Summary: Ms X complains the Council has failed to meet her assessed need for care and support since November 2020. The Council accepts it has failed to meet Ms X’s needs for a significant periods of time. That is a service failure which has caused injustice to Ms X. The Council needs to apologise, pay financial redress and take action to improve its record keeping.

The complaint

1. The complainant, whom I shall refer to as Ms X, complains the Council has failed to meet her assessed need for care and support since November 2020.

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The Ombudsman’s role and powers

2. 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)
3. 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, sections 30(1B) and 34H(i), as amended)
4. This complaint involves events that occurred during the COVID-19 pandemic. The Government introduced a range of new and frequently updated rules and guidance during this time. We can consider whether the council followed the relevant legislation, guidance and our published “Good Administrative Practice during the response to COVID-19”.

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How I considered this complaint

5. I have:
• considered the complaint and the documents provided by Ms X;
• discussed the complaint with Ms X;
• considered the comments and documents the Council has provided in response to my enquiries;
• considered the Ombudsman’s guidance on remedies; and
• invited comments on a draft of this statement from Ms X and the Council, for me to consider before making my final decision.

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What I found

6. The Council has provided over 200 pages of case notes (some repeated) of its contact with Ms X, her advocate and others. I refer to the key contents in this statement. Despite their volume, it is clear from other information the Council has provided that there are significant gaps in its records.

What happened

7. Ms X is a single parent of a child with autism. Ms X received her own diagnosis of autism in 2019. She has sensory difficulties and takes medication for anxiety when needed. When the Council assessed her needs in 2019, it identified the need for an enabling support package to help with paperwork, menu planning, shopping and to source activities (such as a recovery programme of mindfulness, anxiety and depression management).
8. The Council agreed to fund up to 10 hours a week of enabling support (£182.40) plus mileage up to £81.00 a week. This included phone, video, face-to-face and back-office support to help with:
• meetings and appointments;
• domestic support;
• shopping and other community activities; and
• contact with statutory services.
9. Ms X was without support between September 2019 and November 2020, after the support from Care Provider A broke down.
10. In November 2020 the Council increased Ms X’s personal budget for advocacy from £500 to £800 a year. It arranged for Care Provider B to support Ms X. Her care and support plan said up to 10 hours a week could be used flexibly by arrangement and was not intended to lock her into pre-set support times. However, Care Provider B could not provide the 10 hours of support Ms X needed. The Council has no record of the support it provided. Ms X told the Council a sensory assessment had recommended a rocking chair. It asked for a copy of the sensory assessment, which she provided on 3 December.
11. In December 2020 Care Provider B stopped supporting Ms X. The Council updated her care and support plan to provide for extended advocacy support. It increased the funding for this from £800 to £1,600 a year. The Council says it also agreed to provide 15 hours a week of enabling support, but the care and support plan does not reflect this. There is nothing in the Council’s records about this or about any attempts to find a different care provider, despite Ms X remaining without enabling support during 2021.
12. By 27 January 2021 the Council had ordered a sensory chair for Ms X. There is nothing further in the Council’s records about the chair until 16 March, when it told the supplier it had not yet sent a cheque to pay for it. It put this down to people working from home because of COVID-19. On 18 March the supplier asked about arranging delivery. On 19 March Ms X complained the Council had given her conflicting information about the chair by telling her:
• it had bought it months ago;
• it was on its way;
• it was in a shipping container;
• it was being delivered to a third party in case Ms X was not in;
• it was not in stock; and
• it had only just been purchased in March.
13. Ms X’s advocate complained to the Council in June 2021. When the Council replied to the complaint in July 2021, it said:
• it did not accept it had been “gaslighting” her (trying to convince her that her perception of reality was wrong). It had not intentionally delayed her assessment or care planning. It had assessed her needs, produced a care and support plan which provided for a package of care;
• there was no evidence it was not delivering her care and support to make financial savings;
• her care package of up to 10 hours a week included face-to-face contact, telephone calls, actions taken by the Care Provider for Ms X and any activity, including travel, to meet her. It apologised if this had not been made clear to her. It would clearly evidence how her support time was being delivered in future;
• it accepted it had not made it clear that Ms X’s support time needed to be planned. It would update her care and support plan to make it clear how and when support would be delivered;
• the order for a sensory chair was delayed by factors arising from COVID-19 and the UK leaving the European Union. It apologised for the impact this had on Ms X;
• it could not comment on the problem Ms X had in accessing therapy, as this was the responsibility of the NHS;
• it accepted the Council’s communications with Ms X had not been adequate. It offered to help rebuild the relationship with her advocate;
• there would be an alternative contact for Ms X in future; and
• it was sorry it had taken so long to complete her assessment and care and support plan.
14. In November 2021 the Council started updating Ms X’s care and support plan to provide for 15 hours a week of enabling support. It says she should have had 15 hours a week since her last assessment, but Care Provider A had not had the capacity to provide this. According to the Council’s records, the 15 hours ended on 31 December 2021.
15. In January 2022 the Council identified Care Provider C but, after contacting it, Ms X found it had limited experience of working with people with autism. She suggested Care Provider D but it could only provide support in 12 hour blocks which would not have met her need for flexible support.
16. Ms X’s new advocate contacted the Council in January, as she was not satisfied with its July 2021 response to her complaint.
17. Care Provider E expressed an interest in supporting Ms X in March.
18. The Council updated Ms X’s care and support plan in May to provide for a direct payment to pay for a 10-week course, which ended in July.
19. In June, after assessing Ms X, Care Provider E said it did not have the capacity to meet her needs. She has since expressed an interest in receiving direct payments to commission her own support.
20. When the Council replied to Ms X’s complaint in July 2022, it said:
• it apologised if Ms X believed it had not shared documents with her (assessments, care and support plans and minutes of meetings). It noted the arrangement in place was to share documents with her advocate;
• it denied saving money had been a motivating factor behind the failure to support Ms X;
• it had identified the need for 10, then 12 and finally 15 hours of support. It apologised that since 2019 it had often not provided her support at the agreed level and at times had provided no support at all; and
• COVID-19 had made it difficult to source her support.

Is there evidence of fault by the Council which caused injustice?

21. It is not possible for me to address all Ms X’s specific concerns. This is partly down to the gaps in the Council’s records. It also reflects the fact it is not always possible to say why things have gone wrong. Commenting on motivation is often nothing more than speculation.
22. The key issue is there is no dispute over the fact the Council has failed to meet Ms X’s needs for significant periods of time since 2019. That is a service failure which has left her without the support she needs and made her life more difficult than it would have been if the support had been in place. Recent years have been a difficult time for Ms X for personal reasons which I do not need to go into here, and not just because of COVID-19.
23. The Council says COVID-19 made it difficult to source Ms X’s support. While that is no doubt the case, it failed to provided support before COVID-19, so it was by no means the only reason and does not excuse its failings. The wording of Ms X’s care and support plan (providing for a fully flexible care package) is likely to have raised unrealistic expectations about what a care provider could deliver.

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Agreed action

24. I recommended the Council:
• within four weeks writes to Ms X apologising for its failings and pays her £1,000; and
• within six weeks draws up an action plan for improving record keeping and provides evidence it has done this.

The Council has agreed to do this.

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Final decision

25. I have completed my investigation on the basis there has been fault by the Council causing injustice which requires a remedy.

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Investigator's decision on behalf of the Ombudsman