Summary: Mrs Y complained the support the Council offered Mr X during a home emergency was inadequate. There was no fault in the support the Council offered.

The complaint

1. Mrs Y complained the support the Council offered Mr X during a home emergency was inadequate.
2. Specifically, Mrs Y said the Council:
• Gave inappropriate initial advice.
• Offered care and support that did not meet Mr X’s needs, and
• Refused to cover Mr X’s full expenses for a short hotel stay while emergency work took place in his home.
3. Mrs Y said Mr X was left out of pocket and had to cover the expenses himself.

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The Ombudsman’s role and powers

4. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. 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. As part of the investigation I have considered the following:
• Mrs Y’s complaint and supporting information.
• Documents provided by the Council and its comments in response to my enquiries.
• The Care Act 2014.The Care and Support (Eligibility Criteria) Regulations 2014.
• The Care and Support Statutory Guidance.
7. Mrs Y and the Council 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

Legislation and guidance

Assessment

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. 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.

Eligibility

10. An adult’s needs are only eligible where they meet all three of these conditions:
• The adult’s needs arise from or are related to physical or mental impairment or illness.
• As a result of the adult’s needs the adult is unable to achieve two or more specified outcomes.
• As a consequence, there is, or is likely to be, a significant impact on the adult’s well-being.
11. The specified outcomes under the Care and Support (Eligibility Criteria) Regulations 2014 are:
• Managing and maintaining nutrition.
• Managing personal hygiene.
• Managing toileting needs.
• Being appropriately clothed.
• Being able to make use of the adult’s home safely.
• Maintaining a habitable environment. 
• Developing or maintaining family or other personal relationships.
• Accessing and engaging in work, training, education or volunteering.
• Making use of necessary facilities or services in the local community including public transport and recreational facilities.
• Carrying out caring responsibilities for an adult or child.

What happened

12. I have detailed below some key events leading to Mrs Y’s complaint. This is not intended to be a detailed account of what took place.
13. Mr X suffers from Alzheimer’s, short term memory loss, and anxiety. He is supported by Mrs Y and his niece, who I shall call Miss A. Mrs Y has Lasting Power of Attorney (LPA) for Mr X's finances and his health and welfare. Miss A has LPA for Mr X’s health and welfare only.
14. Mrs Y contacted the Council on 2 February 2022. She said Mr X needed emergency plumbing work and a boiler replacement, so required emergency respite care for 7 and 8 February. Mrs Y said Mr X is very anxious and she worried he would be in danger if he remained at home during the work.
15. The Council told Mrs Y the case was due for allocation to assess what action it needs to take. Mrs Y asked if delaying the work by a week would allow enough time for the Council to assess Mr X. The Council said it could not guarantee this.
16. The Council spoke to Miss A on 3 February to discuss the support she gives. Miss A said she supports Mr X with shopping, medication, and food. Mr X can heat meals and is independent with mobility and toileting. The Council asked if Mr X’s family could support him while the work took place. Miss A said there is no room at her home for Mr X to stay.
17. Mrs Y emailed the Council on 3 February. She said Mr X would have no heating or hot water until the second day of the work, which Mrs Y changed to start on 16 February. Mrs Y said Miss A will take Mr X away for a short holiday as this is the least disruptive choice. Mrs Y said she phoned care homes about vacancies for a short stay, as the Council cannot guarantee to complete an assessment before 16 February. She said care homes asked for about £1,400 per week for a minimum of two weeks. A hotel for two nights would cost £286 for two rooms (one for Mr X and Miss A’s husband and one for Miss A and her children). Mrs Y said Mr X will keep receipts for food and petrol, to be paid by the Council. She said the cost of the hotel was more due to the half term holidays but was needed as Miss A has two children. She said the date of 16 February for the work must be kept for health and safety reasons.
18. The Council prioritised the case and booked Mr X’s assessment for 9 February.
19. The assessor identified Mr X has needs around his wellbeing, in terms of making decisions and managing his life. However, they decided Mr X does not have two or more eligible needs for Council funded support under the Care Act.
20. Following Mr X’s assessment, the assessor discussed the case with a social work manager. The assessor considered Mr X’s anxiety would be too great if he stayed at home during the work.
21. The social work manager agreed the Council could pay up to £200 for Mr X’s care and support during the works at his home. They told the assessor to first offer £150 and see if the family accept.
22. The assessor spoke to Miss A on 10 February. Miss A declined the Council’s offer of £150 and £200. The assessor also offered care visits in Mr X’s home three times a day during the work. Miss A declined this as well. She said Mrs Y was raising a complaint.
23. Mrs Y complained to the Council on 11 February 2022. She said the Council’s offer of support did not meet Mr X’s care needs or cover the cost of a hotel stay.
24. Mrs Y also said during the initial contact, adult social care told Miss A the Council does not have to help Mr X.
25. Mrs Y wanted the Council to pay full hotel costs, plus food and petrol, totalling around £400.
26. The Council sent its final complaint response on 30 March 2022. It said:
• During the assessment, Miss A asked for a contribution towards a two-night hotel stay with two rooms, costing £70 per room per night, with an added request for petrol and food. Following the assessment, the Council offered £200 towards hotel costs. It did not uphold Mrs Y’s complaint that its offer did not meet Mr X’s care needs.
• The case notes do not confirm adult social told Miss A the Council do not have to help. A social worker assessed the anxiety of staying at home during the work would be too great for Mr X. The Council offered three house calls per day to help the family support Mr X, but the family declined. It also offered £200 towards hotel costs.
• If Mr X remained at home during the work, he would have had to provide and pay for his own meals.
27. Mrs Y was dissatisfied with the Council’s response. She brought her complaint to the Ombudsman on 26 April 2022.

My investigation

28. In response to my enquiries, the Council told me Mr X was not known to adult social care services when Mrs Y requested respite care. Its first response was therefore to explore whether there was support available within Mr X’s own network while it arranged an assessment. The Council said that, while individual choice is a key value under the Care Act, it can explore other solutions.
29. The Council uses a direct payment calculator to work out expenses. The cost for overnight care is £54.04. Mr X was staying away for two nights so this would total £108.08. The cost for a personal assistant is £11.05 per hour. The Council calculated eight 30-minute visits (three for day one and two and two visits for day three when Mr X returned home) at a cost of £44.20. The total was therefore £152.28. The Council felt its first offer of £150 was reasonable to meet Mr X’s needs but it agreed to increase this to £200 given the urgency.
30. The Council said it does not pay daily living expenses or personal expenses, like food and drink or household shopping. It said these are seen as usual living expenses and it does not pay them to service users or carers.
31. The Council also said it does not normally pay travel expenses for carers. Support given to carers is subject to assessment under the Care Act.
32. The Council said it responded to Mrs Y’s requests within the timeframe she set. She made her own arrangements to pay the plumber and landlord to delay the work and the Council is not responsible for this.
33. Likewise, the Council said it is not responsible for costs relating to repair of a property, so it would not pay cleaning costs. The Council also said Mr X has a cleaner who visits each week so arrangements were already in place.
34. On its discussions with Mr X’s niece, the Council said she has LPA for health and welfare, and it was therefore suitable to consult with her about the best way to meet Mr X’s needs. It said Mrs Y was also part of the discussions but refused the Council’s offer of support.

Analysis

35. I have not seen clear evidence about exactly what the Council discussed with Mrs Y and Miss A at the outset. While it is possible an officer said adult social care cannot help, or that it was up to the family to make arrangements, the Council did not withdraw Mrs Y’s request for an assessment. Also, the internal communications I have seen between social workers show the Council was aware Mr X may have some care needs and it needed to assess him.
36. While I do not dismiss Mrs Y’s complaint that the Council gave incorrect or misleading advice, I have not seen evidence of significant fault or injustice in that regard.
37. Mrs Y was unhappy the early contact focused on what support the family gave or could give. That is part of the process and is not fault. Councils should consider the support a person is receiving, and they do not have a duty to provide a paid service to meet eligible needs.
38. There is no set timescale in the Care Act or statutory guidance for a needs assessment. It should be completed in a reasonable time, depending on the urgency of need. The Ombudsman usually expects councils to complete assessments in four to six weeks.
39. In this case, it took the Council just over a week to arrange and complete Mr X’s needs assessment. It then made an offer of care and support, or a monetary contribution to the cost of Mr X’s care, the following day. I found the Council conducted matters in a suitable timeframe.
40. The Council decided Mr X does not have eligible needs under the Care Act for a package of Council funded care. It was therefore not under a duty to produce a care plan or provide a funded service to Mr X. Nevertheless, it offered to contribute towards a hotel stay. While this did not cover the full costs of the hotel stay and expenses, the Council was not under a duty to do so.
41. I appreciate Mrs Y’s concerns about the anxiety Mr X would suffer if he stayed at home during the work, and that home care visits would not be suitable. However, the records I have seen show the Council’s offer of care visits came after its offer to contribute to a hotel stay was rejected and was offered as an alternative. The Council was therefore not at fault.
42. Mrs Y made private arrangements on behalf of Mr X to pay compensation to the landlord and plumber for changing the work dates. That was Mrs Y’s decision, as Mr X’s LPA. The change in dates did not arise due to any fault by the Council and there is no obligation on the Council to fund this.

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Final decision

43. I have completed my investigation. There was no fault in the support the Council offered.

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Investigator's decision on behalf of the Ombudsman