Summary: Miss X complains the Council poorly supported her and her father, Mr Y, during his admission into hospital and when he was later discharged home. Miss X says as a result her father did not receive the right care and support once he was discharged home. Miss X also says it caused her distress and frustration as her fathers registered carer. We have found fault in the Councils actions for failing to discuss details of the care provider, give an estimate of costs or provide a financial pack. We have also found the Council failed to discuss care needs with Miss X or return her call. The Council has agreed to issue Miss X with an apology and pay a financial payment.

The complaint

1. Miss X complains the Council poorly supported her and her father, Mr Y, during his admission into hospital and when he was later discharged home.
2. Miss X says as a result her father did not receive the right care and support once he was discharged home. Miss X also says it caused her distress and frustration as her fathers registered carer.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), 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)

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How I considered this complaint

5. I considered evidence provided by Miss X and the Council as well as relevant law, policy and guidance.
6. Miss X and the Council were invited to comment on my draft decision. I have considered any comments before making a final decision.

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What I found

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. 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.
9. 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.
10. In considering whether an adult with care and support needs has eligible needs, local authorities must consider whether:

• the adult’s needs arise from or are related to a physical or mental impairment or illness;
• as a result of the adult’s needs the adult is unable to achieve two or more of the specified outcomes;
• as a consequence of being unable to achieve these outcomes there is, or there is likely to be, a significant impact on the adult’s wellbeing.

11. An adult’s needs are only eligible where they meet all three of these conditions.
12. Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The Council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. It should confirm the final amount of the personal budget through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person's care and support needs.
13. Local authorities should consider whether the individual would have substantial difficulty in being involved in the assessment process and, if so, consider the need for independent advocacy.
14. Local authorities may combine an assessment of an adult needing care and support or of a carer with any other assessment it is carrying out either of that person or another where both the individual and carer agree, and the consent condition is met in relation to a child. This will also avoid the authority carrying out two separate assessments when the two assessments are intrinsically linked. If either of the individuals concerned does not agree to a combined assessment, then the assessments must be carried out separately.
15. Section 19(3) of the Care Act gives councils power to meet an adult’s needs for care and support if the needs appear urgent even if an assessment has not taken place.

What happened

16. Mr Y was admitted to hospital in late May 2024. A social worker met with Mr Y in early June 2024 and said he would not be eligible for reablement care due to assessing him as having long term needs.
17. An Occupational Therapist (OT) met with the Mr Y and his family in early June 2024 and discussed that as Mr Y had long term needs discharge to assess would not be appropriate. The Council completed a Care Act Assessment in early June 2024 which noted that Mr Y would need a long-term care package.
18. The hospital discharged Mr Y in mid-June 2024. Miss X agreed to support Mr Y until the Council could put services in place. The following day the Council discussed details of what care would be appropriate for Mr Y which was due to begin the day after.
19. Miss X contacted the Council the day the care was due to start to cancel the care package as she said it had it in place with little discussion. Miss X said she would like the Council to put in place a direct payment.
20. The Council completed a Care Needs Assessment in early August 2024. The notes from the assessment record the Council discussed the costs of care with Mr Y and Miss X and discussed sheltered housing and Extra Care Housing. The Council notes say it would issue a letter to Mr Y about his options, and he would then think about what he wanted to do. The Council sent a letter to Mr Y the same day.
21. Miss X emailed the Council in early September 2024 and said Mr Y did not want to go any further due to the cost and requested a new financial assessment. The financial team said an assessment was not necessary as it had completed one within the last year. It said it would send a letter about contributions and Disability Related Expenses (DRE).
22. The Council received a referral from the Ambulance service in mid-September 2024.
23. Miss X discussed DRE with the finance team in mid and late September 2024. The finance team told Miss X what evidence it would need from her to complete an assessment.
24. A further Care Act Assessment took place in late October 2024 and again Mr Y said he wanted to think about what he wanted to do in terms of the care he received.
25. Miss X contacted the Council in December 2024 and requested respite care for Mr Y. The Council discussed this with Mr Y and Miss X who initially agreed to put respite care in place. The Council contacted various care settings and called Mr Y and Miss X back to confirm a placement had been found. However, Mr Y had decided he did not want to go into respite care.
26. Mr Y was admitted to hospital in mid-December 2024 after a fall. The hospital then discharged Mr Y with no services being in place. The notes from the time record Mr Y had said he did not feel services were required.
27. Miss X raised a complaint with the Council in mid-February 2025. Miss X said the Council had failed to explain the package of care or the costs associated with this. Miss X also said the Council put in place a care package with no communication and did not issue a care plan. Miss X also said the Council had failed to give correct information about DRE’s.
28. The Council issued a response to Miss X’s complaint in late March 2025 and said it could not see what information it gave to Mr Y and Miss X about care options or costs. The Council said it would reinforce with staff about including family members in decision and providing relevant information. The Council confirmed care needs assessments took place in June. It apologised for not providing financial information and said it would address this with staff. The Council said it could not see what advice it gave about DRE’s and could not see respite care was requested before December 2024. The Council said further needs assessments were not competed as Mr Y had said he wanted time to think about how he wanted to go forward. The Council also apologised for failing to return a call Miss X had made.
29. Miss X raised a further complaint in April 2025 and said she was unhappy the Council did not offer reablement care and that she was not involved in Mr Y’s care planning. Miss X said the Council did not complete care needs assessments within the relevant timescale and did not assess Mr Y’s long-term needs. Miss X also said she was not happy how different opinions were presented very close together about Mr Y’s needs which led to the Council stopping services and reinstating them quickly. Miss X also said the Council had referred to out of date information when making its assessment. Miss X said the Council did not provide her with any advice about respite for carers.
30. The Council issued a stage two response in mid-May 2025 and said it did not offer reablement care based on the OT opinion. It apologised for the delay in responding to the complaint and lack of involvement Miss X had in Mr Y’s care planning. The Council said it completed Mr Y’s initial care needs assessment within timescale, but the face-to-face assessment was delayed because of resourcing issues. The Council said differing opinions were due to differing professional opinions. The Council apologised for the lack of communication regarding finances and recognised the importance of discussions around DRE’s. The Council also recognised that it provided incorrect information or no information about sheltered housing or carers break. The Council also apologised for the delay and confusion caused by the lack of communication.
31. The Council said it regretted the numerous discrepances which had impacted Mr Y’s care and support. It said it was implementing changes to improve its service and apologised and offered Mr Y £250 to recognise the hardship and distress caused to him.

Analysis

32. The Council has accepted it did not complete the care needs assessment within the relevant timescale, it should have discussed Mr Y’s care needs with Miss X and should have provided the details of the care provider to Miss X. Not doing so is fault and has caused Mr Y and Miss X distress and frustration.
33. The Council has also accepted it should have given estimates of the costs of care and provided Miss X with a financial pack. The Council accepts it should have also discussed Disability Related Expenses with Miss X and Mr Y. Not doing so is fault and has caused Mr Y and Miss X distress and frustration.
34. The Council has also accepted it should have discussed Miss X’s needs and possible carers break or respite with her. Not doing so is fault and has caused Miss X distress.
35. I appreciate the Council did try to put care in place to help Mr Y but Mr Y declined this.
36. I understand from Miss X that Mr Y now has an established routine, and carers are not needed.
37. The financial remedy offered by the Council in recognition of the faults identified is in line with our guidance and as such is a suitable offer to resolve the complaint.
38. I understand the Council has also taken action to improve its services following Miss X’s complaint.

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Action

39. Within four weeks of a final decision, the Council should:

• Write to Miss X and Mr Y to apologise for the distress caused by the faults identified. 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 I have recommended in my findings.
• Pay Miss X and Mr Y £250 to recognise the distress and frustration caused.

40. The Council should provide us with evidence it has complied with the above actions.

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Decision

41. I find fault causing injustice.

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Investigator's decision on behalf of the Ombudsman