Summary: Miss Y complained about the Council’s assessment process and its decision that her mother should move from residential care to extra care housing. She also complained about the Council’s failure to make reasonable adjustments when communicating with her mother. We do not find fault in the Council’s assessment process or its decision. However, we do find fault in the Council’s failure to consistently meet her mother’s reasonable adjustment needs, but we are satisfied this did not cause a significant injustice.

The complaint

1. Miss Y complains about the Council’s assessment process which led to the decision that her mother, Ms X, should move from a residential care home to extra care housing.
2. Miss Y also complains about poor communication by the Council and its failure to make reasonable adjustments for Ms X, specifically by not providing documents in large print.
3. Miss Y says these matters caused significant distress and had a negative impact on their mental health.

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The Ombudsman’s role and powers

4. 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)
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 Miss Y and the Council as well as relevant law, policy and guidance.
7. Miss Y 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

Care and support assessment

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.

What happened

9. In late 2023, Ms X had a stroke and was admitted into hospital where she remained for several months. Prior to this, she lived with her daughter, Miss Y, in private rented accommodation. When Ms X was discharged from hospital, she moved into a residential home.
10. In 2024, the Council carried out a full assessment of Ms X’s care and support needs. As part of the assessment, the Council visited Ms X at the care home, spoke with Miss Y, and reviewed Ms X’s care records. Following this, the Council concluded that Ms X did not meet the eligibility criteria for 24-hour residential care. It decided her needs could instead be met in extra care housing, with an adapted self-contained flat, a daily care package, and access to carers on site at all times for emergency support.
11. Ms X, supported by Miss Y, initially explored the option of extra care housing. However, they raised concerns about affordability and instead requested that Ms X move to a different residential care home.
12. The Council considered this request but declined to fund an alternative residential placement. It finalised the assessment in early 2025, maintaining its decision that Ms X should move to extra care housing.
13. Ms X and Miss Y continued to challenge the decision. In April 2025, Miss Y requested that the Council arrange an Occupational Therapy (OT) assessment to support decision-making about Ms X’s care and support needs.
14. Later that month, the Council completed a new OT assessment, which Ms X and Miss Y both attended.
15. As the family did not agree with the outcome that Ms X was not eligible for residential care, the Council arranged for a fresh care and support assessment to be completed by a senior practitioner. An assessment was scheduled for June 2025 but could not be completed on the day. A second appointment was arranged but was later cancelled by the family. During the initial visit, Miss Y told the Council that Ms X would be at risk if living alone and that neither she nor other family members would be able to provide emergency support.
16. Miss Y then complained to the Council, appealing the decision to move Ms X into extra care housing. She said the decision had been made without an up-to-date OT assessment, which she had requested but not received, and asked the Council to complete an OT assessment and reconsider its decision.
17. The Council responded to the complaint. It said an OT assessment was completed in April and supported Ms X’s ability to live in a less restrictive community setting with appropriate care and support. The Council said it had offered to carry out a fresh care and support assessment, but as this had been declined by the family, its original decision remained that Ms X did not meet the eligibility criteria for residential care. It also confirmed it would support Ms X to apply for extra care housing and would continue to fund her current residential placement until a move was arranged. However, it said that if a move did not take place, it would not continue to fund the residential placement indefinitely.
18. Miss Y then brought the complaint to the Ombudsman.
19. After the complaint was brought to us, the Council completed a further care and support assessment with a senior practitioner who had no prior involvement in the case. This reached the same conclusion that Ms X’s care and support needs do not require residential care and can be met within extra care housing.
20. In response to my enquiries, the Council explained it had considered whether Ms X could return to a community tenancy with a care package. It decided this was not viable because Ms X does not have a property to return to and such an arrangement would not provide the additional background support available within extra care housing. The Council also considered sheltered or retirement housing but decided this would not meet Ms X’s needs and was not readily available. The Council said Ms X requires daily planned care and access to additional emergency support.
21. The Council said it had attempted to provide advice about Ms X’s potential entitlement to housing benefit and other welfare support to help meet the costs of extra care housing. It said it would support her with applications and that, based on comparable cases, it believed the accommodation would be affordable. However, it said it had been unable to progress this because Ms X declined further engagement, including care navigator support, additional information, and advocacy.
22. The Council confirmed it has not completed the full financial and affordability checks required to finalise an extra care housing tenancy. It said this was because Ms X has declined to engage with the process or accept the support offered.
23. The Council acknowledged it has not always provided documents in line with Ms X’s reasonable adjustment requirements. It said it has now added a case flag to remind staff of these requirements and has taken printed documents to Ms X in person and offered to read through them where alternative adjustments could not be made.

My findings

Assessment process and decision-making

24. The Ombudsman is not an appeal body. This means we do not take a second look at a decision to decide if it was wrong. Instead, we look at the processes an organisation followed to make its decision. If we consider it followed those processes correctly, we cannot question whether the decision was right or wrong, regardless of whether an individual disagrees with the decision the organisation made.
25. The Council carried out a care and support assessment in line with its duties under sections 9 and 10 of the Care Act 2014. It gathered information from a range of sources, including visits to Ms X at the care home, discussions with Miss Y, and a review of care records. It also obtained input from Occupational Therapy.
26. The Council concluded that Ms X did not meet the eligibility criteria for 24-hour residential care and that her needs could instead be met in extra care housing, with a self-contained flat, planned daily care, and access to on-site support at all times. This was a professional judgement the Council was entitled to make, provided it followed a proper assessment process.
27. Miss Y disagreed with the Council’s conclusion and raised concerns about Ms X’s safety if living alone and the family’s inability to provide emergency support. The Council considered these concerns as part of its assessment and subsequent reviews but maintained its view that extra care housing could meet Ms X’s needs in a less restrictive setting.
28. Where there was ongoing disagreement, the Council took steps to address this by arranging a further care and support assessment with a senior practitioner who had not previously been involved in the case. Although this process was not completed on the first occasion and a later appointment was cancelled, the Council’s actions demonstrate it was willing to review its decision and seek to resolve the disagreement.
29. After the complaint was brought to us, the Council completed a further assessment which reached the same conclusion.
30. The Council also considered alternative ways of meeting Ms X’s needs, including a return to a community tenancy with a care package, sheltered housing, and retirement housing. It provided clear reasons why these options were not considered suitable or viable.
31. I am satisfied the Council’s assessment process, taken as a whole, was carried out in line with the Care Act 2014 and relevant guidance. I do not find fault in the Council’s decision-making and therefore cannot question whether that decision was right or wrong.

Reasonable adjustments

32. The Council has acknowledged it did not always provide documents in line with Ms X’s reasonable adjustment requirements. This was fault.
33. However, the Council has since taken steps to address this by adding a case flag, providing printed documents in person, and offering to read documents aloud where alternative formats were not available. I am satisfied these actions were appropriate and have remedied the identified fault.
34. There is no evidence the failure to consistently meet the reasonable adjustment requirement affected the outcome of the assessment or decision-making process. I therefore find that, while there was fault, it did not cause a level of injustice that would warrant a remedy.

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Decision

35. I find fault not causing significant injustice.

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Investigator's decision on behalf of the Ombudsman