London Borough of Islington (18 016 444)

Category : Adult care services > Disabled facilities grants

Decision : Upheld

Decision date : 27 Nov 2019

The Ombudsman's final decision:

Summary: Ind C complained about the way in which the Council dealt with their request for adaptations (a DFG) to their flat and their request to allocate a social worker. The Ombudsman found there was fault with the way the Council progressed the DFG request and a delay in responding to the complaint. The Council has agreed to apologise and provide a financial remedy for their distress.

The complaint

  1. The complainant asked us to use non-gendered pronouns. I have used ‘they’ instead of ‘he/she’, ‘their (needs)’ instead of ‘his/her needs’ and ‘them’ instead of him/her.
  2. The complainant, whom I shall call Ind C, complains that:
    • There was an unreasonable delay by the Council in providing them with the soundproofing they needed in the living room. At first, the Council only approved sound proofing in the bedroom. It took a long time before it agreed to soundproof the living room as well.
    • They is not happy the Council shared information with their Housing Association.
    • The Council failed to allocate a social worker within a reasonable timescale.

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What I have investigated

  1. I have investigated how the Council progressed Ind C’s DFG application(s) and if there was an unreasonable delay in allocating a social worker. I have only investigated if there has been fault with regards to what has happened until January 2019. However, I have included some facts that are more recent, for completeness.

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The Ombudsman’s role and powers

  1. 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)
  2. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
  3. 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)
  4. We may decide not to start or continue with an investigation if we believe there is another body better placed to consider this complaint (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

  1. I considered the information Ind C and the Council provided to me. I also carried out a telephone interview with several Council officers who have been involved with Ind C’s case. I shared a copy of my draft decision statement with Ind C and the Council and considered any comments I received, before I made my final decision.

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What I found

  1. Ind C completed and sent an Occupational Therapy (OT) self-referral form to the Council on 10 May 2018. In it, they said that:
    • Reason for referral: My sleep has been disturbed for three years.
    • The aspect of my disability most affected by this property is the noise from the flat above. I am kept awake or woken up every few hours. The person above has been spoken to and this is not an Anti-Social Behaviour issue. It is an issue whereby the floor of the flat above is the ceiling of my bedroom.
    • I want the ceiling lowered, and isolation put in between the lowered ceiling and the actual ceiling.
    • I would be extremely grateful if this grant was given as it would change my life by removing the noise barrier that affects my sleep and causes agitation and anxiety. It would improve my lifestyle so much, the noise insensitivity I manage with ear plugs, headphones and listening to mindfulness and relaxation music during the night. If I wasn’t woken up by creaking floorboards, I could sleep through and for longer.
  2. Ind C followed up their referral on 29 May 2018. Their email said: “I require the funding to lower ceiling and soundproof my bedroom ceiling”.
  3. An OT visited Ind C on 22 June 2018 to assess their request. Ind C said they told the OT they wanted soundproofing in the entire flat. However, the Council says Ind C did not ask at any point to soundproof any other area than their bedroom. It says Ind C asked to be assessed for insulation to the bedroom ceiling, because noise from the flat above affected their sleep. Ind C told me they did mention the entire flat.
  4. The records of the visit say that:
    • Ind C reported they could manage to cope with noise levels during the day. However, they is affected by disturbed sleep due to noise in the night.
    • Ind C agreed to send letters from their consultant and GP to the OT, which would confirm their medical conditions.
  5. Ind C did not send in a letter from their consultant, at this point in time. However, they sent a letter from their GP to the Council on 20 July 2018. The letter said Ind C has a possible diagnosis of MS. It also said Ind C is struggling with a range of symptoms including Hyperacusis (increased sensitivity to noise) and insomnia.
  6. The OT made a referral to the Disabled Facilities Grant Team (DFGT) on 05 July 2018, to consider the feasibility of resolving Ind C’s problem. However, the OT advised Ind C two weeks later that they should contact the Noise Team of their Housing Association. This was very confusing for Ind C who believed this meant their DFG request had been refused. They made a complaint about this, which was upheld. The Council acknowledged that: advising them to log a noise complaint with their Housing Association was not appropriate. The Council apologised for the distress this caused Ind C and for the delay in having their DFG application considered.
  7. Based on the information the OT obtained through the assessment, the OT completed an “OT Recommendation Form” on 1 August 2018. The form said, amongst others, that:
    • Area of difficulty: noise sensitivity resulting in difficulty sleeping through the night.
    • Recommended works: to investigate sound insulation for bedroom ceiling.
  8. On 22 August 2018, Ind C forwarded a letter to the Council from their hospital consultant. The letter said that:
    • Ind C was diagnosed with MS in 2009 and experiences neurological symptoms. These include fatigue and sleep disturbance. Their symptoms are exacerbated by their sleep disturbance.
    • They also suffers from noise sensitivity, which further exacerbates their sleep disturbance and other symptoms. They has been experiencing significant noise issues where they lives and, despite their attempts to address this with earplugs and sound-minimising headphones, their nightly sleep continues to be disturbed.
    • I understand they has applied for a DFG to improve the sound­proofing in their bedroom. I fully support their application for this grant.
  9. On the same day, Ind C told the senior OT that: “The only person the OT team needs to discuss my need with is me and I am very happy for you to contact my consultant neurologist or GP”.
  10. The Council sent a DFG application form to Ind C at the end of August 2018 and asked them to complete this. The Council also asked them to obtain permission from their housing association to carry out any work.
  11. Ind C completed the application and sent it to the Council on 10 September 2018. In the application form Ind C said, underneath point 14 “What works has been recommended”: sound proofing of the bedroom, living room, bathroom, hallway, kitchen and living room. The quotes for the building work they had obtained and submitted to the Council, were for the entire flat as well.
  12. On 28 September 2018, the Council told Ind C that it was waiting to hear from their Housing Association if it would agree to work being carried out at their apartment. It added that: Based on the information provided already, your application is likely to be approved.
  13. Ind C told the Council on 4 October 2018 that they submitted an application for soundproofing in their bedroom and the off room. However, they also wanted to apply for soundproofing of their living room / kitchen, hallway and bathroom. Ind C asked to confirm if the DFG application would consider soundproofing the whole flat, or only the bedroom and off room.
  14. The housing association initially wanted to have proof, via a sound test, that the works proposed would significantly reduce the noise from the flat above. However, it eventually decided on 12 October 2018 that the works could go ahead without this. It only approved work to the bedroom, because the OT recommendation had only mentioned this room.
  15. The Council told Ind C that: it only approves a disabled facilities grant for the works or adaptations recommended by the occupational therapist. They have recommended sound proofing works to your bedroom, which has now been approved. Any additional or variation to the works or adaptations would have to come from the occupational therapist who carried out the assessment.
  16. Work to the bedroom was completed by mid-November 2018.
  17. Ind C made a complaint about the Council’s decision on 24 October 2018. Ind C said they was confused why the DFG approval was limited to the bedroom area. Ind C said they fully explained to the OT the extent of their disability issues, and that they wanted the living room and bedroom areas soundproofed. They said they gave specific reasons and provided medical evidence.
  18. Ind C chased the Council for a response to their complaint on 10, 19, 22 and 26 November. 2018 The Council logged it as a complaint on 28 November and provided a response on 23 January 2019.
  19. Ind C wanted a social worker or OT to asses/assist with regards to a grant application they wanted to make to charities for cooker, flooring and for sound minimising headphones. Ind C also said they wanted to again: apply for a Disabled Facilities Grant for soundproofing in living room area. The Council sent a self-referral OT form to Ind C on 28 November 2018, so they could request an OT assessment to progress this.
  20. It was a different OT who carried out the OT assessment in January 2019. The OT form states that Ind C said they was severely noise sensitive and had been diagnosed with Hyperacusis. They said the noise in the living room affected their daily activities and they had to constantly wear earplugs and headphones.
  21. The OT obtained information about Hyperacusis. The information from “Action on Hearing Loss” and the NHS said that treatments, including cognitive behavioural therapy (CBT), exists to make a person less sensitive to everyday sounds. A person should not avoid noisy situations as this would make them even more sensitive to noise.
  22. The OT advised Ind C on 9 January 2019, that they should provide more information about their Hyperacusis. The OT suggested that Ind C should obtain a letter from their Consultant Neurologist that explains:
    • How Hyperacusis affects them.
    • What investigations were done to diagnose it.
    • What treatment Ind C is undergoing for it.
    • What the severity is of this problem.
    • If auditory desensitisation has been tried and whether the consultant supports the use of earplugs or noise reducing headphones.
  23. Ind C said the Council asked their GP to provide a copy of two years of medical notes, without their consent. Ind C said they refused.
  24. Ind C completed a consent form that said:
    • The Council could contact their Consultant Psychologist by phone or email.
    • The Council could contact their GP. However, they said they provided a letter from their GP so could see no reason for further contact.
    • They asked their Consultant Neurologist for a revised letter (so) they did not see any reason to contact him.
  25. Ind C subsequently provided:
    • A letter from their Consultant Psychologist, which said: ‘Ind C has sensory hypersensitivity, particularly to noise. They finds noisy environments distressing and this can manifest in physical pain’.
    • A letter from their GP, which said that: “Noise sensitivity resulting in pain has been longstanding. They continues to be affected by noise in the rest of their living space which affects their ability to concentrate and function on a daily basis”
    • A letter from their Consultant Neurologist, which said: 'They has been experiencing significant noise issues where they lives and despite their attempts to address this with earplugs and sound minimizing headphones, their nightly sleep and daily work and activities continue to be disturbed. I understand that they has applied for a DFG to improve the sound-proofing in their bedroom and living room areas. I fully support their application for this grant.
  26. The Council told me the decision to deny the application was made on the medical advice for treating Hyperacusis. There is consistent information in official websites (including the NHS site) that therapies recommended for hyperacusis consist of supporting the individual to build up gradual tolerance of noise levels rather than attempting to eliminate all noises. This should therefore be pursued through their GP.
  27. Ind C was unhappy with this decision and made a complaint. They also involved a solicitor who said that Ind C was considering to ask the Courts to Judicially Review the Council’s decision. The solicitor asked the Council on 20 February 2019 to review its decision.
  28. The Council responded to Ind C’s complaint on 21 March 2019. It explained again that their request for soundproofing was denied, because (for reasons explained above) there was no clinical ground to support their application. If they remained unhappy, they could ask for a second opinion on their grant application from a different OT or Manager.
  29. Ind C’s solicitor asked the Council on 1 April 2019 to review its decision. The solicitor reminded the Council that it had told Ind C on 28 September 2018 that “Based on the information provided already, your application is likely to be approved” (see paragraph 20 above). The Council reviewed the case and decided that, under the circumstances, it would be the best option to provide the adaptation to the living room, rather than going to Court.
  30. The Council informed Ind C’s solicitor on 12 April 2018 that it had now approved the DFG funding for sound proofing the living room. This was completed at the end of May 2019.
  31. Ind C says it was unethical by the Council to suggest desensitisation therapy for a person with Autism.

Assessment

  1. The records I have seen, show that, until 10 September 2018, Ind C was only asking for soundproofing their bedroom. This was further confirmed in a letter from their consultant at the time, who said he supported their request to soundproof the bedroom.
  2. Ind C indicated on 10 September 2018 in their DFG application form, that they also wanted other rooms to be soundproofed. They further discussed this with the Council on 4 October 2018. Although it was clear to the Council that Ind C was now also asking for sound proofing other rooms, there is no evidence this was brought to the attention of the OT service, before the Council made a decision on their DFG application in October 2018.
  3. Overall, it took too long to progress Ind C’s request for sound proofing. The OT assessment took place on 5 July 2018, but it took until 30 August 2018 before Ind C received a DFG application form. It then took until mid-October 2018 before the application was approved. However, some of this delay was due to the time it took the Housing Association to provide its approval.
  4. Ind C made an official complaint on 24 October 2018 about the OT’s recommendation and the Council’s decision to limit the soundproofing to the bedroom. The Council told Ind C on 23 January 2019 that the Grant Team Manager said that: where a service user is dissatisfied with the outcome / decision of their grant application, the client may request a second opinion from a different OT or manager. However, Ind C was unaware of this at the time and the Council failed to offer this second opinion. Another OT visited Ind C in January 2019 to assess them and assist them with their grant applications.
  5. There was a delay by the Council in responding to Ind C’s complaint of 24 October 2018.
  6. The above delays would have been frustrating for Ind C, for which the Council should apologise.
  7. I did not find fault with the OT’s request for Ind C to obtain further information from their Consultant Neurologist about their noise sensitivity. In effect, the OT wanted further information from their medical professional about how Ind C’s noise sensitivity affected them, what treatment they was undergoing for this, and whether avoiding daily noise was beneficial or actually harmful for their condition. The OT needed this to be able to reconsider if the requested adaptations would be necessary and beneficial. Ind C said they would obtain a response from their Consultant Neurologist. However, the letter did not provide a sufficient answer to the issues raised by the OT. As such, the Council concluded it had not received sufficient medical information / evidence to change its view that avoiding noise would not be beneficial.
  8. This is a decision for the Council to take on the merits of the case. The Ombudsman cannot substitute his judgement on what would be right for what a council has decided. He must consider whether there was fault in the way a council reached its decision.
  9. I found there was no fault with regards to the way through which the Council made its decision in 2019. The Council carried out an OT assessment, which captured Ind C’s needs. It was unable to obtain a copy of their medical records but considered the letters it received from their GP and consultants. Without fault, I will not question the merits of that decision (see paragraph 5 above).
  10. It is clear that it would have been beneficial in this case, if the OT could have had a direct conversation with Ind C’s Consultant Neurologist to discuss its findings (as summarised in paragraph 34 above). Ind C told me they had provided permission to the Council to contact their consultants. However, the consent form was not clear about that and the Council told me it had to be particularly cautious with Ind C around this subject.

Ind C’s complaint about the delay in social care assessment and allocating somebody to assist with completing charity application forms

  1. Following Ind C’s request for adaptations to their property, an OT carried out an assessment of their needs for adaptations, in June 2018. The assessment form says that:
    • OT observed that Ind C was mobile and drives herself to the shops.
    • Ind C reported they was independent with all transfers (chair / bed / bath / toilet).
    • Ind C manages all their personal care and domestic tasks independently.
  2. Ind C sent an email to the Council on 22 August 2018 that said, amounts others, that they wants ‘access to a social worker’. The OT service told the Council’s Access Team the following day, that Ind C would like a care needs assessment.
  3. Two weeks later, a Business Support Officer from the Council’s Adult Integrated Community Services Team, sent a form to Ind C to complete. The officer explained the Council needed more information about the difficulties they had, to be able to refer them to the social work team for an assessment by a social worker. The Council told me that the information in the OT report, did not indicate that Ind C had any needs for care and support. It therefore needed more information from Ind C to determine if a Care Act Assessment was required.
  4. The Council did not receive a response from Ind C and followed this up on 2 October 2018. The Council explained again to Ind C that they should explain what difficulties they has, what support they receives and what support they wants. It told Ind C that it would make a referral to the social care team once it received their response.
  5. However, Ind C said they was not willing to share any personal information with a business team. They wanted an appointment with an adult social worker and, if this was not something the Council could arrange, “then we have nothing further to discuss”. Ind C also said the social worker should be from the same race and experienced in LGBTI and Autism.
  6. Ind C did not subsequently come back to the Council to ask for a needs assessment. However, they did ask for support from a social worker with completing and submitting funding application request forms to send to charities etc.
  7. According to the Council’s records, the Council established in early November 2018, that Ind C wanted support from a social worker to complete funding applications for certain items of equipment, to send to send to charities/funds (see paragraph 26). One of the funds needed a social worker / charity worker to fill in the form online. The Council visited the funds’ website, which said a charity worker could complete the form. As such, it contacted Ind C and advised it would usually refer clients to local charities if a client needed support with form filling. This would also be quicker than waiting to be allocated a social worker.
  8. Ind C advised the Council that one of the charities said that only a professional, such as a social worker or OT, should contact them with regards to applications. The Council sent Ind C an OT referral form, as a result of which an OT was allocated to their case and visited them in January 2019 to carry out an assessment and assist Ind C with their applications.
  9. The OT assessment in January 2019 said that:
    • Ind C reported they is independent with all domestic and personal care tasks.
    • Their flat was observed to be clean, and tidy. The garden was also tidy.
    • They is able to access the community by car.
    • Client presented as fully mobile (no walking aids used), good mobility skills observed (strength, balance and gait), full range of movement al lower limbs, and able to complete all functional transfers without assistive equipment.
    • Ind C advised that they tries to exercise regularly, and practices yoga.
  10. If Ind C is unhappy about the support the OT / Council has provided since January 2019 with regards to completing the application forms, then they should first make a complaint about that to the Council.
  11. The Council carried out a care needs assessment in July 2019. It concluded that Ind C’s needs were not eligible for support via the Council. Ind C was unhappy with this decision and has since made a complaint to the Council about this.

Assessment

  1. The Council told me that the information it obtained through its OT assessment in 2018, did not indicate that Ind C had any eligible support needs that the Council should assess / meet.
  2. Despite the Council’s requests (see paragraph 52 to 55), Ind C did not provide the information the Council asked for in 2018 to progress their request for a care needs assessment by a social worker.
  3. Ind C asked the Council on several occasions in 2018, to allocate a social worker to them. However, it took until November 2018 before Ind C explained to the Council why they needed to allocate a social worker. Ind C needed this because: the specific nature and type of application they wanted to submit, necessitated the input of a social worker / OT. Once the Council was aware of this, it asked Ind C to complete an OT request form and it allocated an OT to support them.

Agreed action

  1. I recommended that the Council should, within four weeks of my decision:
    • Provide an apology to Ind C for the faults identified above, and the distress these have caused them. It should also pay them a financial remedy of £100.
    • Put a mechanism in place to ensure that, when a client is unhappy with the recommendation of an OT as part of a DFG application, they are informed at the earliest opportunity of their right to request another OT assessment.

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Final decision

  1. For reasons explained above, I found some fault with regards to the actions of the Council. I am satisfied with the actions the Council will carry out to remedy this and have therefore decided to complete my investigation and close the case.

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Parts of the complaint that I did not investigate

  1. I did not investigate Ind C’s complaint about the Council sharing information about them with the Housing Association, because this is an issue they should refer to the Information Commissioner's Office (ICO).

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Investigator's decision on behalf of the Ombudsman

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