Summary: The Council failed to properly assess Mr Y’s care and support needs in accordance with legislation. It also failed to properly consider his mother’s needs as a carer in accordance with legislation. Consequently, both Mr Y and his mother have likely missed out on services to which they were both entitled and from which they would have derived benefit. We have made recommendations to address this.

The complaint

1. Mrs X complains the Council has failed to properly assess her adult son, Mr Y’s care needs.

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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 an injustice, 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 the complaint;
• considered the correspondence between Mrs X and the Council, including the Council’s response to his complaint;
• considered information the Council provided to this office;
• taken account of relevant legislation;
• offered Mrs X and the Council an opportunity to comment on a draft of this document.

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What I found

Relevant legislation

5. Sections 9 and 10 of the Care Act 2014 say councils must assess the needs of an adult who appears to need care and support. The council must do this regardless of whether it thinks the person has eligible needs and regardless of the person’s finances.
6. The statutory guidance at part 6 says a council must consider “the total extent of a person’s needs” before it “considers the person’s eligibility for care and support and what types of care and support can help to meet those needs. This must include looking at the impact of the adult’s needs on their wellbeing and whether meeting those needs will help the adult achieve their desired outcomes”.
7. After assessing the total extent of a person’s needs, the council should consider which are eligible needs under the Care Act 2014. The guidance says councils must consider whether:

• The adult’s needs are due to a physical or mental impairment or illness.
• The adult’s needs mean they cannot achieve one or more specified outcomes.
• As a consequence of being unable to achieve one or more of the specified outcomes there is, or is likely to be, a significant impact on the adult’s wellbeing.

8. The Act gives local authorities a legal responsibility to provide a care and support plan. When preparing a care and support plan the local authority must involve any carer the adult has. The support plan may include a personal budget which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

Carers

9. The Care Act puts carers on an equal footing with those who have care needs. Councils have a duty to promote the wellbeing of carers and to prevent burn out and crisis. Wellbeing is defined in Section 1 of the Care Act 2014.
10. A council must consider whether to carry out a carer’s assessment if it appears the carer has need for support. It must assess the carer’s ability and willingness to continue in the caring role. It must also consider the results the carer wishes to achieve in daily life and whether support could contribute to achieving those results. (Care Act 2014, s10)
11. The Act says the local authority can meet the carer’s needs by providing a service directly. In these cases, the carer must still receive a support plan which covers their needs and how they will be met. (Care Act 2014, s 25)
12. The Council can also provide a carer’s personal budget, which must be sufficient to enable the carer to continue to fulfil their caring role. The Council should consider the carer’s wishes for their day-to-day life. The Council should try to agree the personal budget and its use during the planning process. (Care and Support Statutory Guidance 2014)

Background

13. This statement is not an exhaustive description of all the events that have occurred in relation to this complaint, but an outline of the key issues as a background to the investigation’s findings.
14. Mr Y is in his early twenties. He has a learning disability, autism and communication difficulties, which are described as severe. He also has depression. He lives with Mrs X, who is his main carer. Until February 2024, Mr Y was in formal education and had EHCP in place. He also has eligible care needs and receives a direct payment to purchase support from a personal assistant (PA). 4 hours support per week during term time (38 weeks of the year), 15 hours per week during non-term time (14 weeks per year),12.5 support hours described as ongoing and 2 nights respite support a month.
15. In February 2024 Mr Y stopped attending education and ceased engaging in community activities. At this point Mrs X was hopeful he would re-engage with education. He also stopped taking his medication. Mrs X contacted the psychiatrist overseeing Mr Y’s care, and after consultation, the psychiatrist said he would write to the Council to request additional support for Mr Y.
16. Mrs X says the Council did contact her in March 2024 to arrange to review Mr Y’s needs, and she assumed this was in response to the psychiatrist’s request. However, the social worker had no knowledge of any request from a medical professional. The social worker (assessor) commenced a Care Act assessment in March 2024.
17. I have had sight of the Council’s assessment completed in April 2024. The assessor records Mr Y to be a student in education, with a college placement two days a week, but that he had not attended college since February 2024, and had disengaged with activities outside the home. Mr Y was reported to require support with all activities of daily living and is reported to rely heavily on Mrs X, his main carer, for support. Mr Y lacks safety awareness and requires constant supervision. Mrs X reported caring for Mr Y had become more challenging and she found caring for him “…daunting, even with the support of a PA…”. Mrs X says she did not receive a copy of the assessment and support plan until June 2024.
18. In May 2024, a professionals meeting took place to discuss Mr Y’s situation, and his needs. Mr Y’s social worker was present, along with the psychiatrist and officers from Mr Y’s educational facility. Mrs X was invited to join the online meeting for the latter part of the meeting, and she was asked what outcome she was seeking. Mrs X said she wanted a mentor for her son. She says the psychiatrist suggested social services action this. Mrs X assumed the Council would source a mentor.
19. Mrs X says she received no update from the Council on the search for a mentor for Mr Y, so she contacted the social worker. The social worker told Mrs X it was not the role of social services to source a mentor, and that Mrs X should source such support, and the support should be funded from the existing direct payment. After contacting several organisations, Mrs X found a service willing to provide mentor support. The service told Mrs X it was the responsibility of social services to arrange such support, and she should contact Mr Y’s social worker to request a review of Mr Y’s needs. Mrs X sent an email to the social worker in June 2024 to explain what she had been told and attached a link to the organisation.
20. Mrs X says the special educational needs team also contacted the social worker to ask what action was being taken in relation to services for Mr Y. The social worker advised a reassessment had been completed in March 2024, so a review was unnecessary. Mrs X says the social worker advised her to consider placing Mr Y in a supported living facility. Mrs X declined, although she says she felt pressured to agree. Mrs X says she is happy to continue to support Mr Y with appropriate formal support.
21. In June 2024 the social worker met with an officer from the special educational needs team. As Mr Y was not attending education, his EHCP ceased, and Mr Y’s care became the sole responsibility of adult services. At this point Mrs X had not had sight of the assessment and support plan completed in April 2024.
22. Mrs X asked social services for a copy of Mr Y’s assessment and support plan. When she received it on 12 June 2024, she noticed the support plan remained unchanged from the previous year, which was education related, with support being spilt into term and non-term time. Mrs X contacted the social worker to ask if she could use the whole of the allocated support hours. The social worker said not and said Mrs X she could only use 16 support hours per week, and if she used more than this it would have to be funded privately or from Mr Y’s benefits. The social worker said as Mr Y had not been utilising all his support hours 16.5 weekly hours was sufficient. Mrs X says she is not using the previous 22.5 non-term time support hours because she was told she cannot, and as Mr Y does not currently leave the house, he requires more support within the home.
23. Mrs X says she has tried to source an agency to provide some of Mr Y’s care. However, the agency rates are higher than allocated for a PA. Mrs X informed social services and she says she was told to keep searching for an agency that charged lower hourly rates.
24. In July 2024, Mrs X sought support from Mr Y’s GP. The GP wrote to social services to request increased support for Mr Y to assist with personal care and medication prompts. The Council responded to Mrs X saying it was not the GP’s role to determine the amount of support Mr Y required, and the requested support could be accessed from the allocated support hours. Mrs X says doing this leaves her with only 9 hours per week, which is insufficient.
25. The social worker gave Mrs X the details for a service completing carers assessments. A carers assessment was completed in July 2024. Mrs X told the assessor she believed some of the support she needed was support that should be incorporated in Mr Y’s care and support plan. Following the carers assessment, Mrs X did not receive a support plan.
26. Mrs X partakes in voluntary work and has been unable to attend support groups, educational courses, and exercise classes all of which she says contributed to her wellbeing. She is now only able to partake in short online sessions. Mrs X says Mr Y is housebound and she feels socially isolated which is impacting on her mental health.
27. In July 2024, Mrs X sent an email to the Council reiterating her dissatisfaction with the care provision for Mr Y, and asked how the decision regarding allocated support hours had been arrived at. She said Mr Y had been housebound since February 2024, and asked how she could pursue a formal complaint.
28. Mrs X did not receive a response. She says despite sending numerous follow-up emails in July and August, she did not receive a response. On 21 August 2024, she sent a further email saying she wanted to escalate her complaint and possibly take legal action. She asked the Council for a final complaint response.
29. The Council responded to Mrs X’s complaint in writing on 7 October 2024, the author of the letter says its adult care assessments take a ‘strength-based approach’ which assesses not only a person’s needs, but what abilities they have or support networks they have access to. The author goes on to say “…the support you give [Mr Y] is arguably his greatest strength and in recognition of that we have assessed your needs as a carer with a view to providing you with further support through our partners…”. The author says the Council disputes Mrs X’s claim that Mr Y’s needs have changed and refers to an assessment of Mr Y carried out in April 2024 in support of this. The author says Mr Y is not using all his current support hours and the unused hours can be used flexibly to support him. He (author) confirms Mr Y’s allocated care hours to be 19.46 per week with two nights respite a month. The author concluded by saying the formal support Mr Y receives, combined with Mrs X’s support is appropriate to meet his needs.

Analysis

30. It is not the Ombudsman’s role to decide if a person has social care needs, or if they are entitled to receive services from the Council. The Ombudsman’s role is to establish if the Council has assessed a person’s needs properly and acted in accordance with the law.
31. In this case, the Council failed on a number of levels to act in accordance with the Care Act.
32. The law is clear, a council must assess total extent of a person’s needs and produce a care and support plan showing how these needs will be met. That is not what happened in this case. The end of education was a significant change in Mr Y’s life. This is not reflected in the Council’s assessment. The Council failed to assess Mr Y’s needs in accordance with the Care Act.
33. Mr Y is an adult, as such, the entirety of his needs is the legal responsibility of the Council, not that of Mrs X. The Council failed to assess which of Mr Y’s needs Mrs X was able and willing to meet over a seven-day period.
34. The care and support plan that flowed from the assessment appears to have been copied from the previous year when Mr Y was still in education. It failed to reflect his changed circumstances.
35. Had Mr Y’s needs been properly assessed, it is probable he would have been entitled to increased support hours, and on this basis, it is probable also, that he has missed out on services he is entitled to receive.
36. In its correspondence to Mrs X in October 2024, the Council refers to a strength-based approach to assessments and Mr Y’s greatest strength being the support he receives from Mrs X. The actions of the Council have done little to promote this ideal. People’s strengths are promoted when they have the services’ they need in place at the time they need them. This is not what happened here.
37. The Council cannot rely on carers/relatives providing unpaid care. It must determine the willingness and ability of any relatives/carers to provide such care. The Council is treating Mrs X as though she is responsible for providing support to Mr Y, and the Council is responsible only for providing her with breaks from her caring role.
38. Mrs X is not saying she does not wish to support Mr Y, but that he needs more support than he is receiving. She is an unpaid carer for most of Mr Y’s care, acting out of love and care. This has placed her under increased strain, which she herself describes as exhausting. This has impacted on her ability to partake in social activities which are beneficial to her, and which would provide her with relief from her caring role.
39. Although the Council completed a carers assessment, it failed to provide Mrs X with a support plan showing how her needs would be met. Mrs X had no meaningful outcome from the assessment.
40. The Care Act puts carers on an equal footing with those who have care needs. Councils have a duty to promote the wellbeing of carers and to prevent burn out and crisis. Wellbeing is defined under Section 1 of the Care Act. Assessments must have regard to the outcomes a carer wishes to achieve. In this case it appears the legal requirements of the Care Act were not followed.
41. The Council failed to communicate with Mrs X effectively and later failed to investigate her complaints properly. It simply reiterated the view of officers from social services. This was a missed opportunity to review all the information and evidence it had on file.

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Agreed Action

42. The Council should within four weeks of the final decision:

• commence a reassessment of Mr Y’s care needs and produce a support plan which reflects his needs over a seven-day period, and explain in detail how these needs will be met, in consultation and agreement with Mrs X;
• following the above assessment, calculate any loss of services to Mr Y since February 2024 and determine a suitable remedy for the injustice cause;
• complete a fresh financial assessment and consider all relevant disability related expenditure;
• allocate Mr Y a personal budget sufficient to meet his needs;
• review Mrs X’s carer assessment and produce a support plan setting out how these needs will be met;
• apologise to Mrs X for the failings set out above, and make a symbolic payment of £1000 to acknowledge the stress, distress, time, and trouble pursuing her complaint with the Council and this office;
• provide evidence of the above to this office.

43. Within three months

• consider any training needs of officers completing or overseeing needs assessments under the Care Act;
• provide evidence of the above to this office.

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Final Decision

44. The Council failed to properly assess Mr Y’s care and support needs in accordance with legislation. It is more probable than not; he has missed out on services to which he is entitled and from which he would have benefited.
45. It also failed to properly consider Mrs X’s needs in accordance with legislation. Consequently, she has missed out on services to which she was entitled and from which she would have derived benefit.
46. The above recommendations are a suitable way to settle the complaint.
47. It is on this basis; the complaint will be closed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman