Decision : Not upheld
Decision date : 30 Aug 2019
The Ombudsman's final decision:
Summary: Mr B complains the Council failed to take appropriate and timely action to support his need for disabled adaptations to his home. The Ombudsman finds that the Council acted without fault in consideration of his needs for disabled adaptations. There were minor delays, in responding to some emails for example, but these did not lead to significant injustice for Mr B.
- The complainant, whom I shall call Mr B, complains the Council failed to take appropriate and timely action to support his need for adaptations to his home, required as a result of his disability.
The Ombudsman’s role and powers
- We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. 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)
- 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
- I considered all the information provided by Mr B about his complaint. I made written enquiries of the Council and took account of the information it provided in response. I provided Mr B and the Council with a draft of this decision, giving them the opportunity to comment.
What I found
- Mr B is the owner-occupier of a three-storey house occupied by him and his wife. He is disabled, having sustained injuries to his back in 2010 and 2012. He also has arthritis in his knees and hip. Mr B’s wife also has health needs as she suffers from brittle asthma and mental ill health.
- Mr B contacted the Council at the end of November 2017. He considered the difficulties he was having in his home with everyday tasks such as washing and toileting could only be remedied through major adaptations to his home, and he wished to apply a Disabled Facilities Grant (DFGs).
- DFGs are provided under the terms of the Housing Grants, Construction and Regeneration Act 1996. The legal framework for DFGs is set out in the Housing Grants, Constructions and Regeneration Act 1996.
- Mandatory DFGs are available, subject to a means test, for essential adaptations to give disabled people better freedom of movement into and around their homes and to give access to essential facilities within the home. The council which deals with DFG applications is the housing authority, in this case the District Council. The housing authority before deciding an application needs to confirm adaptations are necessary and appropriate to meet a disabled person’s needs. The housing authority must therefore consult with social services authorities to decide this, and information may come from an assessment of need by an occupational therapist (OT) or by private contractors.
- An assessment visit was made by an OT in January 2018, as well as a joint visit by the OT and an officer from the District Council as housing authority to consider the most appropriate adaptation for moving between the floors of Mr B’s home. The OT then prepared a Statement of Need to support the grant application to the District Council. The Statement said that equipment or minor adaptations would not remove risks present in the current bathroom or on the stairs. It noted Mr B was dependent on walking sticks for all mobility and was awaiting a health service assessment for an electric wheelchair. It said, “He felt he was at risk of falls on the stairs, cannot manage essential personal hygiene and struggles with the dimensions and design of the current shower cubicle”. The proposed adaptation deemed necessary and appropriate by the OT to meet Mr B’s needs was a level entry shower, auto toilet, and through-floor lift, plus the widening of doorways.
- Based on the information provided by the OT, the District Council agreed a schedule of works for the adaptations deemed reasonable and practicable to meet Mr B's needs on 5 March 2018. The specification at this time was for a 'standing' lift which Mr B would walk into, which would allow him access the first floor.
- In the meantime, Mr B had sent the Council an email saying he now he had a new diagnosis of aggressive osteo-arthritis in his left hand, an inability to weight bear and an increase in his weight. At the beginning of May he advised the District Council that his mobility had deteriorated greatly since the initial OT assessment and he had suffered several falls. Mr B told the Council he now had a wheelchair on order, but its weight meant that the lift which has been specified would not be adequate. He had spoken with the lift supplier and what was now being mooted was a larger lift, which would also give access all three floors of the property. He said that this was a better longer-term option, anticipating future needs.
- Because of this reported change, the District Council had to consider whether a reassessment of Mr B’s needs was necessary and so it liaised with the County Council about this. In addition to liaising with the District Council, the OT contacted Mr B and advised a further visit would be necessary to look at the specifications for the through-floor lift and consider how Mr B’s needs might best be met. The visit took place on 11 May, after which the OT acknowledged Mr B’s preference to have access to all three floors of the home, but advised him the District Council would have to sign-off any alterations under the DFG as it must consider the most cost effective way of meeting needs , and it was likely to take the view that all the needs on the housing statement (access to a room for sleeping, a suitable bathroom and WC, and safe movement around the home with access to all essential facilities) could be met on the first and second floors.
- On 20 June a revised schedule of works was agreed by the District Council for new works that were deemed reasonable and practical and this was forwarded to Mr B to obtain quotes. Mr B was unhappy with what was proposed, and said that what needed to be agreed to meet his family's needs was a three floor lift to provide access to a first floor wet-room (which should have the auto-toilet and seat lifter) and access to the second floor bedroom; level access to the garden from the kitchen; and a lift in the garden for drive access.
- At the end of June, the OT visited Mr B again, with a senior OT. Mr B told the officers that he would not be reliant on the wheelchair and could ‘hobble’ to the wet room etc as required. The matter appeared to be at an impasse as no agreement was reached on what was acceptable to both Mr B and the Council. As an interim measure the County Council liaised with the District Council to arrange the installation of the auto-toilet ahead of any wet-room to relieve some of the difficulties Mr B was experiencing. The OT then set about attempting to gather medical evidence from Mr B’s GP about his mobility now and in the foreseeable future, to inform decisions about appropriate adaptations. Liaison between the two councils continued, and there were conference calls which included Mr B and officers from both councils.
- In correspondence with the GP, the OT sought clarification of Mr B’s current diagnosed conditions, the impact on his functional ability and anticipated prognosis over the next three to five years, and clarification of his mobility needs for the foreseeable future. The OT noted Mr B had expressed the opinion that he would be able to walk with a stick on each floor of his home if he had a through floor lift to avoid the need for him to use the stairs. The OT asked if that was also the GP’s opinion.
- In the meantime, in addition to chasing and clarifying responses from the GP, the OT continued to liaise with the District Council and there were conference calls which included Mr B and officers from both councils.
- Mr B’s GP confirmed that Mr B’s arthritic knees were causing him some problems but ‘not sufficiently bad enough for the surgeons to be keen to operate’. Mr B said he would submit medical reports which it seemed the GP had not seen. Mr B did submit reports, but these dated from 2013/14. Mr B said it had been the Council which had introduced the matter of wheelchair access within the home, when he had been happy with the proposal for a standing lift. He suggested he could be reassessed if he needed full wheelchair access to his home in future. The Council took the view that the information it now had presented a mixed picture of Mr B’s needs, ranging from someone who has limb pain problems sitting and standing, to being in need of an indoor/outdoor wheelchair and so longer term wheelchair dependent, to information from Mr B that he could walk, backed up by the medical opinion it had recently received.
- By the beginning of November 2018, the Council considered that there was not enough evidence to support the full wheelchair accessible adaptation at this time. However, given his reports about the number of times he had fallen, the Council felt that it needed to consider an adaptation that would be fit for the future, that is a suitable wheelchair accessible adaptation. The Council suggested engaging an independent consultant to assess the medical impact of Mr B’s disability and anticipated future impacts, but at Mr B’s suggestion it first contacted the GP again.
- In October 2018 Mr B had applied to the District Council for planning permission for an external lift shaft. That application was refused on design grounds on 27 November. Then, on 3 December, the District Council refused the application for a DFG, on the grounds that the works applied for were not necessary and appropriate, nor reasonable and practicable. In reaching this view the District Council took into consideration that ongoing enquiries of medical professionals at this point had not satisfied the County Council that a wheelchair lift was needed, so there was still uncertainty about what was required to meet needs.
- In December 2018 the Council said it would now look at engaging an independent consultant. In February 2019 when a consultant in spinal injury was found to undertake this assessment, Mr B declined this as he did not feel the person selected was appropriate. He said he had seen this consultant before, and he did not feel he would be independent, and he wanted a specialist in arthritis.
- The Council once again sought information from the GP, whose view was that a lift to three floors or other major adaptation was not necessary. The Council then decided one further assessment would be completed, this time by a Principal OT, and that took place on 29 April 2019. The recommendations from that assessment were for re-housing in the longer term, and possible stair rails or a stair lift to the first floor in the short to medium term.
- There were some minor delays by the Council, for example in responses to emails due to officers being on annual leave, but those delays did not lead to significant injustice for Mr B. Insofar as the substantive issue is concerned, the Council took appropriate action to seek to establish Mr B’s needs and to review what was required to meet those needs when it received information from him about his worsening condition and conflicting information from medical professionals. It engaged appropriately and throughout with the District Council as the housing authority dealing with the DFG and took steps to secure the installation of the auto-toilet while the decision on the DFG was still pending.
- I have completed my investigation on the basis set out above.
Investigator's decision on behalf of the Ombudsman