Summary: Mrs X complained the Council did not properly deal with her daughter’s Care Act assessments during her transition from the Council’s Children Services to its Adult Services. Mrs X also complained that this resulted in the Council failing to provide her daughter with a suitable supported living accommodation to meet her needs. There was no fault by the Council with how it dealt with Mrs X’s daughter’s transition to adult social care provision.

The complaint

1. Mrs X complained the Council did not:

• properly take into account her daughter, Y’s, vulnerabilities/disabilities and it did not consider Y’s professional medical evidence when it assessed Y’s needs during her transition to adult social care provision
• provide Y with a suitable supported living accommodation to meet her needs and to keep her safe.

2. Mrs X said as a result, Y’s needs were unmet and there was a delay in placing her in a suitable accommodation. She said Y was unable to settle in the unsuitable placement which led to Y’s attempted suicide.

Back to top

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 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. 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)

Back to top

What I have and have not investigated

5. I have investigated matters from January to June 2024. This covers the period when the Council first conducted a Care Act assessment for Y to when Mrs X made a complaint to the Ombudsman.

Back to top

How I considered this complaint

6. I considered the information Mrs X and the Council provided about this complaint.
7. I sent Mrs X and the Council a copy of my draft decision and considered all comments received before reaching a final decision.

Back to top

What I found

Looked after children

8. Under Section 20 of the Children Act 1989, a looked after child is any child who is subject to a care order or accommodated away from their family by a local authority. The child becomes looked after when the local authority has accommodated them for a continuous period of more than 24 hours.

Transition from children to adult care services

9. When a child reaches 18 years old, they are legally an adult. Responsibility for meeting their needs moves from a council’s children services to its adult services. The legal basis for assessing their needs changes from the Children Act 1989 to the Care Act 2014.
10. Statutory guidance says transition assessments should begin when a council can be reasonably confident about what the young person’s needs for care and support will look like when they turn 18.

Care Act Assessments

11. The Care Act 2014 states councils must assess any adult that appears to have needs for care and support. An adult’s needs arise from or are related to physical or mental impairment or illness; the adult cannot achieve two or more specified outcomes because of those needs, and there is likely to be a significant impact on the adult’s wellbeing.
12. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs.
13. Once a council has determined a person is eligible, it must set out the person’s needs and how the council will meet those needs in a Care and Support Plan. The council must meet those identified eligible needs. This includes securing a suitable placement which meets the person’s identified needs as agreed in the person’s Care and Support Plan.

Mental Capacity

14. A person aged 16 or over must be presumed to have capacity to make a decision unless it is established, they lack capacity. Where someone’s capacity is in doubt, councils must assess the person’s ability to make a decision. Councils must follow the law set out in the Mental Capacity Act 2005 to decide if individuals can make choices about their care and may need to carry out an assessment of capacity if there is doubt.
15. A person is not to be treated as unable to make a decision merely because he makes an unwise decision. Capacity is decision specific, can vary over time and an assessment may become outdated.

Background

16. Mrs X’s daughter, Y, has some physical and complex mental health conditions.
17. Y had been in care and looked after by the Council for a couple of years under the Council’s children services. Y received an intensive support package and a high level of supervision due to her health conditions and support needs. For instance, Y was supported by two carers for 24 hours per day to keep her safe and to reduce the risk of self-harming.
18. Y was due to reach her 18th birthday in July 2024.

Key events

19. In January 2024, the Council conducted a Care Act assessment for Y in preparation of her transition to adulthood. The assessment was to also identify a suitable accommodation and the support Y required to manage her daily needs and to keep her safe and well. The assessment found Y had eligible care and support needs. It was also identified that a Mental Capacity Act (MCA) assessment was required to be completed to determine if Y could make informed decisions about her care needs and finances.
20. Following the Care Act assessment, Y’s care and support plan showed it was agreed she would be placed in a supported living accommodation in early August 2024 after her 18th birthday. This type of accommodation was to provide Y with supervision and support to help her live as independently as possible.
21. In April, Y’s new allocated social worker (SW) completed an MCA for Y. The outcome of Y’s MCA was that she had no capacity to manage her finances, but she had capacity to make decisions about her care and support needs. The SW also completed another Care Act assessment for Y and found she did not have eligible care and support needs. The SW noted the Child and Adolescent Mental Health Service (CAMHS) had referred Y to the adult mental health services who would undertake its own assessment and support Y’s mental health needs.
22. The SW’s recommendations included:

• Y’s two carers should start to withdraw their support before her 18th birthday to empower and build her confidence with not having 24 hours of support.
• Y should engage with learning new skills such as using home appliances and other tasks to aid her independence.
• there was no current need for a funded care package for Y by adult social care services.

23. Following the April assessment, the Council decided to place Y in an independent living accommodation (Placement 1) on or before her 18th birthday with no staff support.
24. Mrs X made a formal complaint to the Council and questioned the difference between the first and the second Care Act assessments completed for Y. Mrs X complained the Council did not properly complete a Care Act assessment for Y and as a result it wrongly decided she had no eligible care and support needs. Mrs X also complained about the Council’s decision to place Y in an independent living accommodation with no staff support. To support her complaint, Mrs X provided the Council with a detailed account of Y’s health conditions, vulnerabilities, and her need for constant staff support with reference to medical reports from Y’s professionals.
25. In response to Mrs X’s complaint, the Council said it was satisfied it had properly completed Y’s Care Act and MCA assessments. It said it considered all relevant information including the children services records, Y’s views, and parental views. The Council said although it did not have a copy of one of Y’s professional medical reports at the time of the assessment, it said the SW had sufficient knowledge about Y’s health conditions to have completed the assessment.
26. As regards the independent living accommodation (Placement 1), the Council acknowledged Mrs X’s concerns about Y having less intense support compared to her children’s services provisions. But it said the placement had been carefully considered based on Y’s April assessment and to build Y’s independence and resilience. The Council said it also explored and referred Y for another accommodation (Placement 2) where she would have her own tenancy with an offer of up to 16 hours of support.
27. In conclusion, the Council assured Mrs X it would complete another Care Act assessment for Y in partnership with other relevant parties and it would consider the professional medical report. It said Y’s reassessment was to identify any eligible care needs she might have, and to put in place any appropriate outcomes to meet her identified needs.
28. Mrs X remained dissatisfied with the Council’s response, and in June, she made a complaint to the Ombudsman.
29. The Council and Mrs X confirmed to the Ombudsman that another Care Act Assessment was subsequently completed for Y in July before her 18th birthday. During the assessment, additional information/evidence was considered which included the previous January and April Care Act assessments, the April MCA, and medical reports from Y’s professionals. The outcome of the assessment was that Y was found to have eligible care and support needs and the Council agreed Y’s needs would be best met in a supported living accommodation.

Analysis

30. Although it is unusual for councils to complete Care Act assessments within a short period and it is unclear why this was done in Y’s case, but it is a decision councils are entitled to make. Therefore, the assessments completed for Y in January and April were not faults. Also, two professionals can come to a different view on a person’s care and support eligibility needs. This was a differing professional judgement and again, it was a decision the Council is entitled to make. This was not fault.
31. I note Mrs X said the Council did not consider all of Y’s professional medical reports when it conducted the April Care Act assessment. Mrs X also said had the Council proceeded with following the January assessment outcome and not decided to reassess Y in April which resulted in a different outcome, a delay in placing Y in a suitable accommodation to meet her needs and to keep her safe would have been prevented.
32. While I acknowledge how distressing the April assessment and outcome may have been for Mrs X, there was no evidence to show the Council did not follow the Care Act processes in reaching its decision. This was not fault.
33. Furthermore, when Mrs X complained about the April Care Act assessment and the disparity in outcomes, the Council completed another assessment for Y. This happened in July, and it was before Y’s 18th birthday. The Council considered additional information including Y’s professional medical reports and found Y was eligible to care and support needs. And the Council decided Y’s identified needs would be best met in a supported living accommodation. This was not fault. The Council acted promptly, and the reassessment decision and subsequent outcome were decisions the Council was entitled to make based on its professional assessment. And it was the outcome Mrs X was seeking.
34. Also, the care and support plan the Council issued after the January assessment showed it agreed Y would be placed in a supported living accommodation in early August 2024 after her 18th birthday. Therefore, there was no delay by the Council in how it dealt with Y’s transition to adult services. All the Care Act assessments were completed before Y turned 18 in readiness for her transition to adulthood.
35. In conclusion, I find the Council followed the Care Act processes when it carried out its professional assessments for Y. These were not faults and the Ombudsman cannot question the merits of the Council’s decision where there is no evidence of procedural fault.

Back to top

Final decision

36. I find no evidence of fault by the Council leading to injustice.

Back to top

Investigator's decision on behalf of the Ombudsman