Decision : Upheld
Decision date : 26 Jun 2019
The Ombudsman's final decision:
Summary: Mr X complains an appropriate remedy has not been provided for the upheld complaints about a care assessment. The Council delayed in assessing the needs of his twin sons who have autism. As a result the family had to manage without necessary adaptations for 10 months longer than should have been the case. A suitable remedy is now agreed.
- Mr X complains the Council has not provided an adequate remedy after upholding all his complaints regarding care assessments for his twin sons.
- He says the delay in providing an extra room to meet their needs has caused distress for all the family and in particular a lack of sleep for months.
The Ombudsman’s role and powers
- 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)
- 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)
How I considered this complaint
- As part of the investigation, I have:
- considered the complaint and the documents provided by the complainant;
- made enquiries of the Council and considered the comments and documents the Council provided;
- discussed the issues with the complainant;
- sent my draft decision to both the Council and the complainant and taken account of their comments in reaching my final decision.
What I found
- Mr and Mrs X have twin sons now aged six. The children, who I will call C and D, both have a diagnosis of autism spectrum condition with sensory processing difficulties. However, the condition affects them differently and they have very individual needs.
- The Council appointed a social worker for C and D in November 2015. The social worker made a referral to the adaptations team in January 2016. In February 2016, an occupational therapist (OT) visited the family at home to assess C and D’s needs. The OT made a referral to a specialist in Autism and Sensory processing. The specialist OT visited the family at home on 12 April 2016.
- Mrs X contacted the Council in April 2017 expressing concern about the OT home assessment and the process to date. She also asked for copies of policies and details of legal requirements and timescales.
- The OT identified minor adaptations to be carried out at the property. A minor adaptation is defined as any adaptation costing under £1,000. If adaptations are required costing over £1,000 then a disabled facilities grant (DFG) application is made. DFG’s are administered by the Borough Council and would usually be made via an OT referral.
- Minor works were carried out in the home in September 2016. This included a sensor which triggered an alarm if a child got out of bed and a lockable door to the kitchen.
- Mr and Mrs X say their concerns about the suitability of the alarm were ignored. While it was suitable to use with one child, their differing needs and sensory issues meant it caused distress to the other child.
- The door provided to the kitchen was of poor quality and quickly warped because it was not painted and was subject to moisture. The door had a lock to keep C and D out of the kitchen but when the door warped the lock did not always work.
- Mr and Mrs X explained C and D, due to their different needs, could not sleep in the same room. They said the suggestions put forward by the OT were not practical. The OT had suggested using the living room for one bedroom but as Mr and Mrs X’s three older children still lived at home this was not practical. Mr and Mrs X say they relied on the help and support of their adult children which is why they remained at home.
- Mr and Mrs X say they felt the OT and social workers did not listen to them or communicate in an effective way which meant they had to complain. They feel this changed the relationship with the officers and ultimately distracted from providing the help they needed.
- Mr and Mrs X made a formal complaint about the lack of action by the Council in providing suitable adaptations for their sons. The Council dealt with the complaint through the statutory children’s complaints procedure. It produced the stage two investigation report on 15 August 2017. This upheld only some of Mr and Mrs X’s complaints and so they escalated the complaint to stage three. The review panel considered the complaints and wrote to Mr and Mrs X on 10 April upholding all of their complaints and making several recommendations. This included a recommendation for the Council to take prompt action to ensure the adaptations were agreed and completed.
- A new OT started working with Mr and Mrs X in April 2017. This OT had specialist training in sensory needs. She recommended a separate room for D because of his significant sleep problems. The OT completed her assessment on 12 May and it was signed off by her manager on 22 May.
- The OT arranged for a technical officer from the Borough Council to visit Mr and Mrs X’s home to consider a DFG application on 24 July 2017
- An application for a DFG was approved by the Borough Council for an additional room. Mr and Mrs X are in the process of appointing a builder and having the work completed.
- Mr and Mrs X complain the Council did not provide a suitable remedy for their complaints which were all upheld by the stage three review panel.
- On the whole, the Council has agreed with the review panel’s recommendations and will implement them. The Council has pointed out it cannot mandate attendance at Children in Need reviews from other agencies. It also says that it is not necessary or proportionate to send a written summary after every visit. The Council has explained why it will not implement these recommendations in full and this is based on its professional judgement. There is no basis to criticise these decisions.
- Looking at the recommendations in connection with the adaptations the Council accepts there was “a delay of some months” in respect of the DFG. The information provided shows the process was still not complete after 18 months. The Council says assessment for young children is an ongoing process due to developmental changes which can be rapid at that stage. It also says it has to be aware it is spending public money and so will look at all possible avenues before committing to high cost adaptations.
- The OT’s initial recommendation was for assistive technology and other minor adaptations. The OT took the view there was insufficient evidence to support major adaptations at that time. I am satisfied this was the professional judgement of the OT and so will not criticise the decision made at that time to carry out minor adaptations and try assistive technology.
- The new OT started in April 2017 and produced her final assessment by 12 May, just one month later. By 24 July she had arranged a meeting at Mr and Mrs X’s property with a technical officer to consider a DFG. The new OT was able to reach a view on what was required within one month and take action on this within two months. The initial OT assessments in 2016 took much longer. The minor works were not actioned until seven months after the initial assessment.
- I consider there has been avoidable delay in determining what adaptations were required for C and D. The Council accepts delay of six months. It says all avenues had to be explored including behaviour management to ensure the full extent of C and D’s needs were known. Looking at all the information available I consider the delay in this case amounts to 10 months. Even allowing time to try out the minor adaptations first and taking into account C and D’s stage of development, I consider the Council should have been able to make a full assessment within eight months. This delay is fault and resulted in the family being without the required extra room for 10 months longer than they should have been.
- I also find fault in the length of time the Council took to complete the statutory complaints process. The guidance “Getting the Best from Complaints – Social Care Complaints and Representations for Children, Young People and Others” gives timescales for the different stages. The stage two investigation should take a maximum of 65 working days. In this case the investigating officer met with Mr and Mrs X on 23 May and the Council sent its stage two adjudication letter on 3 October. This is more than 65 working days.
- Mr and Mrs X then had to request a review within 20 working days and the review panel had to take place within another 30 working days. If I assume the whole timescale was used, the review panel should have been held by 13 December. The review panel did not meet until 28 March.
- It is noted that Mr and Mrs X did not make a specific complaint about delays in the statutory process. I noted the delays when considering the complaint and it would not be appropriate for me to ignore this even when a specific complaint is not made. Delays in the complaints process can cause further distress to service users and their families and can mean a delay in getting the correct services. As the complaints process is a statutory process, a council is required to keep to the published timescales. The delays in this case are fault.
- To remedy the injustice caused to Mr and Mrs X and C and D by the Council’s fault, it will, within one month of my final decision:
- Make a full written apology to Mr and Mrs X;
- Pay them £3,500 to recognise the distress and inconvenience caused as a result of the delay in assessing and recommending appropriate adaptations. In reaching this figure I have taken account of the impact on all the family; and
- Pay £250 to acknowledge the distress and time and trouble as a result of delays in the statutory complaints procedure.
- I have completed my investigation with a finding of fault for the reasons explained in this statement. The Council has agreed to implement the actions I have recommended. These appropriately remedy any injustice caused by fault.
Investigator's decision on behalf of the Ombudsman