Summary: Ms X complains about the way the Council handled her request for support and direct payments. We have found there was a delay by the Council in completing the assessment. This was fault and caused Ms X an injustice in the form of loss of service and uncertainty. We recommend the Council apologise and make a symbolic payment to remedy the injustice. We have found no fault by the Council in the other matters Ms X complains about.

The complaint

1. Ms X complains the Council wrongly closed her application for adult social care support and told her to apply for another benefit, leading her to believe she could not receive help from the Council. She said the Council failed to complete a person led assessment, leaving her unable to make a decision and failed to provide her with a female social worker when requested. It also wrongly recorded details of a conversation and said she refused help. Ms X said the Council also took too long to deal with her application and queries.
2. Ms X said this has left her distressed, confused, and frustrated and without the services she is entitled to.

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The Ombudsman’s role and powers

3. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(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 have considered Ms X’s complaint and the information she provided. We made enquiries of the Council and I have considered its response.
6. Ms X and the Council had the opportunity to comment on my draft decision. I considered all comments before reaching a final decision.

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What I found

Relevant law and guidance

7. The Care Act 2014 and the supporting guidance ‘Care and Support Statutory Guidance’ sets out the process to be followed by councils when assessing social care needs. The guidance is clear that eligibility, “… must be made based on an assessment and cannot be made without having first carried out an assessment. Once an eligibility determination has been made, and the local authority has determined whether it will meet the person’s needs (whether eligible or not), it must then carry out a financial assessment if it wishes to charge the adult and confirm that the adult is ordinarily resident in the authority”
8. The law and guidance do not set out timescales for the assessment process. Instead, the guidance says an assessment should be completed over “an appropriate and reasonable timescale” and that councils must consider “the urgency of needs and a consideration of any fluctuation in those needs”.
9. The guidance goes on to say that “at all times the person should be informed where they are in the care planning process, what will happen next and the likely timeframes.

Direct Payments

10. 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 must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.
11. The gateway to receiving a direct payment must always be through the request from the person. Councils must not force someone to take a direct payment against their will. They should not place someone in a situation where a direct payment is the only way they can get personalised care and support.
12. Councils must tell people during the care planning stage which of their needs direct payments could meet. However, councils must consider requests for direct payments made at any time and have clear and quick procedures in place to respond to them.
13. After considering the suitability of the person requesting direct payments against the conditions in the Care Act 2014, the council must decide whether to provide a direct payment. In all cases, the council should consider the request as quickly as possible.

The Council’s direct payment policy

14. The Council’s policy sets out what individuals can use their direct payment for, which includes employing personal assistants to provide support with household tasks or personal care. It also sets out what a direct payment cannot be used for.
15. The policy says the Council’s preferred method of payment for direct payments is via a pre-paid card. However, the Council offers five different routes for setting up a direct payment, as follows:

• Route 1 – adult uses a pre-paid card without support;
• Route 2 – adult uses a pre-paid card with support from family/friend or a direct payment support service;
• Route 3 – the direct payment is fully managed by a direct payment support service through a managed account;
• Route 4 – adult uses a separate bank account without support; and
• Route 5 – adult uses a separate bank account with support from family/friend or a direct payment support service.

Scope of investigation

16. I shall deal with what I consider to be the main points of concern. There is an extensive amount of correspondence between Ms X and the Council. It is neither necessary nor expedient to detail all this here. I have considered the information, and this has informed my decision making.
17. We cannot investigate complaints that have been brought to us more than 12 months after the complainant ought to have been aware they had reason to complain. We are only able to exercise discretion if there are good reasons to do so.
18. Ms X said the Council wrongly closed her case in October 2021 and told her to apply for another benefit. I see no good reason why Ms X could not have bought a complaint to us sooner.
19. Ms X bought her complaint to our service in March 2023, meaning we will usually only investigate as far back as March 2022. I have exercised my discretion to investigate the complaint from January 2022, when the Council re-opened Ms X’s case.
20. Following the Council’s response to Mrs X’s complaint, Ms X has raised ongoing issues. I have limited my investigation to events between January 2022 and March 2023, when Ms X complained to the Ombudsman.

What happened

21. In January 2022, Ms X contacted the Council requesting an adult social care assessment.
22. On 19 January, the Council contacted Ms X by telephone. Ms X said she was struggling with household chores and attending medical appointments. Ms X said she required help with daily living activities including meal preparation, domestic chores, money management, laundry, and shopping. Ms X also requested a female social worker.
23. In March, the Council told Ms X that she was on a waiting list to be allocated a social worker. The Council agreed to make a referral to a disability resource centre to support Ms X with her Personal Independence Payment (PIP) review. The Council also made a referral to a food bank. Ms X said she required support with cooking and cleaning. The Council told Ms X that its partner organisation could support her with this.
24. On 27 April, Ms X contacted the Council again requesting an update on allocating a social worker to assist her with a package of care. Ms X said she was struggling to carry out daily activities. Ms X also requested support with her PIP. The Council signposted Ms X to a charity.
25. The next day, Ms X’s case was allocated to a male social worker. The social worker called Ms X and offered to make a home visit to discuss Ms X’s support needs. The social worker said he would be accompanied by a female staff member known to Ms X. Ms X declined a home visit. The social worker recorded that all future communication with Ms X would be via telephone, email or text message.
26. On 5 May, the social worker spoke to Ms X and completed an assessment over the telephone. The social worker recorded that Ms X required support with personal care, house cleaning, meal preparation and shopping. The support would be facilitated through direct payments. Ms X said she preferred to have a personal assistant so she could be supported by someone she knew and trusted.
27. Later the same day, the social worker and Ms X exchanged several text messages. Ms X said she had previously requested a female social worker. The social worker said that Ms X would have to go back on the waiting list until a female worker was available. He said this would delay Ms X’s request for a package of care. Ms X said she had already waited a long time and asked the social worker to progress her request for support. The social worker requested further information from Ms X’s GP.
28. On 18 May, the social worker made a referral for advocacy support for Ms X.
29. On 26 May, the Council received a response from Ms X’s GP.
30. The social worker sent an email to Ms X and set out the care hours that he could request a personal budget for. This included 8.5 hours support each week. Ms X said she required ten hours support each week.
31. On 9 June, the Council completed a direct payment pre-assessment over the telephone with Ms X.
32. On 17 June, the Council agreed to a package of care for ten hours per week, through a personal assistant funded by the Council via direct payments. The direct payments would be facilitated through a managed account by one of its providers (the Provider).
33. On 12 July, Ms X contacted the Council and said the Provider had not contacted her about her direct payments. Ms X said her personal assistant was asking for payment.
34. Ms X said she no longer wished to work with the Provider and wanted to manage the direct payments by herself. The social worker explained Ms X would be responsible for managing payroll for her personal assistant, payslips, income tax, national insurance and holiday pay. Ms X said she was happy to do this. The social worker then explained Ms X would need to open a new bank account solely for the purpose of the direct payment. Ms X said she wished to use her existing bank account and provided details of this. The social worker explained this was not possible.
35. On 14 July, Ms X contacted the Council about a direct payment query. An officer spoke to Ms X and explained there was a delay by the Provider in assigning an advisor to Ms X. Ms X explained her social worker was on holiday and she was not prepared to wait until he returned. Ms X said she wanted to manage the direct payments herself and reiterated her request for a female social worker. The officer said he would make a request for the reallocation of Ms X’s case.
36. On 18 July, the Council spoke to Ms X. The Council advised Ms X that to receive the direct payments she needed to have a pre-paid card or set up a separate bank account. Ms X refused. The Council sent Ms X guidance on the direct payment process.
37. On the same day, Ms X complained to the Council. Ms X said her personal budget for care and support had been agreed since 14 June, but the Council was insisting she open a new bank account to receive the direct payments. Ms X also complained that she requested a female social worker and the Council had failed to respond to her request.
38. On 27 July, the Council sent a letter to Ms X for her to agree and/or amend the draft statement of complaint. Ms X responded the next day. Ms X said her assessment was inadequate and she felt she was unable to make a full and well-informed decision about her care.
39. On 2 August, the Council allocated a female social worker to Ms X. The social worker contacted the Provider and was informed that an advisor would be allocated to Ms X that day. The social worker spoke to Ms X about arranging a home visit to discuss her support needs and complete an assessment. Ms X said she wanted to speak to her advocate and solicitor before completing another assessment.
40. The next day, Ms X sent a text message to her social worker. Ms X said the Provider had contacted her about her direct payment account, but she had already told the Council she wished to manage the account by herself. Ms X said she was ‘livid’ that the Council was trying to force the managed account route upon her.
41. On 4 August, Ms X told the Council that her previous personal assistant only worked for one week. The Council asked Ms X how she had been coping without support. Ms X said she had received support from her family and a neighbour. Ms X said she had potentially identified another personal assistant. The Council said Ms X would need to provide more information about the personal assistant for verification purposes.
42. Later the same day, Ms X sent a text message to the social worker accusing the Council of bullying her. Ms X said she had been left without support and the Council was pushing her to have a managed account for her direct payments.
43. On 11 August, Ms X requested an assessment with her advocate present.
44. On 16 August, Ms X told the Council that her personal assistant would be starting in a few days.
45. The next day, the social worker sent a letter to Ms X. This letter was dated 12 August. The letter stated that the Council had offered Ms X a home visit to complete an assessment, but Ms X refused. It confirmed Ms X’s recent request for a face-to-face assessment at her GP surgery. The social worker agreed to contact the surgery to see if this was possible. The social worker said she had offered to meet Ms X at the Council offices, but Ms X declined. The Council confirmed that Ms X’s advocate had spoken to her and advised her about the direct payment process.
46. The letter acknowledged Ms X had informed the Council that she wanted to manage the direct payments herself. The social worker confirmed the direct payment had been agreed and Ms X had been informed she required a separate bank account for the sole purpose of managing this. The letter said Ms X had the option of a pre-paid card which she had also previously declined. The Council said it was still waiting for information about Ms X’s new personal assistant. The Council enclosed a leaflet about direct payments.
47. On 23 August, the Council responded to Ms X’s complaint. It said the social worker had advised Ms X of her responsibilities as an employer for her chosen personal assistant and if she chose to manage the direct payment herself then a separate bank account would be required. The Council said this would allow it to monitor payments from the account to ensure they were made in accordance with direct payment requirements.
48. The Council confirmed that the Provider had allocated Ms X case on 2 August. It said payments to Ms X’s personal assistant should be released following an introductory conversation between Ms X and the Provider. The Council apologised for the delay but did not uphold Ms X’s complaint.
49. The Council confirmed that Ms X’s assessment was completed over the telephone as Ms X had declined a home visit. Following the assessment, the social worker secured a personal budget for the agreed support Ms X required. The Council said this budget would not have been approved if the assessment lacked adequate information. The Council did not uphold Ms X’s complaint but agreed that a female social worker would visit Ms X at home and undertake a further assessment.
50. The Council acknowledged that Ms X had not received a copy of the assessment. The Council apologised and confirmed that a copy was sent on 29 July.
51. On 22 August, Ms X requested an advocate that was familiar with the Care Act. Ms X said her current advocate could not help her with the assessment or support planning. The Council agreed to make a referral.
52. On 26 August, Ms X informed the Council that she had set up a new bank account for the direct payments.
53. On 12 September, Ms X informed the Council that she would be looking for a replacement personal assistant. Ms X also asked when her new assessment would be completed.
54. On 20 September, Ms X requested a review of her complaint. The Council responded a month later. The Council confirmed that Ms X would need to have a separate bank account for managing her direct payments. The Council said all other elements of Ms X’s complaint had been appropriately investigated and responded to in the first response letter. The Council signposted Ms X to the Ombudsman should she remain unsatisfied.
55. On the same day, the Council informed Ms X that her case had been reallocated to a male social worker. The social worker contacted Ms X to arrange a reassessment. Ms X refused stating she had requested a female social worker.
56. On 7 October, Ms X was allocated a female social worker. Ms X confirmed that direct payments were being made to her bank account.
57. On 13 October, the social worker carried out a home visit to Ms X to complete a reassessment. Ms X’s advocate was present. The social worker asked Ms X how she was finding managing the direct payments. Ms X said it was fine, but she was finding some aspects confusing. The social worker explained Ms X had the option of using a Provider. Ms X asked the social worker to speak to another Provider about the timescales involved in setting up a managed account.
58. The next day, Ms X sent an email to the social worker expressing her dissatisfaction. Ms X said she felt the social worker was trying to “catch her out” and had recorded the visit on her phone. The social worker responded to Ms X and apologised for how Ms X felt about the home visit and assessment. The social worker also confirmed that she had not recorded Ms X.
59. Following the reassessment, the Council increased Ms X’s direct payments and issued a new support plan.
60. On 17January 2023, the social worker contacted Ms X by telephone to arrange a review of her support plan. Ms X did not answer, so the social worker sent her an email. The email explained the Council was responsible for ensuring the direct payments were being used appropriately and Ms X was required to provide copies of bank statements. The social worker attached a factsheet about this. The social worker also requested further information about the personal assistant supporting Ms X.
61. On 28 February, the Council informed Ms X that her complaint had been investigated at stage one and two of its complaints procedure. The Council signposted Ms X to the Ombudsman if she remained unsatisfied.
62. On 6 March, the social worker sent Ms X an email stating she was still waiting for Ms X to arrange a telephone review for her direct payments. The social worker also said Ms X had not provided the information she requested in January.
63. On 13 March, Mrs X complained to the Ombudsman.
64. On 20 March, the Council tried to contact Ms X by telephone regarding overdue bank statement for her direct payment review.

Analysis

Social care assessment

65. The Care Act does not specify or provide guidance about how long any type of assessment process should take. The statutory guidance states that an assessment should be carried out over an appropriate and reasonable timeframe taking into account the urgency of the needs or situation and consideration of any fluctuating needs.
66. Ms X approached the Council in January 2022 requesting support and an assessment. The Council completed an assessment in May 2022. This was almost 16 weeks after Ms X’s request.
67. In response to our enquiries the Council has acknowledged there was a delay in allocating a social worker in a timely manner. It said this was due to several factors including limited staff availability. Whilst I acknowledge the limited resources available at the time, it is unreasonable that Ms X’s assessment was not considered until May 2022. We consider that it is reasonable for Council’s to complete an assessment within four weeks of receiving a request. Therefore, in this case the Council should have completed the assessment in February 2022.
68. This delay caused Ms X an injustice because once the Council completed its assessment, it concluded Ms X was eligible for support from the Council via direct payments. Had the Council finalised its assessment without delay, Ms X would have benefited from support sooner. I cannot say with certainty when the support would have been implemented as there were a number of factors which caused delays after the assessment was finalised. However, the delay has resulted in injustice to Ms X in the form of uncertainty and a loss of service. I recommend a symbolic payment to remedy this injustice.
69. Ms X also complained the assessment was inadequate and not person led. Ms X declined a home visit to complete the assessment and therefore it was completed over the telephone. Ms X had the opportunity to explain the support she required. Following the assessment, the social worker set out a personal budget for the support Ms X required. Following further communication from Ms X the social worker amended the support hours from 8.5 hours per week to 10 hours per week. I find no fault in the way the Council carried out Ms X’s assessment. In response to Ms X’s complaint about this, the Council agreed to complete a reassessment. This was good practice.

Ms X’s request for a female social worker

70. When Ms X contacted the Council in January 2022, she requested a female social worker. The Council allocated a male social worker to Ms X at the end of April. When Ms X complained the Council allocated a female social worker in August 2022. There have been four social workers allocated to Ms X’s case between January 2022 and March 2023. Two of these social workers were female.
71. The Council allocated social workers to Ms X according to the resources available at the time. It is clear the Council failed to implement Ms X’s request for a female social worker however I cannot say this has caused Ms X an injustice. If a female social worker had been allocated to Ms X sooner, there is no guarantee that Ms X would have engaged with the Council and assessment processes differently. My reason for saying this is because, when the social worker offered to carry out a home visit in April 2022, with a female worker Ms X declined. At the time the Council advised Ms X that if she wanted a female social worker her case would be referred for reallocation and Ms X would be placed on a waiting list. Ms X asked the male social worker to continue with her assessment. When the female social worker offered to carry out a home visit in August 2022, Ms X declined.

Direct payments

72. Ms X says the Council insisted she opened a separate bank account for her direct payments. The Council’s process for setting up a direct payment is set out in paragraph 16 above. The Council is entitled to administer direct payments as set out in its policy. The Council repeatedly informed Ms X about this and explained that a separate bank account was required for monitoring purposes. The Council offered Ms X the option of a pre-paid card which Ms X declined. Ms X opened a new bank account in August. If Ms X had opened the bank account sooner, this delay could have been avoided. I have found no fault by the Council here.

Telephone call on 14 July 2022

73. Ms X disputes that a Council officer called her on 14 July 2022 and therefore she considers the information recorded was inaccurate. In response to Ms X’s complaint the Council provided a call log which showed a telephone call with Ms X took place as stated. I have reviewed the Council’s case records which also show that a call took place that day. I find no fault by the Council.

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Agreed action

74. Within four weeks of my final decision the Council will apologise to Ms X and make a symbolic payment of £300 for the injustice caused by the delay in completing an assessment.
75. The Council should provide us with evidence it has complied with the above actions.

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Final decision

76. I have found fault by the Council causing an injustice to Ms X. I have completed my investigation on this basis.

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Investigator's decision on behalf of the Ombudsman