Summary: Mr X complained the Council delayed completing an Occupational Therapy (OT) assessment required for his Disabled Facilities Grant (DFG) application to carry out adaptations to his house. Mr X says this has delayed the adaptations and put him at a risk of harm as his house does not meet his needs. The Council was at fault because there was an eight month delay carrying out the OT assessment. The Council has agreed to apologise and make a payment to recognise the distress, frustration and uncertainty the delay caused.

The complaint

1. Mr X complained the Council delayed completing an Occupational Therapy (OT) assessment required for his Disabled Facilities Grant (DFG) application to carry out adaptations to his house. Mr X says this has delayed the adaptations and put him at a risk of harm as his house does not meet his disability needs.

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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 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)
3. Service failure can happen when an organisation fails to provide a service as it should have done because of circumstances outside its control. We do not need to show any blame, intent, flawed policy or process, or bad faith by an organisation to say service failure (fault) has occurred. (Local Government Act 1974, sections 26(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 considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
6. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Relevant law and guidance

7. Disabled Facilities Grants are provided under the terms of the Housing Grants, Construction and Regeneration Act 1996. Councils have a statutory duty to give grants 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.
8. In March 2022 the government issued non-statutory guidance “Disabled facilities Grant (DFG) Delivery: Guidance for local authorities in England”.
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 March 2022 guidance identifies five key stages to delivering home adaptations:
• Stage 1: First contact with the service. Councils should ensure the public has access to information and advice about the DFG process
• Stage 2: First contact to assessment and identification of the relevant works. An occupational therapist (OT) will assess the person’s needs and potential solutions through home adaptations
• Stage 3: Identification of the relevant works to submission of the formal grant application. The person completes and submits the application form together with designs and costing for the works (where necessary)
• Stage 4: Grant application to grant decision. The Council will check the application and issue a decision letter. If a council refuses a grant, it must explain why
• Stage 5: Approval of grant to completion of works. The works are arranged and carried out and the necessary quality checks made
11. A council should decide a grant application as soon as reasonably practicable. In addition, the timescales for moving through the stages will depend on the urgency and complexity of the works required. The guidance gives the following timescales in which stage one and two should be completed:
• Urgent and simple works – 30 working days
• Non-urgent and simple works – 70 working days
• Urgent and complex works – 65 working days
• Non-urgent and complex works – 90 working days
12. The guidance recommends councils treat cases as urgent in the following circumstances:
• Coming out of hospital and at risk
• Living alone and at risk
• Severe cognitive dysfunction and at risk
• Living with a carer who is elderly or disabled
• Living without heating or hot water and at risk
• Limited life expectancy

What happened

13. Mr X is disabled and cannot use the stairs without assistance. Mr X’s bedroom is on a separate floor to the bathroom, neither of which are on the ground floor. Therefore, Mr X contacted the Council in December 2023 after having several falls on the stairs, to request the house be adapted to meet his needs.
14. In February 2024, the first contact team undertook an initial OT assessment. The purpose of the initial OT assessment was to determine whether the Council could resolve the issue quickly through providing specialist equipment. However, in this case, the assessor identified that adaptations such as stairlifts or a ground floor extension might be necessary. Therefore, the Council put Mr X on a waitlist for a further OT assessment with the community OT service.
15. In October 2024, Mr X made a complaint about the Council’s delay in carrying out the OT assessment.
16. In January 2025, the Council issued a final complaint response. The Council said it had previously advised there was a waiting period of 18 to 24 months for an OT assessment. It said Mr X had been on the waitlist for 10 months. The Council said it would carry out a telephone screening to determine if it could prioritise an assessment for Mr X. The Council did not uphold Mr X’s complaint as it said it had followed process and there are no shortcomings identified.
17. Mr X remained dissatisfied with the Council’s handling of the matter and complained to us.
18. At the end of January 2025, the Council completed Mr X’s OT assessment to assess current function and suitability of stairlifts. The Council determined a stairlift for the second floor would not be possible and is exploring the feasibility of a ground floor extension.

Council’s response to our enquiries

19. The Council said it has a very high demand for OT assessments and to reduce its OT assessment wait times, it is doing the following:
• Screen and risk rate all the cases on the OT waiting list into high, medium and low priority. Depending on the priority, a trusted assessor can manage the case rather than a qualified OT
• Outsourcing cases
• Further recruitment of Occupational Therapists
• Training staff to become trusted assessors
• Weekly allocation meetings with senior OT’s to discuss new referrals and those already on waiting lists
• Fortnightly group meetings to develop initiatives to support how the OT waiting list can be effectively managed

My findings

20. In December 2023, Mr X contacted the Council after having several falls on the stairs, to request the house be adapted to meet his needs. The Council said the adaptations Mr X required are complex. Mr X does not fall under the urgent category so his application would be classified as ‘non urgent and complex works’. For this category, stage one and stage two of the DFG process, which includes the necessary OT assessments, should take place within 90 working days. Therefore, the Council should have carried out the relevant OT assessments by May 2024. However, the Council did not carry this out until January 2025, which was a delay of eight months.
21. The Ombudsman can make findings of fault where there is a failure to provide a service regardless of the reasons for that service failure. The Council has a high demand for OT assessments and a backlog of cases which has had an impact on Mr X’s case. This caused the matter to drift without meaningful progression. This was fault which has caused Mr X distress, frustration and uncertainty. However, I cannot say this delayed any adaptations to his house as the Council has not approved any works yet.
22. The Council has explained the actions it is taking to reduce the delays. Therefore, no service improvement is required.

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Action

23. Within one month of the final decision the Council has agreed to take the following action:
1. Apologise to Mr X to recognise the distress, frustration and uncertainty the delays in carrying out the OT assessment have caused. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The Council should consider this guidance in making the apology I have recommended.
2. Pay Mr X £300 to recognise the distress, frustration and uncertainty the delays in carrying out the OT assessment have caused.
24. The Council should provide us with evidence it has complied with the above actions.

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Decision

25. I find fault causing injustice. The Council has agreed actions to remedy injustice.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman