Summary: Ms X complained about the way the Council dealt with her request for a Disabled Facilities Grant. We find the Council was at fault for delay in arranging the Occupational Therapy assessment. There were also faults in its communication with Ms X. The Council has agreed to apologise to Ms X for frustration caused. It is already writing an action plan to address Disabled Facilities Grant wait times.

The complaint

1. Ms X complained about the way the Council dealt with her request for a Disabled Facilities Grant (DFG). She said there were delays in it arranging a visit by the Occupational Therapist (OT) and in its decision to approve the grant.
2. She said the delays have meant she has had limited access to several rooms in her home including the bathroom and kitchen which has had a significant impact on her physical and mental health. She said that had resulted in her having to have spent much of the past year in bed, and that her recovery period would have been sped up if the Council had assessed her sooner.
3. Ms X wants the Council to improve its timescales for considering current and future DFGs.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
5. 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

6. I discussed the complaint with Mrs X.
7. I referred to ‘Home adaptations for disabled people: a detailed guide to related legislation, guidance and good practice’ (the Guidance).
8. I referred to the LGSCO Focus Report ‘Good administrative Practice during the response to COVID 19’ issued May 2020.
9. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Disabled Facilities Grants

10. Disabled Facilities Grants (DFGs) are provided under the terms of the Housing Grants, Construction and Regeneration Act 1996. Councils have a statutory duty to provide grant aid to disabled people for certain adaptations. Before approving a grant a council must be satisfied the work is necessary and suitable to meet the disabled person’s needs and also reasonable and practicable.
11. There are three stages to the home adaptations process. The Guidance gives target timescales for dealing with cases at each of the three stages depending on whether it is urgent or non-urgent.
• Stage 1 - starts with the initial enquiry at the first point of contact to the date when the OT sends a recommendation to the adaptation service. Suggested timeframe 5 working days urgent cases, 20 working days non-urgent cases.
• Stage 2 - from the OT recommendation to approval of the scheme. Suggested timeframe 30 working days urgent cases, 50 working days non-urgent cases.
• Stage 3 - from the approval of the scheme to the completion of the works. Suggested timeframe 20 working days urgent cases, 80 working days non-urgent cases.
12. An urgent case is defined as a situation where the disabled person cannot be discharged from hospital or cannot access essential facilities within the home. A case is defined as non-urgent if the person cannot use the home fully but can access the toilet and bathing facilities.

How the Council provides home adaptations

13. The Council’s Accessible Homes Service (the Service) responds to referrals for home adaptations. This is a multi-disciplinary service made up of OTs, surveyors, case workers and contractors.
14. Initial referrals are dealt with by the OTs. They may provide the applicant advice about self-help options; arrange for equipment and minor adaptations; invite the applicant to an assessment centre; or arrange a home visit from an OT.
15. The Service prioritises referrals as either:
• High – this applies to applicants:
1. who are likely to live less than a year; ;
2. where there is a breakdown in the care network and/or carers are unable to continue their role;
3. where there is evidence of recent and rapid deterioration in condition,
4. where the is a high and immediate risk of physical injury to person or carer.
• Standard- where the person and/or their carer are experiencing significant difficulties but are not at immediate or high risk.

COVID-19 and the impact on the Accessible Homes Service

16. The Council said that because of the COIVD-19 pandemic the Accessible Homes Service had to reprioritise the delivery of its service to people requiring urgent adaptations to assist with hospital discharge or to prevent rehousing (i.e urgent high priority stair lift adaptations). It said that within the OT team four people were either shielding or unable to work because of childcare. It said it continued to provide stairlifts and minor adaptations. It also developed a virtual assessment process.

What happened

17. Ms X is disabled and a wheelchair user with a chronic health condition. She contacted the Council in January 2020 and told it she was in the process of buying a new property that would need adapting after she had moved in. The Council agreed to place her on its waiting list for an OT assessment. It wrote to her and confirmed there was a twelve month wait for an OT home visit.
18. Ms X moved into her new house on 25 March 2020. That move coincided with the COVID-19 pandemic. A Social Worker from the Council telephoned Ms X for a COVID-19 welfare check the following month. In that call, Mrs X told the Social Worker she could not leave her house because of accessibility issues. Ms X said she had stopped her personal assistant from entering the house because of COVID-19.
19. The Social Worker contacted the Service. They asked if it could assess Ms X for any minor adaptation that could help in the short term. They also asked if the Service could reprioritise Ms X because of her deteriorating health.
20. The Service contacted Ms X. Ms X confirmed she had privately paid for a stair lift but that she could not access the downstairs toilet and was struggling to use the kitchen. She confirmed she wanted to complete an extension but needed OT advice to ensure there was enough space for her wheelchair. The Service said it was not completing home visits because of the COVID-19 restrictions. It discussed the possibility of a virtual assessment and said it would contact her further once things had ‘settled down’.
21. Ms X emailed the Service in May 2020 asking for an urgent virtual assessment. An OT Aide sent the email to a supervisor asking if the referral could be allocated to an OT to complete a virtual visit. Ms X said the Council did not respond to that email.
22. Ms X said she contacted the Service further in June where it said would consider a virtual assessment. She said it told her there were staff shortages and it would contact her further at the start of July. Ms X said she contacted the Service in July and August about the delays. These contacts are not in the Service’s case records.
23. In October 2020 Ms X complained to the Council about delays in arranging the OT assessment. The Service reprioritised Ms X’s application as high. It wrote to her and confirmed it would complete the OT visit as soon as possible. It said a home visit was needed because of the range and complexity of access issues.
24. The following month the OT visited. That assessment identified Ms X’s house needed modifications to the kitchen; a ramp at the front of the property; the bathroom door replacing and doors widening. The OT completed a works request, setting out the modifications Ms X needed in December 2020.
25. The Service arranged for an external surveyor from a Home Improvement Agency (HIA) to visit the property to confirm a scheme of works for the modifications identified as needed by the OT. It asked the surveyor to provide costings for the scheme.
26. The surveyor visited the property in January 2021. Ms X provided the surveyor with architect designs and plans for the adaptations that she had already commissioned. The designs included modifications in addition to the OT’s report, which she stated she was happy to pay for herself. The surveyor contacted the Council and said Ms X had builder’s quotations but had not given these to them. The surveyor suggested the Council continue with Ms X’s existing plans.
27. The Service responded to surveyor. It said despite Ms X having her own preferred works scheme, it had asked the surveyor to confirm the costings needed for work that was eligible for DFG funding. It needed the costings for it to approve the DFG.
28. At the end of March 2021, the surveyor sent the Service the final schedule of eligible works. Four weeks later, the Service sent Ms X the DFG application form. It wrote to Ms X the same week confirming it had approved the grants and the works could commence.

The Council’s response to my investigation

29. The Service confirmed it took longer than it would aim for to assess Ms X because of difficulties caused by the COVID-19 pandemic. It said it had tried to move her case forward as soon as it was able to. However, the Council feels it could not have arranged the OT assessment earlier than it did.
30. It said the Service was reviewing its Adaptations Policy and was preparing an action plan to address timescales for dealing with waiting lists and timeframes for future assessments and DFG approvals.
31. It said Ms X’s scheme of works for adaptations was outside of DFG eligible works to meet the need and that she had chosen to progress with an ‘off-set scheme’- where she was using DFG funding towards a different scheme at a higher cost. It said it had not delayed in progressing the application but it needed the surveyor to provide costings of eligible works.

My findings

32. Although the Council accepted Ms X onto the OT waiting list in January 2020, I have considered its actions since March 2020 as that was when she moved into her new house and became eligible for DFG support.
33. The Guidance recommends a timeframe of 20 days between first contact with the Council and the OT assessment. Ms X moved into the property at the start of the first national lock down. The Council suspended home visits and prioritised the most urgent cases. We would not have expected it to have visited Ms X within that timeframe.
34. Ms X spoke to the Council in April 2020 about a virtual assessment. The Council said it would contact her once things had ‘settled down’. Whilst I recognise the Council was in a period of uncertainty, it should have provided Ms X a timeframe of when she could expect to hear from it further about the virtual assessment. It failed to do that. That was fault.
35. Ms X emailed the Council the following month asking about an urgent virtual assessment. Despite this email being escalated for consideration, I can see no evidence of how the Council considered this request or told her about any outcome. That was fault. These above faults have caused Ms X avoidable frustration.
36. Ms X said she spoke to the Council in June, July and August. These contacts are not recorded in her case records. That was fault. That means there is no evidence of what information the Council gave Ms X. In addition, there is no evidence of how the Council considered her suitability for a virtual OT assessment. The Council did not appear to make that decision until October 2019; that was six months after she asked for one. That delay was fault.
37. Following Ms X’s complaint, the Council reprioritised her OT assessment request to high and the OT visited within a month. This suggests that if the Council had reviewed her personal circumstances and health needs sooner, it may have reprioritised her earlier and arranged a visit. Although I recognise COVID-19 had a significant impact upon the Council, Ms X did experience some delay in waiting for her OT assessment. That delay was fault. That has caused Ms X an injustice. Ms X said the effect of living in a house that she has been unable to access properly has affected her illness and pain levels.
38. It took four months from the OT recommendations to the Council approving the grant. Although longer than recommended, the case records show the Council needed further information from the surveyor about the scope of the works and costings before it could approve the DFG funding. The Council stated that it was a major adaption and complex scheme of works. Although there was a short delay between the surveyor confirming the costings for the scheme of works and the Council issuing the DFG approval, I do not consider that delay so significant to be considered fault.

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Agreed action

39. Within one month of my final decision the Council had agreed to:
• apologise to Ms X for any delays in arranging her OT assessment and for any avoidable frustration and uncertainty caused by its communication with her during this period.
• Remind relevant staff to record decision making and contacts on case records.

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Final decision

40. We find the Council delayed in arranging Ms X’s Occupational Therapy assessment. There were also faults in its communication with her. The Council has agreed to apologise to Ms X to remedy any injustice caused. Therefore I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman