Summary: Miss X complains about how the Council has dealt with her occupational therapy assessment. The Council is at fault as it delayed in carrying out an occupational therapy assessment, delayed in pursuing the recommendations of the assessment and delayed in responding to Miss X’s complaint. The delays caused distress, frustration and avoidable time and trouble to Miss X which the Council has agreed to remedy by apologising and making a payment of £1000 to her and taking further action.

The complaint

1. Miss X complains about how the Council has dealt with an occupational therapy assessment and its recommendations for adaptations. In particular, she complains the Council:

• delayed in carrying out an occupational therapy assessment and then carried out an inadequate assessment;
• delayed in carrying out the recommendations of the occupational therapy assessment;
• failed to respond to her complaint.

2. As a result Miss X has been unable to access her bathroom to bathe and has been unable to use her wheelchair and independently leave her property for longer than necessary. Miss X also cannot use her kitchen to prepare food.

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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 an organisation’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 complaint and the information provided by Miss X;
• discussed the issues with Miss X;
• made enquiries of the Council and considered the information provided;
• invited Miss X and the Council to comment on the draft decision. I considered any comments received before making a final decision.

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What I found

Law and guidance

6. Disabled Facilities Grants are provided under the terms of the Housing Grants, Construction and Regeneration Act 1996. Councils have a statutory duty to give grant aid to disabled people for certain adaptations. Before approving a grant, a council must be satisfied the work is necessary, meets the disabled person’s needs, and is reasonable and practicable.
7. The Council’s complaints procedure provides it aims to respond to complaints within 20 working days. If for any reason it will take longer to reply then the Council will let the complainant know. The complainant can contact the Council if they are unhappy with the Council’s response. The Council will consider the most appropriate way to respond and provide a response within 20 working days.

What happened

8. Miss X lives in a property owned by a housing association with her partner and son. The tenancy of the property is in Miss X’s partner’s name. Miss X suffers from a number of medical conditions and has restricted mobility. She uses a wheelchair outside.
9. The Council’s records show Miss X contacted the Council in June 2020. Miss X said she had bought a powered wheelchair but could not use it as she needed a ramp over the doorstep and over steps on the footpath. Miss X said her partner and son had to lift the wheelchair over the steps so she could use it outside. The Council’s record notes Miss X was unable to manage stairs and was living downstairs.
10. In July 2020 the Council allocated Miss X’s case to an occupational therapist to visit Miss X to carry out an assessment.
11. The Council’s records show an officer next spoke to Miss X in July 2021. She apologised for the delay in carrying out the assessment and notes an occupational therapist would visit Miss X in the next couple of weeks. Miss X also asked to explore the possibility of having a stair lift.
12. The occupational therapist visited Miss X in early October 2021. The assessment notes Miss X was unable to access the bathroom and unable to go outside due to the steps. She recommended a disabled facilities grant (DFG) application to include a stairlift. She also recommended a ramp so Miss X could access the community. The record of the visit set out the plan for Miss X which included a raised toilet seat, ramp for front access, and a stairlift to be funded by a disabled facilities grant.
13. Miss X considers the assessment was inadequate as the visit was brief and the occupational therapist had to be prompted to look at the kitchen. The assessment and record of the visit do not record an assessment of the kitchen. In response to my enquiries the Council has said that during the assessment Miss X demonstrated she could move around the property on crutches and did not show a need for an adapted kitchen.
14. In November 2021 Miss X contacted the Council to complain that she had not been able to contact the occupational therapist for an update. The occupational therapist later advised Miss X she was waiting for permission from the housing association as it owned the property.
15. In December 2021 Miss X made a complaint to the Council about a number of issues including the delay in carrying out the occupational therapy assessment, an inadequate assessment, the occupational therapist not responding to her emails or calls and not taking seriously the risks to Miss X of not being able to leave the house. The Council acknowledged Miss X’s email and said she would receive a response in early January 2022.
16. In mid February 2022 Miss X requested her complaint be escalated as she had not received a response. The Council replied and advised it could not escalate the complaint as she had not yet received a response to her initial complaint. The Council said it had contacted the service and asked them to respond to Miss X without delay.
17. The Council sent an email to Miss X in early March 2022 with a response to her complaint. Miss X sent a further email to the Council to say she believed that the housing association had granted permission for the works in November 2021. She also said someone had visited her to measure for a modular ramp but found this would be unsuitable due to the size of step and as the path to the property. Miss X also said the Council had not addressed all the issues she raised in her complaint.
18. In approximately May 2022 the Council provided the raised toilet seat to Miss X. She contacted the Council to ask for an update on the ramp and DFG. The Council’s records show it contacted the housing association about visiting Miss X with a housing surveyor. In June 2022 Miss X contacted the Council as the housing association had not visited her. The Council sent an email to the housing association asking if it had visited Miss X about the ramp.
19. I asked the Council to account for the time taken to carry out the occupational therapy assessment and progress the recommendations. The Council has said:

• There is a national shortage of occupational therapists which has impacted on its service. The amount of referrals has increased but it has not increased its workforce so delays inevitably occur.
• It constantly monitors the assessment waiting list but often DFG work is not classed as high priority.
• Once an occupational therapist has assessed a person then they have to complete detailed forms to evidence the level of need and risk.
• Grant requests are currently managed by the district council who is also struggling to manage the volume of requests.
• The delay in providing the toilet seat was caused by the occupational therapist being away from work and the actions were missed.
• The Council has also said it is still waiting for the housing association to decide if it will allow the adaptations to proceed.

20. Miss X has said the delays in assessing her and progressing the ramp has meant she cannot use the wheelchair which she is paying for and cannot go outside. The delays in progressing her DFG application for the stairlift has meant she cannot sleep upstairs and use the bathroom. She also cannot use the kitchen.

Analysis

Delay in carrying out the occupational therapy assessment

21. Councils should carry out occupational therapy assessments in a timely way to identify a person’s needs and to decide if they require aids and adaptations. The Council took 15 months to carry out an occupational therapy assessment for Miss X as it was struggling to meet the demand which outstripped its resources. This is an excessive timescale which is service failure and is fault. The delay will have caused distress and uncertainty to Miss X. It also caused avoidable time and trouble to Miss X as she had to chase the Council for the assessment.
22. Miss X considers the assessment was inadequate as it was brief and did not address that she required adaptations to her kitchen. The Council has said the occupational therapist assessed Miss X’s ability to use the kitchen. But this is not recorded in the assessment or in the record of the visit. I therefore cannot be satisfied, on balance, that the occupational therapist properly assessed Miss X’s ability to use the kitchen. Miss X also cannot be satisfied that the Council properly assessed her ability to use the kitchen.

Delay in providing the raised toilet seat

23. The occupational therapist identified that Miss X needed a raised toilet seat. But the Council did not provide this for a further six months following the assessment as the occupational therapist’s recommendations were missed. This is fault. It is likely to have taken a month for the Council to have ordered and provided the toilet seat to Miss X. So, the Council’s delay meant Miss X lived without an aid which could improve her daily life for five months longer than necessary.

Ramp and DFG

24. The Council has said that the occupational therapist will carry out a risk assessment following the occupational therapy assessment to establish the level of risk and need given its resource issues. There is no evidence to show such a risk assessment was carried out for Miss X. Nevertheless, the Council had identified that Miss X could not access the outdoors and could not access the bathroom without adaptation so it should have progressed the ramp and the DFG application in a timely way.
25. The Council has said the ramp and DFG have not progressed as the housing association will not give permission for adaptations until it has spoken to Miss X’s partner as he is the tenant. Miss X has said the housing association gave permission in November 2021. There is no evidence to show whose position is correct. But there is also no evidence to show the Council has consistently pursued the ramp and DFG with the housing association since the occupational therapy assessment in October 2021. I am mindful that progressing the ramp and DFG is not entirely within the Council’s control as it is also reliant on the housing association and district council to take action. But it is now 10 months since Miss X’s assessment. So, the Council needs to pursue the matter with some urgency with the housing association and other relevant organisations to address the issues which are preventing the installation of the ramp and progress of the DFG application or find other solutions.
26. I cannot say the delays by the Council have solely caused Miss X to be without adaptations which could improve her daily life for longer than necessary. This is due to the involvement of the housing association and other organisations. But, on balance, I consider the Council’s failure to consistently pursue the installation of the ramp and DFG will have contributed to the delays. This will have caused distress and uncertainty to Miss X.

Complaint

27. The Council delayed by two months in dealing with Miss X’s complaint. This is fault. The Council has also not provided a sufficient explanation to show why it did not consider escalating the complaint when Miss X had not received a response. The delay will have caused frustration and avoidable time and trouble to Miss X.

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Agreed action

28. That the Council will:
1. send a written apology to Miss X for the distress, uncertainty and avoidable time and trouble caused to her by the delays in carrying out an occupational therapy assessment, delays in pursuing the ramp and DFG application and delay in replying the her complaint. The Council should also apologise to Miss X for the delay in providing the toilet seat which meant she lived without an aid which could improve her daily life for longer than necessary.
2. make a symbolic payment of £500 to acknowledge the distress, frustration and avoidable time and trouble caused to Miss X by the delays in carrying out the occupational therapy assessment, delays in pursuing the ramp and DFG application and delay in replying to her complaint.
3. make a payment of £500 for the delay in providing the raised toilet seat which caused Miss X to live without an aid which could improve her daily live for five months longer than necessary. This payment is in accordance with our guidance on remedies.
4. offer a further occupational therapy assessment to Miss X to assess her ability to use her kitchen. If Miss X accepts the offer the Council should carry out the assessment within one month of her acceptance.
5. by training or other means, reminds officers in the occupational therapy section of the Council’s timescales for replying to complaints to prevent the delays experienced by Miss X for recurring.
6. draw up an action plan, including timescales, to pursue the ramp and DFG application with the housing association and other relevant organisations to avoid further delay and explore other options for Miss X to access her property with her wheelchair if the ramp is not feasible. The Council should provide a copy of the action plan to Miss X and the Ombudsman and keep Miss X regularly informed of the action taken.
7. draw up an action plan, including timescales, to address the excessive delays in carrying out occupational therapy assessments and following up the recommendations of the assessments. The Council should provide a copy of the action plan to the Ombudsman.

The Council should take the action at a) to e) within one month of my final decision. It should take the action at f) within two months of my final decision and the action at g) within three months of my final decision.

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Final decision

29. Fault causing injustice to Miss X.

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Investigator's decision on behalf of the Ombudsman