Summary: Mrs C complained about the Council’s handling of Mr X’s care and support visits and arrangements. We found the Council at fault for failing to clearly communicate the purpose of its review, having some errors in its report, and lack of record keeping of steps taken to find Mr X a suitable placement. The Council will apologise and make payment to acknowledge the injustice its faults caused Mr X and Mrs C.

The complaint

1. The complainant, Mrs C, complained on behalf of her son (Mr X) about the Council’s handling of his care and support arrangements. She said:
• the required Care Act assessment process was not followed as the purpose of the review meeting was not made clear to Mr X, the care home and herself;
• the assessment report was inaccurate, missing information, and had information which was irrelevant or untrue. It was subsequently used for Council’s funding panel to reach its view;
• it wrongly found Mr X could be placed in a tenancy with a care and support package; and
• it was agreed Mr X needed step down support, but the Council had not shared information about the steps it had taken to find supported living accommodations, and the supported living which is currently approved was found by Mrs C.
2. Mrs C said, as a result, Mr X experienced distress and uncertainty which impacted his mental health. She also said she experienced distress during the process.

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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 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)
4. 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)
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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How I considered this complaint

6. I considered evidence provided by Mrs C and the Council as well as relevant law, policy and guidance.
7. Mrs C and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.
8. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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What I found

Relevant law and guidance

Care Act 2014

9. 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.
10. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.

Care Act Statutory Guidance

11. The Care Act statutory guidance sets out key principles which should be followed. This includes:
• The local authority must involve the person being assessed in the process as they are best placed to judge their own wellbeing;
• In the case of an adult with care and support needs, the local authority must also involve any carer the person has (which may be more than one carer), and in all cases, the authority must also involve any other person requested;
• The local authority should have processes in place, and suitably trained staff, to ensure the involvement of these parties, so that their perspective and experience supports a better understanding of the needs, outcomes and wellbeing;
• Where local authorities identify that an adult is unable to engage effectively in the assessment process independently, it should seek to involve somebody who can assist the adult in engaging with the process and helping them to articulate their preferred outcomes and needs as early as possible. This will include some people with mental impairments who will nevertheless have capacity to engage in the assessment alongside the local authority; and
• A whole family approach to take a holistic view of the persons needs for care and support, including how this impacts the person and the family.

What happened

12. Mr X is an adult with health conditions which impacts his ability to manage his daily life and live independently. He has a care and support plan which sets out his needs and the support he should receive.
13. Mr X has lived in a care home since 2018. In 2022 the Council considered a request for him to live closer to his family an in more independent accommodation. He was subsequently added to a list for supported living accommodations with a request for this to be near his family to enable support.
14. In 2023 Mrs C asked the Council to provide Mr X with supported living accommodation near the family again. She said this was because he was more independent, and the care home was therefore no longer suitable for him.
15. In Autumn the Council spoke with the care home, which agreed Mr X should be moved to more independent living. It also acknowledged his current accommodation was causing him some stress and anxiety.
16. In November 2023 the Council met with Mrs C to obtain her views. She said X should be moved to a supported living accommodation near the family.
17. In late 2023 the Council reviewed Mr X’s care and support plan which found he no longer required a care home. It set out the options:
• a supported living placement, but there were less placements possible as it had to be near to the family; and
• a tenancy may be suitable. A housing register application should be made which the care home could assist with; and
• Mr X could then be provided with a package of care relevant to the accommodation he was moved to.
18. Mrs C met with the Council shortly after and shared her view an independent rented accommodation would not be suitable for Mr X, and his mental health had deteriorated due to his concerns about moving to such accommodation. She also said the care home had supported Mr X with the housing register and a bus pass application. However, the housing application was closed as not all information had been included.
19. It was agreed Mr X’s care and support plan should be reviewed. A new social worker was to do so in February 2024.
20. In early March 2024 the social worker called the care home to arrange a review visit to Mr X and asked the care home to inform him about the visit.
21. A week later a review of Mr X care and support plan took place at the care home. This included Mr X, staff from the care home and the Council.
22. Mr X spoke with Mrs C shortly after and told her about the visit. He said he had asked for Mrs C to be contacted by the Council. The Council subsequently spoke with her to obtain her views about the more independent living options.
23. In the following months the Council, the care home and Mrs C continued to communicate, and a meeting was held. This included:
• Mrs C was unhappy a Care Act assessment had been completed without this being clear to the care home, Mr X and herself. The Council explained it was a review meeting which it had told the care home about beforehand;
• Mrs C continued to raise her concerns about Mr X moving to private rented accommodation and she felt she had not been included enough in the decision. Information about privately renting a flat had been shared with Mr X and he had become upset;
• The Council explained a joint funding panel between NHS and the Council had considered the funding of Mr X’s care and support plan and the options for Mr X. There was limited supported living placements in the area Mr X wanted, and he had previously refused a placement in a different area. It explained the care package he would be entitled to;
• the Council sought an update from the care home about the housing register application. No update was available. The Council asked the care home to action the progress. It became clear Mr X may have received some of the communication but had not acted on this; and
• Mrs C asked for a copy of the Care act assessment, which the Council shared. She found errors in the assessment and asked for these to be corrected. She also said Mr X’s mental health had deteriorated since late 2023 had not been included.
24. The care home continued to support Mr X with his housing application in Summer 2024, and the application was completed.

Mrs C’s complaint

25. Mrs C complained to the Council about its handling of Mr X’s care and support arrangements. Below are the key points of her complaint and the Council’s responses:
• the required Care Act assessment process was not followed as the purpose of the review meeting was not made clear to Mr X, the care home and herself;

The Council explained it had conducted a review of Mr X’s care and support in March 2024 and it had informed the care home beforehand. It also obtained Mrs C's views. It apologised if she had found the terminology used confusing.

• the assessment report was inaccurate, missing information, and had information which was irrelevant or untrue. It was subsequently used for Council’s funding panel to reach its view;

The Council amended the assessment report three times after the initial report was shared. This corrected some errors and added some further information, but not all Mrs C’s disagreements were changed.

• it wrongly found Mr X could be placed in a tenancy with a care and support package; and

The Council explained it had considered views of Mr X, Mrs C, and the care home, including risks. It had presented the options to the funding panel and found supported accommodation or a tenancy with a care package was appropriate.

• it was agreed Mr X needed step down support, but the Council had not shared information about the steps it had taken to find supported living accommodations.

The Council said it had for some time attempted to find supported living accommodation for Mr X, but none were available in the area Mr X and the family wanted. It also said Mr X had refused a placement in another area.

26. Mrs C asked the Council to escalate her complaint as she did not accept its reasons. She said the Council response was wrongly provided by an officer involved in the case and she had not been informed about a placement Mr X had refused before.
27. The Council did not change its view and provided Mrs C its final response in Autumn 2024. It explained Mrs C had been aware of the potential placement in 2023 and had shared it would have been acceptable if it was in an area closer. It also found it was appropriate for an officer involved in the case to respond at stage one of its complaints process as this officer was now the manager and the complaint related to more recent matters.
28. Further meetings and communication between Mrs C and the Council took place in late 2024. This included a further review of Mr X’s care and support plan.
29. Mrs C asked the Ombudsman to consider her complaint. She said she found out about a supported living placement near the family, which she contacted. The Council has since agreed for Mr X to be placed there.

Analysis and findings

The March 2024 visit regarding Mr X’s care and support plan

30. I have considered whether the was fault in the process the Council followed during its March 2024 visit to the care home, where it assessed Mr X.
31. The evidence shows the Council informed the care home about the visit a week before and asked for Mr X to be notified about its visit. It explained this was a review visit of his care and support plan.
32. I found fault by the Council in how it notified Mr X about this visit. While Mr X has been found to have capacity, the Council was aware he relied on support and views from Mrs C. I am therefore not satisfied its notification to the care home about the review was enough to ensure Mr X was aware of what the purpose of the visit would be. Nor was the purpose of the visit to the care home itself. He could therefore not make an informed choice of whether to ask Mrs C or anyone else to be present to support him.
33. While it is likely Mr X would have found any visit from the Council challenging, I am satisfied this caused Mr X some unnecessary frustration and uncertainty which could have been prevented.
34. I found there was no significant distinction in this case whether the visit was referred to as a review or a care act re-assessment. This is because:
• it was already agreed and accepted he needed a more independent placement;
• the review was to establish Mr X’s views about more independent placement and his level of independence;
• Mr X asked for Mrs C to be contacted which the Council subsequently did, and it obtained her views on the options being considered.

The accuracy of the care and support plan review

35. The Council shared its assessment report with Mrs C after her request. This then led to three amended reports due to some errors, and some information being amended or removed. This was fault and some of the corrections should not have been necessary for Mrs C to ask the Council to correct.
36. However, I am not satisfied the amendments had any impact on the decision making of the Council or the joint funding panel. This is because the changes were limited and were unlikely to change the view on Mr X’s needs and ability to manage in a more independent placement.
37. I therefore found the fault did not cause Mr X an injustice, but Mrs C experienced some frustration and time and trouble to have the assessment report corrected.

The decision around Mr X’s placement options

38. Mrs C and the Council agreed a supported living accommodation would be appropriate for Mr X. I acknowledge Mrs C disagrees with the Council’s view that a tenancy with a care package would be appropriate.
39. However, I am not satisfied there was fault in the process the Council followed to reach its decision. Nor that the errors in the assessment report had any impact on the decision making by the joint funding panel.
40. While Mrs C disagreed with its view, it therefore reached a decision it was entitled to make. Without clear evidence this was inappropriate, and the Council failed to consider such evidence, I cannot criticise its decision. I therefore found no fault by the Council on this matter.

Finding a supported living placement

41. The Council has agreed it should attempt to source a supported living accommodation for Mr X. Since Autumn 2023 it said it had actively done so.
42. I acknowledge there are limited supported living placements available in the area Mr X needed near his family. However, Mrs C asked the Council about the steps it had taken to find such accommodation for Mr X, and I have also sought this evidence from the Council. Other than consulting with one placement, which Mr X declined as it was not within the area near his family, I have not seen any evidence the Council took active steps to find him a suitable placement. This was therefore fault.
43. I cannot say whether this resulted in Mr X missing out on any placements. However, Mrs C has recently found a placement in the area he needed, and this has subsequently led to a placement which the Council has agreed to. I am therefore satisfied the Council’s fault caused Mr X a loss of opportunity to be placed in a more suitable placement for a year.
44. In addition, I am also satisfied this caused Mrs C some frustration with the Council as she had to chase its actions and found an appropriate placement for Mr X herself.
45. I am not satisfied the limited availability of supported living accommodations in the specific area is a service failure. This is because the Council cannot be expected to ensure such placements are available within a relatively confined area.

The Council’s handling of Mr X’s housing register application

46. The Council found Mr X should be added to its housing register in late 2023. It asked his care home to support him with this. However, the evidence shows it was not until seven months later, in Summer 2024, the application process was completed.
47. I found this delay was fault by the Council. While I understand it was the care home which had been asked to support Mr X with this, the Council remained responsible for ensuring the registration was progressed and actioned for properties to be applied for on Mr X’s behalf. It failed to keep appropriate oversight to ensure this took place which therefore caused a delay.
48. However, I am not satisfied the Council’s fault caused Mr X or Mrs C an injustice. This is because they disagreed a tenancy with a care package would be appropriate. Although, I do acknowledge it contributed to Mrs C lack of trust in the Council’s ability to support Mr X appropriately.

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Action

49. To remedy the injustice the Council caused to Mrs C and Mr X, the Council should, within one month of the final decision:
1. apologise in writing to Mrs C to acknowledge the injustice its faults caused her and Mr X;

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. pay Mrs C a symbolic payment of £250 to acknowledge the frustration and uncertainty she experienced, including the time & trouble she had to chase the Council and take steps herself to find a suitable placement; and
3. pay Mr X £500 to acknowledge the frustration and uncertainty the Council’s faults caused, including his loss of opportunity to be placed in a more suitable placement for up to a year.

In total the Council should pay Mrs C and Mr X £750.

50. Within three months of the final decision the Council should also:
1.  
2.  
3.  
4. remind staff in its Adult Social Care team to clearly communicate the purposes of any visits, reviews or Care Act assessment to individuals, their representatives, and care homes as appropriate in a timely manner. This is to ensure individuals and care providers have the opportunity to form their views and seek support before such events takes place;
5. remind staff in its Adult Social Care team who conduct reviews and reassessments under the Care Act to ensure information and details about individuals is accurate. This may include adding or removing information which is no longer relevant or appropriate to retain; and
6. review why no records were kept of consultations for Mr X’s placements. It should also remind its Adult Social Care staff and Placement team to ensure actions are recorded to ensure it can evidence any steps taken to find appropriate placements for individuals.
51. The Council should provide us with evidence it has complied with the above actions.

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Decision

52. I have completed my investigation with a finding of fault which caused Mr X and Mrs C an injustice. The Council will apologise and make payment to acknowledge the injustice its faults caused them.

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Investigator's decision on behalf of the Ombudsman