Summary: We have completed our investigation. There was no fault in how the Council assessed Z’s care and support needs. However, the Council was at fault for failing to deal properly with Mrs X’s complaint. The action already carried out by the Council is a suitable remedy for the injustice suffered by Mrs X.

The complaint

1. Mrs X complained the Council are not providing the care and support outlined in her adult child Z’s care and support plan. She said the Council are failing to provide suitable funding and practical support for Z.
2. Mrs X said the Council have removed funding for activities that Z has enjoyed over the past two years, without explanation. She is concerned about the impact this will have on Z’s mental and physical wellbeing.
3. Mrs X said the lack of support from the Council is stopping Z gaining important life skills.

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The Ombudsman’s role and powers

4. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)
5. 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)
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)
7. 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

8. I have investigated how the Council assessed Z’s care and support needs in 2023.
9. I include matters relating to 2022, for context. I have not investigated the assessment that took place in 2022. This is because these matters are late.

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How I considered this complaint

10. I considered the complaint and information provided by Mrs X and the Council.
11. I referred to the Ombudsman’s Guidance on Remedies, a copy of which can be found on our website.
12. Before proceeding to a final decision, I considered comments made by Mrs X and the Council on the draft decision.

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What I found

Law and Guidance

13. 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. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
14. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.
15. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
16. 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)
17. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.

What happened

18. Z is a man in his twenties. He has a learning disability, Downs Syndrome and is on the autistic spectrum.
19. Z has a care and support plan, and Mrs X has a carers wellbeing plan in place.
20. As part of Z’s care and support plan, Mrs X receives direct payments from the Council to arrange provision outlined in the plan. This has been ongoing for several years.
21. The following information is relevant to the complaint being investigated. It does not include everything that has happened.
22. Z left college in July 2022. Upon leaving college, the Council reviewed Z’s care and support plan.
23. In December 2022 the Council explained the recreational activities it would fund as part of Z’s care and support plan, and the activities it would not. It recognised it was important for Z to include physical activity in his routine.
24. Mrs X objected to the plans proposed by the Council. She wanted more money from the Council for Z to take part in recreational activities during the week. She felt it was important for Z expand on his life skills and to socialise with other young people with similar needs to him.
25. At this time Mrs X had extra money in her direct payments account. She said the direct payments built up during the Covid 19 pandemic because of services temporarily closing.
26. While assessment of Z’s needs by the Council were ongoing, Mrs X used the surplus money to fund Z’s weekly activities, as she saw fit.
27. Z spent a day a week at a recreational centre outside the local area. I will refer to it as centre C. Centre C offers a range of wellbeing activities for people with learning disabilities and in a similar position to Z.
28. Upon reviewing Z’s care and support plan, about one year later, the Council assessed Z’s care and support needs. It said based on Z’s needs, it would not agree funding for travel and attendance costs for him to go to centre C. It said Z’s needs could be met in different ways, and closer to home.
29. It agreed to fund part of the proposed care that Mrs X and Z asked for. It proposed to increase the budget to meet the outcomes listed in Z’s care and support plan. However, the increased budget did not cover everything Mrs X said Z needed in his weekly schedule.
30. Mrs X said:
• The Council should fund four days at a day centre, not the proposed three, and one of those should include funding for centre C,
• The Council should fund travel in a taxi to and from centre C,
• The Council should fund an enabler (carer for Z) to stay overnight with him once a week for him to develop his life skills independently from his parents.
31. The Council said these things were not necessary to meet outcomes in Z’s care and support plan. It suggested several alternatives to Mrs X and Z.
32. In mid-November 2023 Mrs X complained to the Council. She complained about four things:
• The Council had not agreed to fund travel to and from, and attendance at, centre C,
• The Council had not agreed to fund an enabler to stay overnight once a week with Z, to support Z to develop his independent living skills,
• The Council had not agreed to fund a fourth day at an activity centre, per week, for Z,
• Funding available to her, as Z’s carer, to organise respite care for one week a year (this matter has since been resolved).
33. The Service Manager dealing with the complaint asked the Councils Disability Lead for an expert opinion. The Disability Lead reviewed the complaint, Z’s care and support plan and the proposed budget for Z.
34. The Disability Lead could not find fault with how the Council approached the assessment or the budget and did not recommend increasing the weekly direct payment. It noted the support Z received from family. It recognised if this were to change the family could tell the Council who would carry out a review.
35. In March 2024 Mrs X received a complaint response from the Council. The Council apologised for the delay in responding to Mrs X’s complaint. The Council did not uphold Mrs X’s complaint. It said it would not increase funding. The carers assessment and direct payment arrangements were due to be reviewed. The Service Manager who responded said she would like to organise these for Mrs X.
36. Mrs X responded to the Service Manager sharing her ongoing frustration with the Council. She said she felt the funding should be increased, and that this should include overnight care once a week. Mrs X was worried about the risk to Z overnight and how he would respond in an emergency without her help.
37. At the start of April, the Service Manager emailed Mrs X. She described further the Councils assessment of Mrs X’s complaint points and expanded on why the Council would not increase the budget for Z.
38. Mrs X responded. She said she did not wish to withdraw her complaint. She remained unhappy with the Council complaint response, her carers assessment and Z’s care and support plan.
39. A face-to-face meeting was offered to Mrs X by the Service Manager.
40. At the end of April, the Service Manager and a colleague met with Mrs X. Mrs X said she felt the Council made insensitive suggestions about what Z could do with his time during the week. She felt the Council did not understand Z’s needs.
41. Mrs X complained to the Ombudsman in May 2024.

My findings

Funding for Z

42. It is not the Ombudsman’s role to decide if a person has social care needs, or if they are entitled to receive services from the Council. The Ombudsman’s role is to establish if the Council assessed a person’s needs properly and acted in accordance with the law.
43. It is not uncommon for unspent direct payments to be reclaimed by a Council. Despite the Council requesting Mrs X return the money, the Council did not reclaim the direct payments that built up, during the Covid 19 pandemic. A large sum accumulated during the time services were closed.
44. In the 2023 review of Z’s needs the outcome of the assessment was that the weekly budget increased by £100. Mrs X complained this was not enough to fund all the activities Z wanted to take part in.
45. The Council suggested alternatives to Mrs X based upon what it felt would enable Z to meet the outcomes in his support plan. The Council also told Mrs X she could spend the budget as she and Z saw fit. If she wanted to prioritise centre C and pay for an enabler to stay overnight with Z once a week, over other activities, she could.
46. Z takes part in a wide range of recreational activities throughout the week. This is a combination of activities organised and paid for by the Council and by Mrs X.
47. Z’s family provide a high level of support to him. This has been factored into the assessment but has not influenced the Council disproportionally.
48. The specific requests made by Mrs X about the day centre activities and overnight care for Z were thoroughly considered by the Council.
49. It is understandable that Mrs X wants Z to have access to as much as possible in his life. Mrs X disagrees with the outcome of the Council’s assessment of Z. However, it is not a requirement of the Council to take responsibility for funding everything Mrs X wants.
50. It is a requirement of the Council to carry out a thorough assessment of Z’s needs, to show how it will meet Z’s needs and to do so using a care and support plan. It has done this.
51. I do not find fault with how the Council conducted itself when organising Z’s care and support plan review, carrying out the review, and deciding on Z’s personal budget.

Complaint handling

52. The Council took 134 days to respond to Mrs X’s complaint at stage one. The Council should have made its response in 20 working days, or 28 days in total.
53. It took the Council about 3.5 months longer to respond than it should have done. This was fault by the Council and caused Mrs X unnecessary frustration and prolonged uncertainty about Z’s care and support budget.
54. The Councils delay responding to the complaint did not change the outcome for Z. I have not found that Z suffered injustice because of the Council taking longer than it should have done to reply to Mrs X’s complaint. The Council apologised for the delay. Given the lengths the Service Manager went to, to try to resolve Mrs X’s complaint, I feel this is an appropriate remedy for the injustice caused by the Council.

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Final decision

55. I have completed my investigation. I do not find fault with the substantive matters complained of. However, the Council was at fault for failing to handle Mrs X’s complaint in a timely manner. The action already carried out by the Council is a suitable remedy for the injustice suffered by Mrs X.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman