Summary: The complaint concerned the Council’s role in Mr C’s care in the months preceding his death. The complaint was made by his daughter Ms B. She said the Council delayed in assessing her father’s needs and when it did, the assessment did not accurately reflect his needs. She said the proposed support was not sufficient and the Council failed to put that support in place. She said the failure to provide the support he needed meant his quality of life was significantly affected and she believed it would have hastened his death. She said that it had a significant impact on her as she was aware of the way her father was suffering because of the lack of support. There was fault by the Council which caused injustice. The Council will apologise and make a symbolic payment to Ms B to recognise the distress caused.

The complaint

1. The complaint concerned the Council’s role in Mr C’s care in the months preceding his death. The complaint was made by his daughter Ms B. She said the Council delayed in assessing her father’s needs and when it did, the assessment did not accurately reflect his needs. She said the proposed support was not sufficient and the Council failed to put that support in place. She said the failure to provide the support he needed meant his quality of life was significantly affected and she believed it would have hastened his death. She said that it had a significant impact on her as she was aware of the way her father was suffering because of the lack of support.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. 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)
3. Service failure can happen when an organisation fails to provide a service as it should have done because of circumstances outside its control. We do not need to show any blame, intent, flawed policy or process, or bad faith by an organisation to say service failure (fault) has occurred. (Local Government Act 1974, sections 26(1), as amended)
4. 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

5. I considered the complaint and documents provided by Ms B and spoke to her. I asked the Council to comment on the complaint and provide information. I sent a draft of this statement to Ms B and the Council and considered their comments.

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What I found

Summary of events

6. Mr C lived on his own in a first floor flat. He had various medical conditions and required oxygen 24 hours a day. He also required a continuous positive airway pressure (CPAP) mask during the night as he had sleep apnoea. He was unable to use either the CPAP mask or the oxygen because of his lack of dexterity and general frailty.
7. Ms B requested the Council assess him for support at the end of August 2021. The Council received a further request for assessment from health services in early September. The Council contacted Mr C on 15 September and he was assessed on 22 September.
8. The result of the assessment was to provide four care visits a day. The Council was not able to find a care provider and no care was put in place before Mr C went into hospital at the beginning of November. He died in hospital three weeks later.

Analysis

The time taken to assess

9. The Council accepted there was delay here. Its aim for contact after a request was 3 days. Ms B requested an assessment for her father at the end of August 2021. And on 9 September the Council received a request for an urgent assessment of Mr C from the health service. The Council first contacted Ms B on 15 September and the assessment was done a week after that. It completed the care and support plan in another week on 29 September. I consider there was fault in the time taken to complete the assessment and care plan for Mr C. The referral from the health service gave an indication of the issues and the Council should have acted more rapidly.

The assessment

10. The Council did not send the assessment to Ms B. Section 10.87 of the Care and Support Statutory Guidance requires that a copy of the care plan should be given to the person whose plan it is and anyone else who acts on their behalf. So it was fault the Council did not send the assessment to Ms B.
11. Had it done so Ms B would have challenged some of the statements. The most significant point here was that Mr C needed help with using the oxygen he needed. He could not use it at all when he was on his own. The assessment does not refer specifically to a need for assistance with the use of oxygen and the CPAP mask overnight. The Council commented that carers would have provided some assistance with this but the lack of specificity about the support which needed to be provided on this key point in the assessment and care plan is fault.
12. Ms B said that both she and her father thought he needed residential care. The assessment does not refer to this. The Council said that extra care housing was discussed as a longer term option. I cannot say whether the Council’s view that Mr C’s needs could be met through the provision of domiciliary care was correct, but Ms B should have had the opportunity to challenge it.

Provision of care

13. The Council was unable to arrange any care before Mr C went into hospital. It contacted 13 different agencies but none had capacity. The Council said that this was because of a national and emerging issue in the Autumn of 2021, as the impact of the pandemic affected the availability of carers nationwide. But it recognised the case worker should have been more proactive in reviewing and discussing alternative arrangements if care could not be sourced. As I explain above, where a council fails to provide a service as it should because of circumstances outside its control that is service failure and is fault.

Injustice and remedy

14. Mr C did not get the services and support he needed in what were to be the last weeks he was at home. Where there has been fault we look to the Council to provide a remedy to those who have suffered an injustice as a result. It is not possible to provide any remedy to Mr C as he has died. But Ms B suffered significant distress knowing her father was not getting the support he needed and the impact that was having on him. In these circumstances we will ask the Council to make a symbolic payment to recognise the distress caused.
15. The Council apologised in its complaint responses to Ms B for the failure to arrange care and to send her a copy of the assessment and care plan. I consider it would be helpful in providing a resolution to Ms B if a suitably senior officer of the Council apologised to Ms B to indicate it has recognised the faults here.
16. In response to the draft of this statement the Council set out the action it has taken to ensure that there cannot be a recurrence of the faults found here. It has arranged that where care cannot be put in place the allocated worker will review every two weeks and consider alternative arrangements in consultation with the family. It has also reduced individual worker caseloads to enable greater focus on the presenting needs. It has also changed the way it organises duty visits, so that each worker now does a duty visit day once a fortnight, writing up case notes and feeding back to the allocated worker by the following day.

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Agreed action

17. The Council will apologise and pay Ms B £500 within one month of the final decision being issued.
18. The Council should provide us with evidence it has complied with the above actions.

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Final decision

19. There was fault by the Council which caused injustice.

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Investigator's decision on behalf of the Ombudsman