Summary: The Council identified failings in the management of Mrs Y’s care and in the way it responded to complaints about this, before the complaint came to this office, but it failed to offer an appropriate remedy for the injustice caused.

The complaint

1. Mr X complains the Council reduced his mother, Mrs Y’s care package without first assessing her care needs and failed to respond to his complaints about this.

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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. It is our decision whether to start, and when to end an investigation into something the law allows us to investigate. (Local Government Act 1974, sections 24A(6) and 34B(8), 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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How I considered this complaint

5. I have:

• considered the complaint and the information Mr X provided;
• considered correspondence between Mr X and the Council, including the Council’s responses to the complaint;
• made enquiries of the Council and considered the responses;
• considered relevant legislation;
• offered Mr X and the Council an opportunity to comment on a draft of this document.

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What I found

Relevant legislation

6. 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.
7. The care and support plan should consider:

• the needs of an individual
• what they want to achieve
• what they can do by themselves or with existing support
• what care and support may be available in the local area. 

Background

8. Mrs Y is in her seventies and has a diagnosis of dementia. She requires constant supervision and needs support with all daily living tasks.
9. Mrs Y lives with Mr X and his wife and young children. Both Mr X and his wife provide support for Mrs Y, in addition to that provided by paid carers.
10. Prior to this complaint Mrs Y received 26.5 care hours per week.
11. Following a visit from social services in December 2023, Mrs Y’s care package was reduced to 17 hours per week. Mr X says the Council took this decision without reassessing Mrs Y’s care needs, or discission with the family.
12. Mr X sent an email to the Council in January 2024 to say the family had not been consulted about the reduction in care hours and asked on what basis the decision had been made. He said the visit by a social worker in December 2023, related to a change in care agency, and confirmation of direct payment paperwork, and did not include a reassessment of Mrs Y’s needs. He said Mrs Y’s needs had increased because of the progression of her dementia, and this was having a significant impact on him and his family. He referred the Council to previous correspondence sent by mental health crisis team highlighting Mrs Y’s deteriorating health condition and asking for an increase in care hours due to the impact on the family. Mr X said the Council had not responded to this.
13. Mr X also reiterated concerns he had expressed previously about the carers attending Mrs Y. He said carers had missed visits, rushed visits, changed timings, missed medication, and provided inadequate meals. Mr X asked the Council to

• reinstate the original care package for direct payments; 
• compensate him for time, trouble, and stress caused; 
• respond to the complaint in a timely manner. 

14. Mr X says the reduced care package was implemented on 1 February 2024, whilst he and his family were away from home.
15. Mr X received a response to his complaint on 19 February 2024, which he was dissatisfied with. After escalating his complaint, he received a further response on 8 April 2024. Mr X was dissatisfied with this response also and contacted the Council again asking for a further review of his complaint.
16. The Council escalated Mr X’s complaint to a senior officer. After further consideration, the officer provided Mr X with a final complaint response on 6 June 2024. The author of the letter acknowledged failings in the management of Mrs Y’s care and in the way it handled Mr X’s complaints about this, saying, “…there were many areas that we could have done better. I was disappointed reading the case file that we have for your mother and I have found instances where we did not live up to our Southwark Council values… your complaint has raised practice issues that I will be taking forward in a reflective practice session with the allocated worker and her line manager and will ensure the learning from your complaint is shared…”. The author apologised and offered Mr X £150 by way of a remedy for Mr X’s time, trouble, and distress.
17. The Council completed a carers re-assessment on 19 June 2024, following which a sitting service was increased to 15 hours per week. Funding for the service was added to the direct payment already paid for Mrs Y’s care. Mrs Y is now in receipt of 32.5 weekly care hours. This includes 15 hours of sitting service over five days; the previous sitting service being 3 days a week.
18. Mr X does not believe the remedy offered by the Council to be sufficient, saying it does not reflect the stress and distress caused to him and his family by the failures in Mrs Y’s care, and does not reflect the time and trouble he was put to because of the Council’s poor complaint handling.

Analysis

19. Following a review of Mr X’s complaint, the Council acknowledged failings in the management of Mrs Y’s care and in the way in which it dealt with Mr X’s complaints about this. Any further investigation by this office is unlikely to add to this.
20. However, the remedy offered was insufficient. It failed to reflect the stress and distress caused to Mr X and his family and fails to reflect the added stress caused by the Council’s poor complaint handling.
21. The Council says lessons have been learnt from the complaint and action taken. The Ombudsman will seek confirmation of this.

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Agreed action

22. The Council should, within four weeks of the final decision:

• make a payment of £500 to Mr X to acknowledge the distress caused by the identified failings;
• make a further payment of £250 to acknowledge Mr X’s time and trouble pursuing this complaint with the Council and this office;
• provide this office with evidence of action taken as a result of lessons learnt from this complaint;
• provide this office with evidence it has complied with the above actions.

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Final decision

23. The Council identified failings in the management of Mrs Y’s care, and in the way it responded to complaints about this, but it failed to offer an appropriate remedy for the injustice caused.
24. The above recommendations are a suitable way to settle the complaint.
25. It is on this basis; the complaint will be closed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman