Summary: We found fault in North Lincolnshire Council’s failure to put support in place after it identified a resident needed it. We also found fault that North East Lincolnshire Council, Humber and North Yorkshire ICB and Navigo took too long to assess the person’s needs. These faults meant the person had to pay privately for support and suffered avoidable distress. The organisations agreed to provide apologies, financial payments, a fresh assessment, and to take actions to learn from these events and improve future practice.

The complaint

1. Mr A complains about an extensive delay and failure of services to provide appropriate support to meet his needs. He said that he asked for an assessment of his needs in October 2021 but, by February 2023, remained without the support he needed.
2. Mr A also complains about the complexity and inefficiency of the complaints service in North East Lincolnshire.
3. Mr A said the lack of support has led to him feeling suicidal and meant he had to take medication which would not have been necessary had suitable support been in place. Further, Mr A said he had to pay privately for a Personal Assistant to support him. He said this, in turn, meant he could not afford to pay bills including those for water, gas and electricity. Further, Mr A said he had needed to borrow a significant sum of money from family members to help pay for his care.
4. In bringing his complaint to the Ombudsmen Mr A said he would like:
1. To receive funding for the support he needs.
2. This funding to be backdated.
3. The costs he has paid for private care to be reimbursed.
4. Compensation for:

• The distress he has experienced because of the lack of support, and the impact this has had on his health and wellbeing, and
• Having been discriminated against and the injury this caused to his feelings.

5. We have investigated the following organisations:

• North East Lincolnshire Council (North East Lincs Council)
• NHS Humber and North Yorkshire Integrated Care Board (the ICB)
• Navigo Health and Social Care CIC (Navigo)
• North Lincolnshire Council (North Lincs Council)

6. This investigation has not considered events after February 2023 as attempts at local resolution were ongoing.

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The Ombudsmen’s role and powers

7. The Ombudsmen have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA,as amended, and Health Service Commissioners Act 1993, section 18ZA)
8. The Ombudsmen investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, the Ombudsmen consider whether it has caused injustice or hardship. (Health Service Commissioners Act 1993, section 3(1) and Local Government Act 1974, sections 26(1) and 26A(1), as amended) If it has, they may suggest a remedy. Our recommendations might include asking the organisation to apologise or to pay a financial remedy, for example, for inconvenience or worry caused. We might also recommend the organisation takes action to stop the same mistakes happening again.
9. Sections 37/41 of the Mental Health Act 1983 (the MHA) allows people to be detained in hospital for treatment necessary for their health, safety or for the protection of other people. Section 117 (s117) of the MHA imposes a duty on health and social services to provide free aftercare services to patients who have been detained under sections 37/41 of the MHA. Councils and ICBs (which have replaced Clinical Commissioning Groups) cannot delegate these aftercare duties, regardless of the day‑to‑day arrangements for delivering a person’s aftercare. In view of this, the relevant council and ICB will always be included in Ombudsmen investigations about s117 aftercare.
10. When considering complaints, if there is a conflict of evidence, we make findings based on the balance of probabilities. This means we will weigh up the available relevant evidence and base our findings on what we think was more likely to have happened.
11. The Ombudsmen cannot question whether a decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the organisation reached the decision. (Local Government Act 1974, section 34(3), as amended, and Health Service Commissioners Act 1993, sections 3(4)- 3(7))
12. If the Ombudsmen are satisfied with the actions or proposed actions of the bodies that are the subject of the complaint, they can complete their investigation and issue a decision statement. (Health Service Commissioners Act 1993, section 18ZA and Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

13. I considered Mr A’s written complaint to the Ombudsmen and the additional information he provided by email. I wrote to each of the organisations to explain what I intended to investigate and asked questions and for copies of records. I considered all the information I received in response. I also considered relevant legislation and guidance.
14. I shared a confidential copy of a draft decision with the interested parties and considered the comments I received. I shared a confidential copy of a revised draft decision with Mr A and all the organisations and, again, invited their comments on it. I considered all the comments I received in response.

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What I found

Relevant legislation and guidance

Section 117 of the Mental Health Act 1983

15. S117 of the MHA requires councils and ICBs to provide free aftercare services to certain people. This includes people who have been discharged from detention in hospital under s37/41 of the MHA. They must provide these services from the point the person leaves hospital until the council and ICB decide the person no longer needs them.
16. S117 does not define what aftercare services are. The MHA Code of Practice (the MHA Code) gives some guidance on this. It details that: “After-care services mean services which have the purposes of meeting a need arising from or related to the patient’s mental disorder and reducing the risk of a deterioration of the patient’s mental condition (and, accordingly, reducing the risk of the patient requiring admission to hospital again for treatment for mental disorder)” (Section 33.3 of the MHA Code).
17. It also notes that aftercare can “encompass healthcare, social care and employment services, supported accommodation and services to meet the person’s wider social, cultural and spiritual needs” (Section 33.4 of the MHA Code).
18. The MHA Code also states that aftercare should aim to support people “in regaining or enhancing their skills, or learning new skills, in order to cope with life outside hospital” (Section 33.5 of the MHA Code).

Care Act assessments

19. Councils must carry out an assessment for any adult when it appears they might need care and support. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. (Care Act 2014, Sections 9 and 10)
20. There is no set definition of an assessment. The aim of the assessment is to identify what needs the person may have and what outcomes they are looking to achieve to maintain or improve their wellbeing. This should then inform the response to any identified needs. The response “might range from offering guidance and information to arranging for services to meet those needs” (Section 6.5 of the CSSG).
21. Councils are encouraged to take a holistic approach to assessment in order to “prevent that person having to undergo a number of assessments at different times, which can be distressing and confusing” (Paragraphs 6.75 to 6.78 of the CSSG).

Responsibility for support provided under the Care Act 2014

22. Councils are “only required to meet needs in respect of an adult who is ‘ordinarily resident’ in their area” (Section 19.1 of the CSSG).
23. There is no set definition of ‘ordinarily resident’. However, councils are guided that it generally refers to the person’s home being in a particular place which they have voluntarily adopted to settle in. Further, councils are advised that “Ordinary residence can be acquired as soon as the person moves to an area, if their move is voluntary and for settled purposes” (Sections 19.14 and 19.15 of the CSSG).
24. Moving between areas does not alter which council and ICB is responsible for a person’s s117 aftercare; this always remains the responsibility of the area where the person was resident when they were detained (Section 19.63 of the CSSG). However, this responsibility is for s117 aftercare alone and “any change in the patient’s ordinary residence after discharge will affect the local authority responsible for their social care services” (Section 19.64 of the CSSG).
25. If there is any dispute about where a person is ordinarily resident it should not delay the process of meeting their needs. “In cases where ordinary residence is not certain, the local authority should meet the individual’s needs first, and then resolve the question of ordinary residence subsequently” (Section 19.11 of the CSSG)

Equality Act

26. The Equality Act 2010 protects the rights of individuals and supports equality of opportunity for all. It offers protection in employment, education, the provision of goods and services, housing, transport and the carrying out of public functions.
27. The Equality Act makes it unlawful for organisations carrying out public functions to discriminate on any of the nine protected characteristics listed in the Equality Act 2010. They must also have regard to the general duties aimed at eliminating discrimination under the Public Sector Equality Duty. The ‘protected characteristics’ referred to in the Act include disability.
28. Indirect discrimination may occur when a service provider applies an apparently neutral provision, criterion or practice which puts persons sharing a protected characteristic at a particular disadvantage.
29. We cannot decide if an organisation has breached the Equality Act as this can only be done by the courts. But we can make decisions about whether or not an organisation has properly taken account of an individual’s rights in its treatment of them.

Brief overview of key events

30. Mr A used to live in North East Lincs Council’s and the ICB’s area. During that time mental health professionals detained him under sections 37/41 of the MHA. Mr A has not been discharged from s117 of the MHA since then.
31. In the second half of 2021 Mr A moved to North Lincs Council’s area. He advised staff at Navigo of this. In early November 2021 Mr A sought support from North Lincs Council. It assessed Mr A in January 2022. The assessment found Mr A had needs which were eligible for support under the Care Act 2014. The assessor said they felt Mr A would benefit from support from a personal assistant for around an hour, to an hour-and-a-half, seven days a week. The assessor noted their view that if this support was not provided Mr A’s mental health may deteriorate.
32. North Lincs Council learned that Mr A continued to be eligible for s117 aftercare, and that North East Lincs Council and the ICB were responsible for this. Because of this, it referred Mr A to Navigo in March 2022 and asked it to fund the necessary support for Mr A. North Lincs Council arranged for a local Mental Health Officer to support Mr A with household tasks once or twice a week in the interim.
33. Navigo decided it would need to complete its own assessment of Mr A’s needs. It completed this assessment in August 2022. The assessment found that Mr A did have needs which were eligible for support. The assessment recommended Mr A receive seven hours of support a week, to help prevent a deterioration in his mental health and to reduce the risk of a readmission to hospital.
34. Navigo took the recommendations of the assessment to a local individual funding panel in September 2022. The panel did not approve the proposals. The panel decided the assessment did not provide evidence that Mr A had needs which were eligible for support. It recommended more work to look at local universal services which might help Mr A, and to complete a more focused assessment with more evidence of Mr A’s needs.
35. Navigo completed a further assessment in the middle of October 2022. This again recommended seven hours of support per week. A panel considered this in November 2022 and, again, did not approve the request. After this panel Navigo arranged an Occupational Therapy assessment for Mr A. It also contacted staff from the mental health service in the North Lincs area to arrange a professionals meeting. By the end of February 2023 the situation remained the same.

Analysis

Reviewing Mr A’s needs before he moved to North Lincs Council’s area

36. Mr A has been detained under s3 of the MHA in the past and continues to be eligible for s117. There is no dispute that North East Lincs Council and the ICB are jointly responsible for Mr A's s117 aftercare. This is because Mr A was resident in their areas when he was detained under a qualifying section of the MHA.
37. From the papers available to me it seems that when Mr A’s detention was rescinded, and for a considerable period after that, he did not receive any ‘bespoke’ services, arranged and funded through s117. That is, he received support from universally commissioned mental health services, but nothing was commissioned specifically for him.
38. Navigo has acknowledged that there is nothing formally recorded on its electronic records system about Mr A receiving a s117 review. It said the records show that Mr A was due a review in March 2019 but there has been no update on the system since then. This is not in line with the MHA and is fault.
39. It is also notable that, regardless of the need for periodic reviews of Mr A’s s117 aftercare needs, Mr A also specifically asked about support under s117. In October 2021 a member of Navigo staff spoke to Mr A on the phone. During the call Mr A asked about a personal budget related to his status as eligible for s117 aftercare. The member of staff noted that they/Navigo “may need to look into this before [responsibility for day-to-day care coordination] is transferred [to North Lincs]”. I could not find any evidence to show anyone looked into this before Navigo referred Mr A on to North Lincs mental health services. This is also fault.
40. The fault identified in paragraphs 38 and 39 is with Navigo but also, ultimately, with North East Lincs Council and the ICB who cannot delegate their responsibility to plan, review and meet Mr A’s s117 needs. Navigo, on their behalf, should have actively kept Mr A’s s117 needs under review, and should have responded to Mr A’s request for support, but did not.
41. It is not possible to do anything other than speculate about what would have happened if Navigo had completed appropriate annual reviews of Mr A’s s117 aftercare. There are too many unknowns and possibilities to be able to confidently say, even on the balance of probabilities, that any one theoretical outcome would have happened. As such, it is not possible to link a specific injustice to the fault identified in paragraph 38.
42. However, on balance, if the fault identified in paragraph 39 had not happened, Navigo would have assessed Mr A’s need for s117 aftercare before North Lincs Council referred the case back to it in March 2022 (which I will turn to later in this statement). It would be reasonable to expect a service to arrange such an assessment of Mr A’s needs with two months of his request. As such, had the fault not occurred, my view is Mr A’s need for individually commissioned s117 aftercare is likely to have been considered by the end of 2021. I will return to the consideration of the impact of this in paragraphs 51 to 54.

Assessing Mr A’s needs in North Lincs

43. North East Lincs Council and the ICB did not ‘place’ Mr A in North Lincs Council’s area. He moved there voluntarily and settled there. As such, North Lincs Council has a separate responsibility to meet Mr A’s needs under the Care Act 2014. This is a different responsibility to the one North East Lincs Council and the ICB have. North Lincs Council does not need to focus on whether Mr A has any needs arising from, or related to, his mental health disorder. Rather, North Lincs Council must consider whether Mr A has any needs which impact his wellbeing and prevent him from achieving the outcomes that matter to him. This can also include considerations about a person’s mental health and emotional wellbeing, along with their social and economic wellbeing.
44. After Mr A asked for support North Lincs Council assessed him in good time. Under the Care Act 2014, local authorities have a duty to assess an individual's care and support needs, and to provide or arrange for the provision of care and support that meets those needs. This duty applies regardless of whether another council might be responsible for meeting the individual's needs under the MHA.
45. If a council identifies that someone in its area has needs which are eligible for support under the Care Act 2014, but also thinks another council might be responsible for meeting those needs under s117 of the MHA, it should take steps to ensure that the individual's needs are met in the meantime.
46. This is not to say that North Lincs Council did not have a right to refer Mr A to North East Lincs Council because it believed some of his needs should be met under s117 of the MHA. However, until it knew if Mr A’s needs would be met elsewhere it needed to ensure they were met. It also had a responsibility to work with North East Lincs Council to determine who would be responsible for meeting Mr A’s needs on an ongoing basis. This is to ensure, firstly, that Mr A received the appropriate care and support he needed. But, also, to avoid any duplication of services or confusion about responsibilities.
47. Confusion about responsibility (or disputes about the same) should not delay the provision of appropriate care. The guidance is clear that care should be put in place first and any disputes about funding should be considered later, separately and without the involvement of the person. This means that North Lincs Council should have acted after it completed its assessment to ensure that Mr A’s needs were met as far as possible. This may have meant providing interim care and support while it waited for North East Lincs Council to confirm whether it would meet Mr A’s needs under the MHA.
48. North Lincs Council arranged some limited interim support for Mr A, but not enough to match its own assessment of what Mr A needed and was eligible for. That it did not arrange support to fully meet the needs it had identified Mr A had is fault. If the fault had not happened Mr A would have received support from around March 2022. On the balance of probabilities, this would have been beneficial to Mr A. It also would have meant that he would not have had to pay for support privately. This, in turn, would have meant that he would not have accrued the same level of debt he now finds himself in.

Assessing Mr A’s needs in North East Lincs – time taken

49. North Lincs Council referred Mr A back to Navigo in March 2022. Even though Mr A no longer lived in Navigo’s area, and was not under its day-to-day care, Navigo still had a responsibility to consider Mr A’s needs and his request for support. This is because Mr A had not been discharged from s117. As such, North East Lincs Council and the ICB, through Navigo, still had a responsibility to understand whether Mr A:

• Had any needs which arose from, or were related to, his mental health disorder. And, if so, whether:
• Meeting those needs would reduce the risk of a deterioration in his mental health condition.

50. While North Lincs Council had completed an assessment of Mr A’s needs, Navigo was entitled to complete its own fresh assessment. However, Navigo did not complete an assessment until August 2022 and did not take this to an approval panel until September 2022, around six months later. Navigo said this delay was due to:

• A particular member of staff member’s training and their awareness of the panel system,
• A lack of attention and response to email conversations,
• Intermittent oversight from Service Managers which was compounded by the lack of a Team Leader and Senior Operational Manager at the time, and
• Organisational changes over the period.

Mr A told me that he had regular telephone conversations with Navigo’s Patient Advice and Liaison Service throughout his wait for an assessment. He said staff did not reference any of these reasons during those calls.

51. Regardless of the reasons, it should not have taken Navigo this long to complete its assessment. This was fault. Without fault, the assessment should have been completed by early May 2022 at the latest. This delay, alongside the earlier failure to respond to Mr A’s request for support before Navigo transferred his care, and the fault I found with North Lincs Council, was another contributory factor for why Mr A remained without support. This is because the avoidable delays meant the confusion about who was responsible for meeting all of Mr A’s needs (and whether they would be eligible for support under one piece of legislation or another) dragged on and remained unresolved for much longer than necessary.
52. On balance, if this fault had not occurred an earlier assessment and panel decision would have reached the same decision it made in September. However,

• Mr A would have been able to challenge this decision sooner,
• The Panel(s) would have been able to ask for additional work and evidence sooner, and
• North Lincs Council would have known of the decision sooner.

53. Also, in April 2023 a panel agreed to fund one hour of support, seven days a week, for six weeks. Mr A is unhappy with the outcome of this panel but his concerns about this are outside the scope of this investigation. Because of this, I cannot comment either way on the agreed package. However, I mention it as it helps to further assess the probable impact of the faults I have identified. It is reasonable to assume that had Navigo begun its assessment of Mr A’s s117 aftercare needs in reasonable time after Mr A’s first request (in October 2021), it would have reached the decision to offer this limited care package earlier than February 2023.
54. As such, the impact of the fault is that it prevented the timely progress of this case and meant Mr A effectively remained ‘in limbo’ for months. Further, had the fault not occurred, during the period under review, North East Lincs Council and the ICB would have funded, at the very least, a total of 42 hours of support for Mr A. This, in turn, means North East Lincs Council, the ICB and Navigo hold some responsibility for Mr A’s decision to pay for support privately and, in so doing, accrue debt.

Assessing Mr A’s needs in North East Lincs – assessment process and decision

55. North East Lincs Council, the ICB and North Lincs Council all had responsibilities to meet Mr A’s needs. However, their responsibilities related to different legislation and, more importantly, different eligibility criteria. Because of this, it was reasonable for Navigo to decide to complete its own assessment of Mr A’s needs to consider, specifically, if they qualified for support under s117 of the MHA. Further, the decision to use a funding panel to consider and approve individual funding requests is not, in itself, unreasonable.
56. From the evidence available to me Navigo appears to have completed reasonably robust assessments of Mr A’s needs. They suggest the assessing professionals took their time to understand Mr A’s views and considered Mr A’s circumstances against established criteria. The panels in September and November 2022 provided rationales for why they did not accept the recommendations of the assessment. They also invited further work and more evidence gathering. As such, I have not found any evidence of fault in the process Navigo followed to assess Mr A’s needs. Because of this, there are no grounds for me to challenge or question the professional judgement of the panels that Mr A did not need support under s117 of the MHA. I appreciate that North Lincs Council reached a different conclusion. However, it was assessing Mr A’s needs against different criteria.

Equality considerations

57. Mr A complains that Navigo’s assessment of his needs took longer than it would have done had he not lived ‘out of area’. Mr A said the only reason he lives in his current social housing is because of a disability. Mr A said, as such, Navigo (and, by extension, North East Lincs Council and the ICB) indirectly discriminated against him because of a protected characteristic.
58. From the evidence available to me I cannot see that the location of Mr A’s home was a contributory factor in the delay in assessing his needs. I have not seen any reference to journey times or travel costs affecting decisions about whether, and when, staff would visit Mr A to assess him. Rather, as Navigo has noted in its own response, the reasons for the delays appear to have been issues which would have affected the local population at large and not just those with protected characteristics. As such, I have not found evidence to suggest there was any fault by Navigo in regard to failing to have proper regard to Mr A’s protected characteristics.

Overall consideration of injustice

59. If the faults in this case had not occurred it is probable North Lincs Council would have funded 12 hours of support each week to meet Mr A’s needs from around March 2022 to February 2023. This equates to roughly 47 weeks, giving a total of 564 hours of funding. It is probable this would have been funded at a rate of around £15 per hour, giving a total of around £8,460.
60. For at least six weeks of that time, without the fault, the other organisations would have paid for 42 of those hours. This would not have been in addition to the support North Lincs Council provided so would have reduced the amount of hours of funding it would have provided to 522.
61. It is possible that North Lincs Council may have reviewed its assessment of Mr A’s needs during this time and changed the amount of provision it considered it needed to provide Mr A. This could have included an assessment that there were no outstanding needs for it to meet. Similarly, it is possible that, after six weeks, Navigo, North East Lincs Council and the ICB would have found a need to commission more care for Mr A. However, I can do no more than speculate about any of these matters and have no way of objectively predicting what may have changed or been decided. Further, until there is another assessment of Mr A’s needs by North Lincs Council, taking into account his agreed s117 care, I do not know if there any needs which should be met under the Care Act. The delays by Navigo, North East Lincs Council and the ICB had an impact on North Lincs Council, not just on Mr A. Without those delays North Lincs Council would have been able to complete further work which could have reduced or removed the amount of support it owed to Mr A. However, this does not change the responsibility it had to put care in place after it assessed Mr A’s needs, and to keep that care in place until it could be satisfied there were no outstanding needs for it to meet under the Care Act, outside of what others would provide under s117. Regardless of any dissatisfaction it may have felt about the delays, it would not have been appropriate for North Lincs Council to have removed funding for Mr A without the relevant assessments. Therefore, on the basis of the evidence available to me, North Lincs Council was responsible for around 92.5% of the funding Mr A should have received but did not, and the other organisations are collectively responsible for around 7.5% of the funding.
62. The Ombudsmen’s approach is to try and put people back in the position they would have been in had the fault not occurred. This means that, for financial matters, we tend to ask services to reimburse people for the cost of support they paid for privately. We do this rather than asking services to pay what they would otherwise have paid for the services they should have commissioned.
63. One of the features of Mr A’s needs is that he is not particularly strong at managing money or record keeping. For this reason it has not been possible to establish a clear account of how much he spent on support during this period. Mr A estimates that, on average, he paid for five hours of support a week. Assessments note the company he used charged £17 an hour. Using these figures Mr A potentially spent around £3,995 from March 2022 to February 2023.

Complaint handling

64. Mr A complains about the complexity and inefficiency of the complaints service in North East Lincolnshire. Mr A complained to Navigo in April 2022 and received a written response around a month later.
65. Mr A explained that he later tried to submit a complaint directly to North East Lincs Council but its website directed people to complain to a Clinical Commissioning Group (since replaced by the ICB). Mr A said when he contacted the ICB it told him to contact Navigo. The papers I have seen show the ICB responded to Mr A’s emails in a timely way in August 2022 and staff tried to clarify the situation. It is apparent that the concerns about North Lincs Council added confusion to the situation.
66. However, from September 2022 the complaint handling does appear to have been unnecessarily convoluted:

• North East Lincs Council wrote to Mr A at the end of September and said it would not be appropriate for it to consider the complaint until the ICB had.
• Navigo wrote to Mr A in late October. It gave a brief overview of events since October 2021. It did not identify any failings in its actions.
• The ICB wrote to Mr A at the end of October and asked to clarify his concerns.
• The ICB wrote to Mr A in early November and asked for a copy of Navigo’s complaint response.
• The ICB wrote to Mr A in the second half of December and said it could not look into his concerns because Navigo was still investigating.

67. As North East Lincs Council, the ICB and Navigo all had responsibilities to Mr A, with considerable overlap, the onus should have been on them to work together to manage Mr A’s complaint efficiently and effectively. It should not have been left to Mr A to separately contact three departments to try to move his complaint forward. This was fault, by all three organisations, and caused Mr A avoidable frustration and stress.

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Agreed actions

68. Within one month of the final decision North East Lincs Council, the ICB and Navigo should collectively write to Mr A to acknowledge the fault identified in paragraphs 38, 39, 51 and 67. They should also apologise for the impact these faults had on Mr A, as identified in paragraphs 42, 51 to 54 and 67.
69. Within one month of the final decision North Lincs Council should write to Mr A to acknowledge the fault identified in paragraph 48. It should also apologise for the impact this fault had on Mr A, as identified in paragraph 48 and 51 to 54.
70. Within one month of the final decision North Lincs Council should arrange a reassessment of Mr A’s need for support under the Care Act 2014. This should take account of a recently agreed package of support other organisations will provide to Mr A through s117 and should consider whether Mr A has any outstanding, unmet and eligible needs for support under the Care Act 2014. If the reassessment identifies any unmet eligible needs it should implement the findings of the assessment in a timely manner.
71. Within two months of the final decision North East Lincs Council, the ICB and Navigo should collectively pay Mr A:

• £300 (in total) to reflect 7.5% of the money Mr A spent on private care.
• £250 (in total) to act as a tangible recognition of the avoidable stress and upset their fault contributed to, in regard to the assessments of Mr A’s need for support.
• £100 (in total) to act as a tangible recognition of the avoidable frustration and stress their fault caused, in regard to the problems Mr A encountered when trying to complain.

72. Within two months of the final decision North Lincs Council should pay Mr A:

• £3,695 to reflect 92.5% of the money Mr A spent on private care.
• £250 to act as a tangible recognition of the avoidable stress and upset its fault contributed to.

73. Within three months of the final decision all the organisations under investigation should create specific, measurable, realistic and timebound action plans to address the factors which led to the faults in this case, with the aim of reducing the chance of recurrences.

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Decision

74. I have completed this investigation on the basis that there was fault which caused Mr A an injustice which will be remedied by the recommendations I have made.

Investigator’s decision on behalf of the Ombudsmen

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Investigator's decision on behalf of the Ombudsman