London Borough of Enfield (23 002 241)

Category : Adult care services > Assessment and care plan

Decision : Not upheld

Decision date : 28 Mar 2024

The Ombudsman's final decision:

Summary: Mrs X said she asked the Council to assess her needs and offer her an advocate since November 2020 and the Council failed to do so. We have not found evidence of fault. The Council has now offered Mrs X an assessment of her needs with the assistance of an advocate.

The complaint

  1. Mrs X complains about the Council’s failure to re-assess her needs for care and support after it carried out a previous assessment in 2019. Mrs X also made complaints relating to the 2019 assessment.

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The Ombudsman’s role and powers

  1. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
  2. 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

  1. I have not investigated Mrs X’s complaints about the needs assessment that the Council carried out in 2019 as the Ombudsman has already investigated this complaint.
  2. Mrs X also said she did not have an advocate in 2019 to make her complaint about the 2019 assessment and therefore the complaint she made was not valid and she should be allowed to make a further complaint about the 2019 needs assessment. I have not further investigated this complaint as it is unlikely we would find fault.
  3. The Ombudsman said, in its previous investigation, that Mrs X did not need an advocate to participate in the 2019 needs assessment. Mrs X did not have any substantial difficulty being involved in the assessment process and there was no evidence that she struggled to take part in the assessment. The Ombudsman said there was no fault in the Council’s decision not to provide her with an advocate and the decision was in line with the Statutory Guidance.
  4. It is therefore unlikely we would find fault now with Mrs X not having an advocate in 2019 to make the complaint about the 2019 assessment and nothing can be achieved from further investigating this.

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How I considered this complaint

  1. I have discussed the complaint with Mrs X. I have considered the information that she and the Council have sent, the relevant law, guidance and policies and both sides’ comments on the draft decision.

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What I found

Law, guidance and policies

  1. The Care Act 2014, the Care and Support Statutory Guidance 2014 set out the Council’s duties towards adults who require care and support.
  2. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support.
  3. The threshold for eligibility is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing. Council must consider whether:
    • The adult’s needs arise from a physical or mental impairment or illness.
    • As a result of the adult’s needs the adult is unable to achieve 2 or more of the specified outcomes.
    • As a consequence of being unable to achieve these outcomes there is a significant impact on the adult’s wellbeing.
  4. Local authorities must arrange an independent advocate to facilitate the involvement of a person in their assessment if the following conditions are met:
    • The person is unable or would have substantial difficulties to be fully involved in the process.
    • The person has no other person, family member or friend who could provide assistance.

Background

  1. Mrs X is an adult woman who has a mental health diagnosis. She says she also has physical disabilities. She says she asked for support from the Council to meet her needs.
  2. The Council assessed Mrs X’s needs for care and support in October 2019. Mrs X said the information in the assessment was not correct and said she had not been offered advocacy. She complained to the Council about the assessment in December 2019. The Council responded to the complaint in January 2020 and did not uphold her complaints.
  3. Mrs X was not satisfied with the Council’s response and asked the Ombudsman to investigate her complaints about the assessment. The Ombudsman carried out an investigation into Mrs X’s complaints about the 2019 assessment and made its final decision in November 2020.
  4. The Ombudsman did not find fault with the Council’s decision not to appoint an advocate for the assessment of Mrs X and said there was no fault in the Council’s provision of reasonable adjustments for Mrs X. The Ombudsman said there was fault as not all the information was accurately recorded in the assessment.
  5. Mrs X contacted the Mental Health NHS Trust for an assessment and the Trust assessed Mrs X. Mrs X made a complaint about this assessment to the NHS Trust. The NHS Trust provided its final response to the complaint in April 2023 and did not uphold her complaints.
  6. Mrs X contacted the Ombudsman in April 2023. She said there was fault in the Council’s assessment from 2019 and wanted the Ombudsman to reinvestigate her complaint about the 2019 assessment. She said she did not have an advocate when she made the complaint about the 2019 assessment. The Ombudsman explained that it would not investigate complaints about the 2019 assessment as the complaints about this assessment had already been investigated.
  7. Mrs X said that the Council had also failed to re-assess her needs for care and support and failed to offer her an advocate since the Ombudsman investigated her previous complaint, despite repeated requests by her to do so.
  8. The Ombudsman said this was a new complaint and Mrs X should have made this complaint to the Council first before coming to the Ombudsman. The Ombudsman then referred this new complaint to the Council in May 2023 so that the Council could investigate the complaint.
  9. The Council responded on 22 June 2023. It agreed to offer a fresh assessment to Mrs X and was in the process of arranging an advocate to assist her in the assessment.
  10. The Ombudsman said it would therefore close its investigation as, even if the Ombudsman had found fault in terms of delay from November 2020 to the present, it could not say whether Mrs X suffered any injustice without knowing the outcome of the needs assessment that the Council had offered.
  11. Mrs X said she still wanted the Ombudsman to investigate the delay from 2020 to 2023 in assessing her and providing her with an advocate. The Ombudsman agreed to investigate the complaint.

My investigation

  1. I asked the Council to send me any communication between the Council and Mrs X about an assessment since 2020. The Council said there was no communication between February 2020 (which related to Mrs X’s previous complaint about the 2019 assessment) and February 2023.
  2. In February 2023 Mrs X contacted the Council to ask for a needs assessment. The Council organised a date for the assessment in April 2023, but Mrs X then declined the assessment as she wanted an advocate to be present. Mrs X was referred to an advocacy service in May 2023 and there was then further communication in the following months when the social worker tried to find a date for the assessment which the social worker, Mrs X and the advocate could attend.
  3. Mrs X then said she still wanted her complaints relating the 2019 assessment to be investigated and said this should take place before the new assessment could be completed. The Advocate explained to Mrs X that she could support her in the new needs assessment but not in a complaint about the 2019 assessment. It is our understanding that the Advocate then withdrew the advocacy service as Mrs X had said she did not want a new assessment until the issues about the 2019 assessment had been addressed.
  4. Mrs X then informed the Council that she did not want to proceed with the new needs assessment as she did not have an advocate and she wanted to know what the outcome of the complaints about the 2019 assessment was.
  5. The Council has confirmed that the offer of a fresh needs assessment is still open to Mrs X and the Council would organise an advocate to support Mrs X in that assessment if Mrs X wanted an advocate.

Analysis

  1. There is no evidence that Mrs X asked for an assessment of her needs and an advocate between November 2020 and February 2023 so I cannot say there was fault in the fact that the Council did not offer an assessment or an advocate during that time.
  2. The Council has offered Mrs X a further needs assessment with the assistance of an advocate and Mrs X can take up this offer if she wishes to do so.

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Final decision

  1. I have completed my investigation and have not found fault by the Council.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman

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