Summary: There was fault by the Council which delayed completing a carer’s assessment for Ms X, in completing a review of Mr Y’s care and support plan and in deciding Ms X and/or Mr Y’s personal budget. This caused avoidable confusion and uncertainty about the funding for respite care. The Council will apologise, make payments and carry out reviews as set out in this statement.

The complaint

1. Ms X complained the Council failed to provide suitable and sufficient respite care for her adult son Mr Y. She said this caused her avoidable distress and exhaustion.

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What I have and have not investigated

2. Ms X complained the Council’s complaint response did not acknowledge the decades of unpaid work she had carried out. I have not investigated this complaint because it is late (see next paragraph) and there is no good reason for Ms X’s failure to complain to us within 12 months.

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The Ombudsman’s role and powers

3. 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 a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
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. 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. I considered the complaint to the Council, the Council’s response and documents in this statement. Ms X and the Council had an opportunity to comment on my draft decision.
7. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance

8. A council must carry out a carer’s assessment where it appears a carer may have needs for support. It 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)
9. Where a council decides an adult has care and support needs which meet national eligibility criteria, it must issue them with a care and support plan which sets out their needs, explains which is an eligible need and says how much funding the person is entitled to. It should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
10. A care and support plan or carer’s support plan is a document prepared by the council which:
• Specifies needs and the extent to which they meet national eligibility criteria
• Specifies the needs the council will meet and explains how
• Includes a personal budget. (Care Act 2014, section 25)
11. A personal budget is a figure in a care and support plan or support plan that gives everyone involved clear information about the cost of care and support and the amount the council will make available. (Care Act 2014 section 26 and Care and Support Statutory Guidance (CSSG), 10.3)
12. Specific consideration should be given to how a personal budget will be used by carers. A carer’s need for support can be met by providing care to the person they care for. (CSSG 11.36)
13. Decisions on which services are provided to meet carers’ needs and which are provided to meet the needs of the adult for whom they care will impact on which person’s personal budget includes the cost of meeting those needs. Councils should consider joint care and support plans/support plans and joint personal budgets (CSSG 11.37).
14. Councils should align personal budgets where they are meeting the adult and the carer’s needs concurrently. Provision should be detailed in both plans. (CSSG 11.38)
15. A direct payment is money a council gives to a person to meet some or all of their eligible care and support needs (CSSG 12.1)
16. A council should review a care and support plan at least every year, on request or in response to a change in circumstances. The purpose of a review is to see how a care and support plan has been working and to decide if any revisions need to be made to it. (CSSG, Paragraphs 13.19-21 and 13.32)
17. A council should revise a care and support plan where circumstances have changed in a way that affects the plan. Where there is a proposal to change how to meet eligible needs, a council should take all reasonable steps to reach agreement with the adult about how to meet those needs. (Care Act 2014, sections 27(4) and (5))

What happened

18. Mr Y is a young man with physical and learning disabilities. He lives with Ms X and is eligible for social care. Mr Y uses a wheelchair and requires full assistance with personal care, toileting, meal preparation and support to get out and about. Mr Y receives a direct payment for support from a Personal Assistant (PA). Ms X manages the direct payment for Mr Y. Mr Y also gets funding for five days a week of day care at two different venues, one of these is a farm. The farm also provides respite care.
19. In February 2022, a social worker met with Ms X and Mr Y. Ms X said she was struggling with her caring role. The social worker noted she was going to look into respite services. The social worker completed a carer’s assessment for Ms X. this described the care she did, the impact of the caring role on her well-being and the things she wanted to achieve. The outcome was Ms X was eligible for carer’s support.
20. The social worker contacted the Council’s brokerage team which suggested two care homes which had spaces for respite care. One did not have many male care workers (it was noted in the documents that Mr Y preferred male staff for personal care). The social worker discussed the care homes with Ms X who said one was too far away and she would prefer Mr Y to have respite care at the farm.
21. The case notes suggest the social worker contacted the farm about respite care and there was no response. There is no record of the social worker pursuing the farm for a response and she was attending to other matters related to Mr Y’s social care arrangements.
22. In May, the social worker received an email from the farm asking if they could provide respite for Mr Y. The social worker asked for costings. Also in May, the social worker and Mr Y met at the farm to discuss his care arrangements. The following week, the social worker and Mr Y met at the other day care and she noted she was going to explore respite care as he had told her he wanted this.
23. At the start of June, Ms X told the social worker they were desperate for respite. She said she felt Mr Y would only be content if he had respite at the farm. Ms X said she wanted to escalate things. The social worker said the farm had not come back to her with costs and so she would look at other options.
24. The farm emailed the social worker at the end of June with information about its respite service.
25. At the start of July, Mr Y and the social worker met. Mr Y said he wanted time away from the family home and to have respite to develop some independence.
26. At the end of July, Ms X complained to the Council about the matter I am investigating and other matters she has not raised with us.
27. At the start of August, Ms X’s partner emailed the social worker asking for an update on respite. The social worker said the farm was going to discuss this with Mr Y. There followed a series of contacts between the social worker and the farm about cost, dates, other arrangements and so forth.
28. At the end of August, the social worker put forward a formal request for funding for respite to the Council’s managers. Managers approved funding for two nights a month at the farm.
29. The social worker completed a carer’s assessment for Ms X in September. The outcome was Ms X was eligible for carer’s support. Ms X’s carer’s support plan said she needed practical support from others to enable her to have a break from her caring role. The undated carer’s support plan said Ms X would have ‘professional support only at this time to support Ms X as a carer for her son’. The cost was said to be one pence/ 52 pence a year.
30. The Council responded to Ms X’s complaint in the middle of September. It said:
1. She had been offered respite but had declined it as it was not at the farm
2. A direct payment had been agreed for Mr Y to have respite at the farm
3. A carer’s assessment had been offered previously and the sitting service was offered but declined as Mr Y did not want different care workers
4. There should be a review of the carer’s assessment and further discussion of the sitting service.
31. Mr Y had his first respite stay at the farm at the end of September 2022.
32. Mr Y’s undated care and support plan set out his eligible needs, his personal budget and the services/funding/ support to meet his needs. There is no description of any respite care provision or funding for this in a personal budget on this care and support plan.
33. The Council told me:
• In February 2022, it explored two care homes for Mr Y to have respite. Both were specialist homes supporting adults with physical disabilities. One could not confirm male care workers. The other was based in a different town and Ms X did not want it.
• The social worker was asked to explore other options including the farm.
• A sitting service was an option but could not guarantee the same care workers each session. This was not within the Council’s control.
• Direct payments were offered. The family wanted an out of area option. Managers needed to consider whether this was good value for money.

Was there fault and if so did this cause injustice?

34. Ms X asked for respite care in February 2022 and disclosed that she was struggling in her caring role. The Council completed a carer’s assessment which was in line with Section 10 of the Care Act. However, it should have also:
1. Reviewed Mr Y’s care and support plan because of a risk that existing care arrangements may need to change because of her potential inability to continue caring for him because of struggling in the caring role. The review should have focused on whether the current care package and funding was sustainable and if not, what needed to happen, given Ms X’s difficulties.
2. Considered whether Mr Y’s care and support plan needed revising if the review concluded circumstances had changed in a way that affected the care and support plan.
3. Issued a carer’s support plan for Ms X following the carer’s assessment.
35. There is no evidence the Council started the above in February 2022. This was not in line with the law and guidance I have set out in paragraph 10 and 16-17 and so was fault.
36. Although the Council did not take the actions it should have, it did try and find some respite provision for Mr Y in two care homes. This did not absolve the Council of its responsibility to complete the actions I have set out at paragraph 34.
37. The delay in carrying out the actions I have set out in paragraph 34 meant there was a knock-on delay in securing respite provision on the farm after the care home options were discounted. I note the social worker made initial enquiries about the farm in March and had no response. My view is she should have been more pro-active in pursuing the farm for a response regarding its respite arrangements and potential costs. Had this happened at the same time as the actions in paragraph 34, it seems likely that Mr Y could have had respite at the farm much sooner, probably by June. This means there was a loss of three months of respite.
38. The Council has since carried out a second carer’s assessment and issued a carer’s support plan Ms X. This is a partial remedy.
39. The carer’s support plan is not in line with Sections 25 and 26 of the Care Act 2014 because it does not specify the carer’s needs the Council will meet or include Ms X’s personal budget. The personal budget of one pence/52 pence cannot realistically meet any carer’s needs and must be an error in the paperwork. It is fault.
40. The law and guidance I have set out in paragraphs 11 to 14 makes it clear that councils can meet carers’ needs by providing services to the adult. So I have considered Mr Y’s undated care and support plan to see whether the Council is meeting Ms X’s carer’s needs by providing services or funding to Mr Y. There are various figures on Mr Y’s plan for providing personal care, support to access the community and for day care, but nothing about costs for respite. This means Mr Y’s respite needs and funding are not addressed in a personal budget in his care and support plan or in Ms X’s carer’s support plan. This is fault as it is not in line with Section 26 of the Care Act 2014.
41. However, it is clear from the case notes that Mr Y had a respite break in September 2022 and that future funding is in place for two nights a month. So, while there is fault in the care planning/personal budget process and in the paperwork, funding is in place. The injustice therefore is a lack of clarity causing Ms X confusion about agreed funding and/or services.

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Agreed action

42. As I have set out in the previous section, the Council delayed by seven months in completing a carer’s support plan for Mrs X and delayed agreeing funding for respite care. It also failed to review Mr Y’s care and support plan and failed to set out the agreed personal budget for respite in the personal budget (either for Ms X or for Mr Y.) This caused avoidable confusion and loss of three months’ respite provision.
43. To remedy the injustice, the Council will, within one month:
• Make payments of £250 each to Ms X and Mr Y to reflect lost respite between June and August
• Make payments of £250 each to Ms X and Mr Y to reflect the avoidable confusion and distress caused by the delay in assessing Ms X as a carer, the failure to give a personal budget and the failure to review Mr Y’s care and support plan
• Issue a written apology to Ms X and Mr Y
• Complete an urgent review of Mr Y’s care and support plan and Ms X’s carer’s support plan to ensure personal budget(s) and respite provision are accurate and current.
44. The payments I have recommended do not in any way represent the value of the unpaid care Ms Y has done over many years, which I have not investigated. They are symbolic payments to reflect the avoidable distress and confusion and loss of respite provision following her disclosure in February 2022.
45. The Council should provide us with evidence it has complied with the above actions.

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Final decision

46. There was fault by the Council which delayed completing a carer’s support plan for Ms X, in completing a review of Mr Y’s care and support plan and in deciding Ms X and/or Mr Y’s personal budget. This caused avoidable confusion and uncertainty about the funding for respite care. The Council will make payments, apologise and take action described in this statement.
47. I have completed the investigation.

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Investigator's decision on behalf of the Ombudsman