Summary: Miss X complained about a lack of care hours provided by the Council for her son. She said the Council has refused extra care hours and had not allocated a social worker. Miss X said this has delayed a care review being completed. We find the Council was at fault. This caused significant distress to Miss X and her son. The Council has agreed to make several recommendations to address this injustice caused by fault.

The complaint

1. The complainant, Miss X, complains about a lack of care hours provided by the Council for her son. She said the Council has refused extra care hours and had not allocated a social worker. She said this has delayed a care review being completed.

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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 cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council done. (Local Government Act 1974, sections 26B and 34D, as amended)
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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What I have and have not investigated

5. I have investigated matters from 2023 onwards. I have not investigated matters that occurred in 2022. This is because I consider it was reasonable to have expected Miss X to have complained about these matters sooner. This is because there is evidence the Council sent Miss X a copy of the assessment and support plan in 2022.

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How I considered this complaint

6. I spoke with Miss X about her complaint. I considered all the information provided by Miss X and the Council.
7. Miss X and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

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What I found

Care Plan

8. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). 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. They should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. Councils must also conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one.

Summary of the key events

10. Miss X and her son, Mr Y moved from a different Council area in May 2022. Mr Y’s case was transferred to East Sussex County Council. It was noted that Mr Y currently had 36 hours of personal assistance (PA) care per week. But Miss X said this was not the case and said no PA hours were in place.
11. Mr Y’s case was allocated to an officer in July 2022 and the officer made Miss X aware they had booked in an assessment of Mr Y’s care needs for August 2022.
12. The Council spoke with Miss X shortly after and said it understood things were not currently working out with the PA’s in place. It said it needed to rearrange the assessment and said once complete it could look at the options.
13. The Council completed an assessment on the 19 August 2022. It was noted that:
• from the previous council area, Mr Y has PA support six days a week via a direct payment (DP);
• the arrangement was not now working as PA’s were having to travel a long way from their homes and therefore only being able to provide some of the hours per week;
• the hours consisted of 2:1 support 30 hours per week for two PA’s when accessing the community;
• Mr Y was not accessing the community due to anxiety and therefore 1:1 PA support was provided; and
• the Council made a referral for 30 hours a week PA support to work alongside Miss X. It also requested one waking night on a 1:1 level which amounted to 40 hours in total.
14. The Council sent Miss X a copy of the assessment and Miss X asked for some amendments to be made.
15. The care and support plan was completed on 24 August 2022. It was noted that:
• the current PA care of 60 hours per week was not working and only some of these hours were provided;
• Mr Y was not getting the hours he had been assessed as needing and this was putting pressure on his parents;
• a referral was completed to try and source a PA due to no agencies having capacity or inability to meet needs;
• a PA had come forward and agreed to drop their hourly rate to £35 from £40. The PA had met with Mr Y and Miss X and said she could meet his needs; and
• the proposed amendments to the care were noted as 21 hours of PA care four times per week. This care was to be provided alongside Miss X to build up the bond with both Miss X and Mr Y.
16. In September 2022 the notes suggest the Council were establishing whether it could agree to the PA’s hourly rate.
17. In October 2022 the Council told the PA its panel had declined to pay £35 per hour. But said it had agreed to pay £30.
18. In the same month the Council spoke with the family and offered respite. The family declined this offer as they said they wanted an experienced PA to get to know Mr Y. They said this offer was not in Mr Y’s best interest.
19. The Council spoke with Miss X and said the funding request previously presented to the panel would be considered again in the anticipation that it would be agreed.
20. On 31 October 2022 the Council confirmed to Miss X and the PA that the support plan had been agreed. This consisted of 21 hours per week four days per week.
21. The Council sent Miss X and the PA a copy of the assessment and support plan on the 10 November 2022.
22. The Council completed a review of the plan in early January 2023. It was noted that:
• Mr Y had been out in the community and developed a relationship with the PA;
• both Miss X and the PA were getting on well and were happy with the hours in place; and
• the social worker would now close down Mr Y’s case to them. They gave Miss X details of who she could contact if she needed support before the next review.
23. The Council wrote to Miss X on 26 January 2023. It apologised for the delay in the case being allocated to a named worker. It said it was experiencing high levels of demand. It advised Miss X to contact it if circumstances changed.
24. Miss X contacted the Council on 9 May 2023. She requested more care hours. She said this included an overnight once a week and help on the evenings. She said the PA was happy to offer these hours. Miss X also said things were quite full on and Mr Y’s dad was away a lot.
25. The Council left Miss X a voicemail a few days later to let her know Mr Y’s case had now been allocated and someone would be in touch to discuss reviewing the support package.
26. A review was carried out on the 8 June 2023. It was noted that:
• Miss X recalled the lack of perceived support in all aspects of Mr Y’s care; and
• Miss X would like to be assessed for a carers budget for treatment to her back.
27. An assessment was completed shortly after. It was noted that:
• Mr Y was not accessing the community due to his anxiety levels;
• Miss X would like to look for two nights a week support now that Mr Y’s dad was working away a lot. It was noted Miss X barley gets any sleep and is finding it difficult;
• In addition to the current PA hours, Miss X would like to add more hours in the evening. This would amount to three hours at a time between 7 and 10pm.
28. The care and support plan completed on 18 July 2023 stated:
• the proposed care would be an additional three wake nights per week. It was noted this was to provide 1:1 personal care and mental health support and was to start as soon as possible.
29. The draft support plan and contingency place was sent to Miss X the following day. The Council also requested a direct payment to fund 51 hours PA support starting from the 1 August 2023.
30. In early August 2023, the Council told Miss X the support plan went to the Council’s panel and was declined. It said:
• it needed to evidence the support Mr Y required in more detail;
• Mr Y needed to be allocated a long term worker;
• Miss X had agreed to complete daily/nighttime logs highlighting Mr Y’s needs;
• Miss X had agreed to speak with the learning disability team around what they feel adult social care could do or support with moving forward;
• the Council had previously suggested the use of a go pro camera in the house which Miss X had declined. But it was noted Miss X said she was happy to take videos on the ipad and forward these so the team had a better understanding of Mr Y’s anxieties; and
• Miss X agreed to complete the logs for one month. After this Mr Y would have a full social care review.
31. The Council rang Miss X in November 2023. It was noted that:
• Miss X said she was frustrated as she had been waiting for more PA hours for some time;
• Miss X had a bad back since May 2023. She said she had a carers assessment and received a one-off payment a few months ago which she said she used for back treatments;
• Miss X said she needed PA support at night as she said she was getting two hours sleep as Mr Y would not settle;
• Miss X said when they lived in the other council area, Mr Y was entitled to 60 hours of care; and
• the officer said they would feedback her concerns.
32. In the same month, the Council’s emails stated it was waiting for the night care logs from Miss X and the recordings that she had agreed to take.
33. Miss X contacted the Council in January 2024. She said following the phone call detailed in paragraph 31, the officer had agreed to call her back. But she said had not heard anything.
34. In response the Council said the call was a welfare check. It said the case had now been allocated to a social worker who would be completing a full review.
35. The social worker visited Miss X towards the end of January 2024. The notes stated:
• the family said there were inaccuracies in the assessment;
• a carers assessment was to be completed;
• Mr Y’s parents and PA were to keep a diary; and
• the Council was to consider overnight support for Mr Y to enable Miss X to sleep.
36. A care assessment and carers assessment took place in February 2024.
37. In March 2024 the Council requested funding for three waking nights per week for Mr Y.
38. The funding for additional care hours was agreed in the following month. This included:
• from the 15 April to the 12 May 2024 waking nights seven times per week for four weeks from 10pm-7am; and
• from the 13 May 2024 waking nights three times per week.
39. The care agency who would be providing a waking night assessment for Mr Y said the family had cancelled the assessment. They informed the Council the next assessment could not be completed until the week commencing the 13 May 2024.
40. An email from April 2024 confirmed the funding had been agreed for three waking nights per week.
41. Following the assessment Miss X told the Council she did not think the care agency could meet Mr Y’s needs. She identified carer’s who had previously worked with Mr Y and asked the Council to reconsider.

Analysis- was there fault by the Council causing injustice?

42. Miss X asked the Council for extra support in May 2023. An assessment was completed the following month and the Council made a request for funding for an additional 30 PA hours to start in August 2023. This request was declined on the basis that evidence was required in support of the increase. Miss X agreed to fill in daily/nighttime logs and take videos of Mr Y over the next month. This was to provide the additional evidence required.
43. We could not criticise the Council for requesting the additional information. It was entitled to do so. There is no evidence to suggest Miss X did send the Council this evidence. The Council has acknowledged that there is no evidence to support the Council following this up with Miss X. Therefore, there is a drift in this case. This is fault.
44. The Council called Miss X in November 2023 which the Council said was a welfare call. Miss X expressed her frustrations at how long she had been waiting for the additional care hours. In January 2024, Miss X contacted the Council to say she had been waiting to hear back from the officer who rang in November 2023. From the evidence seen, there is nothing in the notes to suggest the officer had agreed to call Miss X back. But it was noted they would feedback Miss X’s concerns.
45. Mr Y was allocated a new social worker in January 2024. The Council later requested funding for additional care which was agreed on the 11 April 2024. The Council arranged for a care agency to provide this care and they completed their assessment in May 2024.
46. Miss X raised concerns with the Council about whether the staff could meet Mr Y’s needs. Miss X asked the Council to consider carer’s she had identified who had previously worked with Mr Y. Miss X told us in June 2024 despite her requests for her preferred carers to carry out the work, the Council had delayed putting this in place.
47. In response to my enquiries towards the Council said funding for the revised provision proposed by Miss X had been agreed in principle. It said it is liaising with the proposed PA in completing the paperwork. It anticipates that this will be completed in a timely manner with a start date being agreed in the next few weeks.
48. The Council has accepted there has been fault in this case. It has acknowledged the delay between January to May 2023. It has also accepted the further delay between July 2023 when the outcome of the panel was received to allocating a social worker in January 2024.
49. The Council said during this time, the case should either have remained with the duty worker or allocated to a long-term social worker to maintain support. It has accepted that having allocated a social worker on the 11 January 2024, there was a delay in arranging an initial visit which was completed on 31 January 2024.
50. The Council said it should have also completed a core assessment and said this has still not been completed. It said it will look to complete the core assessment and correct any inaccuracies that Miss X had previously identified.
51. In response to my enquiries the Council said in regard to Miss X’s comments that they were entitled to more hours of support during the day, this was being considered in July 2023. It was not unreasonable for the Council to have requested further evidence. But it said it would have anticipated that Mr Y continued to have an allocated worker who could have supported with this request. Going forward the Council said it will consider the need for Mr Y’s social worker to remain in the case once the additional care had started. This would be beyond the usual 6-week review period, should this be required.
52. In recognition of the distress caused to Miss X and Mr Y for the first period of delay in assessing Mr Y from January to June 2023 the Council has offered a £500 payment. I consider this to be appropriate and in line with our guidance.
53. In addition, for the delay in allocating the case and not following up more robustly with evidence required further to the funding panel’s decision on 27 July 2023 to 11 April 2024, the Council has recommended a further financial remedy. This is in recognition of the impact this shortfall in care had on Miss X. It has recommended a payment of £3030.30. I consider this to be an appropriate figure.
54. As stated in paragraph 44, the care agency carried out an assessment in May 2024. But Miss X told the Council she wanted the care to be provided by carer’s she had identified as she said the care agency could not meet Mr Y’s needs.
55. We could not criticise the Council for arranging this care. The Council considered this to be suitable and that is a decision the Council is entitled to take. But since the assessment which was held on the 13 May 2023, the additional hours have not yet been finalised. As stated in paragraph 47, it appears things are moving in the right direction. But this does cause uncertainty to Miss X as to when this care will be finalised.

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Agreed action

56. To address the injustice caused by fault, within one month of my final decision the Council has agreed to:
• write to Miss X and Mr Y with an apology that takes account of our published guidance on remedies and accepts the findings of this investigation;
• pay Miss X and Mr Y £500 to acknowledge the distress caused to them by the fault identified in this statement;
• pay Miss X £3030.30 as recommended by the Council in recognition of impact its failings had on the care;
• arrange a day to complete the core assessment to correct any inaccuracies; and
• in regard to the additional care which is yet to be finalised, put whatever arrangements the Council has made in place. If this is not possible, explain to Miss X why and detail when it expects this to be finalised.
57. The Council should provide us with evidence it has complied with the above actions.

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Final decision

58. There was fault by the Council. The actions the Council has agreed to take remedy the injustice caused. I have completed my investigation.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman