Summary: There was a long delay in putting care services in place for Mrs X. That had an impact not only on her but also on Ms A, who has her own caring responsibilities. The Council has apologised and put services in place and will now also offer a payment in recognition of the lost period of care and the distress that caused.

The complaint

1. Ms A (the complainant) complains that the Council took too long to organise support for her mother Mrs X, who has some mental health problems. She says the impact on her as a carer has been significant as she also cares for her child with special needs.

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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. 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

4. I considered evidence provided by Ms A’s representative and the Council as well as relevant law, policy and guidance.
5. Ms A and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

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What I found

Relevant law and guidance

6. 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.
7. 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.
8. 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)
9. 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.
10. Section 117 of the Mental Health Act imposes a duty on councils and NHS clinical commissioning groups (CCGs) to provide free aftercare services to patients who have been detained under certain sections of the Mental Health Act. These free aftercare services are limited to those arising from or related to the mental disorder, to reduce the risk of their mental condition worsening, and the need for another hospital admission again for their mental disorder.

What happened

11. Mrs X is an elderly lady with longstanding mental health problems: one of her daughters, Ms A, provides care and support for her mother but also cares for her own son, a teenager with special needs.
12. Ms A had previously contacted the Council for support for Mrs X but in July 2023 wrote to complain that the allocated social worker had no understanding of Ms A’s caring role for her son, and that there was still no support in place for her mother who had suffered from paranoid schizophrenia and had continuing mental health problems and a need for support. Ms A had support in her complaint from a special educational needs advocate, who identified that the social worker had not taken a holistic approach to the family’s needs, had failed to put support in place for Mrs X, and had tried to arrange visits to Mrs X when Ms A was unable to attend.
13. The mental health services manager met Ms A on 28 July and agreed to allocate a new social worker although she said that might take some time because of staff availability.
14. The new social worker was allocated in August and visited Mrs X for an initial assessment in September. There was sporadic contact for the next twelve months despite Ms A’s attempts to contact the social worker. The Council’s files show that the social worker had a period of prolonged planned and unplanned absence in the autumn of 2023. She visited Mrs X again in November and carried out a carer’s assessment of Ms A in March 2024. In May 2024 she asked the GP to make a referral for a Community Psychiatric Nurse (CPN) for Mrs X and an Occupational Therapist from the Community Mental Health Team was appointed in July. A mental health support worker was also appointed to assist with accompanying Mrs X to appointments.
15. In July 2024 Ms A’s advocate made a further complaint to the Council on Ms A’s behalf. She said the situation had stagnated and there had been no care plan or any real support put in place for Mrs X. She said there were long gaps in communication and evidence of Ms A reaching out to the social worker for support in her caring role without any response. She said this had caused carer crisis and Ms A was no longer able to support both her son and her mother in the way she had. She asked for a “clear and timely plan of action”
16. The mental health team manager replied in August She upheld the complaint about the lack of action and apologised for the failure to provide support. She acknowledged that progress had been “unacceptably slow and protracted with long delays between communication with the family and (the social worker) completing her assessment of Mrs X’s needs”. She said the time taken to complete the assessment fell far short of the Council’s expectations. She set out a timeline for the next actions needed.
17. A review of the care plan in April 2025 showed that Mrs X’s needs were now deemed to be “fully met” The provision in place included 2 x 1 hour support weekly to provide “Personal Care, engagement, walk in the garden, empties the bin, changes the bed” as well as the assistance of a mental health support worker who supported Mrs X to attend health appointments. The review concluded “plan is working well and no increase in support is needed”.
18. In April 2025 Ms A complained to the Ombudsman about the delay in the provision of services to Mrs X. She said the delay had caused pressure on her as a carer and left her emotionally and physically exhausted, both in providing care and in chasing up progress which should have been made earlier.
19. In October Ms A’s advocate also complained to the Council about a delay in undertaking a financial assessment for Mrs X and a failure to take into account what the advocate believed was Mrs X’s status under Section 117 of the Mental Health Act to received free aftercare. She asked for a nil contribution towards the cost of care.
20. The Council replied with an apology for some delay in processing the financial assessment, between April and September 2025. It said there had been a high demand for such assessments and said the charges would be payable only from September in view of the delay. It confirmed however that as Mrs X had never been detained under section 3 of the Mental Heath Act, she was not entitled to section 117 aftercare funding.

Analysis

21. There was a long period of delay between the identification of need for services for Mrs X and their provision. During that time there was only sporadic contact from the allocated social worker and periods when there was no communication at all. That was fault, which the Council acknowledged. It caused injustice not only for Mrs X but also put intolerable stress on Ms A who already had a significant carer role for her son.
22. There was no fault in the decision not to award section 117 funding. Mrs X was not eligible.

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Action

23. The Council has already apologised for the inaction and delay in providing services.to Mrs X but should go further to recognise how much injustice that caused to Mrs X and to Ms A. Within one month of my final decision the Council will offer £500 to Mrs X for the loss of services. It should also offer £1000 to recognise the considerable impact that had on Ms A who was trying to care for her mother and her son at the same time and suffered significantly as a result.
24. Within one month the Council will also review the way in which regular communication with service users is monitored and provide details of improvement action.
25. The Council should provide us with evidence it has complied with the above actions.

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Decision

26. I have completed this investigation on the basis that I find fault causing injustice. Completion of the recommendations at paragraphs 23 -24 above will remedy that injustice.

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Investigator's decision on behalf of the Ombudsman