Summary: Ms C complained about the Council’s decision that her brother does not have eligible needs, which has resulted in a decision he is no longer eligible to live in supported living accommodation. We did not find fault with the way in which the Council made its decision.

The complaint

1. The complainant, whom I shall call Ms C, comlained to us on behalf of her brother, whom I shall call Mr B. Ms C complained she does not agree with the Council’s decision that her brother does not have any eligible social care needs. Ms C said that, as a result, he is no longer eligible to live in supported living accommodation.

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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. 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 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

5. I considered the information I received from Ms C and the Council. I shared a copy of my draft decision statement with Ms C and the Council and considered any comments I received, before I made my final decision.

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What I found

6. Mr B has a learning disability and moved into a supported living environment in 2017. An assessment of Mr B’s needs in 2018 stated the following:
• Nutrition:
1. Shopping: Mr B needs support to write a shopping list. He has a history of significant weight gain and therefore needs guidance and advise to make appropriate and healthy food choices. He experiences anxiety when in supermarkets and will often become flustered.
2. Diet: He needs assistance to maintain a balanced and varied diet. Without this he would lack some nutritional requirements which would impact his physical health.
• Finances: although Mr B can manage some paperwork and basic finances, he requires support with more complex documents and decisions, such as paying larger bills (including rent) and agreeing to contracts. This is due to difficulty reading and understanding content, meaning he needs someone to explain this clearly and in detail.
• Personal care: Mr B needs prompts and encouragement on a weekly basis with having a shower, shaving and cutting toenails, to strike a balance between the risk of self-neglect and independence. He also needs support to monitor and manage his oral hygiene. He works well when there is a routine in place, and he receives regular prompts and encouragement to maintain his personal hygiene. Without this there would be a significant risk of self-neglect.
• Attending appointments: Mr B needs assistance from one person to identify when he needs to make (health) appointments. He also needs help with managing these and identifying a way of getting to the appropriate place.
7. However, a subsequent more recent reassessment has concluded Mr B does not have the level of needs required for supported accommodation. The records also state that Mr B has told the Council he wants to live independently. Mr B’s care records and statements from the care provider have also said that Mr B has regularly told his care provider that: he does not need its support, he prefers to manage things on his own, that he is self-caring and fairly independent. Furthermore, the Council has said that neither Mr B, nor his sister and advocate Ms C, have flagged up any specific incidents of concern in 2021 that have shown / proven that Mr B is unable to live independently and manage his needs. I myself have also not seen evidence in the Council’s records, of specific incidents having been reported.
8. Ms C believes her brother should not live in an independent flat but should continue to live in an environment in which he is monitored and prompted to do things when needed. However, she feels his current supported accommodation and care provider are unsuitable, and she would therefore like him to move to another scheme. She said her brother has a lack of understanding of his own situation and does not accept support as the relationship broke down with the provider. Ms C added she raised numerous incidents with the Council.
9. The Council carried out a reassessment, which started in March 2021. As part of this, it spoke to Mr B, his family and his care provider. The assessment recorded that:
• Mr B would ideally like to move out of his current accommodation. He has lived there for three years and has little interaction with the staff and other residents.
• Mr B currently has some care hours from the supported living provider, but states he has little to do with them.
• Ms C has been concerned her brother has not been receiving enough support. She said Mr B has self-neglected in the past and he needs monitoring and prompting on a regular basis, particularly around his diet.
• The care provider said that Mr B has become more independent since he first arrived, and staff provide very little support to him now. They advised that:
1. Mr B has two 1:1 hours per week, which they spend on going for a walk or a coffee with him, as he no longer wants or needs support.
2. Mr B shares appointment letters with staff but no other letters. He declines support with correspondence and manages his finances.
3. He has become independent with meal planning and shopping for the right foods, often completing an online food shop and going to the shop independently. Mr B cooks independently and prepares his meals in batches. He also enjoys a take-away 2 to 3 times a week.
4. He says different things to staff and family. He does not tell family he declines support. He does not engage with staff and always says he wants to live independent
• Outcome:
1. Mr B is independent but needs support to find and secure an appropriate work or voluntary placement. As such, he has been referred to a service who will support him with this.
2. If Mr B moves to new, more independent accommodation, he will need enablement support to help him navigate his new surroundings and learn new information.
10. It has become clear there has been a difference of opinion between what Ms C says her brother needs, what Mr B has said, and what the care provider has said (and recorded) with regards to Mr B’s needs. As such, the Council proposed to put enablement support workers in place for a short period, as part of its reassessment, to be alongside Mr B and assess what he can (not) do. It explained to Ms C that this team could spend some time with Mr B and further assess him and his needs within his home environment. This was an appropriate proposal as a way forward. However, Ms C declined this suggestion. She said she felt this suggestion was unnecessary and would only delay the process, as the Council already had enough information on her brother’s needs.
11. The Council informed Mr B in a letter of the outcome of the assessment in June 2021, which was followed by an eviction letter by the care provider. The letter said the assessment concluded that his needs no longer met the eligibility threshold. This meant he would no longer be eligible to receive care support hours and he could therefore no longer remain at the supported living complex.
12. The Council has said that, despite its decision that Mr B was no longer eligible, it only stopped funding his care package on 15 November 2021. This was to try and enable the Council and the care provider to support Mr B to engage with the Enablement Team and the process of finding new accommodation. However, Ms C has told her brother not to engage with this. Nevertheless, the Council told me it has allocated a new housing officer to Mr B to support him with finding suitable alternative accommodation.
13. The Council received a letter from Mr B’s GP in August 2021. It said that Mr B seemed to be a vulnerable adult who is likely to be put at risk if he is not assessed correctly. However, the letter did not explain why the GP felt this. The social worker tried to obtain further information about this, but the GP practice did not respond.
14. The GP surgery sent another letter in February 2022. It said that:
• Nutrition: The GP is concerned about Mr B’s diet, which is impacting on his overall health. His bank statements show a high level of takeaway food. Furthermore, the Learning Disability practice nurse spent a lot of time with Mr B discussing healthy choices. She found that Mr B was able to understand the information but unable to act on it without support and prompts. The GP said Mr B would need to change his eating habits and lifestyle to avoid diabetes. For this, he would need support and regular prompting with following a healthy diet and living a more active lifestyle.
• Finances and correspondence: Following the GP’s assessments, the GP’s view was that Mr B is unable to understand or make sense of letters regarding his finances and other such matters. Furthermore, while the Council has signposted him to organisations that can assist him with this, he doesn’t have the ability or understanding to contact them to arrange help. As such, he needs support from someone he trusts and knows, who can help navigate the complexities of adult life.
• Personal care: Following its assessments, its view is that, when left to his own devices, his personal hygiene suffers, highlighting his inability to prioritise or weight the importance of this.
• Conclusion: The GP concluded Mr B is a vulnerable adult, and independent living would not be appropriate for him. He needs some form of supported living, and the level of support he has been receiving is not enough. He needs prompting for self-care and decision making and to make healthy living choices to avoid a decline into poor health. He is also vulnerable to people who want to exploit him and, combined with his anxiety, he would benefit from a solid, constant presence from an individual or a team who can help him make choices in life.
15. In response, the Council said that:
• Mr B has shown he is very capable of learning new skills such as laundry, cooking, online shopping. He has stated that he wishes to increase his independence by moving from his current property. Its view is the above issues can be addressed through support by its enablement team.
• Mr B had not been accessing the support on offer for some time at his placement prior to his last assessment, as evidenced in the daily care records provided. He did not assess this, even with encouragement.
• There have been no specific incidents raised before or during the assessment in 2021 relation to his safety or self-neglect.
• He goes out regularly by himself, he attends a daily activity group, accesses transport to his destinations independently. He has the ability to learn new skills surrounding safety.
• It has tried to discuss the GP’s letter with Mr B in a meeting in March 2022, but Mr B did not attend this. It will try to establish with the GP if they have referred Mr B to a dietician.
16. Ms C continues to believe her brother needs to be in supported living to keep him safe, with a care package of support to support or prompt him when needed. She has said her brother has little interaction with, and support from, the current care provider, because they are not interested or motivated to work with him and encourage him. She believes he still has needs in the area of nutrition, finance, correspondence and personal care.
17. The Council has said that Mr B will receive support from the Enablement Team when he moves into independent accommodation. He will need support to establish new routines, access activities, identify resources, assist with planning and where to access support through the Council’s universal and drop-in services. This support will also enable the Council to review if Mr B is subsequently eligible for any ongoing care support via the Council. Mr B still has an allocated social worker who will remain involved until he is settled in his new accommodation. If at that point we need to re-assess and put in place more formal support in the form of a care package or personal assistant, the Council will do this. It has explained this to Ms C.

Analysis

18. I did not find fault with the way through which the Council made its decision. The Council carried out a reassessment of Mr B’s needs that involved Mr B, Ms C and the care provider. The Council considered Ms C’s comments and concerns and concluded in 2021 that Mr B no longer has eligible needs. When Ms C said she was unhappy with the outcome of the assessment, the Council suggested to put enablement support in place to further assess Mr B’s needs within his home environment. However, Ms C declined this offer. The Ombudsman cannot question a decision the Council has made if it followed the right steps and considered relevant evidence (see paragraph 3).
19. The Council has since received a letter from Mr B’s GP which it has considered. It has told Ms C the letter has not changed its view that her brother can live independently. It has explained that, after Mr B has moved it will provide enablement support to him to support his transition into new accommodation and consider ongoing support if the enablement team identify a need for this.
20. It will also carry out a six-weeks care review with Mr B to see how he has been doing since his move.

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Final decision

21. For reasons explained above, I found I should not uphold the complaint.

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Investigator's decision on behalf of the Ombudsman