Summary: Mrs C complained about the way in which the Council supported her mother. We found fault with the way an assessment was carried out, which however did not result in an injustice to Mrs C or her mother.

The complaint

1. The complainant, whom I shall call Mrs C, complained to us on behalf of her (late) mother, whom I shall call Mrs X. Mrs C complained:
• About the way in which the Council carried out a Mental Capacity Assessment of her mother.
• The Council failed to inform her, in the appropriate manner (a letter with a breakdown), what the outcome was of her mother’s financial assessment.
2. Mrs C also complained that an environmental risk assessment, carried out by a care agency contracted by the Council, was not done properly.

Back to top

The Ombudsman’s role and powers

3. 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)
4. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), 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)

Back to top

How I considered this complaint

6. I considered the information I received from Mrs C and the Council. I shared a copy of my draft decision statement with Mrs C and the Council and considered any comments I received, before I made my final decision.

Back to top

What I found

The complaint about the Mental Capacity Assessment

7. Mrs C complained about a mental capacity assessment (MCA) of her mother, which she said resulted in unnecessary distress to her mother. Mrs C said that:
• The telephone assessment was not needed because, according to the Council, an Occupational Therapist (OT) had already assessed, and concluded, the previous day that her mother did not have capacity.
• The Council has since said the telephone conversation was not a Mental Capacity Assessment. However, the assessor said in emails to her that he would carry out a MCA. Furthermore, during the introduction, the assessor said that he would be carrying out a MCA.
8. In response, the Council told Mrs C that:
• Although the officer completed a video call with you and your mother, this was not to complete or contribute towards an MCA. It was noted to be more of a follow-up courtesy call.
• The officer had previously arranged to complete a MCA on 17 September 2020. However, upon reading the OT’s notes, it was evident to him that the OT had already completed an MCA on 16 September 2020 and had deemed that Mrs X lacked capacity to make decisions. The records show this matter was discussed with you on 17 September 2020.
9. In response, Mrs C has said the video call was definitely a mental capacity assessment and not "more of a follow up courtesy call". She said the call was arranged as a mental capacity assessment and it was not clearly explained to her that the call would not be such an assessment. She said the assessor did also not say that an OT had already completed an MCA the previous day. The assessor started the conversation by introducing himself and explaining he was conducting a mental capacity assessment under the Mental Capacity Act.
10. The Council told me that, further to the above, the officer did not complete any MCA paperwork following the telephone/video call of 17 September 20, which he would have done if a formal MCA had taken place.
11. The Council provided me with a copy of the record the officer had made at the time of the video call. The record states:
• The video call had initially been intended to be a MCA. However, the officer was aware of the OT assessment the previous day.
• The officer said he went ahead with the call because Mrs C messaged him to say she was with her mother waiting for the call.
• The officer explained to Mrs C that, following the OT’s visit, it was not necessary to complete a “full” [capacity] assessment.
• The officer recorded, after the call, that he agreed with the OT’s assessment that Mrs X was currently lacking capacity to make decisions about her care.
12. Mrs C also complained about the way in which the assessment was carried out. She said that, although the officer was pleasant during the assessment, the officer asked her mother questions in a way, using language etc, that was not dementia friendly. As such, Mrs C said she had to explain many things to her mother in more easy language.
13. The Council has said the officer attended its course “Dementia awareness training and communicating with people living with dementia”. The Council is sorry if the officer used language that was not dementia friendly. It said it would not have been the officer’s intention to upset Mrs X or her daughter.

Analysis

14. The record states the officer was aware there had been a recent MCA assessment but decided to go ahead with the call because it had been agreed and Mrs C was already at her mother’s place. The officer also recorded that he explained there was no need to do a full capacity assessment, because one had already been completed. The Council told me the call was not to contribute to a MCA, but the above shows there was a MCA aspect to the call.
15. It is not possible for me to determine to what extent, if any, the officer’s language was inappropriate; too difficult to understand for someone with dementia.

The complaint about the financial assessment

16. Mrs C complained to the Council that it failed to inform her, in the appropriate manner (a letter with a breakdown), what the outcome was of her mother’s financial assessment. She said the Council only told her on the phone that ‘there is a record that says her mother will be self-funding’. However, the officer could not explain why. Mrs C complained that she has asked the Council to confirm this in writing, along with an explanation / breakdown, which she says the Council failed to provide.
17. A letter to Mrs X from August 2020 said the Council’s financial assessment assessed that her maximum contribution towards the cost of her care would be £327. It also included a breakdown that showed how the Council calculated the charge.
18. Mrs C sent an email to the Council confirming her mother had received the letter. However, she asked for a breakdown to show how the £327 had been calculated. She made a complaint in October 2020 that she had not received a breakdown, to which the Council responded on 19 October 2020. It sent her a letter that day which provided a response to Mrs C’s questions and explained how the Council had arrived at the charge.
19. Mrs C told me she continued to correspond with the Council around finances after this date and is unhappy, because she was waiting for a response that she did not receive.

Analysis

20. The Council provided an explanation and a breakdown in August and October 2020, to show how it had calculated Mrs X’s contribution. As such, I have not upheld Mrs C’s complaint that the Council did not explain this to her.
21. If Mrs C is unhappy about what happened after 19 October 2020, she should first make a complaint about that period to the Council, to enable it to investigate that period through its complaint process. If Mrs C is subsequently unhappy with the Council’s response about that, she can refer that aspect of her complaint back to the Ombudsman.

The complaint about the environmental risk assessment

22. Mrs C complained that an environmental risk assessment, carried out by a care agency contracted by the Council, was not done properly. She said:
• The form asks about gas appliances and gas fires. The assessor ticked to indicate that “the igniters are working” and “the control taps are in good condition”. However, there was no gas cooker at her mother’s property. Furthermore, the assessor did not see the gas fire and so could not have checked this.
• The assessor also ticked that the vacuum cleaner, washing machine, microwave, cooker fridge, iron, fires/heaters were in good condition. However, she did not check these.
• It was concerning this assessment was then signed off, as having been conducted when clearly it was not done.
23. Mrs C said a family friend was present throughout the above visit and confirmed the above.
24. In response, the Council said Mrs C did not share a full copy of the forms she referred to, as part of its investigation. I subsequently obtained and forwarded a copy of the Load Management Risk Assessment Form and the Environmental Risk Assessment Form to the Council. In response, the Council said that:
• Environmental Risk Assessment Form:
1. The document is not signed or dated. The care agency advised that the staff member who completed the visit is no longer employed by them. As such it is not possible to ask the staff member questions about how they completed the form.
2. It is difficult to establish if the document was a work in progress, which may be why the Enabler did not sign/date the document yet. Perhaps the intention was to revisit the form when Mrs C was present.
3. It is therefore difficult to draw conclusions from this, given the circumstances.
25. The Council told me it accepts that it should have commented on this aspect of her complaint, as part of its complaint response. The Council is sorry for this oversight.

Analysis

26. Based on the handwriting, it is sufficiently clear that both documents were completed by the same staff member. The areas of concern Mrs C pointed out in the Risk Assessment form were indeed checked in a manner as described by her. I have no reason to doubt Mrs C’s statement that the staff member did not check each of these. As such, I upheld this aspect of Mrs C’s complaint. The form was not signed.
27. Although Mrs C did not raise any specific issues as part of her complaint with regards to the Load management risk assessment form, I found it was incomplete as answers to many of the sections / questions were missing. As such, it should not have been signed off by the staff member.
28. However, while the above is fault, it did not result in an actual injustice occurring to Mrs C or her mother. In response to my draft decision statement, the care provider has said it is sorry for the above shortcomings and has since changed the way it records and processes assessments.

Back to top

Agreed action:

29. I recommended that the Council should, within four weeks of my decision, assure itself the care agency has the correct process in place to ensure these assessments are done correctly.
30. The Council has agreed with my recommendation.

Back to top

Final decision

31. For reasons explained above, I found there was fault. However, this did not result in an injustice.
32. I am satisfied with the action the Council will carry out to remedy this and have therefore decided to complete my investigation and close the case.

Back to top

Investigator's decision on behalf of the Ombudsman