Summary: Mr Y complains about delay in the Council’s assessment of Ms Z’s social care needs. He says this created significant financial loss and distress because Ms Z’s care and support needs were initially unfunded between March and November 2022. The Council has now agreed to backdate direct payment funding for the whole period during which Ms Z’s daughter has provided care. We agree this is an appropriate remedy for the injustice caused by fault.

The complaint

1. Mr Y complains the Council delayed in allocating Ms Z’s case and assessing her social care needs. As a direct result he says there was a delay in setting up direct payments to fund the care she needed.
2. Ms Z employed a personal assistant in March, but the Council will only backdate funding to July 2022, despite previously agreeing to fund the whole period. Mr Y says this decision has caused financial hardship and avoidable distress to Ms Z’s family and carers.

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The Ombudsman’s role and powers

3. We may investigate a complaint on behalf of someone who cannot authorise someone to act for them. The complaint may be made by their personal representative (if they have one), or someone we consider to be suitable. (Local Government Act 1974, section 26A(2), as amended)
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 an organisation’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. Before writing this draft decision, I spoke with Mr Y and made enquiries of the Council. I considered the Council’s response which included a proposal to remedy the complaint.
7. I considered the relevant law and guidance around adult social care assessments and direct payments.
8. Mr Y and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

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What I found

What should happen

9. The Care Act and the supporting guidance ‘Care and Support Statutory Guidance’ sets out the process to be followed by councils when assessing social care needs. The guidance is clear that eligibility, “… must be made based on an assessment and cannot be made without having first carried out an assessment. Once an eligibility determination has been made, and the local authority has determined whether it will meet the person’s needs (whether eligible or not), it must then carry out a financial assessment if it wishes to charge the adult and confirm that the adult is ordinarily resident in the authority”
10. The law and guidance do not set out timescales for the assessment process. Instead, the guidance says an assessment should be completed over “an appropriate and reasonable timescale” and that councils must consider “the urgency of needs and a consideration of any fluctuation in those needs”.
11. The guidance goes on to say that, “At all times the person should be informed where they are in the care planning process, what will happen next and the likely timeframes”.

What happened

12. Ms Z had a stroke in December 2021. The effects of the stroke were significant, and Ms Z spent approximately four weeks in hospital. To enable her safe discharge, Ms Z received a temporary package of ‘reablement’ care in her home for a period of six weeks. This ended in February 2022.
13. Around this time Ms Z’s daughter, whom I will call Miss X, made a referral to the Council seeking an assessment of her mother’s long-term care and support needs. Mr Y says the family heard nothing from the Council and he and Miss Z made approximately ten telephone calls to the Council between March and June. Despite this, he says the Council could not provide any indicative timescales for the assessment requested in February.
14. In the meantime, Mr Y says Ms Z did not have a formal package of care in place. The Council says it offered a commissioned care package, but the family declined. We have seen no evidence of this or any of the social care files because the Council confirmed its proposal to remedy the complaint.
15. Ms Z received care from Miss X, who says she had no choice but to leave her employment to be her mother’s full-time carer and Personal Assistant.
16. The Council allocated a social worker to Ms Z’s case on 21 June and made an appointment to start the assessment on 7 July.
17. Mr Y spoke with the allocated social worker by telephone on 1 August. During this call Mr Y asked the social worker to confirm if funding for Ms Z’s care and support needs would be backdated by the Council to March. Mr Y says the social worker confirmed Ms Z would receive backdated funding for the whole period.
18. The Council has since confirmed the allocated social worker had a period of long-term absence from work between August 2022 and February 2023.
19. Mr Y says a further six weeks passed before the Council completed the financial assessment on 31 August. The Council then issued a pre-payment direct payment card in mid-November to fund Ms Z’s care and support needs, for which her personal budget was £608.94 per week minus a weekly client contribution of £17.60.
20. Dissatisfied with the length of time taken by the Council to assess Ms Z and to allocate funding, Mr Y complained to the Council. In its initial response the Council accepted some fault and said:
• It failed to return Mr Y’s calls and to update him on the timeliness of allocation which created delay in the assessment and provision of direct payments.
• The social worker experienced unforeseen circumstances and took urgent leave from work which created further delay in the assessment process.
• There was delay in completing a pre-financial assessment.
• It will backdate direct payments to 31 August when the financial assessment completed.
21. Mr Y did not accept the Council’s proposal and complained again. The Council responded in February 2023 and confirmed it had reconsidered Ms Z’s case. It said: “… following discussion with the direct payment lead for the council, to make a final offer, and as a gesture of goodwill, to backdate the direct payment to 7 July 2022. It was at this point that there were clear discussions with the allocated worker that for Ms [Z] a direct payment was the best way to meet her social care needs”.
22. Mr Y complained to the LGSCO because he maintained his view that the Council should backdate funding for the entire period Miss X has cared for her mother. He says that significant delays in the allocation of the case, and the subsequent assessments, created consequential delay in allocating funding. He says that Ms Z should be put back in the position she would have been, were it not for that delay.

Findings

23. The Council has already accepted fault in the way it handled Ms Z’s case. It acknowledges there was delay both in allocating her case and then completing the social care and financial assessments. This was in part due to the social worker’s unplanned absence from work. The Council initially offered to remedy this with a backdated payment to July as a “gesture of goodwill”.
24. I concur with the Council’s findings and agree there was unexplainable delay in Ms Z’s case and the Council did not act in accordance with the statutory guidance. This says assessments should be completed in an appropriate and reasonable timescale, considering the urgency of the person’s needs. Ms Z had significant needs; both in terms of her mobility and cognition. This was evident from the need for her to have a temporary package of care to facilitate her hospital discharge.
25. In response to our enquiries, the Council said, “We have identified that Ms [Z] was incorrectly informed by one of our officers that the DP could be backdated to when she employed a PA [Personal Assistant] in March”. Following this, the Council has proposed to backdate the funding to cover the whole period with an additional £250 for distress and uncertainty.
26. This is an appropriate remedy for the complaint made by Mr Y, and we have completed our investigation with a finding of fault causing injustice to be remedied with the actions listed below.

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Agreed action

27. Within four weeks of our final decision, the Council will provide us with evidence it has:
• Made arrangements to backdate Ms Z’s direct payments to March 2022;
• Paid £250 to Mr Y for the avoidable distress, time and trouble caused by the Council’s actions.
28. Within eight weeks of our final decision, the Council will also provide evidence to show:
• What measures it has put in place to reduce timescales around the allocation of referrals and the completion of social care and financial assessments.

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Final decision

29. Subject to further comments by Mr Y and the Council, I intend to complete my investigation with a finding of fault causing injustice for the reasons explained in this statement.

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Investigator's decision on behalf of the Ombudsman