Summary: Mrs X complained about the Council’s handling of her application for disabled adaptations. In particular, she says the Council agreed to a downstairs extension then changed its mind. The Council was at fault for telling Mrs X the extension was approved before completing its assessment. It has already apologised for this. There was no fault in the way it reached a later decision to approve a through floor lift and ground floor toilet.

The complaint

1. Mrs X complained about the Council’s handling of her application for disabled adaptations. In particular, she says the Council agreed to a downstairs extension then changed its mind. Mrs X says the Council’s proposed option is not suitable as there is insufficient turning room for her wheelchair. She has yet to receive any adaptations to meet her needs causing her distress and inconvenience.

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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. 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)
4. 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

5. I have considered the information provided by Mrs X in writing and on the telephone. I have considered the Council’s response to my enquiries.
6. I gave the Council and Mrs X the opportunity to comment on a draft of this decision. I considered any comments I received in reaching a final decision.

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What I found

The relevant law and guidance

7. Local housing authorities have a statutory duty to provide grant aid to disabled people for a range of adaptations to their home. The adaptations might include installing a ramp, providing a downstairs bedroom or bathroom or providing a stairlift.
8. A council has to be satisfied that work is necessary and appropriate to meet the needs of the disabled person and that work can be carried out.

The Council’s procedures

9. The Council’s leaflet ‘adapting your home’ sets out that ‘Creating an accessible ground floor bedroom and/or bathroom will usually involve adapting existing rooms. …Providing additional rooms by building an extension will only be considered in exceptional circumstances’. ‘Before providing additional rooms we would look at all the options with you first, including moving’. It sets out the options for when a ground floor bathroom, bedroom and/or toilet may be provided in certain circumstances including if:
• existing rooms on upper floor levels cannot be reasonably adapted to make them suitable for safe use.
• you have a deteriorating condition which means that ground floor rooms would meet your future needs better than adapting the first floor.
• you are unable to use a lift (stair lift or through lift) safely, it is not structurally feasible to provide a lift or a lift would restrict manoeuvring.
10. The Council uses Occupational Therapists to assess the need for adaptations. If they recommend an adaptation the recommendation is passed to the Council’s Accessible Homes Team. For adaptations costing over £10,000 the request is reviewed by a panel of Occupational Therapists, Housing Managers and Accessible Homes staff to discuss if the property is suitable for the work.

What happened

11. Mrs X is a council tenant. She has five children. She has physical and mental health conditions which affect her mobility. She moved into the property in Spring 2017. Mrs X says her physical condition worsened and so, in March 2018, an Occupational Therapist (OT) visited Mrs X to assess for potential adaptations to the property.
12. The OT recommended a ground floor bathroom be installed with a patio area and wheelchair access from the house.
13. In late August 2018, a Council officer rang Mrs X to say the Council panel had agreed to the creation of a downstairs bedroom and level access shower with toilet. During the call Mrs X requested a bath rather than shower be fitted. She also asked about creating level access to the garden. The officer said they would add this to the request for an extension. They explained there was a delay before a surveyor would be allocated. Mrs X later emailed the Council to request a hard standing at the front of her property. The Council wrote to Mrs X in early September 2018 to advise her referral for an extension was on a waiting list to be allocated to a surveyor.
14. In late September 2018 Mrs X’s case was considered again by the Council’s panel, due to her request for further adaptations. The panel deferred its decision. It requested further information on Mrs X’s needs and the suitability of the property for adaptation. The case was allocated to an OT to gather more information on the specifics of the scheme to meet Mrs X and her family’s needs.
15. In early October 2018, the OT carried out a home visit to Mrs X. Following the visit, the OT sought further information about Mrs X’s medical conditions and the Council placed the adaptations on hold.
16. The OT telephoned Mrs X in November 2018. They explained they had considered information about her medical conditions and following their visit did not consider it appropriate to progress an extension. They considered a stair lift or through floor lift would enable her to get up and downstairs safely. They also recommended a downstairs toilet. Mrs X did not agree to the recommendations. The OT requested a surveyor visit to assess the feasibility of their recommendations.
17. Mrs X spoke to the OT again in December 2018. They apologised for the delay in a surveyor visiting. They told Mrs X the surveyor had advised, based on photographs they had seen, that installing a ground floor toilet looked feasible. The notes record the OT ‘explained there were inconsistencies with the conditions she reported and what the medical professionals involved in her care confirmed’ Mrs X remained of the view an extension was the only suitable solution to her problems. In the notes the OT recorded it was not appropriate to support an adaptation that would discourage Mrs X from moving around. ‘There is however a risk that she is not always going to be able to manage the stairs safely due to the impact of her condition and means to get up and down the stairs needs to be explored’.
18. In February 2019, a surveyor visited Mrs X with the OT to consider the viability of a stairlift or through floor lift as an alternative to the extension. The surveyor confirmed it would be possible to install a ground floor toilet. They considered it possible to install a stairlift or a small through lift from the living room to the bedroom. Mrs X says there is no space for the lift as it would reduce the living space she needed because of the size of her family. Also she would be unable to turn around in her wheelchair when downstairs. The OT noted Mrs X said she walked from the bedroom to the bathroom using her walking stick. The OT noted they explained she was eligible for adaptations but the money needed to be used in the most reasonable and practical way to meet her needs. In the notes the OT recorded they apologised and said they ‘understood a mistake had been made telling her an extension would be provided before the confirmation of her conditions had been completed’.
19. Mrs X complained to the Council in February 2019. She wanted to know why the Council had delayed the matter and changed what was agreed. She requested another assessment. The OT wrote to Mrs X summarising their views. They said they had assessed Mrs X as requiring a safe means of getting up and down stairs and a ground floor toilet. Adaptations to install a toilet and through floor lift were the most reasonable and practical way to meet her needs. They noted Mrs X said she needed to remain in bed to be comfortable and offered support to assess Mrs X’s seating needs. They noted remaining in bed would not be good for Mrs X’s health in the long term.
20. The Council responded to Mrs X’s complaint later the same month. It said that in agreeing adaptations ‘we confirm conditions, diagnoses and prognosis with medical professionals involved with the person being assessed. Unfortunately, this was completed after your case was discussed by the Housing Panel who agreed the adaptations. Unfortunately, the medical evidence you have supplied does not confirm that your conditions are such that you need to remain on the ground floor’. It said Mrs X told the OT she needed to stay in bed most of the day and if she was downstairs this would help her stay part of family life. The OT had concerns minimal movement would have a negative effect on Mrs X’s ability to move in the longer term. They recommended a downstairs toilet and lift.
21. Mrs X remained unhappy and the Council reviewed the complaint in March 2019. It noted some of the pages from the medical evidence she submitted were missing and asked her to provide these. It sought her permission to contact medical professionals and asked for a letter from her GP or consultant confirming her diagnosis. The Council wrote to the relevant medical professionals and the OT contacted Mrs X’s consultant for their input.
22. The OT noted Mrs X walked to the toilet currently and did not need a wheelchair turning space in the bedroom or lounge. They also noted the lift would have a safety feature which would mean it would not operate if someone was underneath it. The Council continued to seek evidence from medical professionals but did not receive a response. Mrs X provided a letter from her GP in July 2019 which stated that home adaptations would help her. In August 2019 Mrs X provided a letter from a specialist confirming the need for a house adaptation although the letter did not state what housing adaptations were required. The Council contacted Mrs X’s specialist again in October 2019 but did not receive a response.
23. The Council responded to Mrs X in November 2019. It said it had considered the medical evidence but this did not justify a ground floor extension. The proposed through lift and downstairs toilet were a reasonable and practical way of adapting her home so she could use it safely. The Council said the adaptations could be arranged swiftly and she should contact the OT if she wished to progress them.
24. Mrs X remain unhappy and contacted the Council. In a further email to Mrs X the Council reiterated that the evidence did not support the provision of an extension on clinical grounds. It apologised for saying an extension was possible but said this decision was made before it had completed the assessment. It said she was quickly informed of the mistake. It referred her to the Ombudsman.

Findings

25. In March 2018 Mrs X was visited by an OT who recommended a ground floor extension and following this, in August 2018, Mrs X was told the adaptations were approved. In November 2018, the Council then told Mrs X the extension was no longer going ahead. The Council was at fault when it told Mrs X the extension was approved before it had fully completed the assessment. This raised her expectations that she would receive an extension and caused her frustration and distress when it was later refused. The Council has already apologised for this. This is an appropriate remedy.
26. The Ombudsman cannot decide what adaptations Mrs X requires. That is the Council’s role. My role is to consider whether there was administrative fault in the process followed. When deciding whether to fund adaptions the Council must decide whether the work is necessary and suitable to meet the person’s needs. The Council considered the evidence provided by Mrs X and sought additional information from relevant medical professionals including Mrs X’s GP and Consultant and an Occupational Therapist. Government guidance and the Council’s policy explain that adaptation of an existing property should always be considered as the first option before considering whether to extend a property.
27. The Council decided Mrs X’s needs could be met with a ground floor toilet and through lift. Mrs X does not agree with the decision but as there is no fault in the way the Council reached the decision I have no grounds to question it.
28. There was a significant delay in the Council responding to Mrs X at stage 2 of its complaints’ procedure. However, this was not due to Council fault. The Council contacted medical professionals and sought additional information from Mrs X which contributed to the delay. In any case this did not cause an injustice as the decision remained that the adaptations recommended by the OT, for a through lift and ground floor toilet, were suitable.
29. The Council has not progressed these adaptations as Mrs X has not agreed to them.

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Final decision

30. I have completed my investigation. The Council was at fault for wrongly advising Mrs X it would provide an extension. It has already apologised which was an appropriate remedy. There was no fault in the way it reached the decision to approve alternative adaptations.

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Investigator's decision on behalf of the Ombudsman