Summary: Mr X complained about the Council’s assessments of his daughter’s care needs, its delays, and not properly considering her needs for additional support. We found the Council at fault for the time taken to complete the assessments and its contact with Mr X about proposed changes to a care plan. This caused significant frustration, uncertainty and distress. The Council has agreed to apologise and pay a symbolic payment to recognise the injustice caused.

The complaint

1. Mr X complains about the Council’s handling of its assessments of his daughter’s care needs over a significant period of time. This included not properly making decisions about, or properly considering, requested increases for 2:1 support. This has caused significant frustration and distress for all the family. He says his daughter was not getting the support she needed, and additional provision was "borrowed” from carers working with her siblings who also have care packages.

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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. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome (Local Government Act 1974, section 34(3), as amended).
4. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
5. Service failure can happen when an organisation fails to provide a service as it should have done because of circumstances outside its control. We do not need to show any blame, intent, flawed policy or process, or bad faith by an organisation to say service failure (fault) has occurred (Local Government Act 1974, sections 26(1), as amended).
6. 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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What I have and have not investigated

7. Mr X made two formal complaints to the Council and approached us for both. We have decided to investigate them under the same reference as they relate to similar themes over a general connected period.
8. Complaint 1 - Mr X received the Council’s final complaint response in December 2023. Mr X complained to us in November 2024. In line with Paragraph 4, this means the events complained of are late. I have exercised discretion to investigate as Mr X manages other complex care matters with his other children which likely impacted on his ability to approach us sooner.
9. Complaint 2 – I am considering matters up until January 2025 (when Mr X received the final complaint response). Mr X is entitled to make a new complaint if he is dissatisfied with the Council’s actions after this point.

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How I considered this complaint

10. I discussed the complaint with Mr X and considered his views.
11. I made enquiries of the Council and considered its written responses and information it provided, as well as relevant law, policy and guidance.
12. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Law and administrative background

Care Act 2014 – assessments and care plans

13. 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. 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.
14. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. We expect councils should complete assessments in a timescale that is proportionate to the complexity of the issues, and normally within 4-6 weeks. Councils should keep people informed about this throughout the process.
15. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has.

Care Act Statutory Guidance – revisions to care and support plans

16. Where a decision has been made that a revision is necessary to a care and support plan, the authority should inform the person, or person acting on their behalf, of the decision and what this will involve. The local authority should take all reasonable steps to agree the revision. The developments of the revised plan must be made with the involvement of the involved persons (Paragraphs 13.26 to 13.28)

Background

17. Mr X’s daughter (“J”) has complex disabilities and medical conditions, along with significant physical and additional needs. J had a large care package provided by the Council through Care Provider 1. This included 1:1 support and overnight care. Mr X has other children who also have complex needs.

What happened – summary of key relevant events

Complaint 1 - 2023

18. In March 2023, Social Worker 1 started an assessment of J to support planning transition to adult social care. Mr X requested an additional 8 hours to ensure safety at home for all the children. This was to reflect J’s unpredictable and challenging behaviour which the hours could go towards supporting, without putting her siblings at risk when J needed help from their carers.
19. The next month, Social Worker 2 took over the case. Between July and August 2023, three different social workers visited J at home on separate occasions and made observations, so did a Moving and Handling (“MH”) Assessor. Social Worker 2 visited J’s school. Social Worker 2 reviewed Care Provider 1’s daily records from the previous three months.
20. In November 2023, Social Worker 2 completed the assessment. They sent this to Mr X with a revised care plan. It reduced the package and removed nighttime hours for J. In their view, the information gathered did not evidence that J made use of the nighttime hours, or that J generally required 2:1 support. They had concerns about restrictive support in place and whether overnight support was needed. Mr X formally complained to the Council.
21. In December 2023, Social Worker 2 met with Mr X to discuss his dissatisfaction with the assessment. Later, Care Provider 1 said it had not been consulted about the hours beforehand. Social Worker 2 said they based it on the care notes. These did not show it providing nighttime care and it expected notes to be accurate. Care Provider 1 raised concerns it could not provide the support J required in the reduced hours.
22. At the end of December 2023, the Council responded to Mr X’s complaint. It was satisfied with the holistic assessment carried out. It said J’s current support and nighttime care would remain until January 2024.
23. In November 2024, Mr X came to us with Complaint 1.

Complaint 2 - 2024

24. J’s hours and support did not change and remained until the end of Complaint 2. Mr X repeated his request for the additional eight hours extra floating support for J. Without this, J was using carers from her siblings, which put them at risk and causing the family significant stress.
25. In March 2024, in light of Mr X’s complaint, the Council decided to complete a re-assessment with Social Worker 3.
26. In April and May 2024, Social Worker 3 visited J at home and at school. They needed input from a Social Care Occupational Therapist (“OT”) to assess J’s needs, and the level of support needed. The OT was allocated at the end of May 2024 after time on the waitlist.
27. In June 2024, the OT carried out home visits. Mr X also sent a copy of a private OT assessment he obtained and further medical information.
28. In July 2024, the OT was not available, and J started at a new day placement. The Council also wanted to review the new setting for the overall care plan for J. Social Worker 3 left the service.
29. In October 2024, Care Provider 2 took over the care packages for J and her siblings, with no changes to support hours. The Council made referrals for further assessments.
30. In November 2024, a MH assessment concluded J required 2:1 support for transfers and handling needs. They made recommendations about equipment to support this.
31. In early December 2024, the OT completed their assessment. They said J needed 2:1 support with her current presentation with movement. They noted Care Provider 2 could not advise what nighttime support J needed while it stabilised the package.
32. In mid-December 2024, Mr X made a second formal complaint. He said the Council had ignored J’s need for 2:1 care.
33. In late December 2024, the Council met with Mr X, along with the OT and Care Provider 2. After a discussion about floating hours, which Care Provider 2 supported, the Council agreed a temporary increase of eight hours for J.
34. In mid-January 2025, the Council allocated Social Worker 4. Two weeks later, the Council responded to Mr X’s second formal complaint. It acknowledged and apologised for the delays with the assessments. As there had been many changes in support for J, Social Worker 4 would do a reassessment to whether the temporary increase would be made permanent.
35. In March 2025, Mr X came to us with Complaint 2.

The Council’s response to my enquiries

36. In response to my enquiries, the Council said a significant factor for the delay in decision making was the lack of consent from Mr X to contact Children’s Services and the health service.
37. With the decision to agree the eight hours floating support, the Council said the evidence from the MH and OT assessment supported this. It also said all the necessary evidence was not available until the assessments were completed, so it felt it would have been difficult to make the decision any sooner.

Analysis

38. It is not my role to decide what care and support a person needs. That is the Council’s role. We look at the process the Council follows to make its decisions. I can only consider whether there was fault in the way the Council made its decision. If there was no fault in how the Council made its decision, I cannot question the outcome.

Complaint 1 – the content of the 2023 assessment and decision to reduce

39. The Council gathered and considered information from visits and other professionals. In the assessment, it explained in detail what it reviewed and how it decided what support hours J should have, and did not warrant the amount of 2:1 Mr X wanted. The Council considered relevant information it had and explained why it came to its views. While Mr X strongly disagreed with the conclusions from the observations and evidence, these were professional judgements, and it was a decision it was entitled to make.
40. I recognise Care Provider 1 said it was not consulted before this, and it had concerns about the decision. But the Council considered the contemporaneous overnight care records it provided. It was entitled to rely on this as evidence in the first instance. After this, the Council noted Care Provider 1’s comments and these were further considered in the later reassessment.
41. I do not consider there is fault in the way the Council made its decision, therefore I cannot question the merits of it. In any event, after Mr X complained, this led to a reassessment which is what he wanted.

Complaint 1 – communication with Mr X about the proposed changes

42. The Council decided it should reduce J’s care package in November 2023. It did not discuss this with Mr X before sending the proposed changes. This is not in line with the Care Act statutory guidance (referred to in Paragraph 16). I cannot see evidence the Council worked with Mr X on developing the changes in the plan, especially as it was a large decrease. This is fault. This lack of transparency caused significant frustration and distress to Mr X.
43. But with the proposed reduction, there was no significant injustice as the Council did not proceed with the changes after Mr X’s complaint. J’s hours remained the same.

Complaint 2 - delay

44. With the 2024 reassessment, the Council gathered further information, made more visits, spoke to other professionals and the Care Providers, and identified opportunities for further referrals. The Council also generally kept in contact with Mr X about progress where it could. Despite the time taken (covered later), these are reasonable steps to take.
45. In December 2024, after reviewing the above, it decided the assessments from the MH team and its Social Care OT supported J’s need for the temporary floating hours. It agreed to these. The Council said it could not make this decision without the information. On balance, I cannot say had it not been for the time taken for the 2024 assessment to get to this point, that the hours would have been in place earlier. This is because it was noted J’s mobility may have declined since and there were also some major changes in 2024 with her change of day placement and to Care Provider 2.
46. I cannot say there has been a loss of this provision for J. However, there is still injustice with significant uncertainty about what might have happened sooner had the assessment not taken as long.

Complaints 1 and 2 – general delays with assessments

47. Complaint 1 – the Council started the assessment in March 2023 and completed it in November 2023. This is around eight months. Complaint 2 – the Council started the reassessment in March 2024 and made a decision in December 2024. This is around nine months.
48. The guidance sets out assessments should be carried out in a reasonable and appropriate timescale, generally within four to six weeks. There is no set deadline, but we would expect it should be proportionate to the complexity of the issues. Given J’s highly complex and significant needs, it is reasonable the process would take longer with a need for more detailed assessments and involvement of co-ordinating and gathering other professional views and visits.
49. The Council acknowledged the delays in the assessments. I recognise factors contributing to periods of drift included changes in social workers, illness, Mr X’s own availability and health needs, and the time taken to gather information from other professionals. Some of these are outside the Council’s control. However, the delay was significant for both assessments. I consider this fault in the form of service failure (see Paragraph 5). This caused significant frustration and distress for Mr X with having to wait a considerably long time for the outcomes.
50. In response to my enquiries, the Council said Mr X’s lack of consent was a significant factor. It did not say this to Mr X in its complaint responses. I have not seen any communication or case notes referring to this being a barrier. If was such a factor, there is no evidence it informed Mr X of this and discussed the consequences of this with him. I am not satisfied of how much a contributory factor it had with delays with the assessments.

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Agreed Action

51. To remedy the injustice set out above, the Council has agreed to carry out the following actions:
52. Within one month of the final decision:
• Apologise to Mr X in writing for the injustice caused by the faults identified (in line with our guidance on making an effective apology); and
• Pay Mr X a symbolic payment of £300 to recognise his frustration, uncertainty and distress.
53. Within two months of the final decision:
• The Council should send written reminders to relevant staff to say: if it, during a review of a care and support plan, it decides revisions or changes are needed to support already in place, it should contact the person first (or person acting on their behalf) to try and develop these revisions together.
54. The Council should provide us with evidence it has complied with the above actions.

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Decision

55. I find fault causing injustice. The Council agreed to recommendations to remedy the injustice, and I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman