Summary: We uphold Mr X’s complaint. The Council took too long to review Mrs X’s care and support and action his request for additional funding for Mrs X while he was unable to care for her temporarily. It also failed to consider a request for residential respite care and took too long to respond to the complaint. This caused avoidable distress and time and trouble for which the Council has apologised and offered an appropriate payment. The Council will re-offer the payment and provide evidence of the changes to services it says it has made.

The complaint

1. Mr X complained the Council mishandled his request for additional funding for care and support for his wife Mrs X when he needed to have surgery and so would be unable to care for her temporarily. He said this caused avoidable inconvenience and distress.

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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(1), as amended)

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How I considered this complaint

4. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
5. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Relevant law and guidance

6. Where a council agrees a person has care and support needs which meet national eligibility criteria, it must issue them with a care and support plan which sets out their needs, explains which is an eligible need and says how much funding the person is entitled to. It should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
7. Statutory Guidance explains a council should review a care and support plan at least every year, on request or in response to a change in circumstances. The purpose of a review is to see how a care and support plan has been working and to decide if any revisions need to be made to it. The council should act promptly after receiving a request for a review. (Care and Support Statutory Guidance, Paragraphs 13.19-21 and 13.32)
8. A council should revise a care and support plan where circumstances have changed in a way that affects the plan. Where there is a proposal to change how to meet eligible needs, a council should take all reasonable steps to reach agreement with the adult about how to meet those needs. (Care Act 2014, sections 27(4) and (5))
9. A direct payment (DP) is money a council provides to a person to arrange their own care and support.

What happened

10. Mrs X has a disability and is eligible for care and support. Mr X is her informal carer. The DP funding is used for:
• Agency care
• Assistance with cleaning, ironing and gardening
• Day centre attendance
• A sitting service.
11. Mr X needed to go into hospital for surgery in February 2025. He told the Council in January he would not be able to provide any of Mrs X’s physical care for 12 weeks after the operation. He asked for residential respite care for Mrs X for two weeks.
12. Records indicate the Council’s duty team were dealing with Mrs X’s case initially. Mr X’s request for additional funding or residential respite care was not approved or implemented by the time he had surgery.
13. The Council allocated the case to a social worker who offered a meeting to discuss a temporary increase to Mrs X’s care package. Mr X said in an email on 20 February that he could not do any of Mrs X’s personal care or continence care. He set out a schedule of care provision by the agency for the 12-week recovery period (which was at week three then). Mr X said before the operation, Mrs X was having 16.5 hours a week of care and two days at the day centre (11 hours of personal care and 5.5 hours for the other things set out in paragraph 10). He said they would require an additional 167.5 hours of care. This was a shortfall of 29.5 hours to what the Council had proposed. He also asked for an additional day at the day centre for 10 weeks. He asked for the Council to increase the DP accordingly.
14. In the middle of March, the Council’s social care team emailed Mr X to say an increase of 26 hours a week had been agreed. (four calls a day, or three on day centre days, to support with personal care, dressing, continence, nutrition and transport to and from the day centre and sitting service) and an additional day at the day centre for 10 weeks. The temporary DP was £813 a week.
15. Mr X said he was not happy and wanted to make a formal complaint. he said the award was only from 3 March, when his surgery was on 6 February. He noted the DP account was soon to run out.
16. The Council sent us a copy of Mrs X’s care and support plan. It said a social worker had carried out a review on 4 March and a temporary increase in hours had been agreed. It noted Mr X said there was a surplus in the DP account which he wanted replenishing.
17. A social worker and Mr X spoke in the middle of March. She said she had sent Mr X’s complaint to the complaints team. The social worker emailed Mr X after saying the Council had agreed from 10 February to 27 April, after which there would be a review:
• Three days a week at the day centre
• 30.5 hours a week of care
• Total cost a week: £918.
18. Mr X said the calculation was still not correct, but he wanted to bring the matter to an end and so suggested leaving things as they were.
19. Mr X emailed the Council in May to say he had not received a complaint response or had a further review of Mrs X’s care and support. He chased the Council for a response several times and said in the middle of June that he was going to approach the LGSCO.
20. The Council’s first response to the complaint said:
1. The duty worker tried to deal with his request.
2. They wrongly assumed care was being managed by only one provider
3. He tried repeatedly to clarify matters.
4. Workers made mistakes on calculations despite his repeated efforts. The Council was sorry for this
5. The allocated worker did not follow up with prompt communication, booking visits or contact and was unprepared to deal with his request despite his clear emails. This was not the standard of service expected. It offered him £50 to recognise his inconvenience.
6. The Council would:
1. Change processes to ensure smooth communication between the access team and social care team; to ensure priority cases were highlighted
2. Hold a DP awareness session and workshop for all assessment team staff
3. Share DP factsheets and workflow of DP processes with relevant staff.
21. Mr X escalated his complaint to the second stage of the Council’s complaint procedure. He raised a number of detailed points around communication and service delivery. The Council offered increased amount of £240 and then £350. It accepted it had failed in how it had handled Mrs X’s case.
22. Mr X initially accepted the Council’s offer. There was then an exchange of emails between him and council officers. For an unknown reason, the payment was not actioned and so Mr X approached the LGSCO.

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Findings

23. The Council was at fault. It should have conducted an urgent review of Mrs X’s care and support and ensured she had care and support to meet those needs that Mr X was unable to meet while he was incapacitated. The failure to conduct a prompt care and support review was not in line with Care and Support Statutory Guidance as I have set out in paragraph seven. It caused Mr X avoidable distress. There was also a missed opportunity to explore residential respite care which was something Mr X had requested. The Council also took too long to deal with Mr X’s complaint which was fault causing avoidable time and trouble chasing up the Council.
24. There is no evidence Mrs X’s needs were not met. Mr X had access to DP funding in Mrs X’s account which he was using to fund the additional care and the increased funding was eventually agreed and paid, albeit belatedly.
25. The personal injustice is remedied by the payment of £350 the Council has offered and the changes to processes in paragraph 20(f) minimise the chance of the same thing happening again.

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Agreed Action

26. Within one month of my final decision, the Council should pay Mr X the £350 it has already agreed and provide evidence of the changes to its processes set out in paragraph 20(f)
27. The Council should provide us with evidence it has complied with the above actions.

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Decision

28. I find fault causing injustice. The Council has already offered action to remedy the injustice and it has agreed to take that action.

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Investigator's decision on behalf of the Ombudsman