Summary: Ms X complained the Council reduced care and support hours for her adult son, Mr Y, without any reassessment of his needs or a review of his care and support plan when he went into supported living accommodation. The Council was at fault which caused Ms X and Mr Y distress and uncertainty. The Council will apologise and pay Ms X and Mr Y a symbolic payment to remedy the injustice caused.

The complaint

1. Ms X complained the Council reduced care and support hours for her adult son, Mr Y, without any reassessment of his needs or a review of his care and support plan when he went into supported living accommodation. This caused Mr Y to miss out on his normal routine and activities he enjoyed, and Ms X had to provide support to meet the shortfall. This caused Ms X and Mr Y distress and affected Mr Y’s mental wellbeing.

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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. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)
4. 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

5. I considered:
• the information Ms X provided and spoke to her about the complaint on the telephone;
• the information the Council provided and its response to my enquiries;
• relevant law and guidance, as set out below; and
• our guidance on remedies, published on our website.
6. Ms X and the Council had an opportunity to comment on my draft decision. I considered comments received before making a final decision.

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What I found

Relevant law and guidance

Assessment

7. 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

8. 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.

Reviews

9. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months. Councils should consider a light touch review six to eight weeks after agreeing and signing off the plan and personal budget.

Mental Capacity

10. The Mental Capacity Act 2005 is the framework for acting and deciding for people who lack the mental capacity to make particular decisions for themselves. The Act (and the Code of Practice 2007) describes the steps a person should take when dealing with someone who may lack capacity to make decisions for themselves. It describes when to assess a person’s capacity to make a decision, how to do this, and how to make a decision on behalf of somebody who cannot do so.
11. The council must assess someone’s ability to make a decision when that person’s capacity is in doubt. How it assesses capacity may vary depending on the complexity of the decision.
12. The person assessing an individual’s capacity will usually be the person directly concerned with the individual when the decision needs to be made. More complex decisions are likely to need more formal assessments.

What happened

13. Mr Y is an adult with learning difficulties, autism and challenging behaviours. In 2022 the Council carried out a mental capacity assessment which said Mr Y lacked capacity to make a decision about where he lived.
14. In early August 2023 Mr Y was living in a temporary placement at a residential care home, Care home 1 and a social worker, Officer 1 carried out Mr Y’s annual review of his care needs. The assessment found Mr Y:
• needed some support and prompting with personal hygiene;
• needed full support with cooking meals but ate independently;
• could manage his toilet needs;
• could dress independently;
• needed 15 hours daily two to one support for indoors and when accessing the community to control his behaviours;
• needed help with keeping his flat tidy;
• was close to his family and visited them every weekend; and
• had sensory needs.
15. The assessment concluded Mr Y’s needs were met at Care Home 1 and he should remain there until his new permanent accommodation was ready to move into.
16. In mid-September 2023 Ms X emailed Officer 1 and asked about the funding for care and support at Mr Y’s new accommodation. Officer 1 emailed Ms X and said ‘as mentioned in a previous email, Mr Y’s hours will remain the same and continue receiving two to one. A six-week review will determine if he has settled and if the care plan meets his needs’.
17. In early October 2023 Mr Y moved into a new self-contained flat at supported living accommodation, Supported Living 1. On the same day Mr Y moved to Supported Living 1 his two to one hours support were reduced from 15 hours per day to five hours per day.
18. Three days after Mr Y moved into Supported Living 1, Ms X emailed the Council and complained Mr Y’s two to one support had been cut from 15 hours per day to five hours per day without an explanation. She said the Council told her Mr Y’s support hours would not change when he moved to his new accommodation and she only found out from the manager at Supported Living 1 about the decrease in his support hours. Ms X said the cut in hours would increase Mr Y’s challenging behaviour and impact on his mental health and they would not have agreed to the move if they had been told Mr Y’s support hours would be reduced. Ms X said she would like the hours to be reinstated, to see evidence to justify the cuts and an explanation why she was not consulted.
19. In late October 2023 the Council responded to Ms X’s complaint and said:
• Mr Y moved into Supported Living 1 with a support package of 15 hours of one to one support per day, a shared waking night and five hours per day two to one care for outside activities. There was additional support within Supported Living 1 for flexibility. Mr Y was not receiving the two to one care as previously commissioned but the new hours met Mr Y’s needs;
• the reduction in two to one care support had not impacted on Mr Y;
• Officer 1 told Ms X before Mr Y moved to Supported Living 1 that Mr Y’s two to one hours would be reduced and it would be monitored and reviewed; and
• it apologised if the manager at Supported Living 1 told Ms X of the reduction in Mr Y’s support hours and it could not say if that was before or after Officer 1 told Ms X.
20. Three days later Ms X emailed the Council and said the Council had not carried out a new needs assessment before Mr Y’s two to one hours were reduced and asked the Council to reinstate his daily 15 hours of two to one support.
21. In early November 2023 the Council sent its final complaint response to Ms X. It said Officer 1 confirmed they completed Mr Y’s care act assessment in early August 2023. Officer 1 would review Mr Y’s placement before the end of November 2023 to establish how Mr Y’s support hours were used and what worked well. The Council told Ms X if she remained unhappy to contact us, which she did.
22. In late November 2023, six weeks after Mr Y moved to Supported Living 1, a meeting took place between Officer 1, a social worker team manager, behavioural support practitioner, supported housing scheme manager, Ms X and another family member. The Council said this was Mr Y’s six-week review. Ms X said concerns were discussed about Mr Y’s behaviour but no action was agreed and she was unclear of the outcome.
23. Ms X said following the meeting in late November 2023 the Council said it would update her on Mr Y’s support hours by the end of November 2023 but the Council did not contact her.
24. In mid-December 2023 a family member sent a judicial review pre-action protocol letter to the Council which asked the Council to reverse its decision to reduce Mr Y’s two to one hours.
25. In January 2024 the Council reinstated Mr Y’s daily 15 hours of two to one support.
26. Ms X said the Council was arranging a care placement review meeting to take place but it had not yet been arranged.

Enquiries

27. Ms X told me as a result of Mr Y’s reduced two to one support he could not always go out where he wanted to go especially during the late afternoon and the care provider was aware of that. Mr Y went to her house on a weekend to undertake activities he wanted to participate in. Ms X also said Mr Y needed encouragement to go out which would not happen without two to one support.

My findings

28. The Council carried out an annual review of Mr Y’s needs assessment in early August 2023 which said Mr Y needed 15 hours two to one support each day for help indoors and outside in the community. Officer 1 emailed Ms X in mid- September 2023 and told her Mr Y’s care hours would stay the same when he moved to Supported Living 1 and he would continue to receive two to one care.
29. When Mr Y moved to Supported Living 1 his two to one support was immediately reduced from 15 hours per day to five hours per day. The change to Mr Y’s support was made without a new assessment of his needs and was not in line with his existing needs assessment. This was fault. It caused Mr Y and Ms X distress and uncertainty over whether his needs were being properly met and over whether Mr Y was able to access all the activities he wanted to.
30. The Council said it would carry out a six-week review after Mr Y moved in to Supported Living 1 to assess if he had settled into his new accommodation and if the care plan met his needs. A six-week review meeting took place in late November 2023 but the Council did not update Ms X on Mr Y’s care needs following the meeting. This was fault and left Ms X with a sense of uncertainty about what was agreed and about the outcome of the meeting. The Council did not issue an updated needs assessment or updated support plan for Mr Y following the review meeting. This was fault and meant the support the Council was providing was not in line with Mr Y’s existing needs assessment and care plan.
31. In January 2024 the Council reinstated Mr Y’s two to one support to 15 hours per day. This was appropriate and was in line with his existing needs assessment. The Council has agreed to carry out a review of Mr Y’s placement. This is required for the Council to establish Mr Y’s current needs and the support he requires to meet those needs.

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Agreed action

32. Within one month of the final decision the Council will:
1. apologise and pay Mr Y £500 to acknowledge the uncertainty and distress caused by not providing support in line with his care plan; and
2. apologise and pay Ms X £250 for the distress and uncertainty caused to her by failing to keep her updated and by Mr Y not receiving appropriate support in line with his care plan.
33. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology.
34. Within one month of the final decision the Council will also remind relevant staff that support should not be reduced unless this is based on a needs assessment and care and support plan.

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Final decision

35. I have completed my investigation finding fault causing personal injustice to Ms X and Mr Y. The Council has agreed to take action to remedy the injustice and prevent reoccurrence of the fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman