Summary: Mrs P complained about the Council’s failure to carry out a proper assessment of her adult daughter’s care needs. She said this resulted in an inadequate support plan that did not meet her needs. We have found there was fault with the assessment. It was poorly written and did not address the issues we would expect. The Council has agreed to apologise, make a payment to Mrs X to acknowledge her time and trouble dealing with the matter and carry out a new assessment. It has also agreed to take action to improve its service.

The complaint

1. Mrs P complains about the Council failure to carry out a comprehensive assessment of her adult daughter’s (Miss X) care needs for many years.
2. Mrs P says recent reviews of an already outdated assessment do not reflect Miss X’s current or future care needs. She would like the Council to carry out a fresh assessment that is accurate and takes account of all relevant information.
3. As a result, Mrs P says Miss X has an inadequate support plan and does not receive enough financial support to meet her needs. Nor has the Council properly considered Miss X’s future care needs.

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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 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
6. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
7. 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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What I have and have not investigated

8. Paragraph 5 (above) applies to this complaint. I have investigated events from May 2022. I have not investigated Mrs P’s complaint about the previous assessment carried out in 2020 because she could have complained to the Council, and then to us about this sooner. However, I have referred to the previous assessment for contextual purposes where necessary.

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How I considered this complaint

9. I discussed the complaint with Mrs P and considered the written information she provided. I made written enquiries of the Council. I took account of all the information before reaching a draft decision on the complaint.
10. Mrs P and the Council had the 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 and guidance

Assessment of care needs and support plan

11. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

Direct payments

12. Direct payments are monetary payments made to individuals who ask for them 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.

The Council’s Review and Reassessment Practice Guidance

13. This states, “if an individual makes contact and requests a review of their services dues to a significant change in their needs or circumstances change, then they will need to have a reassessment”.

What happened

14. The following is a summary of the key events relevant to this complaint. It is not intended to provide a detailed account of everything that happened.
15. Miss X is a young adult with several diagnoses, including autism, who requires support with daily living. She lives at home with her parents who are both in their seventies. For several years Miss X has received a direct payment from the Council. She has used this to attend a day centre and to employ a personal assistant. Her support plan was last reviewed in September 2020. This was carried out over the telephone due to Covid-19 restrictions. Mrs P says the review was inadequate and failed to address the issues she raised, including the longer-term care arrangements that she felt needed to be put in place.
16. In May 2022 the Council carried out a review. This did not lead to an increase in support.
17. Mrs P objected to the review and its outcome. Amongst other things, she said:

• it contained inaccurate and out of date information;
• it did not provide a personal budget that would fund activities that she was led to believe had been agreed;
• it failed to make provision for Miss X’s longer-term future when Mrs P was no longer able to care for her; and
• the personal budget was less generous than other service users she was aware of.

18. Mrs P said the personal budget should be increased from £2552 to £3822 per month. This would allow Miss X to attend the day centre more often and have access to other essential services. She sent several emails to the Council explaining her position. These were copied onto the review document.
19. The Council’s position remained the same and so Mrs P made a formal complaint in January 2023. In response the Council apologised for the fact Mrs P felt she had not been listened to but said “it could not do anything about that” because the worker who carried out the review was no longer in post. Mrs P was offered “a full and holistic reassessment”.
20. By this time, Mrs P says she had lost confidence with the Council. She says the complaint response failed to address the matters she had raised. For this reason, she brought her complaint to the Ombudsman.

The Council’s current position

21. In response to my enquiries, the Council has said:

• Mrs X was given ample opportunity to comment on aspects of the review she was not happy with;
• there was no fault with the review;
• the review was only partially completed. A needs assessment should have carried out, instead of just a well-being review;
• Mrs P’s expectations as to Miss X’s entitlement were unrealistic; and
• Mrs P was offered a new assessment in July 2022 but this was refused.

Analysis

22. It is not the Ombudsman’s role to say what a person’s needs are, or what services they should receive. The Ombudsman’s role is to consider if a council has followed the correct process to assess a person’s needs. In doing so we look at what information the council considered. If a council considers all this information properly the Ombudsman cannot find a council at fault just because a service user disagrees with its decision, or outcome of an assessment.
23. I have several concerns about the May 2022 review.
24. The reason for the review was described as “planned care act reassessment work”. It explained that Mrs P felt that Miss X’s care needs had changed, and a complete review was needed and a discussion about how these needs would be met. In accordance with the Council’s policy (paragraph 14 above) this should have prompted a reassessment.
25. Instead, what happened was effectively a “review of a review”. Much of the 2022 assessment was copy and pasted from the previous review. It is confusing to read because it includes Mrs P’s comments on the previous review from 2020, with no response from the Council as to whether these issues had been considered and properly addressed. Mrs X described it as “a mess” and that “information is just randomly thrown in with almost no logic or order to it”. I agree with her analysis.
26. I found the Council’s response to my enquiries about the quality of the review was contradictory. It says there was no fault with the review, yet the worker should have completed a full needs assessment. Instead, she completed only what the Council refers to as a “well-being review”. The Council accepts it should have been a “robust reassessment at this point to look at eligible needs, how those needs could be met, looking at community resources and how to use the current budget more effectively”.
27. I agree this is what I would have should have happened in this case, especially as the Council has been told Miss X’s needs had changed and the support plan was inadequate. In this case Mrs P explained in some detail why she felt a reassessment was needed with a specific focus on Miss X’s longer term care needs and a possible move into supported living.
28. It is also concerning that, aside for the introduction, Miss X is referred to as “XX” throughout most of document. I see no logic to this as all other parties are given their full names. In my view this is inappropriately impersonal. The same practice was used in the previous review and not corrected. This suggests the document was copy and pasted without due care being given.
29. Overall, the confusing content and lack of consideration about Miss X’s eligible care needs, and how they should be met was fault.
30. It is also disappointing that the inadequacies of the 2022 review were not properly acknowledged during the complaints process. In my opinion it is unclear whether Mrs P’s complaint was upheld or not. In my view it should have been. This is further fault.
31. To the Council’s credit, it offered to carry out a full reassessment as an outcome from the complaints process. But it is understandable why Mrs P was reluctant to agree when the Council had not confirmed there had been problems with the previous reviews. I am confident that a comprehensive reassessment of care needs as suggested by the Council will allow the case to progress in a positive way.

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Agreed action

32. The Council has agreed to take the following action within four weeks from the date of my final decision.
1. Apologise in writing to Mrs P.
2. Pay Mrs P £250 to acknowledge her distress, time and trouble dealing with the complaint.
3. Carry out a completely new assessment. All previous reviews should be disregarded.
4. Remind all assessment/review staff of the Council’s Review and Re-assessment Practice Guidance.
33. The Council should provide us with evidence it has complied with the above actions.

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Final decision

34. I have found the Council to be at fault and the Council has agreed with my recommendations to remedy the injustice caused. On this basis I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman