Summary: Mr X complains the council delayed a re-assessment of his mother’s care needs and failed to update him and respond to his queries appropriately. We found there was delay in acting and that the Council’s communication could have been improved, causing Mr X frustration. We recommended the Council provided a written apology and sent a written explanation of its decision on Mr X’s request for additional care for his mother.

The complaint

1. Mr X complains that the council:
• Delayed responding to a request he made in March 2023 for a re-assessment of his mother’s care needs and a delay agreeing funding.
• A member of staff that he spoke to was rude and unprofessional.
• There was a failure to get back to him and poor communication about the matter in general.
• The Council’s response to the complaint did not explain why his mother’s case had been moved to an alternative team without him being informed.

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The Ombudsman’s role and powers

2. 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)
3. 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

4. I spoke to Mr X and considered the complaint he raised. I asked the Council for information and considered its response to the complaint.
5. Mr 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

Council Policy for Reviewing Care and Support Plans

6. The Council’s policy states:
7. Where a request is made and there is information to suggest someone’s circumstances have changed, an immediate review should be arranged. The policy sets out that reviews should be person centred and where possible, involve the person who needs care. It sets out factors to consider when arranging a review.
8. Section 9.4 describes actions to take if there is disagreement about the review outcome. It states attempts should be made to achieve a local resolution and staff should review available evidence. Where necessary a manager should be involved and records should be kept to explain the decision and how it has been explained.

What Happened

9. Mr X’s mother (Mrs Y) lives with him and she has various care needs. Mrs Y receives a package of care at home in addition to the support provided by Mr X and his wife. The existing package of care involves four care calls per day. These are funded via direct payments.
10. On 29 March 2023 Mr X contacted the Council to request an increase in the length of each of the care calls. This was because Mrs Y now took a long time to eat her food and needed constant prompting.
11. The Council advised Mr X that a review of Mrs Y’s care would be needed before the care package could be increased. The Council promised to call Mr X back the following day. An officer did call Mr X but got no answer.
12. Mr X complained on 25 April and a team manager called Mr X. Mr X explained he was frustrated by the lack of contact from the Council. The team manager explained a new worker in the Community Team was being allocated because of a restructure and they would make contact to arrange to complete a re-assessment. As this would take some time to complete, the team manager agreed to temporarily increase the support while it was being arranged.
13. A response to Mr X’s complaint was sent on 24 May. It responded to a complaint Mr X made about rudeness by a particular officer who stated she was off-duty when she answered the call and promised a call back that Mr X did not receive. The Council explained the reasons and context for her comments and it acknowledged a query Mr X raised was not passed on. The letter set out actions the Council intended to take. These included reminding duty workers to be clear if someone different may take a query forward, reminding staff to give realistic timescales for actions to be carried out and to remind staff of the need for professionalism and sensitivity when dealing with families, who were often going through stressful times.
14. The Community Team spoke with Mr X in early May and carried out a review of Mrs Y’s care needs on 1 June.
15. Mr X chased the outcome on 8 June, stating the officer who visited had told him she would refer the matter to a panel, hopefully on Tuesday 6 June. The Council updated Mr X about expected timescales. An assessment report was completed on 19 June and this was put to a panel on 20 June. Mr X stated he intended to go ahead and arrange a longer evening call with the care provider in the meantime.
16. On 20 June the panel refused the increase on the basis that more information was needed to explain what was happening and why the existing care package was unable to manage this. The panel sought information from the care agency providing the care. The officer contacted Mr X and arranged to visit Mrs Y to observe her care on 6 July 2023.
17. The Direct of Adult Social Care spoke to Mr X on 19 July. They explained there were some staffing issues that may delay the completion of the assessment. Mr X raised the issue of an interim increase of funding that the team manager proposed in April. The Director asked staff to look into this following the call. On 31 July, after Mr X chased for an update, the Council arranged for Mrs Y’s personal budget to be increased by £57.13 per week to allow care calls to be extended while the re-assessment continued. The increase was backdated to 1 May 2023. The backdated payment was made on or around 2 August.
18. Two visits were arranged to observe the care calls on 18 and 22 August. As a result of the visits information was requested from Mrs Y’s GP regarding her fluid intake. The Council told us the observations of the care visits carried out in August 2023 identified no need for extended care calls. As a result, the Council did not refer the matter back to the panel.
19. On 29 September Mr X chased the Council for the outcome of the review and assessment visits. He noted several other issues had not been resolved from previous contacts. These were, provision of a shower seat and arranging a carers assessment for him. The Council provided an update on 2 October. It later confirmed the carers assessment referral had been made and should take place shortly.
20. There is evidence the Council contacted Mrs Y’s GP and the care company providing her care. The GP provided information. The care company stated Mr X, as a holder of Lasting Power of Attorney (LPA) had told them they could not share information with the Council without his agreement. Mr X had not agreed to the care company sharing information with the Council.
21. On 19 October the Council emailed Mr X to book in a full care needs assessment for Mrs Y. I understand Mr X did not reply to her email. However, in correspondence with the chief executive’s officer on 19 October about a subsequent complaint, Mr X stated he no longer wanted to deal with that social worker and wanted another member of staff allocated. A response to several specific questions Mr X raised was sent on 24 October.
22. When social workers arrived to carry out the assessment on 26 October, Mr X stated he had asked the Council to change his mother’s social worker and he would not allow them to enter.
23. The Council stated due to concerns about Mrs Y’s overall care and wellbeing the matter had been referred to a risk panel and while it had determined that there were no grounds to increase Mrs Y’s direct payments and extend her care calls, social workers were continuing to monitor the situation. The Council extended an apology to Mr X for the delays in communication and the delays putting in place the temporary direct payment increase and further visits carried out in August 2023.

What should have happened

24. When a service user or their carer requests a review of their care plan, this should take place promptly. Mr X’s request was made in March 2023 because he had some concerns that his mother’s needs were not being met. The Council’s policy says arrangements to review a care plan in these circumstances (where it is believed someone’s needs may have changed) should take place immediately. The review did not take place until 1 June. The initial delay was fault.
25. There was no fault in the Council’s decision that more information was required to consider increasing Mrs Y’s care package. This is a decision the Council’s panel was entitled to take. However, there was some further delay in arranging to visit and observe care visits and in considering they matter further. This was also fault.
26. The Council told us its August visits identified no need for extended care calls, so it determined there was no need to refer this back to the panel. I note there is ongoing work to monitor and review Mrs X’s circumstances. However, it appears the Council has made a decision not to extend the care calls. It is not clear whether this was communicated to Mr X and, if so when. On the basis of the information we have seen, the lack of communication about this was also fault.
27. The Council responded properly to Mr X’s complaint that a staff member had been rude and its response to this element of Mr X’s complaint set out learning from the issues he raised and reasonable actions to take from the complaint.
28. The Council explained the reason why a different officer had been assigned to Mrs Y’s case related to a restructuring of teams and responsibilities.
29. Mr X complains in general that the Council does not keep him updated about expected timescales. It is evident that Mr X has chased the Council for updates at various points in the period we are considering. There is evidence of updates being given to Mr X by council officers on occasions. However, there has also been delay in acting, and on some occasions, staff have given Mr X the impression that actions could be completed more quickly than they have been in practice. The delays and, at times, lack of updates, evidently caused Mr X frustration. When there have been such issues, I note that council officers have offered Mr X an apology.
30. There has also been a delay in taking other actions. In April a team manager acknowledged it would take some time to carry out the assessment due to restructuring. They agreed to consider a temporary increase in direct payments while the assessment was carried out. They also spoke to Mr X about arranging a carers assessment. These actions were not followed up until Mr X raised them again when complaining to the Council. There also seems to have been a delay providing a shower stool.

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Recommended action

31. Within four weeks of our final decision:
32. The Council should provide a written apology to Mr X for the delays in taking actions and for the issues with communication that we have identified. The apology should adhere to our guidance on making effective apologies. This can be found on our website, within our Guidance on Remedy here.
33. The Council should provide Mr X with a written explanation of its decision not to extend care calls.
34. The Council should provide us with evidence it has complied with the above actions.

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Final decision

35. There was fault. I have now completed my investigation.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman