Summary: Miss X complains the Council has failed to assess her needs as her son’s carer properly, leaving her without support. The Council was at fault over the way it did her 2024 carer’s assessment. It needs to apologise, make a symbolic payment to her, and reassess her needs as her son’s carer. The Council also needs to take action to improve its working practices.

The complaint

1. The complainant, Miss X, complains the Council has failed to assess her needs as her son’s carer properly, leaving her without support.

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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. 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

4. I have considered evidence provided by Miss X and the Council, as well as relevant law, policy and guidance.
5. Miss X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

What happened

6. Miss X lives with her son, Mr Y, who has cerebral palsy.

2023

7. Council officer A from its Carers Support Centre visited Miss X in April 2023 to assess her needs as her son’s carer. The assessment said:
• Mr Y was meant to get 49 hours a week of support, but was only getting 48 hours, so he needed an extra hour.
• Mr Y had a main personal assistant (PA1) who worked 40 hours a week, and two further PAs who worked six (PA2) and ten hours (PA3) respectively. Miss X says the two further PAs actually work four hours each.
• PA1 supported her son with voluntary work Monday to Thursday.
• On a Friday Miss X, Mr Y and PA1 went shopping together.
8. The assessment addressed Miss X’s ability to achieve these outcomes. It said she:
• was unable to maintain a habitable home all of the time
• was unable to manage and maintain nutrition most of the time
• had deteriorating physical and mental health
• was unable to develop / maintain relationships all of the time
• was unable to engage in work or learning all of the time
• was unable to engage in recreational activities all of the time
• was unable to make use of necessary facilities / services all of the time.
9. The Council’s resource allocation system gave Miss X 45 points, which put her in “Band 4 – Up to £350” and identified an indicative personal budget of £350. Social worker B told Miss X the outcome during the visit. Miss X said she would use her personal budget to:
• buy a new fridge freezer;
• buy things so she could start sewing again;
• take part in recreational activities again; and
• possibly buy a tablet.

2024

10. Social worker C visited Miss X and her son in June 2024 to review his needs and assess her needs as his carer. Social worker C did not fill the carer’s assessment in until after returning to the office. It appears this was because they did not yet have remote access to the Council’s system. Miss X says she was not aware that social worker C was assessing her needs as well as her son’s. She therefore contacted the Carers Support Centre about her assessment. It told her it now did joint assessments for anyone who cares/d for someone who had a care and support plan.
11. The review of Miss X’s needs as her son’s carer said:
• She had asked for another two hours a week for her son, so he could attend evening activities, but this was subject to “management approval”.
• She said PA1 worked 40 hours a week for her son (8am to 4pm Monday to Friday), PA2 worked 10 hours over two evenings and PA3 worked six hours on a Sunday, but this was eight hours more than Mr Y’s 48 hours.
• She said her son volunteered with four charities, but two of them said that was not correct.
• Social worker C suggested alternating the shift pattern to meet Mr Y’s needs (to provide more evening respite), but Miss X declined.
• She said she was on her own (with her son) most evenings and weekends. When he was out, she had “to be a phone call away at all times”.
12. Miss X said it could take an hour each morning to meet her son’s personal care needs, including stripping his bed and putting the bedding in the wash. She said her son could have toileting accidents six times a day, which involved hoisting him from his chair, changing and cleaning his wet clothes. Although her son wore continence pads in the evening and overnight, they leaked. Social worker C offered to refer Mr Y to the continence team, but Miss X declined. Miss X said she did household tasks during the day, including five loads of washing a day, and advocated for her son.
13. The assessment addressed Miss X’s ability to achieve these outcomes. It said she:
• was unable to maintain a habitable home some of the time
• could manage and maintain nutrition
• was at risk of deteriorating physical and mental health
• could develop and maintain relationships
• was unable to engage in work or learning some of the time
• was unable to engage in recreational activities some of the time
• was unable to make use of necessary facilities / services some of the time.
14. The assessment went on to address those outcomes Miss X had some difficulty in achieving:
• Physical/mental health – social worker C suggested Miss X alternate/rearrange the timing of the shift pattern to meet Mr Y’s needs and relieve her of her caring duties, but Miss X declined. Miss X was also offered respite but declined. Social worker C noted Mr Y had three PAs and was out in the community with them from 8am to 4pm Monday to Friday. The assessment identified nothing Miss X wanted to improve her wellbeing.
• Maintaining a habitable home environment – Miss X was offered respite but declined. The assessment identified nothing Miss X wanted to improve her wellbeing.
• Engaging in work, training, education or volunteering – the assessment identified no problems in meeting this outcome but said Miss X wanted an extra two hours a week to meet her son’s needs. It said social worker C had offered ways of using the existing hours “appropriately” and offered referrals to other services: occupational therapy; continence services; speech and language therapy, but Miss X turned them down.
• Making use of necessary facilities or services in the local community – Miss X was offered respite but declined. The assessment identified nothing Miss X wanted to improve her wellbeing.
• Engaging in recreational activities - Miss X said if she went out with her son in the evening, she would still have to complete an hour of personal care when they got home. Miss X said she wanted to feel more valued as a carer. Social worker C assured Miss X she was valued,
15. The Council decided Miss X had eligible needs in relation to one or more of these outcomes, but did not say which ones or how many. The Council’s resource allocation system gave Miss X 9 points which put her in Band 1 “community resources – commissioned services, or support networks” and identified an indicative personal budget of £0.

Miss X’s complaint

16. Miss X complained to the Council in July.
17. When the Council replied to Miss X’s complaint in August 2024, it said:
• Its review of Mr Y’s needs did not identify the need for two extra hours a week of support, as requested by Miss X;
• It had offered Miss X respite for her son, to give her a break from her caring role, but she had turned this down;
• After the review meeting, social worker C input the information from Miss X’s carer’s assessment which generated a £0 carer’s personal budget;
• It was saddened that Miss X did not feel valued as a carer and apologised for the circumstances which made her feel that way. It said it recognised and appreciated “the invaluable role carers play in contributing to the health, wellbeing and independence of those they care for”.

Is there evidence of fault by the Council which caused injustice?

18. There was a significant difference between the 2023 carer’s assessment and the one done in 2024. It is difficult to understand why that would be the case, given that there has been no significant change in Mr Y’s or Miss X’s circumstances.
19. There is nothing in the 2024 assessment to explain why Miss X no longer has any difficulty managing and maintaining nutrition, or developing and maintaining relationships. There is also nothing to explain why she now has less difficulty achieving the outcomes she had more difficulty in achieving in 2023. Although assessments are supposed to reflect the views of the person being assessed, that does not appear to have been the case with the 2024 assessment. It appears to have reflected the views of social worker C, rather than Miss X.
20. Completing the assessment after the visit meant there was a lack of transparency. The Council should have given Miss X an opportunity to correct any errors. This would have ensured the Council addressed any disputes over her needs and the difficulties she had achieving the outcomes set out in the Care and Support (Eligibility Criteria) Regulations 2015.
21. Any assessment should be a collaborative process. That does not mean disputes and disagreements can always be avoided. But where these occur the Council needs to address them and provide reasons for its decisions. The failings I have identified with Miss X’s 2024 carer’s assessment reflect fault by the Council. It is not for me to say what the outcome would have been if there had been no fault. The Council needs to correct its fault by reassessing Miss X’s needs. The doubt over what the outcome would have been if there had been no fault with the 2024 assessment is an injustice which also requires a remedy.

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Action

22. I recommend the Council:
• Within four weeks, writes to Miss X apologising for the distress she has been caused, pays her £200 and redoes her 2024 carer’s assessment;
• Within eight weeks, takes action to ensure: carer’s assessments are carried out in a transparent way; people are given an opportunity to correct any errors with their assessment; and any disputes over a person’s needs are addressed in the assessment.
23. The Council has agreed to do this. It should provide us with evidence it has complied with the above actions.

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Decision

24. I find fault causing injustice which requires a remedy. The Council has agreed to implement the remedy.

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Investigator's decision on behalf of the Ombudsman