Summary: There was no fault in the Council’s decision to reduce the number of hours it funds, as part of the complainant’s home care package. The Council was entitled to decide, upon reassessment, the complainant did not require the level of support it had previously approved. We have therefore completed our investigation.

The complaint

1. I will refer to the complainant as Mr J.
2. Mr J complains the Council significantly reduced the number of hours it funds for his home care package, despite the fact his needs have increased. Mr J says he is unable to manage with the reduced hours.

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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)

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How I considered this complaint

5. I reviewed Mr J’s correspondence with the Council, the Council’s case notes, copies of Mr J’s current and previous care plans, and the paperwork the Council completed as part of his care needs review.
6. I also shared a draft copy of this decision with each party for their comments.

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What I found

7. The following is a summary of the key events relevant to this complaint. It is not intended to provide a detailed account of everything which happened.
8. Mr J has several health conditions which affect his mobility. He lives on his own, and since 2008 the Council has commissioned a home care package for him.
9. Mr J’s previous care package involved a total of 52 hours of visits per week, with 10hrs on Mondays, 8hrs on Saturdays, 4hrs on Sundays, and 7hrs on all other days. The purpose of the care was to assist Mr J with dressing, washing, preparing food and various other duties.
10. The Council undertook a care plan review in 2018, where it reaffirmed this package. The Council says it sought to arrange reviews in the years after 2018, but Mr J refused to engage with it, until early 2021.
11. In April 2021, the Council carried out another care plan review. A social worker and occupational therapist visited Mr J at home, in the presence of his longstanding care worker. They asked Mr J and the care worker to describe how he managed daily tasks, and precisely what the care worker did to support him.
12. Both the social worker and occupational therapist noted that Mr J’s comments were inconsistent with their observations – for example, they noted he was able to roll over onto his side without assistance, despite having told them he could not do this. They also noted the care worker spent a lot of time doing things which were not actually necessary, such as preparing each of Mr J’s meals from scratch, rather than bulk cooking and freezing food.
13. After the review, the Council decided Mr J did not need the level of support his previous package had been intended to provide. It reduced Mr J’s support hours from 52 per to week 36.5 per week, including 4.5hrs of visits per day, and a further 4hrs of flexible time per week, for Mr J to use on cleaning, shopping, and support to attend medical appointments.
14. Separately, Mr J’s longstanding care worker left, and the Council commissioned a new agency to provide his care.
15. On 17 May, Mr J submitted a formal complaint to the Council. He said he had been asking for 24hr live-in care since the beginning of his package in 2008, and that his recent review was the first in 11 years. He complained, as a result of the review, his care had been reduced from “8 hours a day down to 4”, and questioned the logic of this, pointing out a person’s care needs generally increase as they get older.
16. Mr J demanded the Council reverse its decision, and either provide 24hr live-in care or ‘improve’ the existing package. Mr J also complained his two new care workers did not speak adequate English, and would not allow him to wear shorts while they showered him.
17. The Council responded on 14 June. It noted it had completed a care needs review in April, and that Mr J had no communication problems and was able to manage his correspondence and finances independently.
18. The Council said it was aware Mr J considered he needed 24hr live-in care, but said it had refused to consider this. The Council also said Mr J had had occupational therapy assessments in 2016 and 2017, and that the Council had attempted to arrange a further review with him in 2020, but he had declined this.
19. The Council quoted both the social worker’s and occupational therapist’s reports, which explained their reasons for why they considered Mr J did not need the level of support he had been receiving, and that, with some adapted equipment, he would be able to live more independently. The Council said it would carry out another review in six months’ time.
20. The Council said Mr J had now said he was happy with his care agency. It noted Mr J’s concerns about support to attend medical appointments, but pointed out it had agreed 4hrs of flexible care time per week for him to use for this purpose.
21. The Council also noted Mr J had nearly £27,000 worth of outstanding contributions to his care fees, which he had refused to discuss during the review in April. It explained this was being dealt with by its debt recovery team.
22. Mr J referred his complaint to the Ombudsman on 19 July.

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Legislative background

Assessment

23. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person 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 care worker or any other person they might want involved.
24. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.

Care Plan

25. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a care worker). The care and support plan should consider what the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any care worker the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

Reviews

26. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months. Councils should consider a light touch review six to eight weeks after agreeing and signing off the plan and personal budget. They should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. Councils must also conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one.

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Analysis

27. The Ombudsman’s role is to review how councils have made decisions. We may criticise a council if it has, for example, not followed an appropriate procedure, failed to take account of relevant evidence, or not properly explained the reason for its decision. But we do not make decisions on councils’ behalf, or offer a right of appeal against their decisions. We cannot criticise a council’s decision where it has been made properly, and nor can we uphold a complaint simply because a person disagrees with what a council has done.
28. In this case, Mr J questions why the Council has reduced the number of support hours in his care plan, when he considers his needs have actually increased. He believes he should have had 24hr live-in care for some years, and says the reduction in hours means he now struggles with daily tasks, and has no support available to escort him to medical appointments.
29. However, I cannot see any reason to criticise the Council’s decision-making process here. Mr J’s care was reviewed, face-to-face and in considerable detail, by a social worker and occupational therapist. They discussed his needs and how he copes with daily tasks, with both Mr J and his then care worker. Both officers made observations that contradicted Mr J’s own statements, and concluded he was relying excessively on his care worker for things which were either unnecessary, or did not require the amount of time it had previously agreed to fund.
30. These are entirely matters of professional judgement, and I have no reason to doubt the officers came to their views having carried out a thorough assessment. I appreciate Mr J does not share the officers’ opinions, but this alone does not give me a reason to find fault. I cannot instruct the Council to disregard its officers’ judgement simply because Mr J does not agree.
31. I also note the Council considered Mr J’s need for support in attending medical appointments, and included an additional four hours per week of flexible care time specifically to cater for this, and other ad hoc duties.
32. I am satisfied there is no fault here.

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Final decision

33. I have completed my investigation with a finding of no fault.

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Investigator's decision on behalf of the Ombudsman