Summary: Mrs X complained that the Council failed to provide her with information to enable her to repay direct payments. She also complained that it delayed in providing an advocate for her adult son and in completing a Care Act assessment for him resulting in his care and support needs being unmet. She also said there were several changes in social worker causing the family distress. We found the Council delayed in providing Mrs X with a new invoice so she could make the repayment and failed to keep the family informed about changes in social workers. The Council has apologised and agreed to make a payment in recognition of the injustice caused.

The complaint

1. Mrs X complains that:
• In November 2022 the Council agreed that she could retain £4602.18 of direct payments and that she should repay £1295.75. However, it did not provide her with the necessary information to do so until several months later, causing distress and inconvenience;
• the Council has delayed significantly in providing an advocate for her adult son and in completing a Care Act assessment resulting in his care and support needs being unmet; and
• there have been several changes of social worker causing further distress to the family.

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The Ombudsman’s role and powers

2. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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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What I have and have not investigated

4. I have investigated Mrs X’s complaint about events which took place between May 2022 and May 2023 when she complained to us. I have decided not to investigate matters which took place before May 2022. We would not normally investigate matters which took place more than 12 months before someone complained to us unless there are exceptional reasons. I do not consider that to be the case here. These complaints are late and Mrs X could have complained to us sooner.

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How I considered this complaint

5. I have considered all the information provided by Mrs X, made enquiries of the Council and considered its comments and the documents it provided.
6. Mrs 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

Legal and administrative background

Care needs assessment

7. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and, where suitable, their carer or any other person they might want involved.
8. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment process.

Charging for social care services

9. A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in places other than care homes. A council can choose to charge for non-residential care following a person’s needs assessment. Where it decides to charge, the council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17)
10. Where a council has decided to charge for care, it must carry out a financial assessment to decide what a person can afford to pay. It must then give the person a written record of the completed assessment. A council must not charge more than the cost it incurs to meet a person’s assessed eligible needs.

Direct payments

11. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.
12. Councils must tell people during the care planning stage which of their needs direct payments could meet. However, councils must consider requests for direct payments made at any time and have clear and quick procedures in place to respond to them.
13. After considering the suitability of the person requesting direct payments against the conditions in the Care Act 2014, the council must decide whether to provide a direct payment. In all cases, the council should consider the request as quickly as possible. Where accepted, the council should record the decision in the care or support plan. Where refused, the council should explain its decision in writing to the person who made the request. It should also tell the person how to appeal against the decision through the local complaints procedure. (Care and Support Statutory Guidance 2014)

Key facts

14. The following chronology is intended only to give an overview of the Council’s substantive actions. It does not describe everything that happened. I have included reference to events falling outside the timeframe of my investigation to provide context.
15. Mr Y is an adult with autism and ADHD. He lives independently but requires support with day-to-day tasks.
16. In 2019 the Council completed a Care Act assessment for Mr Y. Direct payments were provided following the assessment. They were managed by Mr Y’s parents, Mr and Mrs X.
17. In 2020 Mr and Mrs X cancelled the care package arranged by the Council because they did not consider it was meeting Mr Y’s care and support needs. Instead, they provided care and support for him themselves. As a result, unused funds accumulated in the direct payment account. The Council later asked Mr and Mrs X to repay this money. They argued they should be allowed to keep it as they had been providing care for Mr Y.
18. In 2021 a further Care Act assessment was completed.
19. In May 2022 Mr Y was receiving support from a social prescriber link worker (‘the social prescriber’) from the NHS. Mr Y’s social worker, Officer A, asked the social prescriber if she was able to act as an advocate for Mr Y as she already had a rapport with him. The social prescriber said she was unable to provide such support and explained the need for an independent advocate. She also said Mr Y did not want support from a care provider for the time being because he was due to move home shortly and would prefer to wait until after the move and repairs to the property had been completed.
20. Officer A contacted an independent advocacy service (‘the advocacy service’). It advised Officer A not to make a referral until Mr Y was ready to engage.
21. In August Officer A contacted the social prescriber again and spoke to Mrs X. Both said Mr Y was still stating he wished to resolve his housing situation before engaging with social services.
22. Later in August officers met with Mr Y and his parents. Officers explained there would be a change of social worker and a new care needs assessment was needed to reflect Mr Y’s current needs.
23. Following this Mr Y was allocated to a new social worker, Officer B. The plan was to introduce an advocate and undertake a Care Act assessment. Officer B contacted Mrs X and also corresponded with her solicitor about the direct payment account.
24. In early September Officer B made a referral to the advocacy service and visited Mr Y to introduce herself.
25. On 12 September Officer B chased up the advocacy service. It responded introducing the allocated advocate.
26. On 26 September Officer B sent an email to the advocate asking when she would be contacting Mr Y.
27. On 2 October the advocate responded saying she had been unable to contact Mr Y. Officer B contacted Mrs X who confirmed Mr Y was aware he had missed calls from the advocate.
28. On 26 October Mrs X contacted Officer B saying Mr Y had not heard from the advocate despite sending an email three weeks previously. Officer B explained the advocate had attempted to contact Mr Y without any response, but he would pass on Mrs X’s contact number and ask the advocate to contact her instead.
29. On 1 November Officer B sent an email to the advocate requesting an update. The advocate explained she had been absent from work because of illness. Officer B asked her to contact Mrs X.
30. On 8 November the Council wrote to Mr and Mrs X confirming they could retain some of the money in the direct payment account to fund the support they provided to Mr Y when no support package was in place. It agreed they could keep £4602.18 leaving an outstanding amount of £1295.75 to be repaid.
31. On 22 November Mr and Mrs X’s solicitor wrote to Officer B asking how they should repay this money as no details had been provided.
32. On 29 November Mr Y was allocated a new social worker, Officer C.
33. On 11 January 2023 Mr and Mrs X’s solicitor complained to the Council saying they had discovered Mr Y’s social worker had changed following a discussion between his social prescriber and his GP. Neither Mr Y nor his parents had been informed of this change. She also complained that Mr Y was still awaiting his Care Act assessment and had had little communication with his advocate. She again requested details of how Mrs X should repay the direct payment money.
34. On 13 January Officer C sent an email to the advocate to arrange a meeting with her and Mr Y.
35. On 1 February Officer C raised concerns with her manager about the lack of contact from the advocate. She received a response from the advocate later that day.
36. On 6 February 2023 Officer C visited Mr and Mrs X with a social work assistant, Officer E, who would also be working with the family. She had experience of working with people with autism. The meeting was to discuss ongoing issues and the need for an assessment. The Council’s notes of the meeting state the family said they were struggling with the lack of communication from social services and were not told that Mr Y had been allocated a new social worker.
37. The same day Officer C contacted the advocate again asking her to contact Mr Y to discuss whether he would like her to be present at the care needs assessment.
38. Later in February Officer D, a social worker who had previously worked with Mr Y, returned to work following a prolonged absence. He contacted Mrs X who told him Mr Y was reluctant to accept support and felt let down by social services. Officer D agreed to visit Mr Y to attempt to re-establish a working relationship with him so he could engage with the Care Act assessment and access appropriate services. He also said he would follow-up the repayment of the £1295.75.
39. On 9 March Officer D visited the family. He discussed with Mr Y the benefits of engaging with a needs assessment. He also explained that adult social care services was undergoing a restructure. Mr Y said it would take him some time to establish a sufficient level of trust with the Council and, rather than have a social worker complete an assessment and then be re-deployed, he would rather wait until the teams were reconfigured before beginning an assessment. It was agreed that, to ensure some continuity during the period of organisational change, Officer D would stay in touch with Mr Y. He also discussed the repayment of the £1295.75 direct payment with Mr and Mrs X. He then sent an email to the debt team asking for an invoice for £1295.75 to be sent to them.
40. On 14 March the Council responded to the solicitor’s complaint. It apologised for the lack of communication regarding the change in social worker.
41. On 31 March the team manager visited the family to discuss their complaint. Mr Y said he was willing to engage in a needs assessment and a referral to an autism enablement service. The team manager explained that Mr Y would be allocated a new worker with experience of working with people with autism. The plan was for her to meet Mr Y and undertake a care needs assessment in the next few weeks.
42. On 17 April Officer D sent an email to the advocate advising that Mr Y had agreed to engage with an assessment and his case would be allocated to a new worker.
43. On 22 May the new worker, Officer E, visited Mr Y to begin a care needs assessment. Supported by the advocate
44. On 5 June Mrs X’s solicitor sent an email to Officer E saying Mr and Mrs X had been ready to pay the £1295.75 for several months but had still not been given the information to enable them to do so.
45. The following day Officer E chased up the request for an invoice to be sent in respect of the outstanding debt. She informed Mrs X’s solicitor that the finance team would send an invoice to Mrs X.
46. On 14 June the care needs assessment was completed. A referral was made to the autism enablement service.

Analysis

Direct payments

47. The Council accepts there was a delay in providing an updated invoice so Mr and Mrs X could repay the £1295.75. It has explained that there was a delay in processing the necessary form for a new invoice to be generated and sent to Mr and Mrs X. It says the social worker believed she had submitted the form to the finance team in March 2023. However, when this was raised as an outstanding issue, the new social worker found the form had not been received. She resubmitted the form and confirmed to Mrs X on 7 June 2023 that this would be processed as soon as possible. The Council says this has now been resolved.
48. I find the Council was at fault in failing to provide Mr and Mrs X with the updated invoice, causing them distress and inconvenience.

Delay

49. Mrs X says the Council delayed in providing an advocate for Mr Y and in completing a Care Act assessment resulting in his care and support needs being unmet.
50. The Council says there was a significant delay in obtaining Mr Y’s consent to refer him for advocacy services and progress the assessment because of his significant anxieties and concerns around trusting its staff. Mrs X says Mr Y’s anxieties and distrust of staff have increased over the years because of failings by the Council.
51. The Council’s case notes show it attempted to arrange an advocate in May 2022 but Mr Y did not wish to proceed with an assessment and support from adult social care until after he had moved home. The independent advocacy service advised the social worker to put the referral on hold until Mr Y was ready to accept their support.
52. It is clear from the Council’s case notes that officers regularly contacted Mr Y and Mrs X to see if he was ready to complete an assessment and be referred to the advocacy service. It was not until mid-August 2022 that Mr Y agreed to proceed. The Council made a referral to the advocacy service on 2 September 2022.
53. The Council’s case notes show there was a delay in obtaining an advocate. She then had difficulties in contacting Mr Y during October 2022 and was then absent from work due to illness. These delays were not the fault of the Council.
54. In January 2023 the social prescriber informed the social worker that the advocate had been in contact with Mr Y and he appeared comfortable speaking to her. However, the social worker was unable to contact the advocate and raised concerns about lack of contact with her manager in February 2023.
55. Following this there were various communications about the need for a new care needs assessment. However, Mr Y said it would take him some time to build trust with those involved before he would be happy to take part in an assessment. It was not until May 2023 that he agreed to engage with an assessment. The assessment was completed in June 2023.
56. I find that there was a significant delay in providing Mr Y with an advocate and in completing the Care Act assessment which resulted in a delay in providing a support service to him. However, the Council was unable to proceed because of Mr Y’s reluctance to engage with adult social care services. I therefore find no grounds to criticise the Council. Officers maintained regular contact with Mr Y and his family and he continued to receive support from the social prescriber during this period.

Changes of social worker

57. Between May 2022 and May 2023 Mr Y had four different allocated workers. The Council has explained that in September 2022 Officer A left the team responsible for Mr Y’s support so a new worker, Officer B, was appointed. Later the same year, Officer B left the Council so Officer C was appointed. In March 2023 the adult social care directorate was restructured and Mr Y’s case was re-assigned to a different team. He was therefore allocated a new worker, Officer E. However, she was already known to Mr Y and his parents as she had provided support alongside the previous worker. As she had experience in working with people with autism, the Council decided her skill set was best suited to provide the most appropriate support to Mr Y and his family.
58. The Council says there are occasions when workers leave teams or need to hand over clients’ cases for other reasons. So, it cannot always guarantee that a worker will be able to keep working with the same client in the long term. It has apologised to Mr Y and his family for any distress or upset caused by the changes in social work.
59. I find no grounds to criticise the Council for the changes in social worker given the reasons for this. However, I find it failed to properly communicate with the family about these changes, particularly in November 2022 when a new social worker was allocated. It failed to inform the family and they did not find out until January 2023 via Mr Y’s GP. This caused distress to Mr Y and his family.
60. The Council accepts communication about the change of workers could have been better and has apologised for this.

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Agreed action

61. The Council has apologised for the delays and the poor communication with Mr Y and his family and has offered to pay Mrs X and Mr Y £300 each in recognition of the inconvenience and uncertainty caused. We would normally recommend an apology and a payment of up to £500 for distress, so I consider this represents a satisfactory remedy which is in line with the Ombudsman’s guidance on remedies.

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Final decision

62. I find the Council was at fault in that it:
• delayed in issuing a new invoice to Mr and Mrs X so they could make the agreed re-payment; and
• failed to keep the family informed about changes in social worker.
63. However, I am satisfied the Council has offered a suitable remedy for the injustice caused.
64. I have completed my investigation on the basis that I am satisfied with the Council’s proposed actions.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman