Summary: Mrs X complained the Council failed to find supported accommodation for her son and did not provide respite breaks for her family. The Council had previously found suitable placements for Y for respite breaks in Manchester but we found the Council did not take sufficient action to find a placement for Y during 2022. Although we found fault by the Council we did not find this caused Mrs X’s son to miss out on a placement or Mrs X to miss out on respite. This was because it seems likely Mrs X would not have accepted a placement in Manchester for Y.

The complaint

1. Mrs X complains the Council failed to find supported accommodation for her adult son and failed to provide respite for her family in the meantime.
2. Mrs X complains in September 2022 the Council led her to believe that it had agreed to place her son in her preferred service, but this was not the case.
3. She complains that she is stressed and burnt out and because of the lack of respite, the situation is affecting her other child and she has been unable to see her elderly parents.

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The Ombudsman’s role and powers

4. 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)
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)
6. 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 has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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What I have and have not investigated

7. We have exercised discretion to investigate the events of this complaint from 2022. We have not investigated older events as it would be reasonable to expect a complaint to have been made to us about these events sooner.

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How I considered this complaint

8. I spoke to Mrs X and considered her complaint. I asked the Council for information and considered its response to the complaint.
9. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Care and Support and After-care (Choice of Accommodation) Regulations 2014

10. The regulations state that people whose care needs can be best met in a residential or supported living accommodation are allowed to have a say in where this is, provided certain conditions are met. Amongst other things the accommodation must:
• be suitable to meet the person’s needs; and;
• not cost the Council more than the amount specified in the individual’s personal budget.
11. An individual can choose a setting that is more expensive than the amount provided for accommodation in their personal budget, but to do so they must agree to meet the additional cost via a top-up payment.

Council Policy

12. The Council told us its policy for providing support services was always to provide them in the Council’s own area. It would first consider in‑house options. If no in‑house options were available that met an individual’s needs, they would consider providers which the Council already had a contract with.
13. If no available in-house or contracted services can be identified to meet someone’s needs, the Council approaches providers on a list; The Greater Manchester Framework. It does this by sending anonymised details of the care and support required to providers on the framework to match suitable available providers with individuals needing support.

Background

14. Mrs X and her adult son, Y, moved to the Council’s area in 2015 from a nearby town. Y has learning disabilities and he is Autistic. Y’s support plan notes that he needs prompting and support with the activities of daily living and support at all times while at home. Y needs 1:1 support at all times in the community to keep him safe.
15. Y’s support plan from December 2023 states that eventually Y would like to move to supported accommodation in the town he lived in before Manchester. However, the priority was putting short break provision in place and opportunities for Y to access the community independently.

Mrs X’s complaint

Seeking a Placement for Y

16. Mrs X told us that her preferred service for Y is outside of Manchester City Council’s area in the town where they used to live. She complained that the Council would not agree to send Y there because it was outside its area, even though it is geographically closer than some of the other services available within Manchester.
17. Mrs X complained that during 2022, a social worker led her to believe that the Council would agree to send Y to her preferred service, but in December 2022 it confirmed this could not happen.
18. Mrs X also complained that the Council has not provided her with respite care to allow her a break from caring for Y.
19. The Council gave us a list of the providers that it had contacted to seek respite or accommodation to Y since 2017. It stated Mrs X had declined the majority of these because she did not consider they would be suitable. The Council noted, as a result, no formal assessments had been done to consider if the providers could meet needs.
20. Case notes from early 2022 show that the Council was arranging an assessment to see if Y met the criteria for Continuing Health Care (CHC). Someone may be eligible for CHC if they have a primary health need and need significant ongoing care. If they are eligible, the NHS would begin funding their care rather than a Local Authority.
21. In Summer 2022, Mrs X’s preferred care provider contacted the Council and asked to discuss a possible placement. There is no record of what discussion took place. However, in October 2022 internal emails at the Council show that costings of the preferred placement had been obtained. It appears this was at the same time as Y’s eligibility for CHC was being considered.
22. As at October 2022 Y’s support plan was not complete. A note on the Council’s records stated it would be ready once funding was agreed.
23. In November, the preferred placement asked what was happening. They referred to there being a pending placement offer. They stated, if the placement was not going ahead, they would need to cease planned visits with Mrs X and Y. In response, the Council explained there was a wider multi-disciplinary team meeting to decide Y’s eligibility for CHC, following which Y’s funding could be discussed and agreed, depending on the outcome.
24. There is evidence the Council explained to Mrs Y that the November meeting was to decide CHC eligibility, not to agree any changes of placements for Y.
25. In December, the Council explained that Y did not meet CHC criteria. The Council stated it had posted Y’s placement to providers on The Greater Manchester Framework again, as this had not been done for some time. The Council stated two providers were interested in assessing Y to provide services and consent was needed to share his information. The Council established one of these was a self‑contained flat unsuited to Y. The Council believed the other would likely meet Y’s needs.
26. In correspondence with Mrs X in December, the Council also mentioned Mrs X’s preferred placement. A social worker stated the Council would not agree to fund until it was evidenced that providers in Manchester could not meet Y’s needs. They stated the Council could not give the preferred placement a date when funding would be agreed as they ‘may need to follow some procedures before funding can be agreed.’
27. In early 2023, 12 providers proposed placements. Some were rejected as they were outside Manchester, and Mrs X did not consider the others were appropriate for Y. One provider considered they could meet Y’s needs but noted Mrs X had stated she did not consider it would be suitable as it was too far from Y’s friends who lived in their previous town.
28. In the later half of 2023 and early 2024, four more placements were considered. One began to provide a daytime activity for Y one day per week. They also considered they could meet Y’s needs, however, Mrs X did not consider the placement was suitable.
29. The Council’s response to Mrs X’s complaint explained that before it would look to place someone outside of its area, it would consider all the available options within Manchester. In Y’s case it found several providers who considered they could meet Y’s needs for respite.

Carers Assessment

30. The Council explained that it conducted a carers assessment for Mrs X in 2019. During 2020 it advised carers that it would not automatically review assessments every 12 months. Rather they should make contact if circumstances changed and a fresh assessment would be arranged. The Council evidenced that it offered Mrs X a carers assessment in March 2023 but it received no response. The Council stated it would be able to arrange a carers assessment if Mrs X requested it.

Was there fault by the Council

Care Placement/Accommodation

31. There was some fault by the Council. Based on the information the Council provided, it took little action to seek a placement for Y during 2022.
32. I note a CHC assessment was being carried out but it is not clear why this took so long and why respite placements could not have been considered by the Council in the meantime. The delay in the CHC process also appears to have delayed updating Y’s care and support plan.
33. However, it is not clear the lack of action in this period had a significant impact. I say this because there is evidence that prior to 2022, the Council had investigated numerous placements for Y and from 2023, further placements had been identified that could meet Y’s needs. Mrs X had declined these placements or not agreed to them carrying out a full assessment. So, while I found it was fault that the steps taken by the Council in 2022 were limited, on balance I do not consider it is likely Y missed out on a suitable placement as a result. Mrs X has not agreed to pursue placements within Manchester when they were available.
34. I recognise Mrs X has a clear idea that the placement in Y’s previous town would be best for him. However, the Council’s policy is to seek to provide services from its own in-house or contracted providers in the first instance. Only where they cannot meet needs would the Council look to expand its search to other providers or locations, where costs may be greater. In this case, some of the Council’s in-house and contracted providers have indicated they could meet Y’s needs. So, I found the Council had not failed to find a placement for Y, these were available. It was not fault that it did not agree to Mrs X’s preference in the circumstances. The Council has encouraged Mrs X to agree to a full assessment of needs with providers it has identified to allow a placement to progress. This is appropriate.

Confusion over Mrs X’s preferred placement

35. Mrs X stated she was led to believe Y would be going to her preferred placement, outside Manchester and that transition plans had started to enable this to happen.
36. The Council’s response to Mrs X’s complaint explained that the Council did not initiate contact with her preferred placement and it did not create a transition plan. There is no evidence from the Council’s case notes that a placement had been agreed or that it had begun transition planning.
37. There is evidence that a social worker was contacted by the preferred placement and that the social worker responded and established the costs of a placement there. However, it was not unreasonable for the Council to establish the costs and speak to the provider. As we state above, the Council’s decision not to agree the out of area placement was not fault.

Carer Assessment

38. There was no fault in respect of assessing Mrs X as a carer.

Apology

39. In its original response to her complaint the Council apologised to Mrs X for the delays that occurred in the CHC process and more latterly due to staffing pressures. I note the Council apologised to Mrs X for the delay in responding to her complaint. As I have not found fault with the Council’s decisions about Y’s placement, I do not have grounds to seek anything further.

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Final decision

40. There was some fault by the Council. It did not lead to a significant injustice to Mrs X or to Y.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman