for the Council to now decide whether it will proceed with an external assessor to conduct the assessment.
  3. I find fault because the Council did not provide Ms X with a copy of the audio recording of the appeal hearing. Ms X had an expectation she would get the recording which was unfulfilled. However, I do not now find the unfulfilled expectation led to significant injustice that warrants a remedy from, the Ombudsman, as the Council was able to provide written minutes of the meeting as a substitute.
  4. I note that Ms X still referred to difficulties accessing information she wanted from the Council. The Council says it took account of Ms X’s requests for information and made reasonable adjustments for her. On the whole, I am satisfied the Council made adjustments for Ms X. However, these efforts were not always successful because Ms X continued to complain about information not been available or difficulties she had gaining access to information.
  5. It is for the Council to note the problems she has with communications. It should then record any reasonable adjustments it will make and ensure the record is available to officers in the adult social care department who deal with Ms X.

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Final decision

  1. There was fault by the Council with regards the failure to provide the promised audio recording. However, this complaint is closed because we do not find the fault caused a significant injustice to Ms X.

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Investigator's decision on behalf of the Ombudsman

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