Summary: Mrs X complains on her own and her mother’s behalf about the Council’s handling of their needs and care assessments. There was no evidence of fault in the Council’s approach. It remains open to Mrs X and Mrs Y to meet with the Council to resolve any outstanding issues and progress needs and carers assessments.

The complaint

1. The complainant, who I have called Mrs X, complains on her own and her mother’s (Mrs Y) behalf about the Council’s handling of her and her mother’s needs and care assessments and says the Council has failed to follow statutory guidance. Mrs X says the Council has recently told her it needs to speak with her mother in person to establish her wishes. Mrs X is unhappy with this and believes it is related to the complaints she has made. Mrs X says her health and wellbeing have suffered as a result. Mrs X is also unhappy the Council had told her it will not respond to any further correspondence until it has been notified of the outcome of our investigation. Mrs X has made further complaints which the Council has ignored.
2. We have Mrs Y’s consent for Mrs X to act on her behalf in this complaint.

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The Ombudsman’s role and powers

3. We may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), as amended)
4. 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 an organisation’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)
5. 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)

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How I considered this complaint

6. I have spoken to Mrs X and considered the information she has provided in support of her complaint.
7. I have considered the information the Council has provided in response to my enquiries.
8. Mrs X, Mrs Y and the Council now have an opportunity to comment on my draft decision. I will consider their comments before making a final decision.

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What I found

Relevant guidance

Assessment

9. 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 carer or any other person they might want involved.
10. 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.

Carer’s Assessment

11. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
12. As part of the carer’s assessment, the council must consider the carer’s potential future needs for support. It must also consider whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)

Care Plan

13. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). 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 carer 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.
14. The Mental Capacity Act 2005 is the framework for acting and deciding for people who lack the mental capacity to make particular decisions for themselves. A person must be presumed to have capacity to make a decision unless it is established that he or she lacks capacity.

Promoting wellbeing

15. The Government’s Care and Support statutory guidance emphasises the importance of councils supporting individuals to achieve the outcomes that matter to their life and promoting wellbeing. Principles that underpin the promotion of wellbeing are:

• The importance of beginning with the assumption that the individual is best placed to judge the individual’s wellbeing. Building on the principles of the Mental Capacity Act, the council should assume that the person themselves knows best their own outcomes, goals and wellbeing. Councils should not make assumptions as to what matters most to the person.
• The individual’s views, wishes, feelings and beliefs. Considering the person’s views and wishes is critical to a person-centred system. Councils should not ignore or downplay the importance of a person’s own opinions in relation to their life and their care. Where particular views, feelings or beliefs (including religious beliefs) impact on the choices that a person may wish to make about their care, these should be taken into account. This is especially important where a person has expressed views in the past, but no longer has capacity to make decisions themselves.
• The importance of the individual participating as fully as possible in decisions about them and being provided with the information and support necessary to enable the individual to participate. Care and support should be personal, and councils should not make decisions from which the person is excluded.

Safeguarding

16. If a council thinks someone might be at risk of neglect or abuse, and cannot protect themselves from those risks, it must make (or arrange for someone else to make) any necessary enquiries. The council must also decide whether anyone should take any action to protect the person at risk. This is set out in section 42 of Care Act 2014. The Care and Support Statutory Guidance guides professionals on how to fulfil this duty.
17. A fundamental part of the safeguarding process is that it should be about promoting the person’s wellbeing and decisions should reflect the person’s wishes wherever possible. (Sections 14.8 and 14.79, Care and Support Statutory Guidance).
18. It is also very important that they take the wishes of the adult into account (Section 14.96, Care and Support Statutory Guidance).

What happened

19. This is a chronology of key events and does not cover everything that happened.
20. Mrs Y was admitted to hospital on two occasions in June 2021 after having falls in her home. Prior to this, Mrs Y lived alone and received support from her family – her son (Mr Z) and her daughter (Mrs X).
21. Before hospital discharge, an assessment was undertaken to determine what support Mrs Y would need at home. In late June. a six-week package of reablement care was put in place to help rebuild Mrs Y’s confidence and regain her independence. A few days later, Mrs X informed the Council she intended to move in with her mother to provide care and support.
22. The Council completed a needs assessment with Mrs Y and Mrs X by telephone on 14 July 2021. It sent a copy of the assessment to Mrs X for checking and comments a few days later. Mrs X returned the assessment with comments and amendments the following day, which the Social Worker accepted. Mrs X says her mother expressed a wish for Mrs X to provide her care, rather than receiving this from external care providers.
23. From the end of July 2021, Mrs X contacted the Council by email to ask questions about the assessment process and other related issues. Mrs X wanted to know the Council’s policy for Disability Related Expenditure (DRE), how the financial assessment process works, how to receive support as a carer, additional support for Mrs Y at night, help with Mrs Y’s medication, physiotherapy support, NHS Continuing Healthcare (CHC) and help with reporting mould in Mrs Y’s property to her landlord.
24. The Social Worker allocated to Mrs Y sought to answer the questions Mrs X asked. They explained they might not be able to respond as quickly as Mrs X wanted. The Social Worker made referrals to relevant teams and individuals where they were unable to resolve or answer the queries Mrs X had made.
25. Mrs X felt she and Mrs Y could not make an informed decision about the care and support they could accept from the Council before knowing the financial implications of this. Mrs X asked the Council for an urgent financial assessment so Mrs Y would know the exact amount of financial contribution she would have to make towards her care.
26. The Social Worker asked the relevant team to arrange a full financial assessment for Mrs Y because Mrs X felt the light-touch online assessment was not detailed enough. The Social Worker explained how the Council typically completed the care and support plan before full financial assessment, because the support identified fed into the financial assessment. Mrs X continued to make enquiries about the assessment process and other related matters. The Social Worker offered to meet with Mrs X and Mrs Y to discuss and address any concerns they had and to progress arranging the support they needed.
27. Mrs X made complaints to the Council in late August 2021 because she felt it was not providing her with sufficient responses to her enquiries and this in turn was delaying implementation of any support she and her mother needed. The Council acknowledged receipt and explained it would need slightly longer than its usual 25 working day timescale to respond to Mrs X’s concerns. The Council advised Mrs X it would aim to respond in 35 working days.
28. By the beginning of September 2021, the Council became concerned that it had been unable to progress the care and support assessment for Mrs Y or implement any kind of support for Mrs Y and Mrs X as her main carer. The Council made two unannounced home visits to Mrs Y (and Mrs X). The Council wanted to speak to Mrs Y directly to check she was aware of the concerns Mrs X was raising on her behalf and to seek her wishes and views directly. Mrs X refused entry to Mrs Y’s home and declined the Council’s offer to arrange an appointment to meet with her and Mrs Y.
29. The Council sent Mrs X two complaint responses on 1 October 2021; one relating to her complaints about her mother’s needs assessment (and related issues) and the other about the support Mrs X needed as her mother’s main carer. The Council’s first complaint response reiterated how the needs and care assessments were undertaken first to feed into financial assessments and that colleagues within the relevant team would be contacting Mrs X to complete the financial assessment for her mother. The Council also apologised for the slight delay in responding to some of Mrs X’s enquiries and explained it asked about some transactions in Mrs Y’s bank statement to check there had been no deprivation of assets. The Council explained it had made home visits to directly obtain Mrs Y’s views and wishes as it remained concerned that Mrs X had not allowed officers to communicate with her mother since her initial telephone assessment in July 2021. The Council explained it could not proceed with providing the support Mrs Y might need because Mrs X maintained her questions had not been adequately answered.
30. The Council second complaint response explained its approach to carer’s assessments, how it was unable to respond to Mrs X’s detailed enquiries in short timescales because of the volume of workloads held by Social Workers and how it was satisfied it had answered Mrs X’s questions correctly.
31. Mrs X has remained dissatisfied with the Council’s responses and approach to assessing her and her mother’s needs. Since October 2021, the Council has responded to further contact from Mrs X by explaining it has already extensively addressed her enquiries and has nothing further to add. Mrs X brought the first of her two complaints to us in early November 2021 because she remained dissatisfied with the Council’s handling.
32. Mrs X has since submitted a further four complaints to us online that the Council has failed to appropriately respond to her further contact and that it has said it will not respond further while the Ombudsman investigates her complaints.
33. The Council wrote to Mrs X in early January 2022 and offered to meet with her and Mrs Y to ascertain their wishes and views about the care and support they both needed.
34. In May 2022, Mrs X told the Council she had reached crisis point and needed urgent respite care for her mother, so she could take a break from her caring role. The Council arranged for Mrs Y to move into a residential care home on 10 May 2022 as respite.

Analysis

35. Mrs X feels the Council has not followed statutory guidance in its handling and approach to her and her mother’s needs. The Council responded promptly following Mrs Y’s discharge from hospital to complete a needs assessment. It has offered a service which would enable further assessment of Mrs Y’s care and support needs in person with the aim of offering support in addition to that which Mrs X provides as her mother’s main carer. While this was not the approach Mrs X requested, it is not evidence of fault for the Council to offer the service it did.
36. The Council has undertaken assessments of Mrs Y’s needs and has received at least five versions of self-assessments for Mrs X and Mrs Y from Mrs X. The Council has explained to us that all the valuable and detailed information from Mrs X will feed into its own assessment of Mrs Y and Mrs X’s needs. The Council does however still need to undertake its own assessments to decide what care and support should be provided.
37. Mrs X believes the Council should be able to progress on the basis of her self-assessment and there is no valid reason for the Council to request direct contact with her mother. The Council has clearly explained its reasons for wanting to speak to Mrs Y about her wishes and views directly. This is in line with statutory guidance which states councils should place individuals at the centre of any needs and care assessments. Mrs Y does not lack the mental capacity to express her views and wishes about the care and support she needs and the Council is not at fault for asking to speak with her directly. I have seen no evidence to suggest the Council’s approach was because of Mrs X complaints.
38. Mrs X is deeply unhappy the Council has now refused to respond to further emails from her about her mother’s care. In response to our enquiries, the Council has explained that it continues to review the content of Mrs X’s contact but has decided it is no longer helpful to continue corresponding with her on matters it considers it has already extensively addressed. The Council has confirmed it will continue to respond and act on urgent matters, which is why it has sought to provide immediate respite when requested.
39. In my view, the Council was entitled to decide it could no longer continue to respond to Mrs X’s correspondence. The Council’s decision that it needs to meet with Mrs Y in person to ascertain her views and wishes is also not evidence of fault and a professional view the Council was entitled to make in accordance with government guidance. It remains open to Mrs X and Mrs Y to engage with the Council in this way if they wish to receive further support.
40. Mrs X has provided extensive comments in response to my draft decision statement and how she strongly disagrees with my findings, the extent of my investigation and my overall approach. While I appreciate Mrs X strongly disagrees with my views, I have not received evidence contrary to that which I have already examined and that would lead me to alter my provisional views.

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Final decision

41. I have completed my investigation with a finding of no fault by the Council.

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Investigator's decision on behalf of the Ombudsman