Summary: Ms X complained about the Council’s failure to adapt her wet room and provide a bath and high power shower. The Council has assessed the situation and determined Ms X’s current washing facilities are adequate and meet her needs. There is no evidence of fault in how the Council reached this view which included considering the impact on Ms X’s mental health.

The complaint

1. Ms X complained the Council failed to adapt her wet room to meet her needs.
2. She says she continues to suffer pain and cannot wash properly without a high pressure shower and bath.

Back to top

The Ombudsman’s role and powers

3. 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)
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)

Back to top

How I considered this complaint

5. As part of the investigation, I have:
• considered the complaint and the documents provided by the complainant;
• made enquiries of the Council and considered the comments and documents the Council provided;
• discussed the issues with the complainant;
• sent my draft decision to both the Council and the complainant and taken account of their comments in reaching my final decision.

Back to top

What I found

6. Ms X suffers from chronic pain in her back, leg, and pelvis and numbness in her foot as a result of an accident many years ago. In October 2021 Ms X was living a ground floor flat with a wet room. She contacted the Council saying the electric shower in the wet room did not have good enough water pressure to enable her to wash properly.
7. A Council Occupational Therapist contacted the housing provider who agreed to change the electric shower for a mixer shower. However, Ms X reported in January 2022 that the flow was still insufficient and the water pressure low. She also requested the installation of a bath in place of the shower.
8. Ms X’s GP wrote a letter in January 2022 in support of Ms X’s request for a replacement shower and her skin issues. The letter said the issue within her accommodation was causing a huge problem and made her psychologically very low to the point she had taken an overdose.
9. The Council visited Ms X at her flat in February 2022 to discuss her issues and see if they could find a solution. Due to other medical conditions, Ms X uses an ointment that is oil based and so difficult to wash off. Ms X uses a seat in the wet room when showering and she opens the window while showering to reduce steam but says this can cause her to be cold. Ms X explained the shower does not have sufficient water pressure to wash off the ointment. She said this means she is in the shower for 20 minutes each time.
10. The Council tested the water heat settings and altered the shower head and found this did make a difference to the flow. Ms X was not happy that this resulted in a smaller area of spray. A discussion took place about the ointment. Ms X said she had not been given any specific instructions about how to rinse off the ointment.
11. Ms X suggested that a bath would be helpful. The Council noted that Ms X’s move to this flat was partly due to her mobility issues and so it was unlikely it would recommend a bath. The Council also noted that issues in the flat were affecting Ms X’s emotional wellbeing.
12. The Council agreed to contact Ms X’s GP regarding alternative ointment that may be easier to rinse off as well as discussing her mental health with her psychiatrist and what support there was for Ms X’s anxieties about the shower.
13. The Council wrote to Ms X’s GP on 3 March 2022 asking about her needs and alternatives to help the situation. The GP replied on 29 March 2022. She explained she had spoken with Ms X about different ointments and said Ms X had tried other treatments but the current ointment was the only one that worked. The GP said that she had told Ms X it was fine if not all of the cream is completely washed off as it would provide a moisturising layer to the skin.
14. The Council wrote to Ms X’s psychiatrist on 2 March 2022. It explained it had visited Ms X’s flat and found the shower was functioning and had normal water flow. The Council explained that it was concerned about the impact the worrying about the shower was having on Ms X’s mental health. It asked if he could consider if any other support or talking therapies might help Ms X. The Council asked for his urgent response with any information or advice that could assist.
15. The Council did not receive a response and so contacted the psychiatrist again on 22 April seeking a response. The psychiatrist telephoned on 26 April. He explained a complex case meeting had taken place and apologised the Council’ Occupational Therapists had not been invited. He said Ms X was experiencing ongoing mental health disturbance and they were working with Ms X to help her understand her challenges.
16. In July 2022, a GP from Ms X’s new GP practice wrote to the Council explaining Ms X’s skin condition and asking if she could be considered for a high-pressure shower and bath to be installed in her current accommodation. The Council replied to the new GP explaining the history of its involvement with Ms X and why it could not offer more support at that time. The Council explained that Ms had adequate washing facilities which included a shower which was easy to use. The Council noted that while Ms X may feel her skin condition and back pain would be helped by lying in a bath, that climbing in and out of a bath was contraindicated for someone with mobility problems.

Analysis

17. Ms X complains the Council has failed to adapt her wet room to meet her medical needs. In particular she has requested a high pressure shower and a bath which she considers would help ease her pain and enable her to wash properly.
18. The Council’s occupational therapists have been involved with Ms X since October 2021. They were in regular contact with Ms X to ensure her wellbeing.
19. Ms X has reported problems with washing and she does not consider the shower at her property is suitable to meet her medical needs. The information provided shows the Council originally worked with the housing provider who changed the electric shower to a mixer shower but this did not resolve Ms X’s problems. Ms X installed a different mixer shower but this was no improvement.
20. I note the Council sought advice, with Ms X’s permission, from other medical professionals working with her. The information provided shows Ms X is receiving support for her mental health issues. I am satisfied the Council took into account Ms X’s physical and mental health concerns when considering the request for the high power shower and bath. The Council then used its professional judgment to decide Ms X’s current bathing facilities were adequate. While Ms X may have a preference for a bath, the Council has explained why this would not be recommended for someone with her mobility problems. The Council sought advice from Ms X’s GP about the ointment and there is nothing to suggest a high power shower is essential. I note the new GP made a request in July 2022 but there is nothing in that letter which has not already been considered by the Council.
21. On the basis of the information provided I am not persuaded there is fault in the Council’s decision not to install a bath and/or high power shower even though Ms X may disagree with it.

Back to top

Final decision

22. I will now complete my investigation as there is no evidence of fault.

Back to top

Investigator's decision on behalf of the Ombudsman