Lancashire County Council (22 010 039)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 13 Jan 2023

The Ombudsman's final decision:

Summary: We upheld Mr and Mrs X’s complaints about the Council’s failure to secure respite care for their adult son Mr Y and about the failure to secure Mr Y a supported living placement. This caused avoidable frustration and avoidable stress and pressure on the family. Provisionally, the Council will apologise, make symbolic payments and take action set out in this statement.

The complaint

  1. Mr X and Mrs X complained for their son Mr Y and in their own right that Lancashire County Council (the Council):
      1. Failed to provide respite care
      2. Failed to provide a supported living placement.
  2. They said the Council’s failings have taken a toll on their mental and physical health and wellbeing as well as denying Mr Y the opportunity to live the life he deserves.

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What I have and have not investigated

  1. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
  2. I have investigated events from June 2021 to October 2022. Mr and Mrs X complained to us in October 2022 so complaints about things that happened between October 2021 and October 2022 are not late. I have investigated from June 2021 because this is when the Council’s most recent assessment of Mr Y’s social care needs took place. Matters before then are late with no good reason.

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The Ombudsman’s role and powers

  1. 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)
  2. 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

  1. I considered the complaint to the Ombudsman, the Council’s response to the complaint and documents described in this statement.
  2. Mr and Mrs X 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

Relevant law

  1. A council must carry out an assessment for any adult with an appearance of need for care and support. The assessment must be of the adult’s needs and how they impact on their wellbeing and the outcomes they want to achieve. It must also involve the individual and where appropriate their carer or any other person they might want involved. (Care Act 2014, section 9)
  2. The Care Act spells out the duty to meet eligible needs (needs which meet the eligibility criteria) which are not being met otherwise than by the provision of care. (Care Act 2014, section 18)
  3. An adult’s needs meet the eligibility criteria if they arise from or are related to a physical or mental impairment or illness and as a result the adult cannot achieve two or more of the following outcomes and as a result there is or is likely to be a significant impact on well-being:
      1. Managing and maintaining nutrition
      2. Maintaining personal hygiene
      3. Managing toilet needs
      4. Being appropriately clothed
      5. Making use of the home safely
      6. Maintaining a habitable home environment
      7. Accessing work, training, education
      8. Making use of facilities or services in the community
      9. Carrying out caring responsibilities.

(Care and Support (Eligibility Criteria) Regulations 2014, Regulation 2)

  1. The Care Act explains the different ways a council can meet eligible needs by giving examples of services that may be provided:
    • Accommodation in a care home or other premises
    • Care and support at home
    • Counselling and social work
    • Information advice and advocacy

(Care Act 2014, section 8)

  1. If a council decides a person is eligible for care, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether and to what extent the needs meet the eligibility criteria and specifies the needs the council is going to meet and how this will be done. The council should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
  2. The care and support plan must set out a personal budget. A personal budget is a statement which specifies the cost to the local authority of meeting eligible needs, the amount a person must contribute and the amount the council must contribute. (Care Act 2014, section 26)
  3. A direct payment is a cash payment a council gives to an adult eligible for care and support. It enables them to arrange their own care.
  4. A council must carry out a carer’s assessment where it appears a carer may have needs for support. The assessment must include an assessment of the carer’s ability and willingness to continue in the caring role, the outcomes the carer wishes to achieve in daily life and whether support could contribute to achieving those outcomes (Care Act 2014, section 10)
  5. The Act makes clear that the local authority can meet the carer’s needs by providing a service directly to the adult needing care. In these cases, the carer must still receive a support plan which covers their needs, and how they will be met. The carer’s personal budget must be an amount that enables the carer to meet their needs to continue to fulfil their caring role and takes into account the outcomes that the carer wishes to achieve. (Care and Support Statutory Guidance 2014)

What happened

  1. Mr Y is a young adult with learning disabilities. He needs someone to care for him all the time. Mr Y lives at home with his family. He goes to a specialist college (College A) Monday to Friday. The Council funds the college.
  2. In June 2021, a social worker completed a social care assessment for Mr Y. He was eligible for adult social care under all the outcomes in paragraph 11 apart from (i). The assessment noted Mr and Mrs Y were meeting some of Mr Y’s needs such as personal care, toileting, being appropriately clothed, managing nutrition and maintaining the home. The assessment also noted his parents’ views and desired outcomes. The assessment said:
    • Mr Y’s sister had been providing some care as an exception to the usual policy that close relatives living in the same household could not be paid to provide care
    • The family wanted to secure a week-night residential placement for Mr Y at College A as a stepping-stone to a supported living placement in future
    • They wanted more respite care. Caring for Mr Y was challenging. Mr and Mrs X had other caring and work responsibilities
    • There had been a direct payment to pay for respite, but they could not access their full entitlement, so some money had been clawed back. They had funding for respite at the short breaks service
    • Mr Y liked activities and socialising. These were hard for the family to arrange because of their location.
    • Two care workers were re-starting with Mr Y in April 2021
  3. Mr Y’s current care and support plan sets out his eligible needs and desired outcomes and his personal budget. He has a direct payment of £575 a week and £3700 for the financial year beginning April 2022 for residential respite care.
  4. Mr and Mrs X complained to the Council in June 2022 about the same issues they have raised in their complaint to us. They had to chase up the Council’s response in July and again in September. The Council responded in September, upholding the complaints. I have summarised the response below:
    • Respite care (the short breaks service) was not available for a long time due to COVID-19 infection risks and this left them without a service. The service was running again but it was in demand, so people were only getting some of their entitlement
    • It asked College A about whether it could offer respite care last year, but they had no capacity due to staff shortages. Mr Y’s social worker was going to ask College A again
    • The social worker started looking for supported living in September 2021. There was a new project which was suitable and had been potentially available in January 2022. However, the house is still empty because of staff recruitment problems. It was sorry for the confusion caused
    • The Council would involve occupational therapists at an early stage to check adaptations
    • The Council may have identified another suitable placement and his social worker would contact them about this.
  5. As actions arising from the complaint, the Council said it would:
    • Get the social worker to attend housing forum meetings and share regular updates on progress, viewing any suitable projects before they were offered
    • Ensure there is good strategic planning around creating housing options for people with similar needs to Mr Y’s. A review was underway.
  6. The Council told us it had not completed carer’s assessments for Mr and Mrs X. It said it would arrange for these to take place.


Failure to provide respite care

  1. The Council has upheld Mr and Mrs X’s complaint about lack of respite care. This was in part due to COVID-19, which I have considered. However, the law requires the Council to meet Mr Y’s eligible unmet needs. His care and support plan set out his entitlement to respite care. This is replacement care to enable his parents to have a break and to achieve some of their desired outcomes in life. They did not get a break which caused avoidable distress.
  2. While I note the pressures on services during the pandemic this did not negate the Council’s duties under section 18 of the Care Act 2014. The failure to provide respite care was fault.
  3. The Council should also have completed carer’s assessments for Mr and Mrs X as required by section 10 of the Care Act 2014. Although their views are noted on Mr Y’s social care assessment, the Care Act requires councils to carry out specific assessments of their needs as carers and outcomes and decide whether any additional provision is required to contribute towards their desired outcomes. The failure to carry out carer’s assessments was fault.

Failure to provide a supported living placement

  1. The Council also upheld this complaint and apologised. I note one placement fell through because of staff recruitment problems. This was not within the Council’s control and so it was not at fault.
  2. However, communication with Mr and Mrs X around placement options and progress was poor and this raised their expectations, causing avoidable frustration. Communication with Mr and Mrs X following their complaint to the Council was also poor and they had to chase the complaints team for a response which took the Council over two months to provide, which was also fault.

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Agreed action

  1. Within one month of my final decision, the Council will:
      1. Meet with Mr and Mrs X and come up with a written plan about how the Council will secure Mr Y’s respite entitlement for this financial year. Including confirming with College A whether it can offer respite nights.
      2. Apologise for the avoidable distress to Mr and Mrs X and to Mr Y for failure to ensure his eligible needs were met. Make them symbolic payments of £500 each to reflect the loss of opportunity to have a break from the caring role and for Mr Y, to reflect the loss of a chance to experience respite breaks and the opportunities these would have afforded him (independence, socialising with peers, meeting new people)
      3. Complete carer’s assessments for Mr and Mrs X and carer’s support plans
      4. Ensure Mr and Mrs X receive updates at least monthly about progress towards securing a supported living placement for Mr Y. Provide me with written evidence of updates.
  2. Within three months, the Council should provide me with a written report of all the options for supported living that have been explored with Mr and Mrs X and Mr Y and a summary of progress.
  3. The Council should provide us with evidence it has complied with the above actions.

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Final decision

  1. I uphold Mr and Mrs X’s complaints about the Council’s failure to secure respite care for their adult son Mr Y and about the failure to secure a supported living placement. This caused avoidable frustration and avoidable stress and pressure on the family. The Council will apologise, make symbolic payments and take action set out in this statement.
  2. I have completed the investigation.

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Investigator's decision on behalf of the Ombudsman

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