Summary: Mr B complains the Council has failed to meet his daughter’s need for respite care, leaving him as her full-time carer and without a break. The Council has failed to provide his daughter with enough support to make informed decision about how her needs should be met. The Council needs to apologise, make a symbolic payment to Mr B and ensure his daughter receives the support she needs.

The complaint

1. The complainant, whom I shall refer to as Mr B, complains the Council has failed to meet his daughter’s need for respite care, leaving him as her full-time carer and without a break.

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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 Mr B;
• discussed the complaint with Mr B;
• considered the documents the Council has provided;
• considered the Ombudsman’s guidance on remedies; and
• invited comments on a draft of this statement from Mr B and the Council, for me to consider before making my final decision.

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What I found

What happened

5. Mr B’s daughter, Ms C, is a young adult with autism. She also has a borderline learning disability. She lives with her father, who meets all her needs. She has a part-time job in a supermarket.

2021

6. In September 2021 we upheld a complaint from Mr B and found fault with the Council over delays in assessing Ms C’s care and support needs and Mr B’s needs as her carer. We also found fault with the Council over the failure to communicate effectively with them and the failure to provide Ms C with a package of support to meet her eligible care needs, when she failed to engage with the support proposed by the Council. The Council agreed to:
• apologise to Mr B and Ms C for its poor communication, delay, and failure to meet their care and support needs;
• pay Mr B £400 and Ms C £300;
• review or reassess Ms C’s care and support needs.
7. The Council assessed Mr B’s needs as his daughter’s carer in October 2021. The assessment identified eligible needs relating to:
• Engaging in work, training, education or volunteering – achieving work ambitions
• Making use of necessary facilities or services in the community – accessing health appointments
• Engaging in recreational activities – either independently or with Ms C
• Developing and maintaining family or other significant relationships
• Maintaining a habitable home environment
8. The Council gave Mr B a one-off personal budget of £400 a year, to achieve these outcomes:
• To take steps towards achieving his working goals, by accessing support services for guidance on balancing his needs with those of Ms C and buying a laptop to access the required resources
• To dedicate some time to himself and focus on his needs/wishes, by accessing carer groups, considering opportunities for time away from caring for Ms C and buying a laptop
9. The Council started reassessing Ms C’s needs in October. Its records said Mr B supported his daughter during the first part of the assessment, but “left when he felt comfortable to leave”. He later told the Council he had not been able to share information about Ms C’s “challenging behaviours and struggles” in her presence. The Council asked him to explain about these behaviours, which he did. The NHS confirmed Ms C had a diagnosis of autism, but did not have a learning disability.
10. The Council completed the assessment in December 2021 and sent a draft copy to Mr B. The assessment identified these needs which Mr B was meeting:
• Managing nutrition – preparing a main meal
• Maintaining personal hygiene – prompting
• Maintaining a habitable home environment
• Emotional wellbeing – to develop and maintain family and other personal relationships, to help with memory, awareness, planning and decision making, and occasional help with behaviour or mood affecting self and others
11. The assessment identified other needs which were not being met:
• Getting out and about – to access activities in the community
• Accessing work, training, education or volunteering – to achieve her ambition of working in childcare
12. The assessment said Ms C did not give any reason to doubt her mental capacity to make decisions about her care and support needs. It said a care and support plan would be requested to provide for:
• a referral to another agency to address Ms C’s aim to work in childcare
• a referral to another agency to receive support from a community coach
13. It said for more intensive periods of respite, it may be appropriate to consider referring Ms C to a shared lives (adult fostering) scheme.

2022

14. Mr B confirmed they were content with the Council’s draft assessment in February.
15. The Council referred Ms C to an employment service in March, to provide support in getting employment in her chosen field.
16. In April Mr B complained no one had been in contact since the officer who assessed his daughter moved to a different post. A social worker met Mr B and Ms C later in April. The social worker noted Ms C’s employment goals and that she would like to take part in activities with like-minded people (e.g. acting, singing or gardening). Ms C agreed to explore shared lives (adult fostering) for respite. The social worker provided information about two day services for Ms C to consider. The social worker met Ms C and Mr B again towards the end of April. Mr B stayed for the first part of the visit. Ms C said she had looked at the day services online but wanted to visit them both before making a decision.
17. In May the Council took Ms C to visit one of the day services. She said she needed time to think about it. She said the employment service was supporting her to apply for work. The Council provided Ms C with information about the Duke of Edinburgh award scheme and opportunities for voluntary work in her chosen field.
18. The Council met Ms C again in July. She said she had expected to be supporting other people at day services, rather than being supported herself. The Council agreed to take her to another day service. Ms C decided not to explore a shared lives placement, saying she and her father did not need overnight respite. Nevertheless, she agreed to consider living somewhere with support in the future. Mr B says his daughter does not understand the benefits of overnight respite as it is not something she has ever experienced.
19. In August the Council produced a care and support plan for Ms C. This provided for a personal budget of £95.48 a week. This was to attend a day service twice a week for activities and social interaction. The Council took Ms C to another day service, and she agreed to go to some taster days after a holiday in September.
20. In November, Ms C told the Council she had been too busy since her holiday to attend taster days. She later told the Council she would not have time to attend them until January 2023, as she would be working more in the supermarket. The Council noted Ms C had not been engaging with attempts to identify employment and volunteering opportunities. It ended its involvement with her. The Council updated the carer and support plan it had produced in August, saying a plan was no longer needed. It said Ms C was more engaged in work and did not have the time for day services until the new year. It said it had advised Ms C of the contact number “for re-referral in the new year”.

2023

21. In July Mr B asked the Council about Ms C’s assessment, personal budget and proposed care. He asked if she had a social worker. The Council told Mr B his daughter had no social worker and he needed to contact its helpline if he wanted support for her. He told the Council his daughter needed social care, and this remained unresolved since his complaint to the Ombudsman (see paragraph 8 above). The Council tried calling Mr B on 10 July but there was no response, and it could not leave a message.
22. On 2 August Ms C’s GP raised safeguarding concerns with the Council on the basis Mr B needed respite to prevent carer breakdown, and Ms C was becoming a danger to herself and to him. The Council decided to address the concerns by reassessing Ms C’s needs.
23. The Council tried calling Mr B on 15 September, but could not get through or leave a message. It tried several more times over the next few days. On 22 September it sent him a text message. The Council told Mr B his daughter had a care and support plan, but it was ended. Mr B asked for a copy of his daughter’s care and support plan. The Council told him it would pass the request to its data protection team, which would respond within 30 days.
24. The Council e-mailed Ms C to arrange a date to assess her, if she wanted an assessment. Mr B told the Council she had received the e-mail but could not respond without his support, as she had no concept of social care or her need for it. He told the Council he was her advocate and said they could check with her GP about her mental capacity and the need for advocacy. In another e-mail, Mr B said his daughter had autism and a learning disability.
25. The Council started reassessing Ms C’s needs in October and completed the assessment in November. The assessment said Ms C presented as having capacity to make decision about her care and support needs, but her diagnosis of autism meant her executive functioning (e.g. make plans and organise) could be questioned. It said she needed time to help her make informed decisions independently. It also said she had a diagnosis of learning disabilities and referred to a 2016 psychological report which identified low scores for conceptual and practical indexes. It noted Mr B’s need for respite.
26. The assessment identified the same needs as in 2021 (see paragraphs 13 and 14 above).
27. When the Council replied to Mr B’s complaint in November 2023, it said:
• When it reassessed Ms C in February 2022, her goals were to have support promoting her independence, employment and social activity.
• They had both turned down support from a third party with promoting independence, but Ms C had accepted a referral to employment services, and other bodies including a rural activity centre.
• By December 2022 Ms C was not engaging with the Proper Job service and decided not to pursue opportunities with the rural activity centre, after taking part in taster days, due to her work commitments.
• Throughout 2022 it had explored respite services with Ms C, but in November she said she did not feel ready for overnight respite.
28. In January 2024 Mr B questioned the need for a financial assessment to work out what Ms C may need to contribute towards the cost of her care.

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

29. Although the Council got information from the NHS in 2021, its assessment of Ms C’s needs did not take account of the psychological report from 2016, which identified the need for support in making decisions. As a result, the Council did not give enough regard to Ms C’s need for that support.
30. The Council told Mr B it had explored respite services with Ms C throughout 2022 but in November she said she was not ready for overnight respite. There is little evidence of the Council exploring overnight respite with Ms C. In July 2022 she told the Council neither she nor her father needed overnight respite. There is no evidence the Council raised the subject again. It also failed to support Ms C to understand the benefits of overnight respite, not least in helping to ensure the sustainability of her father’s caring role, but also in promoting her independence.
31. The Council continued to support Ms C in identifying suitable day services, but in November she said she would not have time until January 2023. The Council then ended its involvement with Ms C, leaving it with her to get in contact again if she wanted to. In effect it made the same mistake it had made in 2021. Ms C needed more support to access services, so the Council should have contacted her in 2023.
32. There is no evidence the Council sent either Ms C or Mr B a copy of her draft care and support plan in 2022. That was further fault by the Council. When Mr B asked for a copy in 2023 the Council responded unhelpfully by passing his request on to its data protection team. But the Council had satisfied itself Ms C was happy for it to share information with her father in 2021, as it sent him a copy of her draft assessment in December 2021.
33. It is not possible to say what the outcome would have been if the Council had provided more support to Ms C, and not ended its involvement with her in November 2022. It is for Ms C to decide what support she is prepared to accept. However, the Council needs to ensure she receives the support she needs to make informed decisions about how her care needs should be met. The lack of engagement with Ms C has put Mr B to the time and trouble of making a further complaint and created uncertainty over what support could have been put in place.

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Agreed action

34. I recommended the Council within four weeks:
• writes to Mr B apologising for the failure to provide enough support to his daughter;
• pays Mr B £300 for the time and trouble he has been put to in pursuing the complaint; and
• takes action to ensure it provides more support to Ms C in making decisions.
35. 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

36. 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