Summary: There was no fault in the way the Council assessed Mr X’s care needs, therefore the Ombudsman cannot question the merits of its decision.

The complaint

1. Mr X complains about the Council’s decision to reduce the duration of his care visits from one hour to 30 mins daily (increased to 45 mins recently). He says the decision was not taken properly because he has not had a review of his needs.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. 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)
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 submitted to this office;
• considered the correspondence between Mr X and the Council, including the Council’s response to his complaint;
• made enquiries of the Council and considered the responses;
• spoken to Mr X;
• taken account of relevant legislation.

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What I found

Relevant legislation

5. Sections 9 and 10 of the Care Act 2014 require local authorities to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to all people regardless of their finances.
6. The Care and Support (Eligibility Criteria) Regulations 2014 sets out the eligibility threshold for adults with care and support needs and their carers. The threshold is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing.
7. Where local authorities have determined that a person has any eligible needs, they must meet these needs. When a local authority has decided a person is or is not eligible for support it must provide the person to whom the determination relates (the adult or carer) with a copy of its decision.

Key facts

8. Mr X is in his forties. He has a physical disability. He lives in his own home and receives domiciliary services commissioned by the Council.
9. In June 2024, Mr X was admitted to hospital for a surgical procedure. Prior to his admission, Mr X received one hour care visit per day, with an additional two hours on Wednesdays.
10. On discharge the Council arranged a six-week period of reablement care and occupational therapy, during which Mr Y’s needs and abilities were observed and assessed. Initially, Mr X received three reablement visits per day. The visits gradually reduced throughout the six weeks.
11. Mr X was reported to be able to manage his personal care needs, medication and meal preparation independently. He used crutches indoors and sometimes a wheelchair and was independent in all transfers. Mr X reported he did his own shopping. He reported needing support with domestic tasks.
12. Notes completed during the assessment period have been provided to this office. The assessment report following the reablement period notes that there were some aspects of his daily needs which Mr X said he could not manage – for example showering, as he said he was at risk from falling - whereas the reablement carers had observed that he could manage this.
13. The Council concluded Mr X needed less support hours and reduced his support to thirty minutes per day.
14. Mr X did not agree with the Council’s decision and contacted the Council by telephone and email to challenge the decision, saying his care needs had not changed, there had been no proper review of his needs, and there was no basis for the reduction in hours. He asked the Council to reinstate his care hours to those allocated prior to his hospital stay.
15. An officer from social services from the Council telephoned Mr X to discuss his care needs. The officer reported Mr X “…was reluctant to provide a lot of information despite advising that the review is how he is managing his day-to-day task currently”. Mr X said since his surgery he was unable to do his own shopping and declined to use an online shopping service.
16. The Council told Mr X the decision to reduce his support hours had been based on information gathered throughout the reablement assessment and information from the occupational therapist.
17. Mr X submitted a formal complaint to the Council in August 2024, saying his care package had been cut and the reduced hours did not allow sufficient time for the carers to complete necessary tasks. A council officer telephoned Mr X to discuss the complaint and then followed up with an email clarifying the matters complained about and the timescale by which Mr X could expect a response.
18. The Council provided Mr X with a response to his complaint in September 2024. The letter is detailed and responds to each point of complaint in detail. The author of the letter explained the outcome of the reablement assessment was based on outcomes of the goals set and feedback from reablement workers.
19. Reablement workers observed and reported Mr X to be independent with personal care, toileting, grooming, dressing, simple meal preparation, medication management, shopping and laundry. Due to Mr X’s mobility issues workers ‘set-up’ for Mr X’s evening meal. Reablement workers logged in and out of Mr X’s home using an electronic recording system. The average visit did not exceed 30 minutes. The author set out the dates of each visit and confirmed Mr X to have been involved in setting and reviewing the outcomes. A shortcoming in communicating the duration of visits was identified, for which the author apologised. The author referred to records evidencing all Mr X’s needs had been met with the allotted time. She (the author) said she could find no record showing Mr X had been told his previous care package would not change.
20. Mr X was dissatisfied and contacted the Council to request it review the complaint.
21. A senior council officer reviewed the complaint, and the complaint response. The officer wrote to Mr X on 17 October 2024 to inform him the outcome remained unchanged, and the Council maintained its position as set out in the previous complaint response.
22. Mr X remained dissatisfied and submitted a complaint to this office.
23. The Council has reviewed Mr X’s care package twice since October in line with Mr X’s increased needs and Mr X is now satisfied with the amount of support he receives.

Analysis

24. It is not the Ombudsman’s role to decide what services a person is entitled to receive. The Ombudsman’s role is to establish if the Council has assessed a person’s needs properly and acted in accordance with legislation.
25. In this case I have found no fault in the way the Council assessed Mr X’s care needs. Decisions about his care needs were taken from information gathered during the reablement period. The records completed by reablement workers included daily records provided to Mr X, and the support he required. Mr X was involved in goal setting at the outset of the reablement period and his comments throughout the assessment process. The records show Mr X’s increasing ability to complete personal care and his needs moved from personal support to those consisting of domestic support.
26. Mr X may have disagreed with the Council’s decision to reduce the duration of care visits, but that does not make it a wrong decision. In response to our draft decision Mr X suggested that the Council had based its reduction of hours on incorrect information, as he said the assessment had taken place while he was bedridden so he could not be described as ‘independent’. However, the assessment was based on information gathered over a period of time so I am unclear how he reached that conclusion.
27. I have seen no evidence which supports Mr X’s claim that support tasks could not be completed within the allotted timeframe when the hours were reduced.
28. The Council acknowledged a shortcoming in communicating the length of visits to Mr X, for which it apologised. This is an adequate remedy.
29. As there was no fault in the process of the assessment, I am unable to question the decisions made.

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Final Decision

30. There was no fault in the way the Council assessed Mr X’s care needs. Therefore, the Ombudsman cannot question the merits of its decision.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman