Summary: there was no fault in the way the Council carried out an assessment of Mr X’s needs under the Care Act 2014 in 2022 and decided he did not meet the eligibility criteria. Nor was there fault in the way officers communicated with Mr X and put special arrangements in place to manage his contact.

The complaint

1. I shall refer to the complainant as Mr X in this statement. Mr X complained that the Council did not carry out a proper assessment of his need for care and support under the Care Act 2014 in 2022. In particular, he says he was not given sufficient opportunity to express his views and he only met the social worker once.
2. Mr X also complained about the way officers communicated with him. He says they terminated his calls and did not call back when he left messages. He feels he has been ignored. He says he was also accused of harassing officers due to the frequency of his contact.
3. Mr X says he needs practical and financial support to help him budget, manage his household bills and maintain his home. He says the Council has not provided an accessible service because officers in the Adult Social Care team are not available when he calls and do not call back promptly when he leaves messages.

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The Ombudsman’s role and powers

4. 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)
5. 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)
6. 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

7. As part of the investigation I have:
• spoken to Mr X;
• considered the Council’s response to my written enquiries and relevant Adult Social Care records;
• considered the Council’s policy on managing risks to staff and the arrangements it put in place to manage Mr X's contact with officers;
• considered the relevant law and guidance.
8. Mr X and the Council were given the opportunity to comment on my draft decision. I considered their comments before making the final decision.

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What I found

Care Act 2014 – relevant law and guidance

9. The Care Act 2014 and the Care and Support Statutory Guidance 2014 set out the Council’s duties to adults who require care and support.

Assessment

10. The Council has a duty to assess adults who appear to need care and support. If the needs assessment identifies two or more eligible needs, the Council will provide a support plan which outlines what services are required to meet the needs.
11. The statutory Guidance says the assessment process is flexible. It may be carried out in the following ways:
• face to face; or
• by a supported self-assessment; or
• online or by telephone.

12. The Council must arrange for an independent advocate to help someone in the assessment process if:
• they have a substantial difficulty in being involved; and
• there is no one available to support them and represent their wishes.

Eligible needs

13. The threshold for eligibility is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how these impacts on their wellbeing. Councils must consider whether:
• the adult’s needs arise from a physical or mental impairment or illness;
• as a result of the adult’s needs, the adult is unable to achieve two or more of the specified outcomes; and
• as a consequence of being unable to achieve these outcomes there is a significant impact on the adult’s wellbeing.

Specified outcomes

14. The outcomes are:
• Managing and maintaining nutrition;
• Maintaining personal hygiene;
• Managing toilet needs;
• Being appropriately clothed;
• Being able to make use of the home safely;
• Maintaining a habitable home environment;
• Developing and maintaining family or other personal relationships;
• Accessing and engaging in work, training, or education;
• Making use of necessary facilities or services in the local community;
• Carrying out caring responsibilities for a child.

What happened

Background

15. Mr X lives alone. Several years ago, he was diagnosed with anxiety, depression and a personality disorder.
16. Mr X told me he has difficulty with reading and writing. He prefers to communicate by telephone. He says he also has problems with his memory. The Council considered he has mental capacity and was able to engage in the care assessment process.
17. Mr X claims social security and disability benefits. He asked for support from Adult Social Care because he finds it difficult to budget and manage household bills. He has built up some large debts as a result. He also struggled to organise repairs in his home. He wants Adult Social Care to contribute to these costs.
18. In March 2022 a social worker tried to contact the energy company on Mr X’s behalf. At the same time Mr X was being supported by a community organisation. It paid for rubbish to be cleared from the house and offered him a small grant to put towards his fuel bills. The community organisation also liaised with a plumber to fix issues with the boiler and heating system.
19. In June 2022 we completed our investigation of a previous complaint from Mr X. We found the Council was at fault then because it had not considered whether to appoint an advocate to support Mr X in an earlier Care Act assessment despite knowing he found it difficult to communicate with organisations and ‘bureaucracies’.

The Care Act needs assessment in 2022

20. I have considered the records of contact between Mr X, his advocate and social workers and managers in 2022. I also read the draft and final versions of the Care Act need assessments and eligibility decisions.
21. This statement does not attempt to set out everything that happened in 2022 but focuses on the events most relevant to this complaint.
22. The records show:
• There was information about Mr X’s personal circumstances in the adult social care records from a previous Care Act assessment in 2021;
• The social worker considered information gathered by Mr X’s former social workers who met him in May and June 2022;
• In late July 2022 the Council appointed an independent advocate to support Mr X through the care assessment process – the advocate was involved until February 2023;
• On 2 August 2022 Mr X had a face to face meeting with two social workers at a Council office. The purpose of the meeting was to introduce him to newly assigned social workers before they started the Care Act needs assessment. This meeting ended when Mr X became extremely agitated and behaved in a way that caused the officers to feel intimidated and threatened.
• Following a risk assessment, the Council decided not to have further face to face meetings with Mr X in order to protect staff. Mr X and his advocate were invited to a Teams meeting with the social worker and manager on 26 August 2022 to complete the Care Act needs assessment. Mr X joined the meeting by conference call;
• Before this meeting the independent advocate had spoken to Mr X to explain the purpose of the meeting and his role;
• The meeting on 26 August lasted for just under one hour;
• The social worker’s notes of the meeting show Mr X explained his needs, what he struggled with and what type of support he hoped to get. He said he would like to live independently and resolve issues with the property which were causing him stress;
• Following a discussion about whether Mr X could use his home safely, Mr X decided to leave the meeting early after the social worker told him Adult Social Care would not pay for repairs to his central heating system.
23. The notes show the social worker considered each of the 10 specified outcomes and recorded Mr X’s comments. She noted Mr X was not prevented from achieving any of the specified outcomes due to a physical or mental illness or disability. He was independent in meeting all his personal care needs. He was fully mobile and had access to the community.
24. An email in the case records says the social worker would call Mr X on 30 August to tell him the outcome of the assessment . She would explain why he did not meet the criteria for support. There is no entry in the case records confirming that she did try to call him then. The Council has since said the social worker could not make contact with Mr X on that date.
25. On 5 September Mr X telephoned the Council after the advocate told him the assessment found he did not have any eligible needs. He spoke to a manager for about an hour. She explained the Care Act 2014 criteria and why Mr X did not have eligible needs.
26. Mr X subsequently spoke to the independent advocate to feed back his views on the assessment. The advocate reported Mr X’s comments to the social worker who included them in the final version of the assessment.
27. On 12 October Mr X spoke to an officer in the Council’s complaints team to complain about several matters. One concern he raised was that his assessment had been rushed and done over the telephone with limited input from him. He also complained he had been waiting two months for the outcome even though someone had promised to discuss it with him.
28. The Council sent Mr X a copy of the needs assessment on 3 November 2022. It explained that he did not meet the eligibility criteria under the Care Act 2014. He was able to achieve all of the specified outcomes (set out in paragraph 14) independently.
29. Although Mr X was not eligible for services under the Care Act 2014, the records show officers have liaised with his GP surgery and made referrals to other local agencies which provide debt advice and mental health support.
30. The Council sent its final response to Mr X’s complaint on 4 November 2022. It did not uphold his complaint about the way the Care Act assessment was done. It said he had been supported by an advocate and was given time to express his views and wishes during the call on 26 August. It said the social worker would discuss the outcome with Mr X shortly.
31. Mr X resubmitted his complaint to us in early December 2022. This investigation has not considered any decisions the Council has made since then.

My analysis: Care Act assessment

32. There is no evidence of fault. The Council made suitable arrangements to enable Mr X to express his views and wishes in the assessment. In response to a recommendation made in a previous Ombudsman investigation, it arranged for an independent advocate to support Mr X through the assessment process.
33. The statutory Care & Support Guidance says a council may conduct a needs assessment by telephone. It says this may be appropriate when the person is already known to the service and does not have complex needs. So there is no requirement for a face to face meeting to complete an assessment. In this case it was appropriate to arrange a telephone assessment, particularly in view of the potential risks to staff identified after the face to face meeting on 2 August.
34. Mr X was given enough time to express his views in the call on 26 August 2022. The assessment includes a detailed record of his comments. And it was Mr X’s choice to leave the call early when he disagreed with a statement the social worker made. Mr X was also given the opportunity to feed back his views to the advocate and these were properly considered.
35. The needs assessment found that Mr X was not prevented, due to any needs arising from a physical or mental illness or impairment, from achieving any of the 10 specified outcomes. For this reason, he did not meet the eligibility criteria for care and support. There is no fault in the way the Council reached this conclusion.
36. Mr X disagrees with the outcome of the assessment. He firmly believes he has eligible needs and should be supported by the Adult Social Care service. But the Council reached a decision it was entitled to make, and as there was no fault in the assessment process, I cannot criticise the merits of its decision.

Communication with Mr X

37. Mr X prefers to communicate by telephone and to speak to Council officers at a time of his choosing. He gets very frustrated if they are not available to speak to him when he calls, or if they do not call back as promptly as he would like.
38. The Council’s Onecall team handles calls for adult social care, children's services, and safeguarding in Northumberland. The Council provided a log of all the calls Mr X has made to Onecall since March 2022. On some days, for example in May and June 2022, Mr X made between eight and eleven calls in a day.
39. I have listened to a sample of call recordings from one day in May 2022. During one call, Mr X swore when he was put through to a team manager and spoke to her in an aggressive manner. On another call he was angry and argumentative when he spoke to the call handler. In one call he said he would like to assault a named officer. The call handlers decided to end some calls.
40. In May 2022 the Council asked Mr X if he would consider having a set time for telephone contact to ensure the social worker would be available to speak to him. Mr X did not want to accept any restrictions on the times when he could call.
41. Later in May the Council carried out a risk assessment and put a communication plan in place to try to manage Mr X’s contact. This included:
• Not giving Mr X a direct line number for his allocated social worker to protect her time and ensure her line was not engaged and other callers could get through. When she needed to speak to Mr X, she called from a withheld number;
• Giving specific instructions to call handlers in the Onecall team about how to handle Mr X’s calls, including what to tell him and who to inform when he called. Staff in the Onecall team were told not to get drawn into long conversations with Mr X;
• Appointing a named officer to be a Single Point of Contact for Mr X – Mr X was given a direct number for the officer. She was also informed each time Mr X called the Onecall. Staff sent a message to the named officer and Mr X’s social worker.

Mr X was informed in writing of these arrangements and the reasons for them.

42. The case records also describe incidents when Mr X raised his voice, or was angry and swore at officers, including the officer who was his Single Point of Contact..
43. As well as contacting Onecall, Mr X made frequent calls to the manager who was his Single Point of Contact. According to the case records, she sometimes had 30 missed calls a day from Mr X. She was often in meetings so she was not available to take his calls. She sent him text messages to let him know that she would call when she was free.
44. In mid-June 2022 the officer acting as Mr X’s Single Point of Contact wrote to him about his telephone contact. She said Mr X could call her or send her text messages. If he called the One Call service, staff would send a message to her. She said she would respond by the end of the day or send a message to say when she could contact him. She said that making several calls a day would not lead to an immediate response.
45. She also explained that the volume of his calls had an impact on the service. It prevented other callers getting through to Onecall in a reasonable time. She asked Mr X to try to limit the number of calls he made.   
46. The Council has regularly reviewed the communication plan at risk assessment meetings since it was introduced.

My analysis: communication with Mr X

47. Mr X gets very frustrated when he cannot speak immediately to officers or when they do not return his calls as quickly as he would like.
48. The evidence shows Mr X’s behaviour has often been unacceptable. He has been verbally abusive, aggressive or unreasonably demanding in some calls. The Council has a duty to protect the health and safety of its staff, including taking steps to protect them from verbal abuse and stress. Staff were entitled to end calls with Mr X when he became abusive or aggressive.
49. Mr X also put the service under pressure by making repeated calls on the same day. The frequent and repetitive nature of Mr X’s calls took up staff time which meant they could not respond quickly to other callers trying to get through.
50. In these circumstances, it was not fault for the Council to put a communication plan in place to try to manage contact from Mr X. The Onecall service is essentially a call handling service which redirects callers to the appropriate team or takes and passes on messages. It was not appropriate for these staff to get drawn into long conversations with Mr X. He says he was trying to show that he was engaging with the service by making regular contact. However it was not constructive to make repeated calls. Mr X was informed of the communication plan, the reasons for it, and it has been kept under review. I find no evidence of fault.

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Final decision

51. I have completed the investigation and found no evidence of fault by the Council.

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Investigator's decision on behalf of the Ombudsman