Summary: There was no fault in how the Council assessed Ms X’s care and support needs.

The complaint

1. Ms X complains the Council has refused to provide the required level of support to meet her assessed care needs. She says this is causing her distress and putting her at unnecessary risk, as she is not getting the support she needs.
2. She wants the Council to review her care needs assessment and increase her care and support package to meet her needs.

Back to top

The Ombudsman’s role and powers

3. 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)
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)

Back to top

How I considered this complaint

5. I read Ms X’s complaint and spoke with her about it on the phone. I also considered information she provided.
6. I made enquiries of the Council and considered information it sent me.
7. Ms X and the Council had the opportunity to comment on the draft decision. I considered their comments before making a final decision.

Back to top

What I found

Background information

8. The Care Act 2014 requires councils to carry out an assessment for any adult with an appearance of need for care and support. If a council decides a person has eligible needs, it must set out how it is going to meet these needs in a care and support plan.

What happened

9. Ms X has health conditions and care and support needs. She lives at home with her family. The Council has been providing Ms X with care and support for several years by way of a direct payment. A direct payment allows Ms X to arrange her own care, rather than the Council arranging it for her.
10. In May 2020, Ms X’s assessed care needs were for nine hours of care support per day and “sleep-in” support each night. The Council says a sleep-in support worker would be expected to provide up to two periods of support each night, with each period lasting no longer than 30 minutes. She also had some additional day time support hours which she could use flexibly, for example, during school holidays.
11. Ms X told the Council she needed three more hours per day to meet her care and support needs.
12. The Council reviewed Ms X’s care and support plan in June 2020. The review states Ms X told the Council the care and support plan accurately reflected her needs, but she felt she needed more support during the night to meet her needs. The Council asked Ms X to complete a night time diary over a two-week period, listing what night time support she was receiving. Ms X did this and provided this to the Council. The review states Ms X told the Council the diary represented the typical variance in her night time support. Ms X has told us her needs fluctuate and can vary significantly between nights and over time.
13. The Council considered the night time diary. The diary showed that, over the two-week period, Ms X received one hour and 40 minutes care support over and above what it would expect a sleep-in support worker to provide. It concluded she should be offered one additional waking night support hour per week, to account for this.
14. It told Ms X of its decision. Ms X was unhappy with this and provided further medical information to support her request for increased waking night time support. The Council reviewed its decision but did not change its position. It increased her care package to include one hour additional waking night support per week, in line with its decision.
15. Ms X complained to the Council. She told the Council she needed the extra day time support for domestic tasks and to keep herself safe. The Council said it had considered her care diaries and the medical information submitted in making its decision. It said it considered her day time needs could be met within the nine hours day support currently provided and had increased her night time support to meet her needs. It asked her to provide evidence as to how her day time care needs could not be met within the current hours.
16. In early 2021, the Council reviewed Ms X’s care and support plan again. Ms X told the Council she needed three additional support hours during the daytime to help her with transfers to and from her wheelchair. She says she had also already told it she needed extra day support for domestic tasks and to stay safe. She also said she needed an increase in night time support.
17. The Council considered her request for an additional three hours of daytime support. It considered medical evidence and professional advice. It decided her needs could be met within the existing care package. It also considered her request for additional waking night support but said there was no evidence she needed an increase to her current agreed level of support.
18. Ms X was unhappy with this decision and complained to the Council. The Council said it had considered her request, information provided and professional advice, but its decision was that her needs could be met within the current package of support. It said if she had ongoing concerns about her transfers or skin integrity, she could request an occupational therapy review or approach the GP or district nurses for further advice.
19. Ms X remained dissatisfied and brought her complaint to us.

Analysis

20. 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. The Council appropriately considered Ms X’s request for an increase in support hours during the review of her care and support plan in June 2020. This included consideration of medical information and the night time diary that Ms X submitted. Based on this information, it decided her needs could be met with one additional hour of waking night support per week. I have seen this information and find no fault in how the Council made this decision. Because of this, I cannot question the decision reached. The Council appropriately increased Ms X’s care package following its decision.
21. When the Council reviewed her care and support plan again in 2021, it considered her request for an increase in daytime support. It considered medical information and professional advice and decided that her needs could be met within the existing care package. It also reviewed her night time support and decided there was no evidence to support a further increase in waking night support. I have seen no evidence to suggest otherwise. There was no fault in how the Council made these decisions, so I cannot question the decisions reached.

Back to top

Final decision

22. I have completed my investigation. The Council was not at fault.

Back to top

Investigator's decision on behalf of the Ombudsman