Summary: Mrs X, complains the Council has not dealt properly with her adult social care. The Council is at fault because there was delay completing a needs assessment and responding to her complaint. Mrs X suffered uncertainty, time and trouble and missed care provision. The Council should apologise, pay Mrs X £200 for uncertainty and time and trouble, and £400 for missed care provision due to delays.

The complaint

1. The complainant, whom I shall refer to as Mrs X, complains the Council:
• Did not include information from an Occupational Therapist in its complaint response, as it said it would;
• Has not contacted her regarding the outcome of the care assessment visit; and
• Handled her complaint poorly because she had to chase a response several times.
2. Mrs X says it has caused stress and impacted her physical and mental health.

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The Ombudsman’s role and powers

3. 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)
4. Our role is not to ask whether an organisation could have done things better, or whether we agree or disagree with what it did. Instead, we look at whether there was fault in how it made its decisions. If we decide there was no fault in how it did so, we cannot ask whether it should have made a particular decision or say it should have reached a different outcome.
5. When considering complaints, we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
6. 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

7. I spoke to Mrs X about her complaint and considered documents she provided. I made enquiries of the Council and considered its response and the supporting documents it provided.
8. 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

9. There is a service level agreement for the provision of Occupational Therapy Posts by Devon Partnership NHS Trust within the Autism Team of Devon County Council. The service is to provide an Occupational Therapy (OT) service to the people of Devon who are under the care of the Devon County Council Autism & ADHD Team.
10. The Council’s eligibility policy says it aims to complete a care assessment within 28 days, but timescales may vary due to the level of requests at any given time.

What happened?

11. This is a brief chronology of key events. It does not contain everything I reviewed during my investigation.
12. Mrs X complained to the Council about delays to a social care assessment in September 2023.
13. The Council responded to Mrs X’s complaint in January 2024.

Analysis

14. The Council did not provide information from an Occupational Therapist in its complaint response. It did explain to Mrs X why a referral had not been acted on, saying, “The Occupational Therapy team you reference is a Devon Partnership Trust service. The referral was made by Devon County Council and Devon Partnership Trust initially accepted the referral. Subsequently a decision was made not to accept a referral without an allocated Devon County Council worker in place. I am very sorry for your experience with a delayed referral.”

This is not fault by the Council.

15. The Council accepted in its complaint response that the complaint response itself and Mrs X’s care assessment had been delayed. The Council says, “Due to demand and capacity issues within the team there was a delay in responding to Mrs X’s complaint.” This is fault by the Council. Mrs X suffered uncertainty and time and trouble.
16. The assessment itself clearly identifies need and a referral to a service, (which hasn't proven workable). The need existed during the period of delay the Council has already accepted is fault. There is no evidence to show the need no longer exists, so by inference, it does. Therefore, there has been an unmet need during the time prior to and following the care assessment. The Council, as accepted in its enquiry response, has been unable to find a way to meet Mrs X’s needs, in a way that is acceptable to her. This is service failure, rather than fault. Mrs X has missed care provision.

Action by the Council

17. The Council has identified necessary service improvements as a result of Mrs X’s complaint, including:
• Implementing an action plan to reduce delays. I have seen the action plan and progress against it.
18. I consider the service improvements by the Council are satisfactory.

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Agreed action

19. To remedy the outstanding injustice caused by the fault I have identified, the Council has agreed to take the following action within 4 weeks of this decision:
• Apologise to Mrs X for her delayed care assessment and complaint response. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings.
• Pay Mrs X £200 for her uncertainty and time and trouble; and
• Pay Mrs X £400 for missed care provision as a result of delay.
20. The Council should provide us with evidence it has complied with the above actions.

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Final decision

21. I have found fault and service failure by the Council, which caused injustice to Mrs X. I have now completed my investigation.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman