Summary: The Council was not at fault in how it arranged (and subsequently ended) free reablement support for Mrs B, in its decision not to involve Mr B when she signed support and consent agreements, or in the information it provided to him about her longer-term support. The Council acted in line with Regulations, and both national and local guidance, and there is no evidence of any fault which caused an injustice to Mrs B.

The complaint

1. The complainant, whom I refer to as Mr B, complains on behalf of his wife, whom I refer to as Mrs B.
2. Mrs B has multiple sclerosis, and was admitted to hospital in October 2018 after falling and hurting her shoulder.
3. As part of its discharge planning, the hospital referred Mrs B to the Council for an intermediate (or ‘reablement’) care assessment. The purpose of this assessment was to find out if the Council could support Mrs B to regain her independence when she left hospital.
4. Mr B says the Council initially told them that Mrs B would receive six weeks of free support when she returned home. However, he says the Council withdrew this support after around two weeks – even though Mrs B had not recovered – and told her she would have to pay for it from then on.
5. Mr B says the Council only withdrew this support because it found out Mrs B could afford to pay for it. He says the occupational therapist (OT) claimed Mrs B’s recovery had ‘plateaued’ to justify making her pay for her own support.
6. Mr B says the Council asked Mrs B to sign a reablement agreement and a consent form when she was alone in hospital. He says the Council should have asked him to be there because he is Mrs B’s registered carer. He says Mrs B signed the consent form and the social worker filled it in afterwards. He says the Council only wanted her consent so it could find out whether she could afford to pay for her own care.
7. Mr B says that, although the Council withdrew its free support after two of the planned six weeks, it refused to allow him to arrange private support for Mrs B, and told him she must continue to pay for the support already in place until the six-week period was over.

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What I have investigated

8. I have investigated Mr B’s complaints about the way the Council provided reablement support to Mrs B, its failure to include him when agreeing her provision, and its refusal to allow him to arrange private support for her.
9. The final paragraph of this decision statement sets out why I did not investigate other matters.

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The Ombudsman’s role and powers

10. 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)
11. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
12. 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 the fault has not caused injustice to the person who complained, or it is unlikely further investigation will lead to a different outcome. (Local Government Act 1974, section 24A(6), as amended)
13. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

14. I considered information from Mr B and the Council. I wrote to Mr B and the Council with my draft decision and considered their comments.

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What I found

What should have happened?

Care and support statutory guidance

15. This guidance, which accompanies the Care Act 2014, provides guidance on how councils should meet their duties under the Act.
16. The guidance says the Council provides intermediate care services (including reablement) to people after they have left hospital, or when they are at risk of going to hospital. Reablement support is provided for a limited period of time to assist a person to regain the ability to live independently.

The Care and Support (Charging and Assessment of Resources) Regulations 2014

17. Regulation 3 of these regulations says councils cannot charge people for intermediate care for a period of up to six weeks.

The Council’s Regaining Independence Service practice guidance

18. This guidance sets out how the Council will provide reablement support. It says reablement will be provided as a free-of-charge service for a maximum of six weeks.
19. It says that, when referring someone for an assessment, the Council must provide a copy of the reablement agreement, and must ensure they understand that the support is free of charge for up to six weeks. However, the Council may charge them after that.
20. It says an OT will assess whether someone is likely to meet their goals within the reablement period. If they are not, then continued reablement care would not be appropriate.
21. It says that, if an OT decides someone needs care for longer than the reablement period, the Council will financially assess them and may charge them for ongoing care. The OT can provide information about this directly to the individual or family.
22. It says that, if someone lacks the mental capacity to make decisions about their needs, the Council will discuss arrangements with their relative(s). It says it will do the same if a relative holds a Lasting Power of Attorney (PoA) for a person needing care.

What happened?

23. On 17 October 2018 a Council social worker visited Mrs B in hospital. Mr B was not present. She signed a reablement agreement which said the Council would provide reablement care, free of charge, “for a period of active reablement as defined by the Occupational Therapist”. It said the PA could be charged after the reablement period was over.
24. Mrs B signed a statement which said, “I have been told that the Community Reablement Service is free for the reablement period (maximum of 6 weeks) which will be defined by the West Sussex County Council OT”.
25. Mrs B also signed a consent form which agreed that the Council could share information with certain other agencies. The Council’s records suggest that she did not actually tick the boxes to say which agencies she agreed to share information with. It appears that the social worker ticked these boxes after meeting her. It is unclear whether he spoke to Mrs B about his intention to do this.
26. After this the Council arranged a reablement assessment. It recorded that Mrs B “has been informed that this service is provided, without charge, for a maximum period of up to six weeks, or until the person is considered to have no further rehabilitative potential”.
27. On 22 October the Council’s OT conducted a reablement assessment. She decided Mrs B needed reablement support to regain independence with personal care and dressing. She said Mrs B had good communication skills, and could communicate her needs and wishes. She said there was no need to conduct a mental capacity assessment.
28. The OT also said:

[Mrs B] has been informed that [this] is a short term reablement service that is free while [she] is working towards goals. Once she has plateaued or stopped achieving her goals, there may be a charge. [Mrs B] is aware that any on-going care costs will be means tested or paid in full if over the … financial threshold. [Mrs B] is over the … threshold.

29. On 29 October the Council sent Mrs B information about finding care and support services.
30. On 5 November the OT conducted a review of Mrs B’s reablement goals. She recorded that Mrs B’s carers had reported that Mrs B had ‘plateaued’ in her progress towards her goals of showering and dressing independently. The OT said Mrs B would benefit from continued support (after the reablement period), and said Mrs B agreed.
31. The OT advised Mr B (who was unhappy that the reablement support was ending) that the free support is only available for up to six weeks while the person is progressing towards their reablement goals.
32. The OT also told Mrs B that the Council would charge her for the support which was already in place until she could find her own.
33. Mr B complained to the Council to following day. He said it had ended Mrs B’s support too early. He said it told them her recovery would take six weeks. He asked what evidence it had that she was not making improvements. He said it told them she would get six weeks’ free support.
34. On 12 November a Council manager spoke to Mr B, who told her he had the details of a local care agency. The manager suggested that Mr B look at the information provided by the OT so he could make a comparison between different providers. Mr B said he did not want to continue with an official complaint.
35. Mr B had several other telephone conversations with the Council around this time. The Council’s records do not show that he asked to end the support Mrs B was receiving, or that he was told he could not do this.
36. In late November Mr B found a care agency which could provide ongoing support to Mrs B. This agency began providing support on 30 November (which meant the support the Council arranged ended on 29 November).
37. In January 2019 the Council sent Mrs B an invoice for the support she received from the end of her reablement period to when Mr B found the new care agency. This was from 7 to 29 November. At £150.15 per week, this invoice totalled £493.35.
38. Mr B complained about this invoice, and – after the Council responded – complained again. His complaints are summarised in the opening section of this decision statement.
39. The Council said it provided information about the limitations to reablement support, and about social care charging. It also said the ongoing support following reablement can be cancelled at any time.
40. However, the Council also said it is good practice to ask a ‘next of kin’ to be present when someone is signing social care documents. It said this did not happen, and it apologised.

My findings

41. The Regulations, the statutory guidance, and the Council’s practice guidance – together – provide a clear picture of the purpose of reablement support, how it should be paid for, and when it should end.
42. Reablement is to support someone to regain the ability to live independently, and is free for a maximum of six weeks (not necessarily a full six-week period). If the Council decides someone will be unable to live without support at the end of the six-week period, then reablement is no longer an appropriate service. There is nothing to stop a Council deciding this in advance, if it does not believe a person will be able to live independently at the end of the reablement period.
43. All the evidence I have seen suggests that the Council advised Mrs B that this service would be for up to six weeks, rather than for six weeks in total. This is clearly set out on the reablement agreement, and the Council’s records say Mr and Mrs B were told this on other occasions as well.
44. Although Mr B says the reablement support should not have been ended before Mrs B was given a chance to recover, the Council’s view was that she would continue to need longer-term support.
45. The Council was entitled to decide (having reviewed Mrs B’s progress) that she would not fully regain independence in six weeks, and its decision is supported by the fact that, nine months on, she still receives support. The Council’s decision to stop the free support appears to have complied with the Regulations and guidance. This was not fault by the Council.
46. Mr B also complains that he was not invited to be present when the Council asked Mrs B to sign reablement and consent forms. The Council appears to have accepted that it is 'good practice' to invite family members, and has apologised to Mr B.
47. However, although the Council says it was wrong, I do not consider this to meet the threshold of maladministration. There is no specific policy or guidance document which says the Council must invite a relative to assist someone to sign forms if that person has the capacity to make decisions about their care.
48. The Council’s practice guidance says it will discuss any reablement arrangement with relatives (or a PoA) if the person lacks capacity. But this did not apply in Mrs B’s case. At no point has Mr B said Mrs B lacked capacity, and the OT assessment said there were no concerns about her ability to understand and explain her care needs.
49. As a result, I have not found fault with the Council on this point, even though it has apologised to Mr B for not involving him when Mrs B signed reablement and consent forms. It also says it will encourage relatives to be present when forms are signed in future.
50. The evidence in Mrs B’s social care file suggests a social worker did complete part of her consent form (but does not say whether the social worker spoke to her about this first). However, this matter did not cause her an injustice.
51. The Council needed to know how much money Mrs B had in assets, and – if this consent form had never been completed – it would have just conducted a financial assessment, with the same result. As a result, I have not looked at this matter further.
52. Mr B’s final complaint is that, although the Council withdrew its free support after two of the planned six weeks, it refused to allow him to arrange private support for Mrs B. He says it told him she must continue to pay for the support already in place until the six-week period was over.
53. There is no evidence that the Council ever told Mr B that he could not cancel Mrs B’s support. This does not, of course, mean the conversation did not take place. However, the Council’s records actually show the opposite. The OT and the reablement team manager appear to have made efforts to provide information about care agencies and how to find them. This started as early as the end of October – a month before the private support started.
54. The private support that Mr B arranged for Mrs B also started shortly before the end of the six-week period, so there was clearly no barrier to him making those arrangements.
55. I have seen nothing to suggest that, had Mr B organised private support earlier, the Council would have told him he was not allowed to do so. In fact, the Council’s records say the opposite. Although this does not mean Mr B is wrong about what he says the Council told him, I have seen no evidence to support his complaint, so I have not found fault with the Council.

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Final decision

56. The Council was not at fault in how it arranged (and subsequently ended) free reablement support for Mrs B, in its decision not to involve Mr B when she signed support and consent agreements, or in the information it provided to him about her longer-term support. The Council acted in line with Regulations, and both national and local guidance, and there is no evidence of any fault which caused an injustice to Mrs B.

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Parts of the complaint that I did not investigate

57. I did not investigate Mr B’s complaints about the Council’s motivation for asking Mrs B to sign the consent form, about it only stopping the reablement support because she could afford to pay for it, or about the OT’s motivation for saying Mrs B’s recovery had ‘plateaued’. I have looked at some of these issues elsewhere in this decision statement, and there is clear evidence that the Council’s decision to end the reablement support was nothing to do with Mrs B’s finances. As a result, it is unlikely further investigation would lead to a different outcome.

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Investigator's decision on behalf of the Ombudsman