Summary: Ms X complained the Council delayed providing her with an update following a care needs assessment. Ms X also complained the Council did not do anything after she told it she needed support at home. Ms X says the Council’s actions caused her avoidable worry and distress and contributed to a decline in her mental and physical health. We found fault by the Council. The Council has agreed to apologise to Ms X and carry out a further needs assessment.

The complaint

1. Ms X complained the Council delayed providing her with an update following a care needs assessment. Ms X also complained she told the Council she needed support at home, including assistance in using her kitchen and downstairs toilet, but the Council did not do anything. Ms X says the Council’s actions caused her avoidable worry and distress and contributed to a decline in her mental and physical health. She also says the lack of assistance from the Council means she cannot access the shelves in her kitchen cupboards. She would like the Council to review her case to see if it can provide her with assistance at home, including help in accessing her kitchen.

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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 discussed the complaint with Ms X and considered the information she provided.
5. I made enquiries to the Council and considered the information it provided.
6. Ms X and the Council had the opportunity to comment on a draft of this decision. I have considered their comments before making a final decision.

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What I found

Care needs assessments

7. 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.

Discharge from hospital and reablement support

8. Schedule 3 to the Care Act 2014 and the Care and Support (Discharge of Hospital Patients) Regulations 2014 set out arrangements for the discharge of hospital patients with care and support needs.
9. On receiving an assessment notice, councils must assess the person’s care and support needs and (where applicable) those of a carer to determine whether it considers the patient and carer have needs. The council must then decide whether any of these identified needs meet the eligibility criteria.
10. Intermediate care and reablement support services are for people usually after they have left hospital or when they are at risk of having to go into hospital. They are time-limited and aim to help a person to preserve or regain the ability to live independently.
11. Regulations require intermediate care and reablement to be provided without charge for up to six weeks. This is for all adults, whether or not they have eligible needs for ongoing care and support.
12. Relevant councils must promote ‘wellbeing’ when carrying out care and support functions. Wellbeing includes the suitability of living accommodation. The Care Act 2014 recognises suitable accommodation as one way of meeting care and support needs. Prevention is critical to the Care Act and home adaptation is an example of secondary prevention.

What happened

13. This chronology includes key events in this case and does not cover everything that happened.
14. Ms X lives by herself in her own home. Ms X has a medical condition which can be subject to flare ups, whereby the symptoms can become worse for some time.
15. In September 2023, Ms X was admitted to hospital to undergo an operation. She was discharged from hospital in early October 2023. Ms X received reablement care at home while she recovered from her operation. Carers visited Ms X three times a day to help her with washing, dressing and basic meal preparation.
16. In late October 2023, the Council carried out a needs-based assessment for Ms X via telephone. The Council told Ms X her reablement care would last for six weeks, and that it would review this to see if she required any further long-term care.

Ms X’s complaint

17. On 1 November 2023, Ms X complained to the Council. She said she had tried to discuss her needs with the officer who carried out the assessment over the telephone but felt the officer had just gone through the motions. Ms X said she would like support to have her home made more suitable for her needs. She said the symptoms of her medical condition were worsened by her having to use her downstairs toilet. Ms X also said she was unable to access the upper and lower cupboards in her kitchen. She asked the Council to carry out an Occupational Therapist’s (OT) assessment and make adaptations to her home.
18. On 8 November 2023, a manager called Ms X to carry out a review of the support provided to her. The manager said Ms X’s carers had reported they were only providing support with light domestic tasks as Ms X was independent with daily living tasks. Ms X acknowledged this and said she expected the six-week care package to end and not continue. The manager told Ms X they would try to arrange an OT visit to urgently assess Ms X in her home environment.
19. The Council provided its complaint response to Ms X on 20 November 2023. It apologised for any distress caused and acknowledged Ms X felt she needed adaptations to the layout of her kitchen. The Council referred to the call with Ms X on 8 November 2023, and said the six-week reablement package had ended. The Council said it would close Ms X’s case but agreed an OT assessment would be beneficial to explore the possibility of adaptations. It said an OT would contact Ms X to arrange an assessment date.

What happened next

20. On 21 November 2023, the Council received an OT referral for Ms X to be considered for adaptations to her home. The referral acknowledged Ms X struggled with meal preparation and in selecting items from her cupboards located above and below her waist, particularly when experiencing a flare up of her medical condition. The OT also recorded that Ms X had limited space in her kitchen as to where she could store crockery and kitchen utensils. The referral acknowledged Ms X felt she would benefit from major adaptations to her kitchen to help her maintain her independence.
21. Ms X remained dissatisfied with the Council’s complaint response and brought her complaint to us in late November 2023.
22. In late December 2023, the Council’s major adaptations panel considered Ms X’s case. It acknowledged the OT’s view that Ms X would benefit from major adaptations to her home to help her carry out meal preparations and to enable her to maintain independence. The panel acknowledged Ms X’s medical condition is long-term and agreed she would benefit from adaptations to her kitchen to meet her long-term needs. The Council placed Ms X on its home adaptations waiting list and decided to carry out a further assessment for access within the kitchen if feasible.
23. In April 2024, we closed our investigation into Ms X’s complaint as Ms X was unable to continue with the process at that time due to personal reasons.
24. The Ombudsman re-started the investigation in September 2024 following further contact from Ms X. Ms X said she had spoken to the OT about the adaptations to her house but had not heard anything more.

Analysis

25. Ms X complained the Council delayed providing her with an update following the needs assessment, and complained the Council did not do anything about her request for home adaptations. The Council says Ms X did not require long-term support from carers as she was managing her personal care and daily living tasks independently. The Council says it has placed Ms X’s request for home adaptations on its waiting list as Priority 3, (low priority), based on the information provided by the OT referral.
26. I acknowledge the Council’s explanation, and its decision made on 20 December 2023. However, the Council made this decision 12 months ago. I have seen no evidence the Council has provided an update to Ms X regarding this matter or considered if her needs have changed substantially in the last 12 months.
27. The Council is at fault as it has not considered Ms X’s needs since its decision 12 months ago, despite being aware of her concerns and the difficulty she continues to experience when using her kitchen.
28. Ms X says she is still unable to access meal preparation items from some of her kitchen cupboards, and that she has to store tins of food in boxes in other rooms of her house as a result. Ms X says she feels undervalued, and the matter has negatively impacted her mental and physical health. I acknowledge Ms X’s comments and have found that the Council’s actions have caused her an injustice.

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Agreed action

29. To address the injustice to Ms X, the Council has agreed to carry out the following actions within one month of the final decision:
1. Provide an apology to Ms X for the fault identified. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings;
2. Make a symbolic payment of £250 to Ms X in recognition of the distress caused;
3. Carry out a re-assessment of Ms X’s needs regarding her ability to use her kitchen and downstairs toilet, and
4. Consider the above re-assessment to determine if Ms X’s priority need for home adaptations has changed.
30. The Council should provide us with evidence it has complied with the above actions.

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Final decision

31. I have found fault by the Council and the Council has agreed to carry out the above action to resolve this complaint. I have concluded my investigation on this basis.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman