Summary: Ms X complains the Council failed to provide consistent care for Miss Y after support from Provider A ended at the end of July 2021. We have concluded our investigation having not made a finding of fault. We conclude that the Council took sufficient steps to reinstate care for Miss Y, and any gaps in care between July 2021 and July 2022 were not the fault of the Council. The Council has also backdated any funding that was agreed.

The complaint

1. Miss Z brings a complaint on behalf of Ms X. Ms X complains the Council have failed to provide consistent care between July 2021 and July 2022, and she has taken on additional caring responsibilities for Miss Y as a result. Ms X says that Miss Y has lost her structure and routine, and her independence as she has since began relying on Ms X. Ms X says this has been emotionally, physically, and mentally draining. Ms X would like the Council to apologise, to ensure appropriate care support is provided and for it to make a financial award in recognition of the lack of care provided during this period.

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The Ombudsman’s role and powers

2. 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’. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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

4. I spoke with Miss Z and considered the information she provided. I also considered the information the Council provided in response to my enquiries. Miss Z and the Council had an opportunity to comment on my draft decision.

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What I found

Relevant legislation and guidance

Care Act 2014

5. 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.
6. 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.

Direct Payments

7. Direct payments are monetary payments made to individuals to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs. Councils should ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they request DPs, the Council should support them to use and manage the payment properly.
8. However, Councils must not force people to take a direct payment against their will. They should not place people in a situation where a direct payment is the only way to receive personalised care and support.

Background

9. Miss Y has Sturge Weber Syndrome and limited verbal communication. In January 2020, Miss Y was referred to Adult Social Care to begin the transition into the Adult Service.
10. In September 2020, Miss Y’s first Adult Social Care assessment was finalised and the Council commissioned services from Provider A for 2 hours of 1:1 care support, 7 days a week.

What happened

11. I have included a summary of some of the key events below, this is not intended to be a comprehensive account of everything that took place.
12. In July 2021, Provider A confirmed to the Council that support for Miss Y would cease at the end of the month.
13. Later in July 2021, a case worker was allocated to review Miss Y’s care needs and support.
14. The Council says it unsuccessfully attempted to contact Ms X 11 times between July 21 and September 21, so it was unable to agree to a care plan going forward.
15. At the end of September 2021, Ms X contacted the Council and agreed to a review in early October 2021. The review was completed as scheduled, and the outcome agreed was for 24 hours of direct payments for personal assistance. Ms X suggested the use of a family member. The Council says it was agreed that it would share a copy of the draft report in a week.
16. The Council concluded its report setting out 24 hours of direct payment for personal assistance. Ms X rescheduled the meeting that was due to take place to a week later. When the Council attended a week later, Ms X was not available.
17. Between mid-October 21 and early-January 22, the Council made four unsuccessful attempts to contact Ms X. Ms X contacted the Council in mid-January to inform it that the family member she had proposed to provide support to Miss Y would not be available to.
18. Following contact from Ms X, the Council says it was liaising internally to source an alternative care provider for Miss Y.
19. In mid-February 2022, Ms X’s legal representatives contacted the Council to raise a complaint, requesting an urgent review be undertaken again. Toward the end of March 2022, a second review was completed. The outcome of this review was for 14 hours of personal care weekly, and 4 hours every Saturday.
20. In early-April 2022, a draft review report was shared with Ms X. Later in April 22, Ms X approved the content of the assessment and recommendations, and the Council proceeded with the agreed recommendations, backdated to begin from the date funding was agreed following the review in October 2021.

Analysis

21. As per the Council’s comments, its protocol is to:
1. Undertake a review
2. Agree recommendations in line with care and support needs
3. Draft the report and submit funding request according to costs
4. Share finalised report and funding information with carers/young person for approval/consent to contact providers
5. Provider is put in contact with carers to confirm they can meet the identified needs, once carers and providers agree then the support can commence.
22. The Council could not undertake a review as per paragraph 21 until it established contact with Ms X. The Council attempted to contact Ms X 11 times between July 21 and September 21 to no avail. It is not clear why reaching Ms X was so challenging, but Ms X has said she has additional caring responsibilities which may have contributed to her availability to speak with the Council. It is clear that any delays in reinstating care support between July 21 and – September 21 were due to Ms X’s availability when engaging with the Council.
23. After contact was successfully made with Ms X in September 21, a review was completed, and an outcome mutually agreed. When the Council attempted to contact Ms X for approval as per paragraph 21, it was again unable to establish contact with Ms X. The Council again attempted to contact Ms X several times between October 21 and January 22 before Ms X informed the Council that the prior agreement could not go ahead due to the family member being unavailable.
24. When the Council did establish contact with Ms X, a review was undertaken, and a plan agreed without delay; matters only stalled when the Council required Ms X’s approval and again could not successfully establish contact with her. It is therefore clear that any delays in reinstating care support between September 21 and January 22 were again due to Ms X’s availability when engaging with the Council.
25. After Ms X requested an urgent review in February, the review was completed shortly after in March and a care plan agreed in April 2022, the Council also agreed to backdate support from when the first review was undertaken in October 2021.
26. I therefore conclude that whilst I acknowledge care support was not consistently in place between July 21 and July 22, I have not found that any delays in the process were the fault of the Council. The Council were proactive, and responsive in trying to reinstate care for Miss Y, but could not progress without the input and agreement from Ms X, with whom it attempted to contact on multiple occasions, but could not successfully establish contact to progress matters. Further, the Council have backdated any funding that was agreed, ensuring that any care costs have been met.

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Final decision

27. I have concluded my investigation having not made a finding of fault. The Council took sufficient steps to arrange care for Miss Y, and any gaps in care between July 2021 and July 2022 were not the fault of the Council. Further, the Council has also backdated any funding that was agreed.

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Investigator's decision on behalf of the Ombudsman