Summary: Mr D complained the Council has failed to provide him with appropriate assistance in securing a care facility for his wife. He also says the Council delayed offering him respite care. We find the Council was at fault as it failed to respond to a request for information regarding a potential care facility and it should have managed Mr D’s expectations better. The Council has agreed to our recommendations to reflect the injustice caused by fault.

The complaint

1. Mr D complained the Council has failed to provide him with appropriate assistance in securing a care facility for his wife (Mrs D). He also says the Council delayed offering him respite care.
2. Mr D says the Council’s faults are having a detrimental impact on his health. He wants the Council to provide proactive assistance in finding a suitable care facility.

Back to top

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 may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), 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)

Back to top

How I considered this complaint

6. I considered information from Mr D. I made written enquiries of the Council and considered information it sent in response.
7. Mr D and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

Assessments and care plans

8. 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.
9. 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.

The Mental Capacity Act 2005

10. 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. The Act (and the Code of Practice 2007) describes the steps a person should take when dealing with someone who may lack capacity to make decisions for themselves. It describes when to assess a person’s capacity to make a decision, how to do this, and how to make a decision on behalf of somebody who cannot do so.
11. The council must assess someone’s ability to make a decision when that person’s capacity is in doubt. How it assesses capacity may vary depending on the complexity of the decision.
12. An assessment of someone’s capacity is specific to the decision to be made at a particular time.

What happened

13. Mr D contacted the Council in May 2021 and asked it to complete an assessment of Mrs D’s care and support needs. He has been caring for Mrs D for many years.
14. A social worker visited Mr and Mrs D in June. He advised Mr D to contact some local community services and the national helpline for carers. Mr D provided information about Mrs D’s needs and said he wanted her to move into a care facility near to their daughter who lives in a different council’s area (Council B). He also asked for a social worker to complete a Mental Capacity Assessment (MCA) for Mrs D.
15. A senior social worker visited Mr and Mrs D in July to complete the MCA. Mr D said Mrs D was diagnosed with Alzheimer’s disease a few years ago and it was getting worse. The social worker said Mrs D met the criteria for a care package, but it was more likely to be carers coming into the home once a day, rather than 24-hour care.
16. Mr D said his preference was for Mrs D to move near to their daughter and into extra care housing. Extra care housing means people can live independently, but staff are usually available for up to 24 hours a day to provide personal care and support services. He said he was not keen on respite care in the home. The social worker told Mr D to look at the other options and consult with Council B.
17. Mrs D said she did not want to move from her home into residential care. The social worker decided Mrs D’s ability to make complex decisions was impaired, but she could understand her care needs.
18. Mr D called the Council. He explained he had contacted Council B, but it would not accept referrals unless the Council contacted it.
19. The Council discussed the matter with Mrs D. She reiterated she did not want to move to Council B or into extra care housing. The Council spoke to Mr D and explained what Mrs D said. It also said it did not consider Mrs D had any issues with her mental capacity.
20. Mr D contacted the Council the following month and said his GP had completed a MCA which confirmed Mrs D did not have capacity. He called the Council the following day and asked for an update. The officer he spoke to told him the case was awaiting allocation. He called again the following week and explained the situation was becoming difficult.
21. Mr D complained to the Council and said it had failed to progress the matter. The Council responded and acknowledged it had taken some time to allocate the case. It said someone would be in touch the following week.
22. The Council allocated a new social worker to the case. She visited Mr and Mrs D in September. Mrs D said she wanted to move to live near her daughter. Mr D asked about respite. The social worker said she would explore respite options and discuss with her manager the process for moving into an extra care housing facility in Council B’s area.
23. The social worker contacted Council B about its extra care housing facilities and whether it would accept out of county residents. Council B said Mrs D could apply for extra care housing as she has a local connection.
24. The social worker also spoke to Mr D about respite. Mr D said it was an afterthought but potentially Mrs D could go somewhere for a few days to give him respite. He said ideally this would be in an extra care housing facility.
25. The social worker assessed Mrs D’s capacity. She said this was inconclusive as Mrs D appeared to be giving answers based on what she thought Mr D wanted her to say.
26. The social worker visited Mrs D again the following week. Mrs D said she wanted to visit a potential extra care housing facility to help her decide what to do. The social worker said she would explore this, and she also suggested a local day centre for her to attend. Mr and Mrs D both expressed an interest in the day centre. The social worker agreed to explore it further.
27. Mr and Mrs D visited the extra care housing facility (Facility A) in December. Mr D emailed the social worker and said the family were happy with it and wanted to proceed.
28. The social worker emailed Mr D on 6 December and said she had sent the nomination for Facility A to Council B.
29. Council B responded the following day and asked for further information, such as a care and support plan and an assessment before it could proceed. The social worker did not respond.
30. Mr D emailed the social worker on 29 January 2022 and told her he was still waiting for a response from Council B. He sent a further email a few days later and said he had spoken to Facility A, and it needed the assessment paperwork before it could assess the referral.
31. The social worker phoned Mr D on 16 February to complete the assessment. She noted in the assessment Mr D had been offered a carer’s assessment but he had declined it. Mr D asked about respite and Mrs D spending some time in a care home to give him a break. The social worker said the Council would not agree to it because there were less restrictive ways to give him some time to himself. She suggested a sitting service or that Mrs D could go to a day centre.
32. Mr D said he did not want support within the home as he did not feel it would work. The social worker said Mrs D had made it clear she did not want to go into a care home.
33. The social worker sent the information to Council B in March. It responded and said Mrs D was not eligible for extra care housing because she jointly owned a property with Mr D.
34. The social worker emailed Mr D and advised him of the outcome. She sent a further email and suggested care for Mrs D at home. Mr D said he was not satisfied, and he had put Mrs D on the waiting list for three other facilities in Council B’s area. He said the Council had failed to achieve anything.
35. The social worker emailed Mr D and suggested someone coming and supporting Mrs D two to three times a week to get out into the community. She also suggested a companionship service or a day centre. Finally, she said she could re-explore the offer of respite in a care home with Mrs D.
36. Mr D said he would need some respite when he went on holiday in a couple of months. He also said he was not sure a companionship service would work.
37. The social worker spoke with Mrs D, and she said she was happy to proceed with a respite placement in a care home. Mrs D went into the care home for two weeks in June.

Back to top

Analysis

38. It is not the Ombudsman’s role to decide what services a person should receive, that is the Council’s role. The Ombudsman’s role is to consider whether the Council has properly assessed/reviewed a person’s needs and eligibility for services. If it has then we cannot question or criticise the Council’s decision.
39. The Council completed an assessment under the Care Act 2014 and decided Mrs D has eligible care and support needs, but they could be met at home and not in a care home. It took account of all relevant information and Mrs D’s wishes. I find no fault with the Council’s assessment.
40. Mr D clearly disagreed with the Council’s assessment, and said he wanted Mrs D to live in a care home or an extra care housing facility. Mrs D made it clear she did not want to move from her home. The social worker decided Mrs D had the mental capacity to make decision about where she wanted to live. That was a decision she was entitled to take. As Mr D did not want care in the home, the matter did not proceed any further.
41. The Council re-assessed the matter after receiving the GP’s report which said Mrs D did not have mental capacity to make decisions about her care and support needs. The Council’s view was that Mrs D’s capacity was fluctuating. However, it agreed to support Mrs D to find an extra care housing facility as she said she now wanted to move to Council’s B area. It was under no obligation to do so however, as its assessment was Mrs D’s needs could be met at home.
42. Council B emailed the social worker on 7 December 2021 and asked for further information. The social worker failed to respond which is fault. The social worker had committed to helping Mr and Mrs D finding a facility, and so she should have been responding to any correspondence about the matter. This fault caused Mr D an injustice as he was put to time and trouble and frustration in chasing the matter.
43. Mr D also says the Council did not check at the outset Mrs D would not be eligible for extra care housing because she jointly owned a property. As the Council had committed to helping Mr and Mrs D, it should have provided them with some information about how the financial process worked for extra care housing facilities. This fault caused Mr and Mrs D an injustice because their expectations were not managed properly.
44. With regards to respite, the Council offered care in the home repeatedly which would have provided Mr D some time away from his caring duties. Mr D declined this. Mrs D said she did not want to stay in a care home, so the Council was not at fault for not pursuing that option initially. Mrs D eventually agreed to go into a care home for short term respite, and the Council then promptly arranged this.
45. The social worker agreed to send information to Mr D by email about day centres in October 2021. She also agreed to speak to a local day centre about where Mrs D could attend. There is no evidence she followed this up at the time, which is fault. However, I do not consider this cause Mr D an injustice. This is because she provided information about the day centre to Mr D in March 2022, but he did not pursue it.
46. Mr D says the Council did not offer him a carer’s assessment. There is no evidence the Council offered Mr D a carer’s assessment after he approached it in May 2021. This is fault, as the Council was aware of Mr D’s role as a carer. There is an injustice to Mr D as he lost an opportunity to have his needs fully explored sooner. However, I consider this was a limited injustice as the Council did consider Mr D’s needs throughout and repeatedly offered him respite in the home, a day centre for Mrs D to attend and a companionship service. Mr D declined all the Council’s offers. I welcome the Council has now resolved this issue and Mr D has received a carer’s assessment.
47. As a resolution, Mr D says he wants the Council to provide proactive assistance in securing a suitable care facility. As I have explained earlier in this statement, the Council’s assessment is Mrs D’s eligible care and support needs can be met at home. Therefore, the Council is under no obligation to assist him with this process. The Council has however advised it is now supporting Mr D to look at privately rented extra care housing facilities.

Back to top

Agreed action

48. To address the injustice caused by fault, by 3 November 2022 the Council has agreed to:

• Apologise to Mr and Mrs D.
• Pay Mr D £150 for his time and trouble and frustration.

Back to top

Final decision

49. There was fault by the Council, which caused Mr D an injustice. The Council has agreed to my recommendations and so I have completed my investigation.

Back to top

Investigator's decision on behalf of the Ombudsman