Summary: Mr C complains the Council and Trust failed to provide him with suitable care, respond to calls, and support him with his direct payments. We will not investigate the complaint as some of the complaints are late. The Council has acted to remedy other complaints and complete a new review. Further investigation by us would therefore not be proportionate.

The complaint

1. Mr C complains the London Borough of Hackney, the “Council” and East London NHS Foundation Trust, the “Trust” failed to:
1. provide enough care to meet his needs;
2. properly communicate with him;
3. keep missed appointments;
4. properly manage his direct payment which resulted in financial distress;
5. reassess his care needs in a timely manner.
2. Mr C says because of these failures he has not had the care he needs. He says the Council’s actions have left him unsupported which has caused him frustration and distress. Mr C would like an increase in his direct payments so he has care to meet his needs, an apology and service improvements.

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The Ombudsmen’s role and powers

3. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
4. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• it is unlikely we would find fault, or
• the fault has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify our involvement, or
• it is unlikely we could add to any previous investigation by the bodies, or
• we cannot achieve the outcome someone wants.
  (Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

5. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something an organisation has done. (Local Government Act 1974, sections 26B and 34D, as amended, and Health Service Commissioners Act 1993, section 9(4).)

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How I considered this complaint

6. I spoke with Mr C and his advocate and considered his written complaint with other supporting information he provided. I also considered information from the Council and the Trust. I considered the Local Government and Social Care Ombudsman’s (LGSCO) Assessment Code, the Care Act 2014 and the associated Care and Support Statutory Guidance.

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What I found

Background to the complaint

7. Mr C has autism and obsessive-compulsive disorder. The Council and Trust have provided Mr C with services for several years. This included a payment from the Council to buy four hours of support services a week. This payment is called a “direct payment” and is based on the Council’s assessment of what meets Mr C’s eligible care needs.
8. Mr C complained to the Trust about the lack of care and the service he received. The Trust responded to the complaint and apologised for the missed appointments and the failure to complete a review. The Trust assigned Mr C a new care coordinator and said it had put in place a system to maintain contact when assigned care workers are absent for prolonged periods of time.
9. Mr C made further complaints to the Council. The Council apologised for further failings in communication. The Council agreed to review Mr C’s needs.
10. The Council reviewed Mr C’s needs but the outcome remained the same. The Council has an appeal route if people are dissatisfied with the outcome of their review or assessment. Mr C did not appeal the Council’s decision but made another complaint. In response the Council offered a further review and said there were gaps in the review because Mr C was not forthcoming with information.

Why we will not investigate

11. All the matters Mr C has complained about are late. I have not addressed Mr C’s complaint about the initial set up of his direct payment as this occurred in 2022 and is significantly outside the 12 month limit. There is no reason why Mr C could not have complained about the set-up of his direct payment sooner. I will, however, address the other matters as they are ongoing, the Council and Trust have both responded, and there were delays outside Mr C’s control from the Trust, Council, and the Ombudsmen.
12. I appreciate both the Council and Trust’s actions have caused Mr C frustration and distress; however, I must consider whether an investigation would reach findings of fault and achieve the results Mr C wants. The Council and Trust have accepted and apologised for failings in communication and missed appointments. The Trust has also provided a communication and contact point and a strategy and improved process for future communication which will benefit Mr C and others.
13. The Council has also accepted flaws in the review it completed. It has agreed to complete a review in the next four weeks to put things right. It will also remind officers, by a staff circular, formal training or team meeting, about what factors officers should consider when completing care reviews.

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Decision

14. We have upheld this complaint because the Council has agreed to resolve the complaint early by providing a proportionate remedy for the injustice caused to Mr C and improving its service for others.

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Investigator's decision on behalf of the Ombudsman