Summary: Ms X complained the Council failed to produce an adequate care plan for Mrs Y and did not arrange care to meet her needs. We do not find the Council at fault.

The complaint

1. Ms X complains about the way the Council dealt with Mrs Y’s care. Specifically, Ms X says the Council:
• produced an inadequate care plan;
• failed to arrange carers that could support with Mrs Y’s catheter and maintaining her home;
• wrongly decided Mrs Y did not need permanent residential care; and
• wrongly refused to fund the residential care or provide the 12-week property disregard.
2. Ms X says this has caused a deterioration in her own mental health. She also said this caused Mrs Y to receive inadequate care, which has impacted her mental and physical health.

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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. 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(1), as amended)

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How I considered this complaint

6. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
7. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Relevant law and policy

8. 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.
9. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan. 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. The support plan must 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.

What happened

10. I have summarised below some key events leading to Ms X’s complaint. While I have considered everything submitted, this is not intended to be a detailed account of what took place.
11. Ms X holds a lasting power or attorney for finance and property, and health and welfare for Mrs Y.
12. Mrs Y had been living independently at home but was admitted to hospital following a fall and was referred to the Council’s adult social care team.
13. The Council completed an adult social care assessment for Mrs Y which found that Ms X visited to provide support and she received cleaning support twice weekly. The assessment found Mrs Y had eligible needs when it came to maintaining personal hygiene, managing her toileting needs, being appropriately clothed and being able to use her home safely. The assessment shows Ms X declined a carer’s assessment but was informed she could request one at any time.
14. The Council then wrote to Mrs Y to provide a support plan and a personal budget. Mrs Y’s package of care started in May 2024 and included assistance with personal care, catheter care, dressing, nutrition and hydration, washing up and laundry, and showering at a weekly cost of £404.82.
15. In June 2024 Ms X asked the Council to complete a social care assessment as she was feeling overwhelmed by the amount of care she was having to provide. An occupational therapist visited Mrs Y and discussed a referral to a social worker to provide additional support with shopping and household tasks to reduce the level of support Ms X was having to provide and Mrs Y consented to the referral.
16. A social worker then contacted Ms X to discuss her concerns and the possibility of a period of residential respite care, which Ms X expressed she felt ought to be a longer-term plan. The Council agreed to carry out a new assessment of Mrs Y’s needs.
17. The Council reassessed Mrs Y’s needs in June 2024 and wrote to her with a revised support plan and personal budget. This largely mirrored the identified care and support needs and personal budget of the previous plan, but also included a one-off direct payment to cover four weeks of respite care.
18. The Council completed a review of Mrs Y’s support plan in August 2024. This found Mrs Y was keen to remain living at home and found no important events or changes since her last review.
19. In October 2024 Ms X advised the Council that Mrs Y had been moved into a local care home. This took place before the Council was made aware of the decision.
20. A social worker visited Mrs Y in the care home to complete another social care assessment. The social worker’s findings recommended Mrs Y’s care and support needs could still be met in her home and she did not need permanent residential care. The Council wrote to Ms X with information about eligibility for funded care and information about paying for care. The Council’s notes suggest Ms X refused to engage with it when it attempted to discuss the social worker’s recommendations.
21. In November 2024 the Council wrote to Mrs Y with a revised support plan. This set out Mrs Y’s current needs and how they were being met. The plan explained Mrs Y was currently resident in a care home, and the Council had assessed her needs while she was there. The support plan noted Mrs Y had said she would prefer to return home but liked that support was on hand whenever called for in the care home.
22. In December 2024 the Council wrote to Ms X to outline the support the social worker had recommended for Mrs Y and explain that its finance team was attempting to contact her.
23. The Council’s notes show Mrs Y is paying for her care privately and is regularly visited by Ms X. The Council has provided journal notes from July 2024 to October 2024 to show the records of care Mrs Y received in her home throughout that time.

Analysis

24. It is not the Ombudsman’s role to decide what services or support 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 Mrs Y’s care needs. The Council identified Mrs Y had eligible care needs that could be met in her home and produced a care and support plan with a package of care to meet these.
26. While I understand Ms X disagrees with the care plan the Council produced, this is in line with the legislation, and I do not find the Council at fault.
27. I understand Ms X feels Mrs Y needed additional carers specifically to support with her catheter and maintaining her home, however the Council appears to have correctly taken account of all her circumstances and what support she was already receiving when deciding on the package of care that would be appropriate for her. The Council reviewed Mrs Y’s care and support needs when it was notified of changes to her circumstances and I do not find fault with the process it followed.
28. I have reviewed the notes the Council provided outlining the care and support visits Mrs Y received and these appear to demonstrate her needs around catheter management and maintaining her home were met without issues. While I understand Ms X disagrees with this, there is nothing in the notes to suggest further assessment was warranted or the package of care was failing to meet Mrs Y's assessed needs.
29. Ms X has said the Council ought to have met Mrs Y’s needs in permanent residential care, however the Council felt her needs could be met in her home and notes show Mrs Y told it this was her preference during discussions. It is not my role to say where Mrs Y’s care should have been delivered, however I find no fault with the process the Council followed to decide this.
30. Mrs Y moved into a residential care facility prior to informing the Council of this decision. As a consequence, the Council did not have an opportunity to assess whether it agreed this was necessary. The Council had agreed to fund four weeks of respite care, but it had not assessed Mrs Y as needing permanent residential care. Once Mrs Y was in the care home, the Council reassessed her needs but still felt her package of care could be delivered in the home. The Council followed the right process when deciding if Mrs Y’s support needs should be met in a permanent residential facility. This being the case, the Council is not at fault for failing to fund Mrs Y’s residential care or providing a 12-week property disregard.

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Decision

31. I do not find the Council at fault and I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman