Summary: We uphold this complaint finding the Council at fault for not completing a carer’s assessment. This caused injustice to the complainant as distress, arising from uncertainty and frustration. The Council accepts these findings and has agreed to apologise.

The complaint

1. Mr J complained the Council failed to arrange an adequate care package for his mother, Mrs K, following her discharge from a nursing home in April 2023. He also complained the Council failed to support him as Mrs K’s carer, including that it failed to complete a carer’s assessment.
2. Mr J says this had a significant impact on his social, financial and general wellbeing. He also experienced stress in caring for Mrs K.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
4. 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)
5. 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

6. Before issuing this decision statement I considered:

• Mr J’s written complaint to the Ombudsman and any supporting information he provided;
• correspondence exchanged between Mr J and the Council about his complaint, which predated our investigation;
• information provided by the Council in reply to my written enquiries;
• any relevant law, Government guidance or Council procedure referred to below;
• any relevant guidance published by the Ombudsman, including our published guidance on remedies - Guidance on remedies - Local Government and Social Care Ombudsman.

7. I gave Mr J and the Council opportunity to comment on a draft version of this decision statement. I took account of any comments they made, or further evidence they provided, before completing this final version.

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What I found

Relevant law and guidance

Care Act assessments for those needing care

8. 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. The assessment focuses on the adult’s needs, how the needs impact on their wellbeing and the results they want to achieve.
9. An adult has ‘eligible’ care needs if an assessment finds:

• they have needs arising from, or related to, a physical illness or mental impairment or illness; and
• as a result, they cannot achieve two or more specified outcomes (for example managing or maintaining nutrition, personal hygiene or maintaining a safe home environment); and
• if, because of being unable to meet those outcomes, there will be (or is likely to be) a significant impact on the adult’s wellbeing.

10. The Council should then draw up a care and support plan. This sets out what support someone needs and how they will receive support.

Care Act assessments for carers

11. A carer is someone who provides unpaid care and support to another person.
12. A carer can ask their local council to carry out a carer’s assessment and the Council must provide one. The assessment helps a council to decide whether a carer needs support to help them live their day-to-day life and to continue providing support to an adult (see Section 10, Care Act 2014).
13. As part of the carer’s assessment, the council must consider the carer’s potential future needs for support. It must also consider whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)
14. A Council may provide support to a carer if the carer’s role has a ‘significant impact’ on their wellbeing. And if, as a result the carer cannot achieve one or more 'wellbeing outcomes’. These include maintaining their physical and mental health and emotional wellbeing; being able to take part in work, training or education; and maintaining their domestic, family and personal relationships.

Key facts

15. The events covered by this complaint took place between April and December 2023. At the start of April 2023, Mrs K was staying temporarily in a nursing home. The Council became aware she had social care needs, and having assessed those, she returned to her home with a package of support from a domiciliary (or home care) agency.
16. The care package the Council set up for Mrs K, involved care workers visiting her four times a day. The Council contracted for them to visit for 30 minutes in the morning and evening to help get Mrs K ready for the day and to bed. They would also visit for around 45 minutes at lunchtime and provided a sitting service of two hours in the afternoon / evening. The support plan prepared by the Council said the care agency would support Mrs K with personal care, toileting, dressing, laundry, medication, mobilising and maintaining her home.
17. When Mrs K returned home, she lived with her husband, Mr K. Mr J was one of two adult children who kept their own home elsewhere. Mr J’s home address was around five miles from Mr and Mrs K’s home. Case notes kept by the Council detail he had a close relationship with Mrs K and was a frequent visitor to her home. The Council recorded its understanding he often stayed overnight.
18. The Council’s care notes show that after Mrs K went home it kept in regular contact with her, Mr K, Mr J and others. I cannot disclose all information contained in those notes, because they contain information from (and about) third parties. But of relevance to this complaint, I noted the following:

• that in early May 2023 the Council recorded speaking to Mr J and him saying that Mrs K’s care package was “working well”;
• that a few days later Mr J reported concerns care workers could not persuade Mrs K to take medication. The Council recorded discussing this concern over the following weeks, including with the care agency supporting Mrs K;
• that a note made at the end of May 2023 said a charity supported Mrs K with shopping, but the notes also say Mr J undertook shopping for her;
• that in mid-June 2023 the Council recorded Mr J saying he considered the care Mrs K received was insufficient;
• that in mid-July 2023, a GP contacted the Council following contact from Mr J. The GP said Mr and Mrs K relied heavily on Mr J for support, and he struggled to provide this;
• that in August 2023 the Council amended Mrs K’s care package to include one day a week where she would visit a day centre;
• that in September 2023 the care agency reported Mr J expressing concerns about Mrs K’s care package.

19. In addition, at the start of September 2023, Mr J completed a ‘simple assessment form’. The Council describes this as an “information gathering tool” used by carers. In effect, it was a form used by the Council for a carer to request a carer’s assessment.
20. On the simple assessment form, Mr J said the care agency carried out washing for Mrs K. But that he carried out cooking, cleaning, laundry and daily activities with Mrs K. Mr J said he was “sole carer” for Mrs K and she was “totally dependent” on him. Mr J said he had “recently stopped work due to an increased caring role”. Mr J said this impacted on his ability to maintain personal relationships, engage in work and to use the community and recreational activities.
21. The Council says this form went to its Integrated Carers Team, where Mr J’s case joined a waiting list for the Council to complete a carer’s assessment. In June 2024 the Council contacted Mr J but he declined an assessment at that point. I assume this is because Mrs K no longer lived at home.
22. Because by December 2023 Mrs K’s needs had increased, with concerns expressed for her welfare from various sources. In addition, Mr K’s health had worsened and he too had care needs. The Council arranged for Mrs K to return to a nursing care setting and she has not subsequently returned home.
23. The Council has suggested the delay experienced by Mr J in waiting for a carer's assessment is not atypical. It told me at the end of June 2024 there were just over 250 people waiting an assessment. It says the ‘median’ wait time was 20 working days, but some people had waited much longer (see below).
24. The Council says since the events raised by this complaint it has:

• improved the statistical information it keeps so it knows at any one time how many people are awaiting carer’s assessments and for how long;
• introduced a ‘prioritisation tool’ to identify cases most urgently needing a carer’s assessment;
• begun designing a better online self-assessment tool that carers can complete;
• begun recruiting more staff to clear a backlog of outstanding carer’s assessments. While it currently undertakes most assessments in six weeks, some people have waited much longer, nearly three years in the worst cases. By March 2025 in anticipates it will complete all carer’s assessments within six weeks.

My findings

25. I did not find fault with the Council’s decision making around Mrs K’s care. I saw nothing in the Council’s care planning documents nor its notes of her case leading me to fault its care planning or its review of that planning.
26. I noted the original care package provided for Mrs K flowed logically from her assessment of need. As well as visits at key parts of the day to help with personal care, the Council also arranged for a daily sitting service to help both Mr and Mrs K.
27. Further, the Council kept the care package under regular review. I can see it did not always run smoothly. For example, with the concerns expressed about the support Mrs K received with medication. But the evidence showed the Council reacted when alerted to specific problems or changes in Mrs K’s needs. This included making changes to the package when Mrs K began attending a day centre. And stepping in quickly when it became clear her increased needs required a move to nursing care in December 2023.
28. I can see Mr J raised more than once a concern that Mrs K’s care package did not meet all her needs. But there was a lack of specificity to the reports. For example, saying with what needs Mrs K needed more help. So, I could not find the Council had information which should have led it to provide more care to Mrs K, in addition to those times where it decided to increase her care package.
29. I recognise that even with the care package, Mrs K also relied on support from those around her and that included Mr J. There is some disconnect between what Mr J declared on the ‘simple assessment form’ and the Council’s notes of Mrs K’s case. The Council recorded Mr J helping Mrs K with shopping. But it did not record him carrying out the other care tasks he later reported undertaking. However, that is not to say I doubt Mr J supported Mrs K in ways other than shopping, including with company and day-to-day activities.
30. I understand therefore why Mr J asked the Council to assess his needs as a carer. But given what I have said at paragraph 28, I have no reason to find the Council should have assessed Mr J’s needs as a carer before he requested this in September 2023.
31. Having made this request, the Council should have acted on it within four to six weeks. It is disappointing that systemic delays in the Council processing such assessments meant this did not happen. The delay meant no carer’s assessment took place before Mrs K entered a nursing home in December 2023. By which time, Mr J could no longer benefit from an assessment. I must record a finding of fault for this delay.
32. I considered next the injustice caused to Mr J by this fault. Had the assessment completed promptly there may have been a small window of time before Mrs K entered nursing care, when the Council may have arranged some support for him. However, it is hard for me to see what that support may have consisted of. I say this noting that Mrs K already had carers visiting the home four times a day for between three and four hours. Also, that she had other informal support provided by Mr K and Mr J’s sibling.
33. I cannot conclude therefore the delayed assessment resulted in any loss of service to Mr J. But he will still have experienced some distress. First, because of the frustration not receiving a response to his request. Second, because of uncertainty in knowing what the outcome would have been. I recommend below the Council provide Mr J with an apology for this.
34. Finally, I also considered the potential wider implications of Mr J’s case. The Council recognised in answer to my enquiries that half those waiting for carers assessments, or more than a hundred people, had waited more than four weeks. Sometimes that delay was much greater than four weeks. It did not provide an explanation for such wide disparities in waiting times.
35. But it helpfully set out details of steps taken to tackle its remaining backlog and improve its service for the future. So, on balance I decided we did not need to investigate the matter further, nor recommend more actions to those steps taken by the Council.

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Agreed action

36. To remedy the injustice caused to Mr J in this case the Council has agreed that within 20 working days of this decision it will write to him with an apology. That apology will take account of section 3.2 of our guidance on remedies which offers advice on our expectations for apologies.
37. The Council will provide us with evidence it has complied with the above action.

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Final decision

38. For reasons set out above, I upheld this complaint finding fault by the Council causing injustice to Mr J. The Council accepted this finding and agreed action to remedy his injustice. Consequently, I completed my investigation satisfied with its response.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman