Summary: There is no fault in how the Council dealt with Ms X’s requests for an adult social care assessment.

The complaint

1. Ms X complained that the Council
1. failed to complete an assessment of her care and support needs when she asked for one in May 2021 or at any time since.
2. referred her to an NHS mental health service without her consent and when her needs were related to her physical health conditions.
3. accessed out of date medical information about her without her consent.
2. As a result, Ms X says she is struggling to manage her needs without support and has experienced significant distress.

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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 spoke to Ms X about the complaint and considered the information she provided.
7. I made written enquiries of the Council and considered its response along with relevant law and guidance.
8. Ms X and the organisation had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Care assessments

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.

Section 75 partnerships

11. Section 75 of the NHS Act 2006 says the government can regulate to allow the NHS and councils to enter a partnership or pool their funds. This means the NHS and a council can agree for the NHS to deliver services on behalf of the council, or vice versa.
12. So far as is relevant to this complaint, this means a council and the NHS can agree that an NHS service will carry out adult social care needs assessments for the council. Such partnerships are sometimes called ‘Section 75 agreements’.

What happened

13. Ms X has physical and mental health conditions which affect her daily life. This includes issues with mobility and chronic pain.
14. In May 2021, she asked the Council for help to live independently. Ms X was living with her parents, but they were abusive to her so she wanted to leave.
15. The Council’s triage of Ms X’s referral identified that she might need an assessment by an OT (occupational therapist) and a social care assessment.
16. The next day, an OT spoke to Ms X on the telephone. The Council decided that Ms X needed a full OT assessment. It explained there was a waiting list for this.
17. The same day, the Council looked at Ms X’s referral for a social care assessment. The Council decided to ask LPFT (Lincolnshire Partnership Foundation Trust) to complete the assessment. LPFT is an NHS mental health service. The Council has an agreement under section 75 for LPFT to carry out social care assessments on its behalf for adults with mental health conditions.
18. The Council says it decided LPFT was the most suitable service to assess Ms X based on:
• the information Ms X provided, including that she was struggling to access mental health services;
• its records of Ms X’s previous contacts with the Council; and
• conversations with LPFT which confirmed that Ms X was open to mental health services.
19. LPFT accepted that the referral for Ms X was appropriate and that she needed an assessment. Ms X did not understand why the Council had referred her to a mental health service when she needed support with her physical health conditions. She therefore declined an assessment from LPFT.
20. In September 2021, the OT completed its assessment. As a result, the Council wrote to the Local Housing Authority recommending it support Ms X to move to a ground floor property with level access. It also agreed to refer Ms X for a further needs assessment.
21. The Council completed a social care assessment in February 2022. It decided Ms X did not have any eligible needs.
22. Following Ms X’s complaint and changes in her housing circumstances, the Council has agreed to complete a new assessment of Ms X’s needs jointly with the OT service. The Council says it is waiting for Ms X’s consent to advance with this.

My findings

23. Ms X complained the Council did not complete a social care assessment in May 2021 and has not done so at any time since.
24. I do not find fault with the Council here. Ms X had the opportunity to be assessed by LPFT in May 2021 and decided not to take this up. The Council completed an assessment in February 2022 which found Ms X had no unmet eligible needs.
25. However, it has agreed to complete a further assessment jointly with the OT service should Ms X wish it.
26. Ms X complained the Council referred her to LPFT, a mental health service, when her care needs result from her physical health.
27. The Council has a partnership arrangement with LPFT under section 75. This means LPFT can complete social care assessments on the Council’s behalf. In deciding that LPFT was the most suitable service for Ms X, I have seen no evidence that the Council failed to consider any relevant information or otherwise acted with fault. Where there is no fault in the decision making, the Ombudsman cannot question the outcome.
28. Ms X also complained that in deciding to refer her to LPFT, the Council accessed her medical information without her consent.
29. The Council has provided evidence that both it and LPFT use the same system to record information under the partnership agreement. The Council did not, therefore, need to get further consent from Ms X beyond that already given in her request for an assessment. This is in line with the Information Sharing Agreement with LPFT and the Council’s Privacy Notice, a copy of which it sent to Ms X in May 2021. I therefore do not find the Council acted with fault.
30. Any complaint Ms X has about the accuracy of the data is a matter better considered by the Information Commissioner.

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Final decision

31. I have completed my investigation. There is no fault by the Council.

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Investigator's decision on behalf of the Ombudsman