Summary: Mrs C complained about the Council’s decision to reduce her daughter’s care package, and the delay in finding a care agency to provide this, which she said resulted in distress to her and her daughter. We did not find fault with the way in which the Council reached its decision to reduce the package. However, there was a delay in putting the support package in place, for which the Council has agreed to apologise and pay a financial remedy.

The complaint

1. The complainant, whom I shall call Mrs C, complained to us on behalf of herself and her daughter, whom I shall call Ms D. Mrs C complained that:
• The Council decided to reduce her daughter’s care from 16 to 3 hours a week, even though her needs have not decreased, and she still needs to receive this amount of support throughout the week.
• The Council failed to provide the three hours of care support for several months.
• The Council did not properly deal with her complaint.
2. Mrs C says this has had a significant impact on her daughter and herself, as her daughter’s carer.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. 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)
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 considered the information I received from Mrs C and the Council. I shared a copy of my draft decision statement with Mrs C and the Council and considered any comments I received, before I made my final decision.

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What I found

The complaint about the reduction in Ms D’s care package

7. Ms D has had 16 hours of support a week for over 10 years. Mrs C complained the Council decided to reduce her daughter’s care support from 16 to 3 hours a week, even though her needs have not decreased, and she still needs to receive this amount of support throughout the week.
8. The Council started to carry out a reassessment of Ms D’s needs in March 2021. As part of the assessment:
• Ms D’s social worker spoke to a support worker and manager of a care agency who had previously supported Ms D. They both said that:
1. Mrs C’s attitude was preventing her daughter from reaching her full potential. She made her daughter out to be much less able than she actually was. Her daughter had been able to show she could do things, which her mother had said she could not. Ms D was more in need of a friend rather than a support worker.
2. The social worker spoke to Ms D’s current care agency in July 2021, who had a similar view. They said Ms D did not need support with any of the tasks / activities the staff do with her. Staff felt they were more of a companion rather than a care worker.
3. Ms D’s daily care notes showed Ms D used her hours mainly to go on dog walks, make her bed, wash pots, and play cards. However, she was independent in these areas.
4. An assessor from the Maximising Independence Team (MIT) visited Ms D on several occasions to observe what she could (not) do.
9. Mrs C has since told me she disagrees with the statement above in 8.1. She said this is why she asked for further assessments of her daughter’s ability at the end of 2021.
10. The social worker organised a video call in August 2021 to discuss the outcome of the above with the MIT assessor, Mrs C and her daughter. The records state that:
• Mrs C said she and her daughter have felt for some time that the type of care she was receiving was not working for her daughter anymore. Mrs C has since told me that, what she meant was that her daughter needed a more experienced support worker who could provide better support.
• The assessor provided feedback from each of the days she had observed Ms D. She said she observed that Ms D had many independent skills, and she was very impressed how Ms D was able to manage different situations.
• The social worker said that, based on the feedback obtained, Ms D’s independent skills have greatly increased, and she did not need care support anymore. Instead, the Council could refer her to the MIT who could look at college courses, jobs and social groups, so Ms D would not feel isolated at home on her own.
• However, Mrs C said that during lockdown, when the care provider could not support her daughter, she became fully reliant on her. She said this almost brought her to her knees, and Mrs C said she did not want to experience that again.
• The social worker said she would leave Ms D with three hours of support a week, for shopping and attending medical appointments. Ms D’s current care provider gave notice on 27 July and stopped support on 22 August 2021. As such, the social worker said the Council would either try to find a provider for 16 hours a week, and then reduce it once they have started, or find a provider for 3 hours a week.
11. After the meeting, Mrs C told the social worker that:
• Five observations from the assessor are not enough to get a clear picture of her daughter’s capabilities and their life. Her daughter always presents more able than she is, and the assessor has not seen her daughter’s vulnerable side or the amount that she (Mrs C) has to pick up and support. She felt it was unfair to expect her (Mrs C) to provide even more support.
• There are endless things her daughter could not manage on her own.
• Since her daughter’s care provider had stopped, her daughter had been with her all day from 11am to 6pm because she had nothing to do to fill her time. Without support in place, she would be socially isolated.
• She would like her daughter to have an IQ test, so everyone understands the level of her understanding. 
• As her daughter does voluntary work for one day at the weekend, her hours could be reduced to 13 hours a week.
12. The social worker referred Ms D to the NHS Learning Disability Service at the end of October 2021 for a further assessment of her level of ability. Subsequent assessments by a psychologist concluded in early 2022 that:
• Ms D is likely to struggle to remember new information and to remember information to solve problems, complete tasks or what is asked of her.
• She has relatively good social skills but may struggle when meeting new people and encountering new situations.
• She can verbally communicate her needs well.
• She may need some support in managing finances and reading important documents for businesses or services she may require. She may benefit from continuing support with banking, complex contracts, and employment.
• It would be good to introduce her to local clubs within her personal interests, to increase meaningful activity and her social circle.
• She has enormous potential and has scope for developing skills if she receives support with her confidence and encouragement. However, she has no confidence to try new things and so does not attempt these. This is possibly due to low self-esteem and ongoing anxiety.
• An independent advocate could be helpful to ensure Ms D can communicate her own needs and wishes independently.
13. The Council has offered independent advocacy support to Ms D, which she has not accepted.
14. Mrs C has raised the following issues with regards to the support she believes her daughter needs:
• If she does not receive any support, her daughter is at risk of social isolation and being totally reliant on her (Mrs C). She needs a break from her role as her daughter’s carer. In response the Council has/said:
1. It referred Ms D to the MIT, “Social Prescribing”, “Circles of Support”, the “Shaw Trust” and “Adults Supporting Adults” who could all assist her with finding a (college) course, paid / voluntary work, or other activities to keep her engaged and occupied each day and provide opportunities to build up a small friendship group that she could do activities with. However, Ms D and her mother have rejected the opportunity to engage with this. Furthermore, Ms D told the Council she is too busy with her jobs (she works a few hours on three days of the week), and one day of care support, to do anything else.
2. It offered a carer assessment to Mrs C in October 2021. However, although Mrs C has regularly mentioned to the Council that she found it difficult to cope with supporting her daughter, she did not take up the offer or contact the Council to ask for a carer (re)assessment, which she knew she could ask for. The Council further said that assessments have shown that Ms D is very independent and does not require more support (all day). Mrs C gets paid for the support she provides to her daughter as she receives a carer allowance (which is paid if a care provider 35 hours of support a week). Mrs C has since told me she has never received carer’s allowance.
• Her daughter does not know how to cook: The records show Ms D knows how to prepare herself breakfast and lunch (sandwich etc). She also knows how to use a microwave to heat up food if needed (for instance when her mother has prepared this for her). Nevertheless, the Council referred Ms D to the MIT to teach her cooking skills. However, Ms D refused this support, saying she preferred to continue to go to her mother for dinner every night. The Council agreed to increase Ms D’s package from 3 to 5 hours and 20 minutes a week, so a care worker could support Ms D with her main meal. The Council has so far been unable to find a care agency to support her with this.
• Support with shopping: It is acknowledged that Ms D is unable to determine if (opened) food in her fridge / cupboard has gone out of date and this may therefore be unsafe for her to eat. This is currently covered in her support plan; she receives support with (making a) shopping (list).
• Support with managing money:
1. Ms D has her own banking app, which her mother helps her with. Ms D can buy things via the app and has shown that she can deal with everyday purchases.
2. Mrs C is her daughter’s PoA and can therefore help her with any more complex issues when needed, such as contracts etc.
• Support with medical appointments: The assessment by the NHS indicated Ms D needs support with attending medical appointments, because she has difficulty understanding and acting on (new) information that she may receive during her visits. Ms D currently receives support with this through her care support package.
• Travel: Mrs C can take a bus independently if she is familiar with the route. The Council has said that if Mrs C wants or needs to visit new places to take part in new activities, it will ensure she has the support in place to enable this.
15. The Council transferred Ms D’s case to a new social worker at the end of March 2022. The new social worker carried out a visit to Mrs C and her daughter in April to discuss her needs. During the visit, Mrs C became tearful and said nobody understands what she actually does for her daughter. She said she felt like she did not have a life of her own anymore after the 16 hours were removed. She said she felt like ending her life on numerous occasions.
16. The Council has said it has not been possible / allowed to speak to Ms D and discuss her needs, without her mother being present. It said Mrs C will not allow her daughter to speak freely on her own. As such, it has been difficult to establish and confirm what Ms D’s wishes are. The Council said various professionals have been unable to see Ms D on her own, as her mother insists being present at all meetings and that all contact with her daughter is through her. In response, Mrs C told me the Council has never asked to meet her daughter alone. She said her daughter does not want to meet with the Council without her (Mrs C) being present.
17. Mrs C asked the Council in July 2022 for a carer assessment, which the Council subsequently carried out.

Analysis

18. I did not find fault with the way through which the Council made its decision. The Council carried out a reassessment of Ms D’s needs that involved contacting previous and current care providers, reviewing daily care records, carrying out observations and discussions with Mrs C and her daughter. The Council considered Mrs C’s comments and concerns and concluded that Ms D’s support could be reduced to three hours a week. The Ombudsman cannot question a decision the Council has made if it followed the right steps and considered relevant information (see paragraph 4). Paragraph 14 above sets out how Ms D’s needs have subsequently been met and/or responded to.

Mrs C’s complained about the delay in finding a new care agency

19. Ms D’s care provider gave notice at the end of 27 July 2021 and stopped support one month later. The reason for this was not related to Mrs C or her alleged behaviour. Mrs C complained the Council failed to provide the five hours and twenty minutes of care support it has said her daughter would need.
20. The social worker submitted a request to find a new provider for Ms D. The social worker told Mrs C it’s Contract Team would email this to all providers in Ms D’s area.
21. The social worker told Mrs C at the end of August 2021 that an alternative to finding a care agency would be a direct payment so she could employ a Personal Assistant to support her daughter. However, Mrs C did not want this.
22. The Council found a care agency at the end of September 2021 to provide three hours of support a week. However, the agency could only start in January 2022. Furthermore, the care agency could not provide the additional 2 hours and 20 minutes support (20 minutes per evening) to support Ms D with her dinner. The Council has not been able so far to provide another care agency who could do this.

Analysis

23. Despite the Council’s efforts, it was unable to find a care provider in Ms D’s area to provide Ms D’s support of:
• Three hours a week with shopping and attending medical appointments, between September and December 2021.
• Two hours and twenty minutes a week with cooking Ms D’s dinner, from October 2021 onwards.
24. This was fault, namely service failure. Based on the records, I found this did not result in an injustice to Ms D, as her mother continued to support her with shopping and attending medical appointments. Furthermore, Ms D did not require any support with heating up food in a microwave and continued to have her dinners at her mother’s place as per her preference.
25. However, the above indicates that it did result in an injustice to Mrs C, because she had to pick up the shortfalls in terms of helping her daughter with shopping and attending medical appointments. The Council should apologise for this and pay Mrs C a financial remedy for the time, trouble and distress this resulted in.
26. With regards to cooking dinner, I found that, even if the Council would have found a care agency to provide this support, Ms D would still have continued to have her dinner at her mother’s place most nights, as this is what she wanted. As such, the Council should only provide an apology for this aspect.

The way the Council dealt with Mrs C’s complaint

27. Mrs C says the Council did not properly deal with her complaint. She complained that:
• She made her complaint on 24 August 2021 and did not receive a response until 4 October 2021.
• The response was written by someone who she had made a complaint about nine years ago. This person should therefore not have been involved in responding to her complaint.
• She immediately escalated the complaint to stage 2 but did not receive a response. She sent a total of 18 emails chasing the complaint, but only received a response on 6 December 2021, and only after she emailed the Council’s CEO.
28. In response, the Council said that
• The Council received Mrs C’s complaint on 25 August 2021. However, it received further complaints on 3 October and 30 September 2021. The Council responded to these emails and added in the additional concerns, which of course resulted in the due date being moved.
• It is unaware of any previous complaint against the officer as this happened nine years ago. Furthermore, the Council only keeps complaint records for seven years and no mention of a previous complaint about the officer has been made to the Council.
• It asked Mrs C for further information on 13 October 2021, after she escalated her complaint. However, she did not respond to this. It resent the request for further information one month later, after she had sent several emails within a three-day period. Mrs C did not respond to this email either. Mrs C asked why she should have to provide any information on the outcome she was seeking. At this stage the Council agreed to carry out a reassessment of Ms D’s needs. Based on the limited information that Mrs C provided on the outcome she was seeking, the Council considered this was an appropriate action because Mrs C was unhappy with the previous assessment.

Analysis

29. I found the Council responded within a reasonable timeframe and there was no fault in appointing the relevant officer to provide the complaint response. Furthermore, having read the complaint response, there is no evidence this had an impact on the Council’s response.

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Agreed action

30. I recommended that, within four weeks of my decision, the Council should:
• Apologise to Mrs C for the time, trouble and distress caused by the delay in finding a care agency and pay her £500.
31. The Council has told me it has accepted my recommendation.

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Final decision

32. For reasons explained above, I found there was some fault by the Council, as a result of which I have upheld Mrs C’s complaint.
33. I am satisfied with the actions the Council will carry out to remedy this and have therefore decided to complete my investigation and close the case.

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Investigator's decision on behalf of the Ombudsman