Summary: There was a delay of about two months in arranging Mr D’s direct payment. This was fault by Kent County Council which has a legal duty to meet a person’s eligible care needs. It meant Mr D lacked support with personal care to enable him to wash. The Council will apologise and pay him £250 to reflect a loss of service to which he had a legal entitlement.

The complaint

1. Mr C complains for his adult son Mr D about Gravesham Borough Council (Gravesham) and Kent County Council (Kent). He says:
1. Gravesham delayed in dealing with Mr D’s application for a Disabled Facilities Grant (DFG) and in organising for the works to be completed. He also complains about the client charge of £20,000
2. Kent delayed in carrying out a social care assessment which led to a delay in Mr D receiving care
3. There was a failure to take into account Mr D’s future needs.
2. Mr C says Mr D was without care at a time when he needed it and he still cannot have a bath or shower.

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The Ombudsman’s role and powers

3. 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)
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 considered Mr C’s complaint to us, Kent’s response to his complaint and both councils’ responses to my enquiries as well as the documents described later in this statement. I discussed the complaint with Mr C.
6. Mr C and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law, guidance, policies and procedures

7. A council must carry out an assessment for any adult with an appearance of need for care and support, applying national criteria to decide if a person is eligible for care. (Care Act 2014, section 9)
8. If a council decides a person needs support, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether they meet any eligibility criteria and sets out how the council is going to meet them. It should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
9. A social care assessment should be carried out over an appropriate and reasonable timescale taking into account the urgency of needs. Councils should give the person an indicative timescale and keep them updated. (Care and Support Statutory Guidance 2014, Paragraph 6.24)
10. Kent has a triage policy it uses to respond to requests and referrals for assessments. Priority two cases should have assessments within four to six weeks. They are where the person has a critical need requiring urgent intervention and cannot access basic facilities.
11. Social services authorities have a duty to meet a person’s eligible unmet needs. (Care Act 2014, section 18).
12. DFGs are for people with a disability who need adaptations to their home. They must be awarded if an applicant meets specified conditions, including that the council considers the work is necessary and reasonable to meet the disabled person’s needs. DFG’s are means tested. The calculation is similar to the way a council calculates entitlement to housing benefit. If the applicant’s contribution costs more than the work, they are not entitled to a DFG.
13. A council should give the applicant a decision as soon as reasonably practicable. It must be within 6 months of the date of the application. The council usually has to pay the grant in full no later than 12 months from the date of the application, unless it has told the applicant it will defer payment.
14. Gravesham’s procedure for processing DFGs is:
• The housing grants team receives a referral from Kent’s assessment and enablement service. The referral includes an OT assessment.
• The housing grants team sends out a preliminary enquiry form. The applicant fills this in with some basic financial details
• The housing grants team enters the information onto a database which calculates the applicant’s contribution and sends out a letter setting out an estimate of the applicant’s contribution
• When the applicant confirms they want to go ahead, the OT sends the housing grants team their recommendations.
• The Homes Improvement Agency completes a formal grant application and sends it to Gravesham’s housing grants team. The application needs to include the OT recommendations, a schedule of works and estimate of costs from two builders, agent’s fees, mandate letter from the applicant and a recent utility bill, evidence of income and savings
• The housing grants team approves the application (or otherwise) within 6 months of receiving it. Gravesham has a target time for approving valid applications within 20 working days.
• Once the DFG is approved, the applicant has 12 months to complete the works.
15. A second type of grant, Home Improvement Grants (HIGs) are discretionary. This means a council can provide an HIG but it does not have to. HIG can be for smaller adaptations and other types of work to homes. Councils should have a policy setting out the help they will give.
16. Gravesham provides fast-track grants which are supposed to be quicker than a DFG and are for adaptations costing £7000 or less where aids and adaptations are urgently needed and if not carried out ‘could directly affect the occupant’s health and safety and welfare.’ Applicants do not have to go through the means test if the cost of the works does not exceed the grant limit. Applicants are assessed by an OT who considers whether quicker adaptations are needed due to urgent health conditions.
17. Home Improvement Agencies (HIAs) help older or disabled people to repair, improve, maintain or adapt their homes. HIAs support a client through the DFG or other grant application process. Some HIAs are run by councils and others are independent organisations.

What happened

18. Mr D has a progressive condition. He uses a wheelchair and lives alone in a flat he owns. Until last year he worked full time.
19. Mr D contacted Kent’s social care team at the start of July 2019 after a fall. An officer completed an initial contact assessment with him over the phone. Mr D said he had fallen and not been able to get back up and he lived alone. He said he did not fall regularly but it made him realise he needed to look into support. The Council decided to allocate an occupational therapist (OT) to assess Mr D as the senior officer screening the referral felt he may need equipment. The case was classed as priority two.
20. The ambulance service also contacted the Council about Mr D in July, having attended his flat when Mr D called emergency services after a second fall. An officer from Kent called him to discuss the ambulance’s service contact. Mr D said he had fallen again and suffered a minor head injury. He said he was happy to wait for the OT to assess him.
21. Mr D’s father phoned the Council at the start of August to raise concerns about Mr D’s condition deteriorating and he may need care in the mornings and evenings. An officer told him Mr D’s assessment would be prioritised.
22. An OT assessed Mr D in the middle of August. The OT noted Mr D had fallen recently and this had knocked his confidence with transfers from and into his wheelchair. Mr D reported his condition had deteriorated and he was struggling with transfers. He was washing at the sink since the fall and not using his adapted shower. The outcome was Mr D was eligible for social care. His estimated weekly personal budget was £161.
23. The OT completed an action plan at the end of the assessment. The agreed actions for the Council were:
• The OT was looking into adaptations to the kitchen, windows, ramps at the back;
• The OT was to look at adapting the main bathroom as Mr D could not use the existing adapted en suite due to its size and shape;
• The OT was going to speak to a social worker to see if Mr D needed further assessments.
24. The OT completed a care and support plan at the end of August. This set out Mr D’s needs and outcomes, how they could be met gave his estimated personal budget of £114 a week. The plan set out a timetable of how Mr D could use the personal budget (45 minutes care in the morning and 30 minutes in the evening.)
25. The OT visited Mr D at the start of September. She went through the details of the home adaptations. After the visit, the OT sent a letter to Gravesham’s housing grants team asking for a DFG and listing the adaptations she was recommending. The housing grants team sent out a preliminary enquiry form to Mr D. He returned the form at the start of October. Gravesham carried out a financial assessment and sent Mr D a letter with his estimated contribution (over £20,000). The letter suggested Mr D use an HIA to assist with the DFG application. This was within a week of Mr D returning the forms.
26. Gravesham’s Housing Partnerships Manager emailed Kent’s OT in October saying he had spoken to Mr D, and, as he had a large client contribution for the DFG, the only option at the moment would be to pursue the shower adaptation and Gravesham would do this under a fast track grant (which was not means tested)
27. A direct payments officer from Kent visited Mr D at the start of October. She explained how direct payments worked. (Direct payments are money a council gives to a person so they can arrange their own care and support).
28. A care and support plan at the start of October looks to be same in content as the plan described in paragraph 24, but the weekly personal budget was £161. It is signed and dated by a case manager and team manager. The care and support plan said Mr D wanted a direct payment and to use an agency or to employ a personal assistant to deliver his care.
29. In the last week of October, Mr D advised Kent’s social care team that he had arranged a care agency to assist him in the mornings and evenings.
30. Kent sent Mr D a copy of his care and support plan at the end of October. He received the first direct payment in November.
31. Mr D’s father complained to Kent in November raising the same issues he has made in his complaint to us.
32. Mr D had another fall in the middle of November. The ambulance service told Kent about the fall. Mr D’s father also contacted Kent to say he was concerned about his son. He asked for a further assessment as he felt Mr D’s condition was deteriorating. Mr D’s father explained to me that the reason for asking for another assessment was that they were concerned Mr D may soon need to use a hoist and they thought this should be considered when planning the layout of the new shower room/toilet. Kent’s OT called Mr D who said he did not need any more care at that time.
33. Kent’s OT and Gravesham’s grants officer spoke at the end of November. The grants officer said she had spoken to Mr D about a fast track grant.
34. The OT and grants officer visited Mr D at the start of December. The purpose of the visit was to discuss funding the adaptations and to reassess Mr D’s ability to transfer from his wheelchair after the latest fall. The grants officer told Mr D about the fast track grant which he could use to fund adaptations, starting with the bathroom. The OT noted that Mr D would contact his father following a fall and he had a lifting cushion to assist him up.
35. Kent’s complaint response of December 2019 said:
• It accepted it did not respond to Mr D’s request within usual timescales and it was sorry for this. The delay was because of setting up the direct payment.
• Mr D worked full-time and this was the reason for the high contribution to the DFG
• Gravesham agreed a discretionary grant for adaptations to the bathroom. Works would start in January or February
• Officers had discussed options for the future with him.
36. In January, the HIA sent Gravesham a schedule of works for it to approve. Gravesham responded the same day approving the works.
37. In March 2020 an officer from the HIA, Kent’s OT and Gravesham’s grants officer visited Mr D. The OT emailed the housing grants officer after the meeting with amended detailed recommendations for the fast track adaptations.
38. Gravesham told me:
• it had not yet received the formal application form from the HIA and until it received this, it could not proceed with the fast track grant for the shower.
• it was awaiting a second schedule of works for the rest of the adaptations as a second grant.
• it had agreed to the works and wanted to proceed as soon as possible but Mr D still needed to complete the formal application
• the freeholder had delayed in providing concern to do the work and it still did not have consent and so it had asked Mr D to contact the freeholder directly.
39. At the time of writing this statement, the HIA’s staff were furloughed.

Was there fault?

Complaint a: Gravesham delayed in dealing with Mr D’s application for a Disabled Facilities Grant (DFG) and in organising for the works to be completed. He also complains about the client charge of £20,000

40. There is no fault in Gravesham charging Mr D for a DFG. As Mr D works full time and the charge is high, Gravesham used discretion to agree a discretionary grant which has no charge. This is in line with the law described in paragraphs 14 and 15 and there is no fault.
41. I do not find there was a delay by Gravesham in dealing with Mr D’s case. It dealt with the pre-application matters promptly (within a month). And, it has not yet received the formal grant application from Mr D (via the HIA) which triggers the six-month timescale for approval and 12-month timescale to complete the works. The HIA staff are furloughed at present and while this has caused a delay, it is not within anyone’s control and so Gravesham is not at fault. Gravesham has also identified a problem with the freeholder not giving permission for the works and this is also not within its control. There is no evidence of delay by Gravesham in the records.

Complaint b: Kent delayed in carrying out a social care assessment which led to a delay in Mr D receiving care

42. Kent’s policy is to assess priority two cases within four to six weeks and it achieved this in Mr D’s case. And Care and Support Statutory Guidance says an assessment should be completed within a reasonable timeframe. In most cases we consider four to six weeks to be an acceptable timeframe to complete an assessment. I am satisfied Kent responded within an appropriate time frame and so there is no fault. Mr D did not give Kent any information when he contacted the social care team to suggest he needed a more urgent assessment. Kent acted in line with Care and Support Statutory Guidance and its triaging policy and there is no fault.
43. However, there was a delay in setting up the direct payment funding which was not made available to Mr D until November. The Council recognised this delay in its complaint response and apologised. The delay was fault because Kent has a duty to meet Mr D’s eligible needs and it did not do so. Once it had determined Mr D was eligible at the start of October, it should have taken prompt action to ensure his direct payment was actioned. I consider the delay of about a month caused avoidable inconvenience to Mr D as he was unable to fund a care agency to provide him with personal care in the mornings and evenings.
44. I am satisfied the direct payment has enabled Mr D to fund care to support him have a strip wash until the adaptations to his main bathroom are completed, thus meeting one of his eligible care needs.

Complaint c: There was a failure to take into account Mr D’s future needs.

45. There is no legal requirement on either council to consider Mr D’s future needs.
46. Statutory guidance requires Kent to review Mr D’s care and support plan at least annually and to agree changes where appropriate. If Mr D’s needs change (for example, his mobility declines and he needs to use a hoist), he should be advised to contact Kent which will complete a review with him and decide whether changes are needed to his care and support plan or if further adaptations are necessary. There is no fault by either council.

Agreed action

47. I have upheld the complaint about a delay by Kent in arranging a direct payment for Mr D. This meant he was without support to enable him to wash for about two months (from the end of August when Kent assessed him as eligible for care and completed a care and support plan, until November when the first payment was made). To remedy the injustice, within one month, Kent will apologise and pay him £250.

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Final decision

48. There was a delay of about two months in arranging Mr D’s direct payment. This was fault because Kent has a legal duty to meet a person’s eligible care needs. It meant Mr D lacked support with personal care to enable him to wash. Kent has accepted my recommendation to apologise and pay him £250 to reflect a loss of service to which he had a legal entitlement. It will do so within one month of this statement.
49. I have completed the investigation.

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Investigator's decision on behalf of the Ombudsman