Summary: Ms Y complained the Council issued a poor quality care plan and wrongly decided to reduce Ms X’s care package. We find no fault in the Council’s decision-making to reduce Ms X’s care package. We find the Council at fault for issuing a poor quality care plan which caused injustice. We are satisfied the action taken by the Council has remedied the injustice to Ms X.

The complaint

1. Ms Y complains about the Council’s handling of Ms X’s care and support needs. Specifically, she complains the Council:
1. issued a poor quality care plan;
2. wrongly decided to reduce Ms X’s care and support hours; and
3. did not complete a further review.
2. Ms Y says the reduction in Ms X’s care hours impacted her physical health and quality of life and caused her significant distress.

Back to top

The Ombudsman’s role and powers

3. 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)
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(1), as amended)

Back to top

How I considered this complaint

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

Back to top

What I found

What should have happened

7. 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. 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.
8. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months. Councils should consider a light touch review six to eight weeks after agreeing and signing off the plan and personal budget. They should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. Councils must also conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one.

What happened

9. Ms X has several health conditions. The Council assessed her care needs. It decided her needs could be met with a care package with two visits per day.
10. In summer 2024, the Council completed a review of Ms X’s care needs. It decided to reduce the length of her daily morning visit.
11. Ms X made a formal complaint to the Council about the quality of the assessment. She said its decision to reduce the length of her morning visit was based on inaccurate information.
12. In October, the Council apologised to Ms X and accepted the assessment was not completed to the required standard. It said it had addressed this and Ms X’s concerns with the relevant officer. It said it would disregard the assessment and organise for another officer to complete a fresh assessment.
13. A week later, the Council arranged another assessment by a different officer. The officer interviewed Ms X and spoke to her medical team and care provider. The Council decided Ms X’s needs could be met with the reduced morning visit.
14. Ms X told the Council she was unhappy with the outcome of the second review. She requested another assessment. The Council decided it was reasonable for Ms X to escalate her complaint to stage two before it considered arranging a third assessment.
15. Ms X escalated her complaint to stage two. The Council told Ms X it was satisfied its officer properly considered all information about her needs in their decision-making in the second care plan review. It gave Ms X contact details for her to tell the Council if her needs changed and she wished to request a further review.

Analysis

Care plan (part a of the complaint)

16. The Council accepts the quality of its first review did not meet the required standard. The Council acknowledged this fault brought its decision to reduce Ms X’s care package into question. I consider this fault caused Ms X avoidable and unnecessary uncertainty.
17. The Council told Ms X it disregarded the first review. As detailed in the section below, I find no fault with the second review which also decided Ms X’s care needs could be met by a shorter morning visit. For this reason, but for the fault in the first review, it is likely the Council would still have reduced the length of her morning visit. Therefore, I consider the fault did not cause Ms X to lose provision.
18. The Council apologised to Ms X, arranged a second review in a reasonable timeframe and addressed her concerns with the relevant officer. I consider these actions appropriately remedied the uncertainty caused to Ms X.

Reduction in care package (part b of the complaint)

19. I am satisfied the Council properly considered all relevant information in its second care plan review and completed its assessment in accordance with the law. I find no fault with its decision-making and so I cannot question the outcome.

Further care plan request (part c of the complaint)

20. Councils must conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one. In this case, I consider the Council’s decision to ask Ms X to complete its complaints procedure before requesting a further assessment was reasonable. It also provided Ms X with contact details for her to use to inform the Council if her needs changed, and if she wished to request another review in future. I find no fault with the Council.

Back to top

Decision

21. I find fault causing injustice. I am satisfied the action taken by the Council has remedied the injustice to Ms X.

Back to top

Investigator's decision on behalf of the Ombudsman