Summary: Mrs X complains the Council was wrong to withdraw night time care for her daughter. She says the Council took account of incorrect information. We have not found evidence of fault by the Council.

The complaint

1. The complainant, whom I shall refer to as Mrs X complains on behalf of her adult daughter Miss Y, that the Council unfairly decided that it was not responsible for her night time care.
2. Mrs X says the Council failed to properly assess her daughter’s needs and as a result of the lack of care, her daughter is at risk of pressure wounds.

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 consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
4. If we are satisfied with an organisation’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 have discussed the complaint with the complainant and considered the complaint and the copy correspondence provided by the complainant.
6. I have made enquiries of the Council and considered the comments and documents the Council provided, including the case notes and reviews of the support plan. Mrs X and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

Back to top

What I found

7. Due to her disability, Miss Y has difficulty turning herself at night time. The Council had assessed she had an eligible need for night time care to assist her to reposition at night. From 2011 to 2019 Miss Y had received direct payments for night time care as part of her care package from the Council.
8. However, the Council reassessed Miss Y’s support plan and care needs in July 2019 and decided that Miss Y did not need night time care. As part of the reassessment the Council asked the district nurse to assess whether Miss Y had a need to be turned at night to protect her skin integrity. The Council also asked for an occupational therapist to assess Miss Y’s ability to turn at night.
9. The Council says the district nurse service advised it would not recommend repositioning a service user at night. The district nurse service said it would normally recommend pressure relieving equipment such as a specialised mattress rather than a carer repositioning the service user. The district nurse service also said that Miss Y did not need turning at night, because she was not at high risk.
10. The Council’s occupational therapist assessed Miss Y’s ability to reposition herself at night and noted that she was unable to do so. The occupational therapist suggested trialling equipment such as a wedge to prevent her lying on her back which could be uncomfortable.
11. Mrs X questioned the Council’s proposal to remove night time care. She sent a letter from Miss Y’s GP stating that she needed help to reposition herself as she was unable to do so independently. Mrs X said that the Council had provided direct payments for night care for eight years and Miss Y’s needs had not changed and had in fact increased.
12. In Mrs X’s view the Council was seeking to save money and it had not provided evidence of its reasons, in line with the Care Act 2014, why it had reduced the package of care.
13. Mrs X asked the Council for evidence of the district nurses’ recommendation. The Council advised that it could not share the information from the district nurse service, but Mrs X could ask for it directly.
14. The Council sent Mrs X a copy of its final review of Miss Y’s care plan in October 2019 which confirmed the Council would not provide care at night. Mrs X and Miss Y disputed certain elements of the plan and the reduction in care. The Council met with Mrs X and Miss Y. It revised some details and noted Mrs X disagreed, but it did not change its view that care was not necessary at night.
15. Mrs X said she would take the matter further and make a complaint. Mrs X says that she intended to research the matter and then contact the Council to question its decision. Mrs X says she checked the Council’s complaints information leaflet, and it did not state there was a time limit to complain.
16. Mrs X and her family assisted Miss Y with night time care. Mrs X later researched the issue and says she found the Council should provide evidence why it had decided to reduce the care provision. She decided to raise this at the next care plan review and challenge the Council. However due to the Covid 19 Pandemic, the expected annual review did not take place and Mrs X experienced her own significant health problems and so was not able to pursue the matter.
17. In July 2021 Mrs X contacted the Council about the delay in carrying out a review and its decision to remove night time care. Mrs X complained the Council should have provided evidence why it was reducing the night time care. She said it had not allowed her to see the district nurses report on which it based its decision.
18. The Council responded that Mrs X’s complaint was outside its 12 months time limit and therefore it would not accept it.
19. Mrs X complained further that the complaint leaflets it had provided did not state that there was a time limit. She also explained the delay was due to no review taking place, the Covid 19 Pandemic and her own health problems.
20. The Council replied noting Mrs X’s reasons for not complaining earlier. But it said that it had carried out a light touch review in June 2020, due to Covid 19, and that Mrs X had not raised the matter then. It gave details of other contacts in 2020 and early 2021 when it emailed Miss Y about arranging a review but received no response. The Council confirmed that in view of the delay and that Mrs X did not raise the matter when it contacted her over the period of 18 months, it would not accept her late complaint.
21. Mrs X pursued the matter as she did not consider the Council advised her the call in June 2020 was a review or send her a copy of the review. The Council emailed Miss Y about a review, when it should have known she would not understand it.
22. The Council replied that it considered it had made Mrs X aware the call in June 2020 was a review and there may be a delay due to Covid 19 in carrying out a further review. It confirmed it did not consider it should accept her late complaint.
23. In its response to our enquiries the Council confirmed there had not been a change in Miss Y’s care needs at night. However, the Council’s understanding of the level of care required had changed following clinical advice. The Council recognised that miscommunication regarding the matter could have been avoided if it had arranged a multiagency meeting with the family.

Analysis

24. At present I do not consider there is evidence of fault by the Council in its decision making regarding the reduction in care. It appears the Council took account of relevant information and considered its own and other assessments. It came to the view that the level of care provided was not correct. I do not see the Council was wrong to review matters. Therefore, as I said in paragraph 2, I cannot question the outcome of its consideration.
25. The Council notes that it could have held a multi agency meeting which may have clarified matters. However, I note the Council attempted arrange a meeting, and when it was unable to do so it continued to seek relevant information and it responded promptly to Mrs X’s queries. The Council explained to Mrs X that it could look at how care was provided. I have not found fault here.
26. Mrs X complained the Council did not release a copy of the email it received from the district nurse service, on which it based its decision. However, I note the Council explained what the email said and advised Mrs X that she could get a copy of it directly from the district nurse service. I have not found fault by the Council here.
27. Mrs X complained the Council was wrong not to accept her late complaint because it did not advise her there was a 12 month time limit. She explained her reasons for not complaining earlier were that:
• She wanted to research the matter
• She decided she would raise the matter at the annual review but the Council delayed this. She thought the delay was due to the Covid 19 pandemic.
• She had significant health conditions herself which prevented her from raising a complaint which could have been stressful.
28. I have considered the Council’s decision making regarding not accepting a late complaint from Mrs X and I have not seen fault in it. While the Council could have made it clearer in its written information that there was a time limit, the Council explained there were several points when it contacted Mrs X and these were opportunities when she could have raised a complaint, but did not.

Back to top

Final decision

29. I have not found fault by the Council. I have completed my investigation and closed the complaint

Back to top

Investigator's decision on behalf of the Ombudsman