Summary: Mrs X complained the Council’s assessments of Mr Y’s care and support needs were not person centred enough and have not taken account of his views or wishes. Mrs X also complained about a lack of support and guidance from the Council in managing Mr Y’s dysregulation and challenging behaviour. There was no fault in the way the Council assessed Mr Y’s needs. There was fault when the Council failed to update Mr Y’s assessment with details about his challenging behaviours. The Council apologised and updated Mr Y’s assessment. This remedies the injustice.

The complaint

1. Mrs X complained the Council’s assessments of Mr Y’s care and support needs have not been person centred enough and have not taken account of his views or wishes.
2. Mrs X said Mr Y wanted to join the Steps programme after college, which the college supported, but the Council refused. Mrs X does not feel current arrangements support Mr Y to live independently.
3. Mrs X also complained about a lack of support and guidance from the Council in managing Mr Y’s dysregulation and challenging behaviour.
4. Mrs X said the lack of clear plan for Mr Y’s future, and the lack of guidance and training to help her support him, led to Mr Y having much higher levels of anxiety.

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The Ombudsman’s role and powers

5. 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)
6. 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

7. As part of the investigation, I considered the complaint and the information Mrs X provided.
8. I made written enquiries of the Council and considered its response along with relevant law and guidance.
9. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Transition from children to adult services

10. When a child reaches 18 years of age, they are legally an adult and responsibility for meeting their needs moves from the council’s children services to its adult services. The legal basis for assessing their needs changes from the Children Act 1989 to the Care Act 2014. However, councils can decide to treat a children’s assessment as an adult assessment and can also carry out joint assessments.
11. The council must involve the young person in the assessment and should consider whether they need an advocate to fully participate. It should also involve anyone else the young person wants to involve, such as their carer. Care leavers will also have a personal adviser to provide support, who should also be involved in the transition planning.
12. The assessment must identify all the young person’s needs for care and support and identify the outcomes the young person wishes to achieve. The assessment should also consider whether the carer is able to continue in their caring role after the young person turns 18.

Staying put

13. Staying put guidance says councils may choose to extend foster placements beyond the age of 18. All councils must have a policy in place to ensure transition from care to independence and adulthood is based on their needs and not on age alone. For some young people with complex special educational needs (SEN) or care needs the council may decide the best way to meet those needs, even after they have turned 18, is through its children’s services and the legislation allows for this to happen. However, children and adults’ services must still work together and agree that children’s services should continue after age 18.
14. Staying put guidance says policies on staying put should set out “whether additional allowances provided when the child was a foster child to ensure they were embedded in the family will continue, for example holiday allowances, birthday and Christmas/festival allowances”.

Assessment

15. 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. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.

Care Plan

16. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan. 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. When preparing a care and support plan the council must involve any carer the adult has. 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.

Shared Lives

17. Shared Lives schemes provide an alternative to traditional social care accommodation and support for adults. Under Shared Lives schemes service users who cannot live independently receive care and support from ordinary family households called Shared Lives carers.
18. Users of Shared Lives schemes may include people with learning disabilities, people with mental health problems, care leavers, and disabled children becoming young adults.
19. Shared Lives care may include:
• Accommodation and support.
• Short breaks.
• Daytime support.
• Rehabilitation.
• Kinship support, where the carer acts as extended family to someone living in their home.
20. Shared Lives Carers can be individuals, couples or families. Carers are recruited and assessed by the council to provide care to services users. Scheme operators have a responsibility to ensure Shared Lives carers receive suitable training around relevant legislation e.g. the Care Act 2014 and the Mental Capacity Act 2005. They should also receive training relating to specific areas such as safeguarding, community living, and personal care.
21. Councils have a responsibility to assess the needs of the Shared Lives service user as set out in the Care Act 2014. There should be a written support or care plan showing how the service users’ needs will be met in the placement.

Steps

22. Steps is a programme for young people with learning needs who have left education but want to learn skills for work and life.
23. The programme works on money, shopping, cooking, laundry, personal care, planning trips, and using public transport.
24. Young people can live in houses run by the Steps programme, or they can visit for the day.

What happened

25. I have summarised below some key events leading to Mrs X’s complaint. This is not intended to be a detailed account of what took place.
26. Mrs X is a shared lives carer for Mr Y. Prior to the issues complained about, Mr Y attended college during the day. He also had some overnight respite stays at the college. He left college in July 2023, meaning Mrs X and the Council had to plan for his next steps before he left.

Mr Y’s views and wishes

27. Mrs X contacted the Council in November 2022. She said when college ends, Mr Y wanted to do the Steps programme during term time and stay with Mrs X during holidays. She asked for Mr Y’s care plan to reflect this.
28. Mr Y’s social worker confirmed they would speak to the college offering the Steps programme. However, they could not guarantee the Council’s panel would agree this, as it would depend on the outcome of Mr Y’s needs assessment.
29. Mr Y’s social worker discussed Mr Y’s future with him in December 2022. Mr Y wanted to live in a house with a group of friends. He mentioned working at a garden or nature centre.
30. In January 2023, the Council told Mrs X the Steps programme is considered a residential placement, so there would need to be a substantial reason for the Council to recommend it.
31. The Council completed a needs assessment for Mr Y on 23 January 2023. The assessment states Mr Y’s carers feel the Steps programme is best for Mr Y, to introduce him to supported living after college.
32. However, the Council noted the Steps programme had not been agreed by its social care service, as there was no identified need for it. The professional opinion of Mr Y’s social worker was that Mr Y’s needs and wishes could be met within the community, with a holistic support plan around transition and access to community resources and support.
33. The Council said all Mr Y’s needs were being met by his college, respite care, and his shared lives carers. It noted Mr Y was due to leave college in July 2023. It said it would explore a new package of support to meet his needs.
34. A shared lives officer provided the Council with a letter from the college on 1 March 2023, supporting Mr Y’s wish to join the Steps programme.
35. The Council telephoned Mrs X on 29 March 2023. It said it would not offer a 38-week residential placement and a shared lives package for Mr Y. It said shared lives meets Mr Y’s needs. Mrs X said Mr Y wanted to have time away. The Council said this can be achieved through respite and Mr Y did not need a 38-week placement. It said it could look at an alternative placement and plan Mr Y’s transition around that. The Council agreed Mr Y’s new social worker would discuss this with Mrs X and Mr Y and start planning around post education.
36. The Council held a transition meeting on 30 March 2023. It planned to develop a package of care for Mr Y to build on his relationships and develop towards supported living. The Council also agreed to look into whether Mr Y could have overnight stays at potential placements.
37. Mrs X contacted the Council in April 2023. She questioned whether the Council was looking for a placement for Mr Y in September. The Council said it would only do so if Mr Y was no longer staying with Mrs X. Mrs X wanted Mr Y to stay with them for now and move on in future. The Council agreed. It said it would not move someone who was happy and whose needs are met.
38. Mrs X also told the Council about a possible volunteering opportunity for Mr Y in September at a local farm (the farm).
39. Mrs X emailed the Council in May 2023. She said Mr Y would still prefer to do the Steps programme. However, if he cannot then he would like to go to the farm four days a week.
40. Mr Y’s personal advisor visited him later in May 2023. They noted he appeared happy. He had visited the farm and liked it.
41. In June 2023, the farm told the Council Mr Y had enjoyed a visit there and it had capacity in September for him to attend three or four days a week.
42. Mr Y’s personal advisor visited him in July 2023. Mr Y was looking forward to starting at the farm and knew some people who attend there.
43. Mr Y was transferred to the Council’s moving on service in August 2023. He remained in his shared lives placement with Mrs X, but now funded by the Council’s adult social care 18-25 service.
44. At a meeting on 1 September 2023, Mr Y said he was enjoying attending the farm. Mrs X said he was coping well with the changes. She wanted to start looking at supported living placements for Mr Y, as Mrs X planned to sell her home.

Challenging behaviour

45. A behaviour practitioner (the practitioner) met with Mrs X and Mr Y in July 2022 to discuss an incident where Mrs X had to restrain Mr Y. The incident happened in the kitchen. Mr Y was startled by the sound of a food mixer. Mrs X reflected on the incident and now double checks things before starting to cook with Mr Y.
46. The practitioner noted Mrs X needed to restrain Mr Y five times in the previous twelve years. This was in the form of a hug from behind.
47. The practitioner recorded they talked to Mrs X about the legalities, risks, and consequences of using restraint or safeholds when not trained. The practitioner recorded Mrs X had good understanding of positive behaviour support, could identify Mr Y’s triggers and the early indications of when he became anxious, and could support him to use strategies to calm down.
48. The practitioner concluded Mr Y did not need a positive behaviour support plan as the family do not have problems managing the few times he becomes anxious or angry and there are no concerns from Mr Y’s college. The practitioner said they talked to Mrs X about least restrictive options for when Mr Y becomes over aroused, giving him space to calm.
49. A behaviour incident took place in November 2022 when Mr Y attended a light festival. Mrs X said it was difficult to manage. She felt it would be easier having two people with Mr Y when he visits a busy environment.
50. A further incident happened in February 2023. Mrs X had to restrain Mr Y in public and the police were called. The Council noted Mr Y’s care assessment had not been updated with the information about his behaviour and safe holds from the practitioner following their meeting in 2022.
51. The Council contacted the practitioner for confirmation of their advice. The practitioner said they found Mrs X knew Mr Y extremely well and was skilled at distraction when he becomes distressed.
52. The Council noted Mr Y’s social worker should update his care assessment to include behaviour strategies in line with the practitioner’s report.
53. There was an incident in May 2023 where Mr Y displayed physical and verbal aggression. Mrs X placed him in a hold position until he calmed down. Mrs X considered this was possibly linked to anxiety and uncertainty about his future plans.
54. The Council referred the incident to the practitioner, who said they would discuss it. They also said the Council should raise a safeguarding alert, which it did.

Complaint to the Council

55. Mrs X complained to the Council in March 2023. She said:
• The Council was not listening to Mr Y’s wishes and feelings.
• His current assessment does not adequately describe his level of need and is out of date.
• His request to join the Steps programme has not been taken to panel and the Council has not said why.
• The Steps programme would meet Mr Y’s needs and provide a transition between his current situation and his goal of living in a shared house with support in the community.
• She requested a written plan about how to manage Mr Y’s behaviour following an incident in January 2022, but this had not been received.
56. The Council responded to Mrs X’s complaint on 28 March 2023. The Council apologised for the delay completing Mr Y’s needs assessment. It said his social worker was making some amendments in line with Mrs X’s comments.
57. It said Mr Y is living with Mrs X under a shared lives agreement which meets his needs under the Care Act, along with support to access college. It said it would not look to find an alternative placement unless Mrs X no longer wanted to be Mr Y’s shared lives carer. It said it appreciated Mr Y wished to join the Steps programme, but said this was not an option put forward by the Council.
58. The Council said it will support the shared lives placement with more respite, currently being met through education. It said this could be a direct payment, day opportunities, and some overnight respite.
59. The Council said it made a referral to a behaviour practitioner, who met with Mrs X and Mr Y. The practitioner suggested some information was incorporated into Mr Y’s care plan, but said Mr Y did not need a behaviour plan. Mr Y’s social worker included the practitioner’s email in Mr Y’s assessment. The Council said they would follow up with the practitioner about any additional information not included.
60. The Council acknowledged some delays completing and updating Mr Y’s needs assessment, including how best to support him in times of uncertainty. The Council apologised for this. It said it would continue to look at ways to support Mr Y and Mrs X as a shared lives carer.
61. Mrs X was not satisfied with the Council’s complaint response. She asked the Council to consider her complaint at stage two of its complaint process. She said she did not feel the Council adequately addressed the areas of complaint she raised. She said Mr Y’s wishes and feelings are still not being listened to and there was still no guidance on how to manage Mr Y’s periods of dysregulation.
62. The Council sent its stage two complaint response on 19 May 2023. It said it sent an updated needs assessment for Mr Y on 17 May. It said Mr Y’s social worker added the practitioner’s letter to Mr Y’s assessment as an attachment. They also included further information from the practitioner. The Council said Mr Y’s views are included in his assessment.

My investigation

63. The Council told me Mr Y’s case assessments in 2021 and 2023 both consider his views. This includes his views about spending time with his mother and continuing his relationship with his shared lives carers. Mr Y’s assessment also details his aspirations to work outdoors and use his horticultural skills.
64. The Council said Mr Y lives with Mrs X under a shared lives arrangement, which Mr Y’s assessments confirm is meeting his needs. There was no indication Mrs X no longer wanted to be Mr Y’s shared lives carer.
65. The Council recognised Mr Y wanted to join the Steps programme. However, it said this was not an option it put forward. Mr Y’s current care package includes a shared lives arrangement with Mrs X, four days a week at the farm, and three nights’ respite at college each month.
66. The Council told me it made a referral to a behaviour practitioner with the aim of providing a plan to support Mr Y’s behaviour. However, the practitioner did not feel Mr Y needed a positive plan. They gave some additional information to be included in Mr Y’s care assessment.
67. The Council said Mr Y’s care assessment now includes details about his behaviour, the triggers, indicators to look for, and strategies to support him.

Analysis

Mr Y’s views and wishes

68. I have not seen evidence the Council did not listen to Mr Y’s wishes. His views are recorded in assessments and in the Council’s case notes of meetings and visits. The Council is aware Mr Y wanted to join the Steps programme, but said it was not an option while his needs were being met in a shared lives placement.
69. Mr Y’s social worker considered his needs could be met with a support plan in the community. That was the social worker’s professional opinion after assessing Mr Y and I did not find evidence of fault.
70. The Council must consider people’s views and wishes, but if it can meet their needs in other ways it is entitled to do so. The respite and support Mr Y receives includes farm work and some stays at the college where the Steps programme is held. This is in line with the sort of activities and experience Mr Y expressed he wanted. I have not seen evidence of fault in the Council’s consideration of Mr Y’s eligible needs. I have also not seen evidence the current arrangements do not meet Mr Y’s assessed needs.

Challenging behaviour

71. The Council was at fault when it did not adequately update Mr Y’s care assessment following the behaviour practitioner meeting in July 2022. I found the Council intended to update Mr Y’s assessment with observations from the practitioner. However, for reasons which are not clear, it failed to do so.
72. The Council’s failure to properly update Mr Y’s assessment caused uncertainty and worry for Mrs X. She was concerned about having to use holds on Mr Y, which could lead to safeguarding issues. She wanted a written plan about what to do in situations where Mr Y’s behaviour escalated.
73. However, I found the remaining injustice resulting from this fault is limited. That is because the Council apologised to Mrs X, and it has now updated Mr Y’s care assessment.
74. I appreciate Mrs X wanted more guidance, but the practitioner concluded Mr Y did not need a behaviour plan. They considered events of escalated behaviour were rare, and Mrs X is already skilled in dealing with Mr Y’s challenging behaviour.
75. There were more incidents of challenging behaviour after the practitioner meeting. This includes an incident where Mrs X had to use a hold on Mr Y and the Council had to raise a safeguarding alert.
76. The Council sought further comments from the practitioner and has updated Mr Y’s assessment. Mr Y’s assessment now contains more information about his behaviour and strategies to manage it. There is still no behaviour plan of the kind which Mrs X wants. However, I do not consider the Council is at fault for this, because I found the practitioner remained of the view Mr Y did not need a behaviour plan. This is something to keep under review. If there are more incidents the Council will need to consider whether another behaviour practitioner meeting is needed.

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Final decision

77. I completed my investigation. There was no fault in the way the Council assessed Mr Y’s needs. There was fault when the Council failed to update Mr Y’s assessment with details about his challenging behaviours. The Council apologised and updated Mr Y’s assessment. I consider this remedies the injustice.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman