Summary: Ms C complained the Council failed to provide residential services to her mother, Mrs D, while it carried out adaptations to her bathroom. The Council was at fault for failing to properly consider a change in Mrs D’s needs. This resulted in Mrs D privately paying for nursing care. To remedy the complaint the Council has agreed to apologise to Mrs D and Ms C, repay nursing care fees, and make service improvements.

The complaint

1. Ms C complains the Council failed to provide respite services to her mother, Mrs D while it carried out adaptations to her bathroom. As a result Mrs D privately funded a care home for two weeks.
2. Ms C complains the Council should have arranged and funded this care and should repay Mrs D her care fees.

Back to top

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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
5. 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)

Back to top

How I considered this complaint

6. I spoke with Ms C and considered her complaint and the evidence provided by the Council; as well as relevant law, policy and guidance.
7. Ms C and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

What should have happened

Disabled Facilities Grants

8. In March 2022 the government issued non-statutory guidance “Disabled facilities Grant (DFG) Delivery: Guidance for local authorities in England, the “Guidance”.
9. This Guidance advises councils in England on how they can effectively and efficiently deliver DFG funded adaptations to best serve the needs of local older and disabled people. It brings together and sets out in one place existing policy frameworks, legislative duties and powers, together with recommended best practice, to help councils provide an adaptation service to disabled tenants and residents in their area.
10. The Guidance says, “2.25 Where an application for DFG has been made, social service authorities should work closely with the housing authority to assess the needs of the individual. The social care authority should consider the wider social care needs of the applicant, including and beyond any adaptation required……
11. 2.27 Social care authorities may also consider using their powers under the Care Act 2014 to charge for their services where appropriate.”

Social Care Reviews

12. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. Councils must conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one.

What happened

13. Mrs D lives in her own home and receives a home support package. Mrs D has several health difficulties which includes a bowel prolapse. On 13 June 2024 the Council agreed a grant for a level access shower and a wash dry toilet.
14. The Occupational Therapy work request to the Accessible Homes, “AH” team says, “OT has discussed impact of works with family, they report they can support Mrs D during this time. Commode is available for her to use. As family are not local please give plenty of notice for when works are planned.” Ms C has no recollection of this conversation.
15. On 4 July the Council records Ms C asking the Council to advise on suitable care homes for Mrs D while it completed the adaptations. The social worker said, “this might take some time to arrange due to needing to pause current support plan, make a new one and have it approved by relevant managers”.
16. On 9 July a manager told the social worker the Council would not fund residential care because the Council had not assessed Mrs D as needing this level of care; and could not fund care just because of adaptation work. The manager said Mrs D would have to pay privately for residential care. The manager told the social worker to speak to the AH team about how it would manage the adaptations so Mrs D had access to a toilet. The social worker told Ms C the Council would not fund residential care and AH would look at making arrangements within the home for Mrs D while adaptations took place. On 11 July Ms C emailed the Council to say she was looking for residential care. Mrs D went into a nursing home between 12 August to 27 August. The Council completed the adaptations on 23 October.
17. Ms C complained to the Council as Mrs D had to fund her own care in a nursing home. The Council responded saying the social worker failed to liaise with AH and partially upheld the complaint. It offered Mrs D £500 towards the cost of the care, saying there was an assumption family would be supporting Mrs D.
18. Ms C says she loaned Mrs D money to pay for the nursing care as Mrs D did not have the funds to pay for the care herself.

Was there fault causing injustice?

19. The Council has accepted fault for failing to liaise with the AH team as advised in the DFG guidance quoted above. The Ombudsman welcomes the early acceptance of fault but in this case I consider there was further fault and unremedied injustice.
20. Ms C told the Council about a change in circumstances and needs which should have alerted the Council to complete a review. I consider the Council did not act in line with the Care Act 2014. It should have completed a review of Mrs D’s needs to establish whether she needed alternative provision, an increase in care support or liaised with AH, to ensure Mrs D’s care needs could be met while it completed adaptation work. The failure to take this action was fault.
21. Having considered all the information available to me I consider on balance it is more likely than not had the Council reviewed Mrs D’s care needs it would have provided nursing care. This is because:-
• Mrs D had no one to care for her or to stay with;
• although there is no schedule of works it appears the toilet may have been available to Mrs D at some points of the day. However Mrs D’s toileting needs are unpredictable and she needs to have access to a toilet at all times of the day;
• Mrs D was already receiving a support package – it is therefore difficult to find out what extra care the Council could have provided other than a form of residential care to meet Mrs D’s needs; and
• in its complaint response the Council says Mrs D met the eligibility criteria for nursing care.
22. I therefore consider but for the faults I have identified Mrs D would not have had to self-fund her care and the Council’s actions have caused her quantifiable financial loss.
23. I also consider the Council failed to properly advise Ms C about the process and timescales in getting approval for alternative provision. The Care Act 2014 says councils should complete reviews in a proportionate and timely manner. There is no reason why the relevant assessments and approvals could not be agreed in time for the start of adaptation work. Ms C had given the Council plenty of notice.

Back to top

Action

24. I have found fault in the actions of the Council which has caused Ms C and Mrs D injustice. I consider the following actions are suitable to remedy Ms C’s and Mrs D’s injustice and to improve future practice.
25. Within one month of the final decision the Council will:
1. apologise to Mrs D for her having to pay privately for nursing care; and to Ms C for the frustration caused by the Council’s errors;
2. on provision of a receipt, repay Mrs D for the private care she paid for, so she can refund Ms C. When making the payment the Council is entitled to deduct any charges that Mrs D would have been asked to pay towards the care;
3. make Ms C a symbolic payment of £150 for her frustration in pursuing the Council and making funds available to her mother.
26. Within three months of the final decision:
1. by team meetings, staff circulars, or training, remind staff about when to carry out social care reviews and that duties under the Care Act 2014 are ongoing even if other Council departments are involved,
2. remind relevant housing and social care staff to work together when there are adaptations so people’s needs are met when completing adaptation work;
3. review the Council’s process/policy to ensure it includes a specific step to consider how people’s care needs are to be met when there is adaptation work.
27. The Council should provide us with evidence it has complied with the above actions.

Back to top

Decision

28. I find fault causing injustice. I have now ended my investigation and closed the complaint based on the above agreed actions.

Investigator’s decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman