Summary: There is no evidence of fault in the way the Council assessed Ms Y’s care needs. As there is no evidence of fault in the process, I cannot comment on the merits of the decision reached.

The complaint

1. Ms X complains the Council failed to provide her niece, Ms Y, with an appropriate package of care.

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What I have investigated

2. Ms X complains about matters dating back to 2015. I have only investigated matters from January 2019 onwards. I have explained the reasons for this at the end of this statement.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. 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)
4. 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)
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 a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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How I considered this complaint

6. I have:

• considered the complaint
• considered the correspondence between Ms X and the Council, including the Council’s response to the complaint
• made enquiries of the Council, and considered the responses
• taken account of relevant legislation
• offered Ms X and the Council an opportunity to comment a draft of this document.

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What I found

Relevant legislation

7. The Care Act 2014 introduced a requirement that local authorities should promote ‘wellbeing’ and signifies a shift from existing duties on local authorities to provide particular services, to the concept of ‘meeting needs’. The concept of meeting needs recognises that everyone’s needs are different and personal to them. Local authorities must consider how to meet each person’s specific needs rather than simply considering what service they will fit into. (Care and Support Statutory Guidance, Ch1)
8. A council must carry out an assessment of any adult who seems to need care and support. It must also involve the individual and where appropriate their carer or any other person they might want involved. (Care Act 2014, section 9). Having identified eligible needs through a needs assessment, the council has a duty to meet those needs. (Care Act 2014, section 18)
9. If a council decides a person is eligible for care, it must prepare a care and support plan. This must set out the needs identified in the assessment. It must say whether and to what extent, the needs meet the eligibility criteria. It must specify the needs the council intends to meet and how it intends to meet them. (Care Act 2014, ss 24 and 25)
10. The care and support plan must set out a personal budget which specifies the cost to the local authority of meeting eligible needs, the amount a person must contribute and the amount the council must contribute. (Care Act 2014, s 26)
11. Where the council is meeting some needs, but not others, the care and support plan should clearly set out which needs it will meet and which ones it will not. It should explain this decision.
12. A person with eligible care needs can have a council arrange their care or, if they wish, they can arrange their own care using a direct payment. (Care Act 2014, s 31).

What happened

13. Ms Y is in her thirties. She has a moderate to severe learning disability and mental illness. She requires support in all areas of daily living. She is unable to process complex information. English is not her first language. The Council reports past difficulties in finding interpreters.
14. Ms Y lives with Ms X, who provides support in all aspects of daily living. The demands on Ms X are reported to be significant. Ms Y will not accept support with personal care from anyone outside of the family and she does not sleep more than 3- 4 hours a night. Ms X receives support from a carers trust.
15. At the end of 2018, Ms X contacted a solicitor about her caring role. The solicitor wrote to the Council reporting Ms X was struggling with her caring role, and to raise concerns about the proposed care and support package for Ms Y. The solicitor said Ms X did not wish to accept the offer of carers assessment, but she would consider it in the future.
16. In November 2018, the Council completed a fast-track assessment using information from a previous assessment completed in 2017. I have seen a copy of this document. It reports further assessment of Ms Y’s needs was required, but the assessor, and Ms Y’s advocate had been unable to engage with her. The Council offered Ms Y a direct payment for 84.5 hours per week pending the completion of a more detailed assessment. The Council wrote to Ms X on 14 November 2018 asking her to sign a direct payment agreement. Ms X did not respond so the Council wrote to Ms X again on on 20 December 2018 offering three options of support. The Council did not hear from Ms X or her solicitor, so a further letter was sent on 18 January 2019 to say a social worker had left two voicemails for Ms X on 15 & 17 January 2019, and that Ms X’s solicitor had not responded to the Council. She reiterated the three options on offer:

• a direct payment of 84.5 hours per week
• commissioned respite at a residential care home,
• immediate homecare provision from the Council’s in-house care team, to include 4 visits a day, and the Council would seek to engage a care provider via its learning disability services to cover additional hours up to 84.5 per week

17. The social worker went on to say she would need to complete a full needs assessment of Ms Y. She asked Ms X to contact the Council by 25 January 2019.
18. Ms X then contacted the Council to ask that all communication be directed to her solicitor.
19. Ms X’s solicitor responded to the Council on 16 January 2019 expressing concern about the proposed options for care and support. The solicitor acknowledged that Ms Y “...could be hard to engage with” and asked that the Council engage a carer to undertake the 84.5 hours per week as soon as possible. The solicitor said Ms X believed her relationship with the existing social worker had broken down and asked the Council to allocate a different social worker to undertake an assessment of Ms Y’s needs. The solicitor also asked, that, if possible the Council appoint a social worker that spoke Ms Y’s language.
20. On 27 February 2019, a social worker completed an ‘Initial Contact Form’. I have seen a copy of this document. The social worker recorded “I am currently allocated as Social Worker to [Ms Y] but cannot get any access to [Ms Y] or her new property so cannot provide any further information regarding her bathing needs within the new accommodation… The family are not allowing social workers access however they do not appear to be opposed to housing or other professionals entering her property/meeting with them. Please can OT contact the family to discuss the need for a bathing assessment”.
21. An Occupational Therapist visited Ms Y and completed an OT assessment in February 2019. I have seen a copy of this document. It records the family to have been recently rehoused, and that aids and adaptations to the bathroom were needed.
22. A social worker wrote to Ms X on 1 March 2019 to say she had called at the house in February 2019 but received no response. She expressed her concern for Ms Y’s wellbeing and said she would visit again on 12 March 2019 and asked “...that you work with us to facilitate this”.
23. Ms X submitted a formal complaint to the Council on 15 March 2019. I have seen a copy of this document. Ms X complained the Council was not providing adequate support for Ms Y, and had not done so since 2015. She said this had impacted on her whole family.
24. The Council appointed an investigating officer. It says, at the time, Ms X and Ms Y were visiting relatives so the Council was unable to meet with Ms X to discuss the complaint until 15 May 2019. The Council also allocated Ms Y a different social worker.
25. The Council met with Ms X on 15 May 2019 to agree a summary of complaint. Following this, the investigating officer wrote to Ms X on 31 May 2019 with a summary of the complaint. After receiving the letter, Ms X contacted the investigating officer expressing her dissatisfaction about the statement saying it did not include every issue that she wanted investigating. It was agreed by the investigating officer that the letter was a summary only and set out the key areas of concern, rather than set out every individual issue but that to accompany this, the investigating officer had taken notes of the issues and included additional details.
26. Ms X contacted the investigating officer again to say she was unhappy with this and would be sending some notes into the Council which she felt were the issues that needed investigating. Ms X was encouraged to do this by the investigating officer. The Council says it received no further contact from Mrs X about the statement of complaint
27. The Council says it contacted Ms X’s advocate to ask that he encourage Ms X to submit further information about the complaint. The advocate agreed to do this. The Council did not receive any further information from Ms X or her advocate, so the investigating officer worked with the original summary of complaint and the comments made in Ms X’s original letter of complaint.
28. The Council completed an assessment of Ms Y in July 2019. I have seen a copy of this document. It is detailed and comprehensive. The assessor reports Ms Y to have “…significant care and support needs in the vast majority of her daily living needs… the amount of physical assistance available on an informal basis is at risk of reducing due to the impact this has on [Ms X] who is currently acting as main carer… It doesn't appear that the level of support [Ms Y] actually needs has changed rather a change on what support can actually be continued on an informal basis.
29. The assessor concluded without Ms X’s input, Ms Y would need a residential care placement, but it was likely such a placement would not meet her specific cultural needs. The assessor reports the Council has “…attempted to commission support workers to facilitate this in the community although this has been unsuccessful and is not likely to change in the near future. As a result, I believe it is proportionate to offer the use of a Direct Payment to commission up to 16 hours of 1-1 support each day”.
30. Ms X did not accept the offer because she believed the allocated hours to be insufficient to meet Ms Y’s needs.
31. The Council provided Ms X with a written response to her complaint on 5 November 2019. I have seen a copy of that letter; the author, the investigating officer confirms the points of complaint:

• You want the issues addressed regarding the support for your niece, [Ms Y]:
• You want to know why it has taken so long to get the support that you both needed;
• You want to know why the previous complaint investigation did not resolve these issues.

32. The officer went onto say “I acknowledge that when I sent the notes and the outcome of our meeting to you, you had contacted me advising of your disappointment as you felt that I had not covered all of your points that you had raised. You then advised me that you were going to set out the points of complaint which you wanted me to consider during my investigation and send them to me, but you did not submit anything further”. The officer provided a detailed response to the above issues. She explained Ms X had refused support offered. The officer referenced three letters, one of which was sent to Ms X in January 2019, offering support which could have been taken as a direct payment, a commissioned service, respite care, or home care, but she declined because:

• Ms X believed the allocated hours were not enough to meet Ms Y’s needs.
• Ms Y had had a previous negative experience of respite care in another area.
• Ms Y did not like strangers, so home care was unsuitable.

33. The officer concluded that Ms X could have accepted a direct payment whilst appealing the allocation of support hours.
34. The officer went into some detail about historical matters and how the Council had dealt with this. She said a previous complaint had not been upheld, and at the time Ms X had the opportunity to make a complaint to the Ombudsman but had declined to do so. Consequently, these issues would not be revisited.
35. The officer said as Ms X did not wish to receive a direct payment, or to accept respite care, the only option was commissioned care, which the Council would ‘explore’. She acknowledged Ms X’s preference for black carers and confirmed the Council would include this request when approaching care agencies but said it could not guarantee the request could be fulfilled. The officer said there were no commissioned care agencies in its area area that employed care staff who spoke Ms Y’s language.
36. Ms X is dissatisfied with the Council’s response. She says it does address all the issues she wanted investigating. She believed the investigation should include matters dating back to 2015, not 2017, specifically she was unhappy that the investigation did not address the manner in which officers had dealt with her family, and that the family felt they had been accused of isolating Ms Y from visitors and her peers. She says the complaint response does not confirm whether the complaint was upheld.
37. In December 2019, Ms X accepted a direct payment to cover 18 hours support per day support for Ms Y.
38. In February 2020, the Council commenced a review of Ms Y needs. I have seen a copy of this document. The assessor reports Ms X to have had recent surgery and that this affected the amount of support she was able to provide to Ms Y. The assessor completed a temporary care and support plan to cover 24 hours, seven days a week. The Council agreed the money could be used to pay a family member because it was unable to commission support that would meet Ms Y’s specific cultural and communication needs, and because Ms Y would not accept personal care from someone unfamiliar. Ms X reported the direct payment to be working well. The assessor recommended the support be reviewed after three months.

Current situation

39. As I understand it, Ms Y is currently receiving an increased direct payment to cover 24 hours a day because of Ms X’s own health issues.

Analysis

40. It is not our role to decide if a person has social care needs, or if they are entitled to receive services from the Council. Our role is to establish if the Council assessed a person’s needs properly and acted in accordance with the law.
41. In this case I am satisfied the Council actions were in accordance with the law.
42. The Council responded promptly and adequately after receiving correspondence from Ms X’s solicitor reporting she was struggling with her caring role. Initially Ms X did not respond to correspondence or telephone contact from the Council, which created some delay. This was not due to any fault by the Council.
43. I have considered the documents provided by the Council which include Ms Y’s assessments and review documents. These show the Council properly considered all relevant factors in line with the requirements of the Care Act
44. The Ombudsman cannot question the outcome of a needs assessment/review that has not been affected by administrative fault. It is the Council’s professional judgement as to how many hours of support Ms Y requires and I cannot question it.
45. Until December 2019, Ms X refused all the care options offered by the Council because she considered the offers unsuitable. She refused respite care because of a previous poor experience and refused home care because Ms Y did not like strangers. This left no other option than direct payments. Ms X refused direct payments because she believed the allocated hours insufficient to meet Ms Y’s needs. Ms X could have accepted the care offered and continued to appeal/complain about the sufficiency.
46. I am satisfied the Council complied with its statutory obligations.
47. Ms X is dissatisfied with the way the Council has investigated her complaint. After receiving a summary of the complaint from the investigative officer, Ms X contacted the officer to express her dissatisfaction and said she would provide further details. She did not do so, so it was not unreasonable for the officer to conduct the investigation as per the initial complaint summary. Ms X believes the investigation should have included matters dating back to 2015. I do not agree with Ms X for the same reasons the Council put forward in its complaint response. Ms X had submitted a previous complaint to the Council in 2016 which was not upheld. She had the option to make a complaint to this office and she chose not to do so.
48. Having considered the Council’s complaint response, I find it adequately addressed the issues raised in the initial complaint summary.
49. However, I do have concerns about the timescale of the Council’s investigation. Ms X submitted a formal complaint to the Council in May 2019, it was not until November 2019 that she received a formal response.

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Final decision

50. There is no evidence of fault in the way the Council assessed Ms Y’s care needs. As there is no evidence of fault in the process, I cannot comment on the merits of the decision reached.
51. It is on this basis; the complaint will be closed.

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Parts of the complaint that I did not investigate

52. We cannot investigate complaints made more than 12 months after the complainant knew about the matter unless there are good reasons to do so. In this case there are no good reasons to do so.
53. Ms X first complained to the Council in January 2016 about the initial assessment in 2015. She opted not to complain to the Ombudsman when she received the Council’s response in 2016. The Council informed Ms X at that time about the Ombudsman’s service.

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Investigator's decision on behalf of the Ombudsman