Summary: Ms X, complains the Council failed to put the support she needed in place when she moved to Hackney in 2022 and, despite accepting its failings, it has failed to resolve them leaving her out-of-pocket. The Council accepts it did not deal with Ms X’s transfer to its area and that this left her paying for care it should have provided. It has offered to pay her £1,668 for the care it did not provide between 13 November 2022 and 5 January 2023. The Council’s offer does not go far enough to remedy the injustice to Ms X. It also needs to pay her for the care it should have provided in October 2022 and the additional care she paid for between January and June 2023.

The complaint

1. The complainant, whom I shall refer to as Ms X, complains the London Borough of Haringey (the Council) failed to put the support she needed in place when she moved to Hackney in 2022 and, despite accepting its failings, it has failed to resolve them leaving her out-of-pocket.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, sections 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. I have:
• considered the complaint and the documents provided by Ms X’s mother;
• considered the comments and documents the Council has provided in response to my enquiries;
• considered the Ombudsman’s guidance on remedies; and
• invited comments on a draft of this statement from Ms X, her mother and the Council, for me to consider before making my final decision.

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What I found

What happened

5. Ms X has a respiratory condition which affects her breathing. She also uses a wheelchair. She used to live in another part of London, where she received direct payments from the local authority to meet her eligible care needs under the Care Act 2014. She used the direct payments to employ personal assistants to visit four time a day.
6. Ms X arranged to move to Haringey in August 2022. Her mother says Ms X called the Council in July to give it the date of her move. She says she had an assessment of her needs over the telephone and understood there would be a full assessment in the six-week transition period, during which her previous local authority would continue to fund her care package (i.e. until 7 October). The Council has no record of this contact with Ms X.
7. According to the Council’s records it received an adult referral for Ms X on 26 August. There is nothing in its records to say what it did about this referral.
8. When Ms X contacted the Council on 12 September, it made a note of her circumstances. This said she:
• Could not transfer from her wheelchair on to other furniture independently
• Had a fully accessible kitchen
• Could only reach the bottom shelf of her fridge/freezer
• Did not have the balance for a bath board, so would benefit from a bath lift
• Could not make a light meal or drink because of weakness in the arms and hands
• Could not dress independently
• Could not get in or out of bed independently
• Could not get on or off the toilet independently
• Needed help with personal hygiene
• Ms X’s package of care from her previous local authority would end on the 7 October
9. The Council’s record of the conversation said it ordered a bath lift. It referred Ms X for an urgent assessment of her care needs.
10. On 14 September the Council asked officers to transfer Ms X’s package of care from her previous local authority from 7 October. It asked them to assess her care and support needs, including the need for help with transfers, which Ms X had identified on 12 September.
11. Ms X was admitted to hospital on 19 October, after two friends found her on the floor of her home.
12. The Council left a message for Ms X on 21 October about taking over her package of care. On 24 October Ms X told the Council she had been in hospital; for five days with pneumonia and sepsis. She said she was likely to be in hospital for a few more days.
13. On 7 November the hospital referred Ms X to the Council for an assessment, as she would need a package of care when she left hospital. It also mentioned the need for a bath chair.
14. On 9 November Ms X’s previous local authority contacted the Council to check whether she had a package of care. The Council said Ms X was in hospital, but it had agreed an emergency package of care for her based on two calls a day. The local authority then e-mailed the Council asking it to assess Ms X. It said when she would be available after leaving hospital and that she would be returning home on 25 November (from a holiday). It asked the Council to confirm it was taking over Ms X’s package of care from 9 November. The Council said it had arranged reablement support until Ms X went on holiday on 12 November.
15. Later on 9 November, a member of the Reablement Team e-mailed colleagues to let them know about Ms X’s circumstances. They said Ms X would be away from 12 to 25 November and had been told she would need a new package of care when she returned and that she wanted direct payments.
16. Ms X asked the Council on 5 December when it would assess her for a long-term package of care. The Council noted her case was still assigned to its Reablement Team. Ms X told the Council she had high needs and was a wheelchair user.
17. Ms X contacted the Council again on 4 January. She said she was paying for a personal assistant and getting help from family and friends, but was struggling.
18. On 5 January the Reablement Team said it could not deal with Ms X, as over two months had passed since it supported her before she went away. It said it had told her to get in contact when she returned. It said the Council’s first response team would now have to assess Ms X. The Council asked its Brokerage Team to arrange an emergency package of care and referred her for an urgent assessment. It told Ms X she would have a financial assessment to work out what she would have to pay for her care.
19. The Council left a message for Ms X on 6 January to let her know her package of care would start that day. It was based on 15.75 hours a week and comprised:
• 45 minutes each morning
• 30 minutes each lunchtime
• 30 minutes each evening
• 30 minutes at bedtime
20. On 9 January the Council noted Ms X had difficulty with tasks around the home and added her name to the waiting list for an occupational therapy assessment.
21. On 20 February Ms X told the Council she wanted direct payments to employ a personal assistant who was more flexible and would help her keep her job.
22. The Council has provided a copy of a strengths-based assessment for Ms X which says it did the assessment on 21 February. This included the same information Ms X had provided on 12 September (see paragraph 7 above).
23. On 24 February an officer told colleagues they needed a care and support plan for Ms X so she could sign a direct payment agreement. Another officer noted Ms X may need a Care Act assessment, and it was not clear why she had been put down for a six-week review.
24. On 2 March Ms X told the Council she was paying a personal assistant to provide an extra 20 hours of support a week.
25. The Council reviewed Ms X’s needs on 12 May. The review said Ms X had eligible needs for care and support relating to:
• Maintaining nutrition
• Maintaining personal hygiene
• Toileting
• Dressing
• Making use of the home safely
• Maintaining a habitable home environment
26. Ms X said she needed help at night with her oxygen respirator machine. The Council told her this was a healthcare need, as the Council did not provide night cover. They agreed the Council would complete a checklist for NHS continuing healthcare on 16 May. The review identified the need to increase Ms X’s package of care by 26.25 hours a week to 42 hours.
27. When the Council responded to Ms X’s complaint later in May, it said:
• It apologised for the time taken to respond and to review her care and support needs.
• It had met Ms X on 12 May and was finalising a review of her care package
• It would look at providing support with Ms X’s application for a discretionary housing allowance.
• It had not completed an NHS continuing healthcare checklist as part of her review, but would either complete one now or liaise with a health care professional if they were already completing one.
• It apologised for putting a care package in place in January, based on what her previous local authority had provided, without consulting her.
• It would invite her to provide evidence of what she had been paying for care above her Council funded package and consider making a backdated payment.
28. Following an occupational therapy assessment on 22 June, the Council ordered a bath lift for Ms X. This was because she had not had regular access to bathing facilities and sometimes went two weeks without having a bath.
29. From 28 June Ms X qualified for NHS Continuing Health Care. This meant the NHS paid for all her care since 28 June and she no longer had to contribute towards the cost of her care.
30. On 8 August the Council wrote to Ms X turning down a request of a discretionary housing payment she had made on 6 May. It told her there was no right to appeal but should write to the Council by 8 September if she wanted it to look at the decision again. The Council says Ms X did not ask it to look at the decision again.
31. In August the Council agreed to increase Ms X’s package of care to pay for an extra 14.15 hours a week, taking the total to 30 hours a week. This was to be in place until the NHS had assessed Ms X for NHS continuing healthcare. It is unclear why this was necessary, when Ms X had qualified for NHS continuing healthcare from 28 June.
32. The Council says it will pay Ms X £1,668.20 to cover the period between 13 November 2022 and 5 January 2023, when it was not supporting her. This is based on a package of care of 15.75 hours a week.
33. The Council accepts there have been long delays for people waiting for assessment under the Care Act. It also accepts there have been problems with people transferring from reablement to longer-term packages of care. The Council says it is moving to a new locality-based model which is focused on providing local, person-centred, responsive services. The aims include reducing waiting times, understanding residents’ needs and providing the right care and support when needed. It says it has also contracted with an external provider to deal with 600 outstanding assessments. It says, unlike in 2022/23, its Reablement Team now sets up any longer-term care and support needed.

Is there evidence of fault by the Council which caused injustice?

34. There is no dispute over the fact the Council did not deal with Ms X’s move to its area properly. The Council should have been able to put a package of care in place for Ms X from 7 October 2022. It did not need to assess her first, but could have taken over the package of care funded by her previous local authority pending an assessment of her needs. Indeed, that is what the Council did in January 20023. By that time Ms X’s needs had changed, but the Council failed to do a proper assessment under the Care Act, despite several times identifying the “urgent” need to do one. It took the Council a further four months to recognise this.
35. While welcome, the Council’s offer to pay Ms X £1,668.20 is not enough to remedy all the injustice caused to Ms X. It also needs to address the fact that she was left without any funded support between 7 and 19 October 2022, and was left paying extra support in 2023.

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Agreed action

36. I recommended the Council within four weeks:
• Writes to Ms X apologising for the failure to meet her needs after she moved to Haringey;
• Pays her £2,038.91 for the care it failed to provide between 7 and 19 October 2022 and 13 November 2022 to 5 January 2023;
• Refunds her for the extra care she paid for between 6 January and 27 June 2023, subject to her providing evidence of this; and
• Pays her a further £500 for the avoidable distress it has caused.
37. The Council has agreed to do this. It should provide us with evidence it has complied with the above actions.

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Final decision

38. I have completed my investigation on the basis there has been fault by the Council causing injustice which requires a remedy.

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Investigator's decision on behalf of the Ombudsman