Summary: Mr X complained the Council breached an agreement by attempting to visit his property without notification or appointment and failed to put in place any support following a fall. There is no evidence the Council breached an agreement with Mr X when visiting his property. The Council failed to consider whether to provide emergency support following a fall but that is unlikely to have resulted in Mr X missing out on support. A reminder to officers is satisfactory remedy.

The complaint

1. The complainant, whom I shall refer to as Mr X, is represented by a friend, whom I shall refer to as Miss Y. Mr X complained the Council:
• breached an agreement by attempting to access his home without notification or appointment which caused him to fall when trying to access the entry phone; and
• failed to put in place any support following that fall.
2. Mr X says he has sustained injuries due to the actions of the Council officer and is at risk of harm.

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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. As part of the investigation, I have:
• considered the complaint and Mr X/Miss Y's comments;
• made enquiries of the Council and considered the comments and documents the Council provided.
7. Mr X, Miss Y 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

What should have happened

8. The care and statutory support guidance says local authorities have powers to meet urgent needs where they have not completed an assessment. Where an individual with urgent needs approaches or is referred to the local authority, the local authority should provide an immediate response and meet the individual’s care and support needs. For example, where an individual’s condition deteriorates rapidly or they have an accident, they will need a swift response to ensure their needs are met. In some cases, the appropriate response may be that the local authority will meet the adult’s needs. In other cases, an immediate referral may be the best way to meet a person’s urgent needs, for example by completing the NHS Continuing Healthcare Fast Track Pathway Tool. Following this initial response, the individual should be informed that a more detailed needs assessment, and any subsequent processes, will follow.

What happened

9. Mr X is disabled and has a long-term, degenerative health condition which affects all aspects of his life, including his mobility, fine motor skills, hearing and ability to communicate independently. Until September 2021 Mr X received a direct payment for a care package. At the time of the events complained of Mr X was not in receipt of any care as the Council had terminated the direct payments care package and Mr X had not accessed the Council arranged care provision offered.
10. On 27 April 2022 a Council officer visited Mr X’s property unannounced for a tenancy check. Mr X says in attempting to answer the intercom he fell and sustained injuries. Miss Y contacted the Council on 30 April to tell it Mr X had multiple injuries to his right hand, arm, head, back, face and dental injuries and that she had stayed with him since the accident as he could not be left on his own. Miss Y asked the Council what emergency contingency plan it would put in place, referring to the need for emergency dental surgery, physiotherapy, osteotherapy, massage and rehabilitation. Miss Y also referred to the need for support for a carer to travel with Mr X to any and all appointments and support for dog care/sitting services while appointments took place.
11. The Council responded on 3 May. The Council advised Mr X to seek medical support from his GP and reiterated the offer to carry out a Care Act assessment to agree a suitable care and support plan.

Analysis

12. Miss Y says the Council breached an agreement by sending an officer to Mr X’s home without prior notification or appointment. Having considered the documentary evidence from Mr X’s file I have not seen any written agreement by the Council to only visit Mr X with notification or an appointment. I therefore cannot criticise the Council for sending an officer to visit unannounced on 27 April 2022.
13. Miss Y says the officer that visited on 27 April 2022 repeatedly pressed the intercom button relentlessly which led to Mr X falling when attempting to reach the entry phone in his hallway, sustaining injuries. In contrast the officer that attended Mr X’s property on 27 April 2022 says she rang the buzzer once outside, once inside and knocked on the door once. There is therefore a discrepancy between what Mr X says the officer did and what the officer says she did. The Ombudsman relies on the documentary records. The contemporaneous note of the visit on 27 April 2022 records only that the officer visited at 8am, could not gain access and was admitted to the block by a neighbour. As the Ombudsman cannot take evidence on oath I cannot reach a safe conclusion, on the balance of probability, on the number of times the officer pressed the intercom button or whether that contributed to Mr X’s fall. If Mr X wants to pursue that point further he will need to consider taking legal action as only a court can determine liability for any injuries Mr X sustained.
14. Miss Y says despite asking the Council for support following the fall on 27 April the Council has not put in place any provision. I am satisfied there is a long-standing history relating to care provision to Mr X which predates the complaint I am investigating and which has been the subject of a different Ombudsman investigation. I do not intend to comment in detail on what happened before 27 April 2022. However, I note the Council has indicated a willingness to carry out an assessment of Mr X’s care needs since 2021 and has arranged care for Mr X, which he has declined. I appreciate that in April 2022 Miss Y contacted the Council to outline the difficulties Mr X was experiencing following a fall and that she asked for emergency support. I am satisfied the Council responded to that by repeating its offer to carry out an assessment and by advising Mr X to seek medical attention for any injuries.
15. As I say in paragraph 8, the care and support statutory guidance is clear the Council has the power to meet urgent needs even when an assessment has not been completed. I would have expected the Council to consider that point when responding to Miss Y following the fall in April 2022. I have seen no evidence to suggest the Council considered whether to provide emergency support. On the other hand though, the communication from Miss Y refers to Mr X requiring medical intervention due to dental pain and other pain as well as support for travel to appointments and provision of care for his dog or sitting services when he attended medical appointments. Miss Y’s communication also made clear she was staying with Mr X at the time and therefore he had not been left unattended.
16. Given the details provided by Miss Y I do not criticise the Council for referring Mr X to medical professionals. That is because the majority of the issues mentioned related to the need for medical attention, rather than a care package. I consider the Council at fault though for not considering whether there was any emergency care it could put into place. Given the Council knew Miss Y was staying with Mr X and as he had repeatedly refused care provision arranged by the Council I do not consider it likely, on the balance of probability, Mr X would have accepted any provision the Council may have offered. Nor do I consider it likely the Council would have offered support without an assessment, given the history of the case. In those circumstances I consider a reminder to officers satisfactory remedy as I do not consider fault by the Council caused Mr X an injustice.

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Agreed action

17. Within one month of my decision the Council should remind officers in adult social care of the provisions of the care and statutory support guidance relating to the power the Council has to provide care support in an emergency even when an assessment has not been completed.

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Final decision

18. I have completed my investigation and found fault by the Council in part of the complaint which caused Mr X an injustice. I am satisfied the action the Council will take is sufficient to remedy that injustice.

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Investigator's decision on behalf of the Ombudsman