Summary: Mr X complained the Council’s Major Adaptations Occupational Therapy (OT) Team has failed to carry out a home assessment for adaptations for a ramp and wet room to meet the needs of his partner. The Council is not at fault. An OT assessment would only be carried out as part of a disabled facilities grant application for which Mr X would need to complete a test of resources, which he chose not to do.

The complaint

1. Mr X complains the Council’s Major Adaptations OT Team has failed to carry out a home assessment for adaptations for a ramp and wet room to meet the needs of his partner, Mr Y. This has caused him and Mr Y distress and uncertainty over what adaptations are required.

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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 consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), 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 spoke to Mr X and considered the information he provided. I considered the information provided by the Council in response to my enquiries and the relevant law and guidance.
6. I gave Mr X and the Council 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

Relevant law and guidance

7. If a disabled person needs adaptations to their property they may qualify for a disabled facilities grant (DFG). These grants are provided under the Housing Grants, Construction and Regeneration Act 1996 (“the 1996 Act”). Councils have a statutory duty to provide grant aid to disabled people to carry out certain necessary adaptations to their home. The maximum amount of mandatory grant is £30,000.
8. Before it approves a grant, a council must be satisfied the work is necessary and suitable to meet the disabled person’s needs and that it is also reasonable and practicable. This usually involves an Occupational Therapist assessing the disabled person’s needs, and a survey of the property to make sure the works are feasible.
9. The grant is means-tested and based on a financial assessment of the disabled person’s income and assets. If the applicant meets the criteria for a mandatory grant, the Council must pay it, less any contribution it has calculated the applicant should pay.
10. Government guidance (Disabled Facilities Grant delivery: Guidance for local authorities in England (2022)) says ‘The DFG means test is in place to ensure that DFG funding reaches those people who are on the lowest incomes and least able to afford to pay for the adaptations themselves’. It goes on to say ‘authorities should consider a preliminary means test for DFG at an early stage. It can be frustrating for both applicants and staff to discover at a late stage that the DFG means test indicates they will receive little or no financial assistance. A preliminary enquiry about resources (e.g. through a self-service online portal such as adaptmyhome.org.uk) can short-circuit these delays and may encourage the disabled person to pursue other solutions’.
11. If the applicant’s calculated contribution is more than the cost of the proposed works, they will not be eligible for a grant. However, the Council can issue a ‘nil approval’, which will allow the work to go ahead. The contribution paid by the applicant can then be taken into account for any future DFG application.
12. NHS continuing health care (CHC) is a package of ongoing care arranged and funded solely by the NHS where the individual has been found to have a ‘primary health need’.

Background

13. Mr Y has a progressive condition which affects his mobility. Mr X and Mr Y own their home.
14. In 2018 Mr X and Mr Y sought a disabled facilities grant for adaptations to their property for a level access shower and through floor lift. The Council sought an initial means test to assess whether Mr X and Mr Y were eligible for grant assistance. The Council’s adaptations panel approved the adaptations in principle subject to this to avoid delays in the process.
15. The Council closed the case in late July 2018 as Mr X and Mr Y were not eligible for DFG grant assistance based on the means test. The notes recorded Mr X and Mr Y opted to complete works privately without a grant. Mr X and Mr Y chose not to progress the works.
16. In early 2020 Mr X fractured his hip and so was no longer able to use the stairs.
17. In June 2021 Mr Y started to receive CHC funding for care and support.

What happened

18. In September 2021 an NHS professional emailed the Council. They said Mr X was trying to get an OT assessment for major adaptations to the home. They stated ‘he seems to be under the impression that he should be entitled to an OT assessment to advise on the adaptations which they will privately fund’.
19. A Council officer contacted Mr X and advised they would ring to discuss the previous recommendations made for Mr Y when he was previously assessed. Mr X replied by email. He advised the previous recommendation for a through floor lift was not appropriate and Mr Y now needed single floor living. They were seeking a ground floor toilet/washing facilities and a ramp system. Mr X wanted an OT assessment of the property.
20. The Officer responded and advised that any adaptations would need to be funded by a disabled facilities grant and so Mr Y would need to complete a means test. They agreed to visit to discuss Mr Y’s difficulties. They said Mr Y was not previously eligible for a grant and needed to fund works himself. The officer asked whether Mr X wanted an early means test.
21. Mr X did not respond regarding the means test. The officer later emailed Mr X and advised they were concerned their input would be limited if Mr Y was not eligible for DFG funding. They advised any assessment of Mr Y’s needs would be for the Clinical Commissioning Group (CCG – the NHS body responsible for delivering services in that area) and cancelled the visit.
22. Mr X complained to the Council. The Council responded in October 2021. It explained it had requested an initial means test but Mr X had refused to complete this and wanted an OT assessment to recommend an adaptation. The Council said an OT assessment should not have been agreed at that time as there was no indication a DFG would have been granted due to a change in their finances. It apologised if Mr X felt misinformed by being directed back to the CCG.
23. Mr X remained unhappy and complained to us. He said he wanted his home assessed to meet Mr Y’s needs. When these needs were assessed ‘we would expect an estimate of the costs of the work then we could consider funding options’.

Findings

24. As Mr Y is in receipt of CHC funding, any assessment of his needs would be a matter for the NHS not the Council. However disabled facilities grants are within the Council’s remit so an assessment for disabled adaptations to be funded through a DFG would be a matter for the Council.
25. Mr X and Mr Y want a ground floor toilet and washing facilities but are not seeking these through a disabled facilities grant. The Council’s role is to assess the need for a grant to fund home adaptations. The Council says it would have completed an assessment if Mr X and Mr Y wished to pursue a DFG. However, an OT assessment would not provide Mr X with an estimate of the cost of the works nor would it determine whether the adaptation was viable; such a decision would be for a surveyor or architect. The OT’s role would be to determine whether it is reasonable and practicable for Mr Y to have the adaptations.
26. Mr X wants an estimate of costs and schedule of works however these would only be produced as part of a DFG application. If Mr X and Mr Y wish to apply for a DFG it is open for them to do so and they would need to complete a test of resources. This may result in a ‘nil grant’ decision. This may then mean Mr X and Mr Y would be expected to arrange the work themselves. The Council’s statutory duty is to determine eligibility for and provide grant aid and Mr X and Mr Y do not qualify for this. It is therefore under no duty to arrange the adaptations and is not at fault.

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Final decision

27. I have completed my investigation as there is no evidence of fault by the Council.

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Investigator's decision on behalf of the Ombudsman