Summary: Ms X complained the Council failed to properly assess her care needs and to provide support to meet those needs. The Council was at fault. It has failed to assess Ms X’s needs and its communication with Ms X was poor. It has agreed to apologise and make a payment to Ms X to acknowledge the frustration and uncertainty caused and to reassess her care needs

The complaint

1. Ms X complained the Council failed to properly assess her care needs and to provide support to meet those needs, following her previous Ombudsman complaint. Ms X says this left her without the support she requires.

Back to top

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. 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.
4. 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)

Back to top

How I considered this complaint

5. I considered evidence provided by Ms X and the Council as well as relevant law, policy and guidance.
6. I gave Ms X and the Council the opportunity to comment on a draft of this decision. I considered any comments before making a final decision.

Back to top

What I found

Relevant Law and Guidance

7. 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.
8. 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.
9. 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.
10. 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)

Background – previous Ombudsman complaints

11. In 2023, Ms X complained to the Ombudsman that the Council delayed assessing her care needs and did not carry out a carer’s assessment after she asked for this.
12. We found the Council at fault for the delay in carrying out an assessment of her care needs which was not completed until October 2023. We found fault with the assessment as it was not clear what, if any, eligible needs Ms X had and it did not explain why the Council considered Ms X did not need formal care services.
13. We also found fault as Ms X had asked for a carer’s assessment and the Council had failed to complete one. The Council agreed to carry out a new needs assessment and carer’s assessment.
14. Ms X also made a separate complaint to us in 2024 about the Council’s delays in carrying out adaptations to her home. We found fault and made recommendations to address the injustice caused.
15. I cannot investigate matters already considered through previous Ombudsman investigations.

What happened

16. The following is a summary of events relevant to the complaint.
17. The Council arranged to visit Ms X in August 2024 to undertake assessments. In response to my enquiries, the Council said a care needs assessment was not completed as it was not required. There is nothing in the Council’s case notes that refers to Ms X refusing a needs assessment. It completed a carers assessment which noted Ms X supported her two adult children, one of whom lived with her and a sibling. It noted Ms X’s ongoing issues with her housing had impacted her mental well being and recommended a one off payment of £125 to help towards travel costs in her caring role.
18. In late September 2024 Ms X complained to the Council about its failure to carry out a care needs assessment, to explain why previously it said she had no care needs, and that the outcome of the carer’s assessment had not been shared with her.
19. The Council responded in December 2024. It apologised and said it would involve Ms X in future before submitting an assessment for funding approval. It said it would arrange a review of her assessment. It sent her a copy of the carer’s assessment
20. The Council arranged to meet Ms X in late December 2024 to complete a new care needs assessment. The notes record Ms X raised her concerns about lack of adaptations, the carer’s assessment and needs assessment. The social worker advised Ms X they would contact the Housing department about her housing issues. However, Ms X became distressed and left the building. The assessment was therefore not completed. The social worker contacted Ms X’s GP to check up on her. The social worker’s manager suggested to the social worker that Ms X may benefit from an advocate to support her through the assessment process.
21. In late March 2025 the manager asked the Duty Team to contact Ms X to ask for her consent to refer her for an advocate, following which the case would be allocated for a review of the care and support she required.
22. An officer called Ms X in April 2025 to ask if she required any advocate. They noted Ms X did not want an advocate but wanted an urgent review as she was previously assessed as having no care needs and she felt this was incorrect.
23. During April 2025 Ms X contacted us to report she had yet to receive the outcome of the assessment from December 2024.
24. During this time Ms X was contacted by the OT service to progress the request for adaptations.

Findings

25. Following an earlier Ombudsman investigation the Council agreed to carry out a carer’s assessment and a reassessment of Ms X’s care needs. The Council carried out a carer’s assessment in August 2024 but did not carry out a new care needs assessment. In response to us it said this was because Ms X did not want one. That is not reflected in the case notes and given Ms X complained about the lack of an assessment in September 2024, it seems unlikely Ms X would say this. The failure to carry out a new care needs assessment is fault.
26. The Council arranged to reassess Ms X’s care needs in December 2024. It did not complete this as Ms X became distressed. I have seen no evidence the Council contacted Ms X to explain it had not completed the assessment. The Council took no further action until it offered Ms X an advocate by phone call in April 2025. However it failed to clearly explain the reasons for this. It should have explained this was to support her given it was not able to complete the previous assessment due to her being distressed. This delay and poor communication was fault. Ms X believed the Council had already carried out the assessment and so was understandably unclear why she had yet to receive the outcome or why the Council offered an advocate.
27. During this time, Ms X was also being regularly contacted by the Occupational Therapy Service for assessments to progress her request for adaptations, following her previous complaint to the Ombudsman. This added to Ms X’s confusion over whether meetings and assessments were to progress adaptations or to identify or address any care needs she may have.
28. The Council’s faults mean Ms X has still not had a reassessment of her care needs. It is for the Council to assess and determine whether Ms X has any eligible care needs. However, the delay in carrying out the assessment coupled with the Council’s avoidably confusing contact has caused Ms X significant frustration and uncertainty.

Back to top

Agreed Action

29. Within one month of the final decision the Council has agreed to apologise to Ms X and pay her £300 to acknowledge the frustration and uncertainty caused by the delay in assessing her care needs. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology.
30. Within two months of the final decision the Council has agreed to contact Ms X and carry out a reassessment of her care needs. It should also offer Ms X an advocate to support her through the process.
31. The Council should provide us with evidence it has complied with the above actions.

Back to top

Decision

32. I find fault causing injustice which the Council has agreed to remedy.

Investigator’s decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman