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Durham County Council (20 008 382)

Category : Adult care services > Disabled facilities grants

Decision : Not upheld

Decision date : 13 May 2021

The Ombudsman's final decision:

Summary: Miss B complained the Council had not properly considered whether her property needed adaptations to meet her needs. As a result she does not have suitable bathing facilities. There was no fault by the Council.

The complaint

  1. I call the complainant Miss B. She complained the Council had not properly considered whether her property needed adaptations to meet her needs. As a result she does not have suitable bathing facilities.

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The Ombudsman’s role and powers

  1. 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)
  2. 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

  1. I considered the complaint and documents provided by Miss B and spoke to her. I asked the Council to comment on the complaint and provide information. I sent a draft of this statement to Miss B and the Council and considered their comments.

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What I found

Summary of the relevant law and guidance

  1. People with disabilities may need adaptations to make their homes easier to live in. Assistance with this is available through Disabled Facilities Grants (DFGs). DFGs are administered by Local Housing Authorities (LHAs).
  2. DFGs are available irrespective of tenure. They may be paid to owner occupiers, private tenants and social housing tenants. DFGs are means tested.
  3. In most cases, the first step in obtaining adaptations is to get an assessment done by an occupational therapist. This will usually be done by a referral to social services, either directly from a social housing landlord or from the LHA that is dealing with an enquiry about a DFG.
  4. The occupational therapist will then decide whether and, if so, what adaptations are needed. The occupational therapist will make a report to the landlord or the LHA.

What happened

  1. Miss B has a long-term, incurable skin condition that causes painful abscesses and scarring on the skin. She also has other health conditions which mean she has limited mobility.
  2. Miss B lives in a housing association property. There used to be a bath in the property but it was replaced with a wet room with shower about five years ago. In September 2020 Miss B asked to be assessed by an occupational therapist for a bath in the property.
  3. An occupational therapist assistant carried out a telephone assessment a couple of weeks later. She concluded that due to Miss B’s other medical conditions and deteriorating mobility, there were concerns about her being able to access a bath and bathe safely. Miss B was unhappy with the decision. The Council agreed to carry out an in-person assessment at the end of October.
  4. The same occupational therapist assistant and an occupational therapist visited Miss B. She said she would be able to transfer in/out of a bath provided the edge was low enough for her to be able to lift her legs over. Both occupational therapists were concerned whether she would be able to manage either a normal bath or a walk-in bath. They were also concerned about infection from Miss B’s abscesses if she was sitting in bath water. They offered other equipment to assist Miss B with bathing, but Miss B did not consider they would help.
  5. Miss B provided a copy of a letter to the Council from the advanced nurse practitioner at her doctor’s surgery. This said Miss B felt she was no longer able to manage her condition with the bathing facilities she had. The nurse said she felt it would be of benefit to have a bath installed.
  6. The occupational therapist spoke to the duty doctor at Miss B’s medical practice. He advised there was no medical indication for immersion in water to manage Miss B’s medical condition.
  7. The Council confirmed its decision that it did not consider the provision of a bath was appropriate.
  8. Miss B complained to the Council and it responded in November 2020. It explained the history and how it had reached its position. Miss B complained to us.
  9. In January 2021 her GP requested a further assessment of Miss B’s bathing needs. The Council said that unless there was further medical information then it would not carry out a further assessment. The GP has not provided any further information to the Council.

Analysis

  1. My role here is not to assess what needs Miss B has and what adaptations are needed to meet those needs. I am considering whether the Council has properly considered and addressed itself to all the relevant information when making its decision.
  2. When Miss B was unhappy with the outcome of the first telephone assessment the Council agreed to carry out a face-to-face assessment. This meant the occupational therapists could gain a full understanding of Miss B’s needs. They considered there were risks to Miss B using a bath. But they contacted Miss B’s GP to see if there were medical needs that indicated a bath was necessary. The advice from the GP was that Miss B’s condition did not necessitate a bath. Miss B says she has never seen that doctor so does not consider he was familiar with her, her medical history or her condition. She says she has received consistent advice that for her bathing is the appropriate way to manage her condition. She said that she had this conformed in a telephone conversation with another doctor at her practice.
  3. I understand Miss B’s view but I do not consider there was fault in how the Council considered this. It met her and asked her doctor for their view. I cannot comment on the views expressed by the doctor.
  4. In response to the recent contact it has been left that if the GP provides more information about Miss B’s bathing needs the Council will consider it. So it is open to Miss B to approach her GP to see if they can provide more medical evidence to the Council.

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Final decision

  1. There was no fault by the Council.

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Investigator's decision on behalf of the Ombudsman

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