Summary: Mrs X’s representatives complain about the Council’s actions in seeking a suitable care provider for Mrs X. They say this meant Mrs X was without the care she needed for longer than necessary. We find no fault with the Council’s actions.

The complaint

1. Mrs X’s representatives complain

• The Council did not properly consider the level of care Mrs X needed when sourcing a suitable care provider.
• The Council’s offer of interim support was not suitable
• The Council should have increased its budget to find a suitable placement.

2. As a result, Mrs X’s representatives had to provide care to Mrs X for longer than necessary and Mrs X was without the care she should have received.

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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. We consider whether there was fault in the way an organisation made its decision. 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. 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. (section 26A or 34C, Local Government Act 1974)
6. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
7. 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

8. I considered Mrs X’s complaint and information from her representatives and the Council, as well as relevant law, policy and guidance.
9. I invited the Council and Mrs X’s representatives to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Legislation and guidance

Assessment

10. 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.
11. 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.

Carer’s Assessment

12. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
13. As part of the carer’s assessment, the council must consider the carer’s potential future needs for support. It must also consider whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)

What happened

14. I have summarised the key events about adult social care that I have investigated from February to November 2024. This is not meant to detail everything that happened
15. The Council received a referral for Mrs X on 28th February 2024. The referral sought a care act assessment and said that Mrs X’s needs were too high for her family members to continue to provide care for her.
16. The Council decided in March 2024 to carry out the assessment. During the assessment, it met with Mrs X and her representatives to discuss her needs.
17. The Council finished the assessment on 2nd May 2024. The result of the assessment was the Council recommended Mrs X needed 24-hour care and needed to be placed in a care home. The Council allocated the case for further assessment of Mrs X’s needs in order to consult with care providers.
18. In June, the Council contacted care providers to see if any could meet Mrs X’s need. This included consulting the family preference of care provider, but none could meet Mrs X’s needs.
19. The Council asked Mrs X’s representatives in July 2024 if it could widen the search area to hopefully find a suitable provider. Mrs X’s representatives declined the search area being widened.
20. The Council asked Mrs X’s representatives if Mrs X or the family would consider paying a top up fee. This would then mean the Council could consult homes with slightly higher prices. Mrs X’s family declined this.
21. Mrs X’s representatives gave a list of care homes they felt suitable to the Council. The Council told the representatives that the providers suggested were far beyond what the Council could reasonably pay.
22. Mrs X’s representatives expressed to the Council that they were frustrated the Council had not yet sourced a placement. They said the Council had recognised Mrs X needed 24-hour care and that it was not seeking to provide person centred care but was only interested in cost saving.
23. The Council offered Mrs X’s representatives nine hours per week of respite via a direct payment. This was to pay for a dementia nurse to provide care.
24. Mrs X’s representatives told the Council they believed it was unfair to only offer nine hours when the Council had recognised Mrs X needed 24-hour care.
25. The Council also offered a four-week respite placement for Mrs X and a carers assessment for her representatives whilst it continued to search for a provider for her. These options were declined by her representatives who felt this would “put Mrs X at the bottom of the pile”.
26. In October, the Council found Mrs X a suitable care provider, and she moved in at the beginning of November 2024.

Complaints process

27. Mrs X’s representatives complained to the Council at first in May 2024 about the delay in completing the assessment. The Council responded in June 2024 to confirm the assessment was completed and that it had allocated the case to a new social worker in the long-term team to find a placement.
28. Mrs X’s representatives complained further in August 2024. They said;

• Mrs X’s needs were severe, and the Council had recognised that she was critical and high risk but had not yet found a placement and were relying on family to provide care.
• The Council had only offered to fund nine hours of a dementia nurse despite recognising Mrs X needed 24-hour care.
• The Council should increase its budget for care for Mrs X and consider the list of providers submitted by Mrs X’s representatives.

29. The Council’s final complaint response said it had completed the assessment which found Mrs X needed care, and offered interim support measures while it sourced a suitable placement for Mrs X. It confirmed that these options remained available to Mrs X and her representatives.

Analysis

30. The Council completed the care act assessment within nine weeks of receiving the referral. Although we would usually expect Council’s to have done this within six to eight weeks, I cannot see the extra week would amount to fault or unreasonable delay.
31. Mrs X’s complaint centres around the delay in the Council securing a care provider after it said she needed 24-hour care in May 2024 to the point she moved into the care home in November 2024. This is about seven months during which Mrs X’s representatives were delivering her care.
32. The Council has been able to show that during this time it

• was consistently seeking placements for Mrs X and discussing her needs with providers,
• asked if it could expand the search area,
• asked if Mrs X could pay a top up to expand which care homes it could consult,
• offered Mrs X’s representatives carers assessments,
• offered to fund a dementia nurse to provide respite, and
• offered Mrs X a four-week respite placement.

33. All support and options were declined by Mrs X’s representatives. I appreciate Mrs X’s representatives feel the Council should have increased its budget to find a placement for Mrs X. However, the Council has a duty to protect the public purse and must make reasonable efforts to find a placement within the financial constraints it has.
34. Part of Mrs X’s complaint is the Council did not offer solutions in a timely manner. Given that all the support and solutions were rejected, I cannot say that this was fault causing injustice. It is likely even if the Council had offered solutions sooner, they would have been rejected.
35. I am satisfied the Council has been able to show it was consistently trying to act and provide solutions during the seven-month period. I find no fault with the Council for its actions in finding Mrs X a placement once it decided she required care.

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Final Decision

36. I have completed my investigation. I find no fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman