Summary: There was delay in the Council’s processing of Ms B’s application for adaptations to her flat. The Council also failed to respond to Ms B’s complaint. The Council has agreed to apologise to Ms B in writing, pay her £150, give her a decision about installing an L-shaped bath/shower and consider including timescales in its policy on delivering adaptations.

The complaint

1. Ms B says the Council has failed to properly consider her needs in its assessment for a disabled facilities grant and has delayed providing adaptations. She says the Council has also not responded to her complaint.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), 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)

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How I considered this complaint

4. I have discussed the complaint with Ms B. I have considered the documents she and the Council have sent, the relevant law and guidance and the Council’s comments on the draft decision.

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What I found

Law and guidance

Disabled adaptations

5. Disabled Facilities Grants (DFG) are provided under the terms of the Housing Grants, Construction and Regeneration Act 1996. There is also detailed guidance on good practice.
6. Councils have a statutory duty to provide grant aid to disabled people for certain adaptations.
7. The Council will need to check that the proposed works are:
• necessary and appropriate to meet the disabled person’s needs.
• reasonable and practicable depending on the age and condition of the property.
8. Councils will often consult an occupational therapist (OT) from the social services department to carry out the assessments.
9. The maximum grant that can be paid in England is £30,000 and the grant is means tested.
10. The Act says housing authorities should approve or refuse a grant application as soon as reasonably practicable and no later than six months after the date of the application. The grant may be paid in instalments or in whole after the works are completed. But it should not be paid later than 12 months of the application date.
11. The guidance has set performance targets for councils to achieve DFG which it says the Council should aim to achieve in 95% of its adaptations.
12. This is split in three stages:
• Stage 1: initial enquiry to OT recommendation.
• Stage 2: OT recommendation to approval of scheme.
• Stage 3: Approval of scheme to completion of works.
13. The timescales for urgent adaptations are:
• Stage 1 (5 working days), stage 2 (30 working days) and stage 3 (20 working days
14. The timescales for non-urgent adaptations are:
• Stage 1 (20 working days), stage 2 (50 working days) and stage 3 (80 working days

What happened

15. Ms B has a rare genetic condition which results in joint hypermobility and fragile skin. She also has agoraphobia and depression.
16. Ms B rents a one bedroom flat from a housing association. She says she contacted the Council in October 2016 to ask for an assessment by an occupational therapist. She says the Council was not responding to her requests because her issues were more related to her mental health than her physical health.
17. The Council’s notes show Ms B contacted them on 5 January 2017 and the Council made an appointment on 5 February 2017 for Ms B to be assessed by an OT on 29 March 2017 at the Council’s assessment clinic.
18. The assessment took place on 29 March 2017 and the OT completed the report on 11 May 2017.
19. The assessment noted Ms B’s physical and mental health conditions. The OT said:
• Ms B’s toilet was higher than 16 inches and Ms B was going to buy a step for this. Apart from this, she was safe in toilet transfers.
• Ms B was fine with bath transfers and did not need any equipment.
• Ms B felt trapped in her flat and wanted to build an open space in her loft to relax and to improve her mental well being.
20. The summary of the OT’s assessment was
• The OT identified no area of need for Ms B.
• She made no recommendations for any works.
• She had advised Ms B that she did not meet the DFG criteria.
21. Ms B’s recollection of the outcome of this assessment is different. She says the OT had told her there was no reason why she would not receive help with the issues she raised but she had to carry out a home visit first.
22. The Council’s notes say the OT made no promises but said she would discuss the case with the manager.
23. The Council says Ms B contacted the service on 15 May 2017 and was told she did not meet the criteria for provision of services. The Council sent Ms B a letter on 15 May 2017 explaining the outcome of the assessment. It said she did not meet the criteria for a DFG and that the case would be closed to the OT. It said that, if she wanted to place her case on the OT waiting list for a home assessment, she should contact the initial assessment team.
24. The Council says Ms B did not agree with the outcome of the assessment and asked for a further assessment.
25. Ms B’s recollection is different. She says she spoke to the OT who told her she would not do the home assessment as she had been promoted. The OT said she would put Ms B on the waiting list for an assessment. Ms B then complained to the manager.
26. The Council offered Ms B an OT assessment at home and this took place on 16 June 2017. The OT said:
• Ms B’s toilet was on a plinth. The OT observed that Ms B’s feet were not fully on the floor but she was on tiptoes. Ms B demonstrated that she used a small bucket to rest her feet on. The OT recommended a bath step. Ms B said she had asked the housing association to remove the plinth, but it had refused. The OT agreed to ask the housing association to remove the plinth if this was feasible.
• Ms B demonstrated getting in and out of the bath. Ms B said she liked to have a sit-down bath as it reduced the pain in her body, but there were times that she was unable to bathe. The OT recommended an over the bath shower.
27. The notes show the OT made an appointment for Ms B and the OT to visit a local day centre / college which helps people with mental health problems. The OT phoned Ms B after the assessment and asked her whether she would attend an informal visit but Ms B said she was not interested and the OT cancelled the appointment.
28. The OT sent her recommendation for the works to the housing association on 18 September 2017. She wrote to Ms B on the same day to explain what had been recommended. She said the Council would close the case and the housing association should be in touch about the works.
29. The housing association wrote to the Council on 31 October 2017 and said that Ms B could qualify for DFG to carry out the works. The housing association therefore asked the Council to assist Ms B in making a DFG application.
30. Oddly, the OT then rang the housing association on 8 November 2017 to ask about the progress of the works and the housing association said the works were scheduled for 2 November 2017 but Ms B had delayed the work.
31. The Council closed the OT’s case on 30 November 2017, but reopened it on 4 December 2017. The OT attended Ms B’s flat on 23 January 2018 to take measurements. The OT wrote to the housing association on 25 January 2018 to ask for written consent to carry out the works and sent through the request for the works to the Council’s surveying team on 14 February 2018.
32. The OT chased the Council for the written consent on 2 July 2018 and the housing association said it had not received the original consent request so the OT emailed it again.
33. The Council says the surveyor left messages on Ms B’s phone between August and October 2018 but received no response. The surveyor took no further action after October 2018.
34. Ms B complained to the Council on 5 October 2018 but received no response to her complaint.
35. Ms B complained to the Ombudsman on 18 February 2019. She said:
• There had been a lot of delay in the process. She had been contacting the Council since October 2016 but was not assessed until 29 March 2017. She says the OT told her during the first assessment that she would receive a second assessment at home.
• Nobody contacted her about the second assessment and the assessment was only offered after she contacted the Council again and complained.
• The works which had been identified in June 2017 had still not been carried out.
• The OT made inappropriate comments during the assessment on 7 June 2017. The OT said that going to church and praying to God would help Ms B’s disability. She said that if Ms B had a more visible disability like Down’s syndrome, she may get help.
• The OT said Ms B should consider counselling as this could improve her agoraphobia and she would be able to leave the house more frequently.
• The Council did not properly consider her mental health condition or her physical conditions in the assessments of her eligibility for a DFG.
36. The Council chased the housing association on 12 March 2019 for the consent form.
37. The Council responded to Ms B’s complaint on 13 March 2018 and said:
• Ms B made a telephone referral in January 2017 and was assessed on 29 March 2017. At this assessment, the OT recommended a further assessment at home which was completed on 13 June 2017. It said the time between the referral and the assessment was within the Council’s timescales but it apologised that Ms B had had difficulties in contacting the Council and in obtaining confirmation of dates.
• It expected officers to conduct assessments professionally and take the client’s views and concerns into account. The key focus of the Council’s intervention would be to improve Ms B’s independence through advice on how to access services in the community. It apologised if Ms B felt that her desires and health concerns were not fully acknowledged.
• The DFG grant for the bathroom works was approved in February 2018. It said there were two reasons for the delay. The housing association had not given its written permission to do the works and the surveyor had been unable make contact with Ms B.
• It apologised for not responding to her October complaint and said this was due to the excessive demand of the service.
• It offered a review of her assessment as Ms B had said her needs had changed.
38. The housing association returned the signed consent form on 5 April 2019.
39. The outcome of the OT’s review assessment dated 3 July 2019 was:
• The OT said the toilet issue had been resolved.
• He agreed that Ms B needed on overhead shower. Ms B said she wanted to replace the bath with an L-shaped bath/shower, but that she was going to self-fund this. The OT said he would discuss this with his manager.
• Ms B explained the problems with the flat in detail. She felt the lounge was too dark, there had been a lot of disrepair problems and insect infestations. She had problems with her next door neighbours who were students and who were noisy. She also had difficulties with her downstairs neighbour who lived a nocturnal lifestyle and whose cooking smells and cigarette/marihuana smoke drifted into her flat. These matters were subject to complaints to the housing association and the Housing Ombudsman had also been involved.
• These issues were outside of the OT’s remit, but the OT discussed whether Ms B would not prefer to move as she was so unhappy in her current flat. Ms B said she could not move from the immediate area as she needed to live close to her mother who was her only support system. This limited her options for rehousing.
• The OT considered Ms B’s request for a loft conversion to provide her with a roof terrace, but said he would not recommend this as he could not justify that it was necessary and proportionate or that it was reasonable and practical.
• Ms B said she was in a position to self-fund the works but needed the OT to request the housing association’s permission. The OT said that it would be better if the request came from a mental health professional as Ms B was essentially saying that she wanted the conversion to improve her mental well being and a mental health professional would be better placed to comment.
40. The OT discussed the request for an L-shaped bath/shower with his manager. The manager said they needed medical evidence to make a decision. Ms B gave her verbal consent for the Council to access her medical information on 9 July 2019, however the GP needed a written consent. The Council informed Ms B on 5 August 2019 that the GP needed a written consent. The Council reminded Ms B about the consent on 23 September 2019 and 9 October 2019, but has not received it yet.
41. The Council has made further comments on the complaint in its reply to the Ombudsman and said:
• Ms B contacted the service on 15 February 2017 and was assessed on 29 March 2017. That assessment concluded that Ms B was able to access all essential facilities and no further recommendations were made. Ms B was sent the outcome of the assessment on 15 May 2017 and was not satisfied with the outcome. She was then offered a further assessment.
• The OT had been interviewed and emphatically denied making the inappropriate comments during the June 2017 assessment.
42. I asked the Council for its internal policy on how it processes applications for DFG and the timescales. The Council referred me to its online policy but this did not include timescales.

Analysis

Delay

43. Ms B says there have been delays in her application for adaptations to her flat.
44. It is difficult to comment on events before 2017 as there is no record. There was overall fault in the way the Council managed the process and there was delay. There was also poor communication throughout the process.
45. Ms B had her first assessment in March 2017. It is difficult to establish what the OT said to Ms B at this assessment. Ms B says the OT told her there was no reason why she could not get help but she would need a further assessment at home. The Council’s records say the OT made no promises but had to discuss the case with the manager.
46. At some point following this assessment, the OT, presumably after discussion with the manager, then decided that Ms B did not meet the criteria for a DFG and that she would close her case without any further assessment. However, the Council failed to inform Ms B of that decision and this is fault.
47. It was only after Ms B contacted the Council on 15 May 2017 that the Council informed Ms B of its decision. Ms B then complained and a further assessment was agreed.
48. The further assessment resulted in a recommendation of works to the bathroom but there was further delay in delivering these works.
49. The OT recommended the works on 16 June 2017, but did not send the recommendation to the housing association until 19 September 2017. This was a delay by three months and was fault.
50. The housing association replied on 31 October 2017 to say it would not fund the works as it expected the works to be funded a DFG. The Council should therefore have started the DFG approval process at this stage. However, the Council closed the case and then reopened it on 4 December 2017. That was further fault.
51. The DFG was approved in February 2018, but there was then further delay. The Council blames the housing association for not responding to the request for written consent. Although I agree the housing association should have responded quicker, there was fault in the Council’s failure to chase or progress the housing association’s response. The Council sent the request in January 2018 but did not chase this until July 2018, 7 months later. The Council resent the request in July 2018 and then did not chase it until March 2019, after the Ombudsman became involved.
52. The second reason for the delay given by the Council is Ms B’s failure to respond to the surveyor’s calls when he tried to make the appointments to do the works.
53. Firstly, it is not clear what works the surveyor was going to do without the housing association’s written consent. Secondly, there was no explanation why it took from February 2018 when the DFG was approved until August 2018 for the surveyor to contact Ms B, which is a significant delay and fault. Finally, I accept that the process may have been delayed if Ms B was not responding to telephone calls from the surveyor, but again, it seems the Council then allowed the matter to drift. If Ms B was not responding, I would have expected the Council to write to her and to set her a deadline for response. If she did not respond by that time, the Council could have closed the case.
54. I agree that the delay after July 2019 is not the Council’s fault as it was waiting for Ms B’s consent to access her medical information.
55. Therefore, my overall conclusion is that at least some of the delay was the Council’s fault. I am also concerned that the Council’s policy does not have any timescales on how it processes applications which is fault in itself.

Assessment process

56. Ms B says the OT made inappropriate comments during the June 2017 assessment but the OT denies making the comments. In the absence of any other evidence, I am not able to say there was fault.
57. I find no fault in the OT’s suggestions and proposals for mental health support. I accept that Ms B is of the view that mental health support cannot help her and she therefore will not engage with it. However, there is no fault in the OT suggesting that Ms B should engage with mental health services and providing her with information of local support that is available.
58. Ms B says the OT has not properly considered her mental health condition and her wellbeing, particularly in relation to her request for the loft conversion/roof terrace. The most recent assessment goes into detail about Ms B’s reasons for seeking the roof terrace and her mental health.
59. However, the OT’s view is that this does not meet the criteria of a DFG. He applies the correct test which is that the works have to be of necessary and appropriate to meet the disabled person’s needs and reasonable and practicable depending on the age and condition of the property. The Ombudsman cannot question the merit of a decision if there is no fault in the way the Council has made the decision.

Complaints process

60. There was fault in the Council’s response to Ms B’s complaint. Ms B complained in October 2018 but the Council failed to provide any response until Ms B came to the Ombudsman.

Injustice

61. I have considered the injustice Ms B has suffered as a result of the fault. The main injustice is the delay in providing the shower and its failure to respond to her complaint.
62. In terms of the shower, it is not clear whether Ms B still wants an overhead shower as she now says she needs an L-shaped bath/shower. The Council has not made a decision about whether the L-shaped bath/shower is needed to meet Ms B’s needs and is waiting for Ms B’s consent to see her medical information before it can make a decision. Therefore I have made the recommendation dependent on Ms B’s consent to provide the information.

Agreed action

63. The Council has agreed to take the following actions within three months of the final decision. It will:
• Apologise to Ms B in writing for the fault.
• Pay Ms B £150 for the delay in processing her application and its failure to respond to her complaint.
• Provide a decision to Ms B about her request for an L-shaped bath shower within 2 months of receiving Ms B’s consent for the disclosure of the medical information.
• Consider reviewing its policy to ensure that it has timescales for DFG applications.

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Final decision

64. I have completed my investigation and found fault by the Council. The Council has agreed the remedy to address the injustice.

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Investigator's decision on behalf of the Ombudsman