Summary: There was no fault by the Council which met Mr Y’s eligible care and support needs while it identified a suitable supported living placement for him and put in place funding to enable Mr Y to receive care and support while his mother Ms X worked.

The complaint

1. Ms X complained the Council failed to ensure appropriate care and support was in place for her adult son Mr Y in a time of crisis over many years. She said this caused avoidable distress and a decline in her mental health. She wants the Council to provide a suitable service for families in crisis.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but we use public money carefully. We do not start or continue an investigation if we decide we cannot achieve the outcome someone wants, there is no or insignificant injustice or there is no worthwhile outcome achievable by our investigation.
3. 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. (Local Government Act 1974, sections 26A or 34C.)
4. Mr Y lacks mental capacity to make this complaint and so cannot give his consent. The complaint is brought by Ms X on his behalf and we consider her a suitable representative to complain for him.
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)

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What I have and have not investigated

The investigation period: August 2023 to May 2024

6. Ms X complained the Council failed her family repeatedly over years. I have investigated August 2023 to May 2024.
7. Events before August 2023 are historical matters when Mr Y was a child. I will not be able to achieve a meaningful remedy given the length of time passed, the difficulty establishing causality and changes in the situation of the parties. The Council responded to complaints from Ms X in 2021 and 2022. It was reasonable for her to have complained to us at the time of receiving the Council’s responses.
8. Ms X has already complained to us separately about a lack of services for Mr Y in 2022 (reference 23020149). We did not investigate her complaint then. We do not allow repeat complaints.

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How I considered this complaint

9. I considered the complaint to us, the complaint to the Council and documents set out in this statement. I discussed the complaint with Ms X
10. Ms X and the Council now have an opportunity to comment on my draft decision. I will consider their comments before making a final decision.

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What I found

11. A council must carry out an assessment for any adult ‘with an appearance of need for care and support’. (a social care assessment) (Care Act 2014, section 9)
12. A social care assessment should be carried out over an appropriate and reasonable timescale taking into account the urgency of needs. Councils should give the person an indicative timescale and keep them updated. (Care and Support Statutory Guidance 2014, Paragraph 6.24)
13. Councils have a duty to meet eligible needs (needs which meet the eligibility criteria). (Care Act 2014, section 18).
14. An adult’s needs meet the eligibility criteria if they arise from or are related to a physical or mental impairment or illness and as a result the adult cannot achieve two or more of the following outcomes and as a result there is or is likely to be a significant impact on well-being:
• Managing and maintaining nutrition
• Maintaining personal hygiene
• Managing toilet needs
• Being appropriately clothed
• Making use of the home safely
• Maintaining a habitable home environment
• Accessing work, training, education
• Making use of facilities or services in the community
• Carrying out caring responsibilities.

(Care and Support (Eligibility Criteria) Regulations 2014, Regulation 2)

15. The Care Act explains the different ways a council can meet eligible needs by giving examples of services that may be provided:
• Accommodation in a care home or other premises
• Care and support at home
• Counselling and social work
• Information advice and advocacy

(Care Act 2014, section 8)

16. If a council decides a person is eligible for care, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether and to what extent the needs meet the eligibility criteria and specifies the needs the council is going to meet and how this will be done. The council should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
17. There is no defined timescale for completion of the care and support planning process. The plan should be completed in a timely fashion and it should not unduly delay needs being met. (Care and Support Statutory Guidance paragraph 10.84)
18. A council must carry out a carer’s assessment where it appears a carer may have needs for support. The assessment must include an assessment of the carer’s ability and willingness to continue in the caring role, the outcomes the carer wishes to achieve in daily life and whether support could contribute to achieving those outcomes (Care Act 2014, section 10)

What happened

19. This section summarises key events and does not include every contact between Ms X and council officers. During the period I have investigated, there are records of regular calls and emails between Ms X and officers. Councillors and Ms X’s MP also exchanged emails with regular updates on Mr Y’s case.

Background

20. Mr Y is a young adult who is autistic and has a learning disability. Mr Y has challenging behaviour. Mr Y’s first adult social care assessment was in 2022, before the events I have investigated. He was at 6th form college. He was eligible for care and support.

2023

21. Mr Y’s care and support plan of June 2023 set out Mr X’s eligible care and support needs and set out funding to meet his eligible unmet needs. Funding was for 18 hours a week of support (3 days a week) It would also enable Ms X to maintain her employment.
22. Ms X’s carer’s assessment of September 2023 said she was a full-time carer for Mr Y and that some respite care for Mr Y would improve her well-being and quality of life and enable her to go back to work and spend more time with her other child.
23. Records indicate there were monthly or bi-monthly multi-disciplinary team (MDT) meetings attended by professionals working with Mr Y including social workers, education staff, a positive behaviour support (PBS) practitioner and NHS mental health services. Ms X asked for these meetings as she felt the Council was not doing enough to support her and she attended.

Date Summary of MDT discussion and action agreed

July Mr Y was having care in the home by a care agency. Care workers were coming to the house to support Mr Y. The social worker said the days and hours were flexible so Ms X could arrange them to suit her. Ms X said three hours were enough as she was not going too far from home. The agency’s manager said she had put in place staff with experience of high complex needs. Staff had received a full day of autism training, breakaway techniques and de-escalation. The PBS practitioner offered additional support to the care agency. The long-term plan was to identify a supported living placement for Mr Y. A care provider was meeting with the family and the Council was referring Mr Y to an organisation to find housing.

September Mr Y had been to school two days that week. A new social worker was taking over his case. A housing referral would be made.

October Mr Y was controlling the home environment. He would not let the PBS practitioner into the house anymore. The care agency was coming into the home, on occasion care workers were leaving due to Mr Y’s behaviour. There was a suggestion of a residential school; Ms X said Mr Y might not want to go to school any more and education might be over for him. The Council had found a long-term care provider which needed to recruit staff and the Council needed to find a property. Ms X was saying she wanted Mr Y to move out and she was having anxiety attacks. The social worker was going to discuss interim support, arrange a mental capacity assessment for Mr Y and look into telecare options including an emergency buzzer.

November A senior manager from the Council attended the meeting plus other professionals working with Mr Y currently or in the past. There had been an incident which resulted in police attending the home. The Council identified a residential placement specialising in care and support for adults with learning disabilities and mental health conditions. This was not considered ideal but was needed to give Ms X some respite.

24. The Council placed Mr Y in a residential placement (a care home) about 90 miles from his family home. The placement was an emergency temporary one after a serious incident at home. The records indicate the Council agreed to provide financial support with train fares for Ms X to visit Mr Y.
25. Emails between Ms X, council officers and councillors indicate Ms X raised concerns about Mr Y’s room not having a window and there not being a bath in the home, only a shower. (Mr Y does not like having showers).

2024

26. The Council carried out a social care assessment in March 2024. The outcome was Mr Y was eligible for care and support under most of the eligibility outcomes described in paragraph 14. The assessment described his needs in detail and desired outcomes.
27. Internal emails and records of contact between council officers, members and Ms X indicate the Council was taking action to find a permanent housing and care for Mr Y. The Council or an organisation acting for the Council, found a property nearer to Ms X in February 2024 and a specialist care provider to provide Mr Y with 24-hour care and support. (I refer to this placement as ‘supported living’)
28. Mr Y moved into supported living in May. His care and support plan of similar date set out a brief transition plan for two weeks to enable Mr Y to move in and settle into supported living. The plan described the funding of over £5000 a week to provide two to one staff for 14 hours a day and one waking night staff

Complaint to the Council and later events

29. Ms X complained to the Council in June about the Council’s lack of support in 2023. She said:
• The situation at home reached breaking point in 2023 when Mr Y was refusing to go to his educational placement and was controlling the home environment, having violent meltdowns and leading to her regularly calling the police.
• Mr Y’s social worker suggested a group home in June, which Ms X said was wholly inappropriate as he could not share a home with others. She was only getting four hours break a week on a Saturday when Mr Y went to his father’s.
• The Council offered and put in place home care for Mr Y. She had doubts about this as historically Mr Y refused to work with staff in the home. The staff were not trained in supporting adults with complex needs.
• The police attended the home three times in one day which led to a meeting and the Council agreeing respite care.
• The respite placement was 100 miles from the family home, it did not have appropriate bathing facilities and was hard for her to travel to visit him. He had to go to another place to bathe.
30. There was a further social care assessment in June. This contained updated information on Mr Y and his care and support needs in supported living. Ms X was noted to be happy with Mr Y’s support.
31. The Council’s complaint response in August said:
• A change of worker is necessary when staff leave. There has been no gap in worker for Mr Y.
• It was sorry it had taken time to resolve support for them, but there were limited options for specialist services and placements and the Council had no control over vacancies.
• The Council tried its best to source a placement close to the family home.
• The homecare agency was the only one which expressed interest in supporting Mr Y and it had provided support for adults with learning disabilities.
• The placement at the care home was a respite placement. The care home would not convert the bathroom for a temporary placement and had arranged for Mr Y to go to another care home to have a bath.
• The Council provided funding for Ms X and Mr Y’s sister to visit him weekly.
• It acknowledged the frustration and distress she experienced while the adult social care team was seeking specialist services and long-term support for Mr Y.
• Mr Y was settling in to supported living; Ms X had some meetings with a council senior manager and told them Mr Y was living his best life.
32. Mr Y’s care and support plan of August 2024 set out the care and support required for Mr Y in supported living and the budget for Mr Y’s care which has been in place since May 2024.

Was there fault?

33. The Council worked within the framework of the Care Act 2014 by carrying out social care assessments and devising care and support plans within an acceptable timeframe, with funding to meet Mr Y’s eligible unmet needs.
34. Mr Y has specialist needs and required a bespoke placement. A permanent supported living placement took several months to source, however, I cannot identify fault by the Council as specialist care arrangements designed around one person will take months to put together. Meantime, the Council put in place a temporary care package of home care and then when this broke down, it, sourced an emergency respite care home placement and provided funding so Ms X could travel to see Mr Y. I accept this was stressful for Ms X and not ideal for Mr Y, but the Council acted without fault and in line with the duty to meet Mr Y’s eligible needs.
35. The evidence indicates the Council considered and addressed Ms X’s needs as a carer as she had identified them in the carer’s assessment she completed in 2023. She said she wanted to be able to return to work and spend time with her other child. The Council put in place 18 hours a week of funding for Mr Y’s care with an agency to enable her to work. While there were problems with Mr Y engaging with the care provider, the records do not indicate any fault in the provider whose staff received additional specialised training to enable them to support Mr Y.

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Final decision

36. I find no fault by the Council.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman