• The complaint
• The Ombudsman’s role and powers
• How I considered this complaint
• What I found
• Final decision

The Ombudsman's final decision:

Summary: Mrs X complains the Council’s actions have prevented her from accessing an appropriate care and support package to meet her assessed needs. The delays in completing Mrs X’s reassessment were in part due to fault by the Council, but this fault has not caused Mrs X a significant injustice. The failure to finalise Mrs X’s support plan or provide her with a support package is not due to fault on the part of the Council.

The complaint

1. The complainant, whom I shall refer to as Mrs X complains the Council’s actions have prevented her from accessing an appropriate care and support package to meet her assessed needs. She complains the Council has refused her request that an independent advocacy agency manage her personal budget and is attempting to manipulate her into an unacceptable and unviable situation
2. Mrs X states the delays and refusal to allow her, via an independent advocacy agency, to recruit a PA following the break down in her care package has detrimentally affected her health and wellbeing.

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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 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

5. As part of the investigation, I have:
   • considered the complaint and the documents provided by Mrs X;
   • made enquiries of the Council and considered the comments and documents the Council provided;
   • discussed the issues with Mrs X;
   • sent a statement setting out my draft decision to Mrs X and the Council and invited their comments.

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What I found

Key facts

6. Mrs X is registered blind. She lives with her husband Mr X, who is her main carer. The Council has assessed Mrs X as needing support and has previously provided Direct Payments which Mrs X used to employ a personal assistant (PA). It has also more recently commissioned a support package for Mrs X. Mrs X complains that she has not received a support package since late February 2018, and Mr X has had to step in to provide this additional support.
7. In late February 2018 Mr X advised the Council Mrs X was experiencing debilitating anxiety, caused by the lack of care provision. He asked about arrangements for the care package and said he had had to step in to support Mrs X. A sensory social worker (Officer 1) asked Mrs X to contact her when she felt able to discuss how to move forward with her care and support needs. There is no record of Mrs X responding to Officer 1.
8. In early March 2018 Mrs X complained to the Council that it had failed in its duty of care to provide her with support for her assessed needs. It had ignored her request for a PA and would not allow a third party or advocacy service to administer her personal budget. Mrs X complained the Council had agreed to provide two carers but without discussing the matter with her, only provided one. She stated her latest carer was not a competent swimmer so was unable to support her while swimming. She was also unhappy the carer had not followed her instructions on how she wanted to be supported and had made inappropriate comments. In addition, Mrs X was concerned the Council had given the carer a copy of her support plan and personal details without her consent.
9. Mrs X stated she had no faith or trust in the Council and would only receive support from her husband until safe and appropriate support was in place. She asked that the Council arrange an emergency review.
10. Officer 1 contacted Mrs X again in April 2018 to offer her a reassessment of her needs. The Council had last assessed Mrs X’s needs in May 2016 and Officer 1 felt it would be useful to revisit this. Officer 1 also confirmed the Council would continue to seek a care package for Mrs X based on her existing support plan, while the reassessment was completed.
11. There is no record in the Council’s case notes that Mrs X responded to this offer of a reassessment. However, Mrs X’s GP wrote to the Council in late April 2018 advising Mrs X was struggling with anxiety and had lost the confidence to go swimming since an incident with the carer. The GP asked the Council to allocate Mrs X a more appropriate carer who could confidently take her swimming.
12. Officer 1 contacted Mrs X again in May 2018 and advised a care provider had indicated they had availability to support Mrs X and asked Mrs X whether she would like the Council to explore this further. Mrs X does not appear to have responded.
13. A service manager (Officer 2) also contacted Mrs X in May 2018 and offered to meet with her to discuss her concerns about the support she had received. Mrs X asked for two meetings. The first to focus on implementing appropriate and safe care to meet her needs and a second separate meeting about any other issues. Mrs X asked whether the option to source a PA and arrange for a third party / advocacy agency to administer her personal budget could be actioned. She also questioned when the Council would pay Mr X for the support he had been providing while Mrs X was without a care package
14. Officer 2 responded on 14 June 2018 and confirmed the Council was not discounting any future approach or option to meeting Mrs X’s assessed eligible needs. But it was important to meet to resolve the issues Mrs X’s had raised about her care, and to plan an assessment of Mrs X’s current care and support needs. In addition, Officer 2 confirmed the Council would not pay Mr X for the support he provides Mrs X. Officer 2 offered to meet Mrs X at her home on 19 June 2018.
15. As Mrs X did not respond, Officer 2 contacted her again on 23 June 2018 and suggested meeting on 27 June 2018. Mrs X advised Officer 2 she had been unaware of his email of 14 June 2018 as the way he had sent it meant it was not visible to her screen reader. Mrs X asserted Officer 2 had acted unprofessionally and incompetently in sending a hidden email, and thereby delaying their meeting. Mrs X also asserted Officer 2 had shouted at her and suggested she needed to get into the real world.
16. On 6 July 2018 another senior officer (Officer 3) contacted Mrs X in relation to her complaints about Officers 1 and 2 and suggested dates for a meeting. Mrs X asked for Officer 3 to provide copies of the strength-based assessment criteria before any meeting. She also sought confirmation the initial meeting would focus on prioritising an appropriate PA and a second meeting would address the Council’s failings
17. Officer 3 confirmed the purpose of the meeting was to clarify the assessment process and to provide an opportunity to discuss her complaints against officers. In response, Mrs X agreed to meet officer 3 on 6 August 2018 but stated the purpose of the meeting would be to clarify that she needed a PA as her needs had not changed. Mrs X stated she did not need assessing but required a suitable person who can meet her already identified needs and goals.
18. Officer 3 advised it was necessary to complete a strengths-based needs assessment to establish her current needs. They also confirmed they would not be carrying out the assessment at the meeting on 6 August 2018.
19. The Council’s records of the meeting on 6 August 2018 state Mr and Mrs X had prepared an agenda they wanted to discuss at this meeting. They wanted to discuss the complaints at a further meeting, once a PA had been reinstated. Mrs X had questions relating to:
    • the timeframe for the assessment process;
    • backdating payments to Mr X for the additional support he had provided;
    • a carer’s assessment for Mr X; and
    • whether her personal budget could be transferred to a third-party advocate.

The records state that Mrs X agreed to an assessment. Officer 3 would not guarantee a timeframe but advised that under normal circumstances an assessment would be completed in 28 days. Officer 3 also confirmed the Council would not backdate payments to Mr X.

20. Following this meeting a social care assessor, Officer 4 contacted Mrs X to arrange a time for them and Officer 5, a sensory social worker to visit to carry out the assessment. The assessment was arranged for 24 August 2018. The records of this assessment state Mrs X did not want to start a new assessment and felt the officers should use the information they already had. She advised her needs were the same as at the last assessment and wanted to talk about provisioning. Mrs X wanted a direct payment to recruit a PA. Officer 4 advised the meeting was to begin Mrs X’s assessment and they would return to discuss outcomes and provision once the assessment was complete. Mrs X advised she needed support with everything on a daily basis.
21. Officer 4 noted there was an uncomfortable atmosphere throughout the meeting, and it was difficult for Mrs X to expand on the specific areas in which she needed support. They state her answers were general or vague and Mrs X resisted attempts to delve into specifics. A further meeting was arranged for 21 September 2018.
22. Mrs X disputes the officer’s account of the meeting and states Officer 5 shouted at her and intimidated her. She states she was left shaking and terrified. Following this initial meeting Mrs X contacted Officer 3 to complain that Officer 5 had been obstructive, rude and hostile during the meeting. She wanted Officer 5 to adopt a more polite, constructive and client centred approach at their next meeting.
23. The Council arranged for an advocate to support Mrs X at the next meeting. The records of this meeting state that Mrs X wanted to talk about direct payments and provisions and that Officer 4 advised they needed to complete the assessment first. Officer 4 suggested a Rehabilitation Officer for people with Visual Impairments (ROVi) would be able to provide more detailed information about Mrs X’s particular difficulties in the areas covered by the assessment, and to understand if she has eligible needs. Mrs X agreed Officer 4 could make a referral to the ROVi.
24. Mrs X did not consent to the Council contacting her counsellor as part of the assessment. Mrs X also declined Officers 4 and 5’s offers to contact volunteer services and community carers and said she would do this herself. A further meeting was arranged for 17 October 2018.
25. The notes also record that Mrs X was unhappy the Council had shared her information with the advocate without her consent. She considered this was a data protection breach. Officer 4 explained it was normal practice to share information with advocates and that Mrs X had consented to the referral to an advocate. Mr X intended to make a complaint about this data breach. He also asked for an urgent meeting with senior management as he felt the Council was treating them as a low priority and leaving them to struggle.
26. Officer 4 noted the meeting was very tense and there was hostility directed towards officer 5.
27. Mrs X notes the care plan states that her consent and permission is needed before the plan can be shared with anyone. She states she agreed to the advocate being present, but the Council did not ask whether it could share the care plan with the advocate.
28. Mrs X made a further complaint to the Council about Officers 4 and 5. She asserted they were delaying and obstructing any resolution and the re-instigation of her entitlement to care and support. Mrs X considered they were discriminating against her and practicing inequality. She questioned their competence to conduct an appropriate assessment for her. Mrs X felt that Officer 4 was inexperienced and needed disability and visual impairment awareness training. In relation to Officer 5 Mrs X complained they had:
    • intimidated her and stated her visually impaired needs were minor and low risk;
    • stated they intended to keep her socially excluded contrary to her needs, rights and goals as set out under the Care Act; and
    • contradicted her every time she described how her blindness impacted on her.
29. Mrs X also formally complained the officers had breached confidentiality by providing information about her to the advocate. She asked the Council to arrange a meeting with senior managers and to instigate a PA for her. She stated Mr X was still having to provide the additional hours of support the Council had failed to arrange and wanted the Council to pay him for these hours.
30. The Council acknowledged her complaint and noted that Mrs X had previously asked that her complaints about individual officers were not investigated until her assessment had been completed. The Council had therefore put them on hold until Mrs X was ready to discuss them with Officer 3.
31. Mrs X confirmed that she wanted the Council to investigate her latest complaint now. Mrs X also confirmed she was willing to meet with the rehabilitation officer but did not consider it appropriate for Officers 4 and 5 to be involved in completing her assessment.
32. A senior officer, Officer 6 confirmed the Council would investigate Mrs X’s latest complaint, and that a senior social worker (Officer 7) would work with the rehabilitation officer to complete the assessment.
33. Officer 6 confirmed the Council had four complaints awaiting investigation:
    • March 2018 relating to the package of care and the conduct of the support worker;
    • June 2018 in relation to Officer 1’s conduct;
    • June 2018 in relation to an email from Officer 2 which Mrs X was unable to access and read;
    • September 2018 in relation to Officers 4 and 5’s conduct.
34. They asked Mrs X to confirm the complaint investigations could commence alongside but separate to the completion of her assessment. Mrs X confirmed Complaints 1 and 2 should only be investigated after complaints 3 and 4 had been investigated.
35. Officer 3 responded to Mrs X’s complaints about Officers 2, 4 and 5 in November 2018. Officer 3 advised that its IT specialist had investigated Officer 2’s email and confirmed it had been sent in the normal way with the reply text in front of the original email text. Officer 3 could not comment on how Mrs X’s reader presented the email but was satisfied Officer 2 had not deliberately sent an email with the message hidden within the text.
36. In relation to Officers 4 and 5, Officer 3 advised the officers’ perception of the discussions was different to Mrs X’s. Officer 3 had contacted the advocate who was present at one of the meetings, but without Mrs X’s consent the advocate could not comment. Officer 3 asked whether Mrs X would provide her consent to discuss the complaint with the advocate. There is no record that Mrs X has provided this consent.
37. Officer 7 and the rehabilitation officer visited Mrs X in November 2018 to go through the draft assessment. Officer 7 explained they would make the suggested amendments and complete the assessor’s summary and make an eligibility determination. They agreed to send the amended assessment to Mrs X for any further amendments and once the assessment was complete, they could explore support planning.
38. Mrs X felt there were numerous omissions and errors in the amended assessment. She asked Officer 7 to visit again with a note taker so that it could be corrected. Mrs X did not feel it was her responsibility to correct the Council’s errors. The Council initially refused to meet with Mrs X and asked her to send any amendments in writing. Officer 7 then agreed to meet Mrs X with Officer 3 at the Council offices. Mrs X advised Officer 7 that she had been unable to access an electronic copy of the assessment, she asked the Council to enable her to access it or provide the document on a memory stick.
39. The notes of the meeting record that Officer 7 had overlooked Mrs X’s request for a memory stick. The notes state Officer 3 suggested they could go out and buy a memory stick and asked Mr and Mrs X if they knew of a local shop that might sell one. Officer 7 was unable to access any petty cash so agreed to send Mrs X a memory stick the following day.
40. Mrs X did not want to go through and re-write the assessment at the meeting, and Mr X declined to provide the officers with his hand-written notes on the assessment. In order to capture Mrs X’s comments on the assessment Officer 7 agreed to arrange for an officer with access to the Council’s system to meet with Mrs X and record her notes. Officer 7 would then review and amend the assessment.
41. Officer 3 asked Mrs X what outcomes she wanted to achieve following the assessment. The notes record Mrs X wanted PAs reinstating but did not want to use a provider the Council contracted with as they were not skilled enough to meet her needs.
42. Another senior social worker and a business support administrator met with Mr and Mrs X to amend the assessment. Mr and Mrs X went through each section of the assessment and advised which sections they disagreed with and what comments they wanted to add.
43. Officer 7 updated the assessment and sent Mrs X a copy of the final version on 17 December 2018. Officer 7 suggested meeting in January 2019 to discuss support planning and Mrs X’s options. Mrs X was unable to make the suggested dates. They were just before Mr X’s birthday and Mrs X felt it was inappropriate to offer meetings at that time. She suggested offering these dates was a deliberate attempt to delay matters. Mrs X asked Officer 7 to email her details of her options.
44. Mrs X asserted there were several discrepancies and inaccurate claims in the assessor’s view section of the assessment. She also questioned why the copy of the indicative budget was now lower than that provided during an earlier meeting. In addition, Mrs X complained Officer 7 had inappropriately asked Mrs X to go to shop and buy a memory stick during their meeting in November 2018.
45. In response, Officer 7 advised they did not routinely check spouses’ birthdays before offering appointments. They offered three further dates and asked Mrs X to confirm which she preferred. Officer 7 also set out Mrs X’s options for support planning as:
    • An individual Service Fund (ISF) which would allow Mrs X to reinstate a PA by using a Council contracted care agency to recruit a PA on her behalf;
    • A contracted care agency. Officer 7 noted Mrs X had said during their earlier meeting that she did not want to use a provider that the Council contracted with as they were not skilled enough to meet her needs. They also noted the rehabilitation officer had explained to Mrs X that the Council could provide support to carers in terms of working with visual impairments.
46. Officer 7 confirmed the Council would not offer Mrs X direct payments due to the issues which arose during Mrs X’s previous management of direct payments. They asked Mrs X to confirm whether she would like to explore the ISF option or contract hours through the Council and a care agency.
47. Officer 7 responded to Mrs X’s concerns about discrepancies in the assessment and the change in the indicative budget. They also denied that they or Officer 3 had asked Mrs X to go to a shop to buy a memory stick.
48. Mrs X was unhappy with Officer 7’s response and complained to the Council. Officer 6 responded in early February 2019 and noted eight officers had been involved in Mrs X’s assessment since August 2018 and Mrs X had complained about five of them. Mrs X’s allegations against these officers included discrimination, wilful deceit, professional incompetence and personal misconduct. Officer 6 stated Mrs X’s approach to officers had been challenging at times and noted Officer 3 had previously asked Mrs X to afford officers the same respect she would expect of them.
49. Officer 6 reiterated that the Council was not willing to consider a managed direct payment, and Mrs X’s options were an ISF or a commissioned support package. Officer 6 acknowledged Mrs X had the right to refuse these offers. They advised that if Mrs X refused these offers the Council had discharged its duty under the Care Act by offering a package of care to meet her needs.
50. Mrs X considered Officer 6’s response inappropriate and expanded her complaints to include Officer 6’s conduct. Mrs X complained she had been ignored and discounted for a whole year. Mrs X did not want a direct payment that she would manage herself nor did she want the Council to manage it. She stated she had repeatedly asked for her personal budget to be managed by another agency of her choosing but the Council had ignored her requests.
51. Mrs X considered the Council had discriminated against her and acted with bias to prevent her from fair access to services. She asked for a meeting with the Director of Services to try and resolve the matter. Mrs X maintained Officer 7 had asked her to go to a shop to buy a memory stick during their meeting in November 2018 and asserted that other officers had colluded with Officer 7 to deny and cover up this action. Mrs X also denied that she had declined services and asserted officers had not offered her relevant or useful services.
52. Officer 6 responded to Mrs X’s complaints in March 2019. They also confirmed that Officer 3 would now investigate Mrs X’s complaints from March and June 2018 which had previously been placed on hold. Officer 6 stated Officers 7 and 3’s recollection of the discussion about purchasing a memory stick was different to Mrs X’s. They state Officer 7 asked whether Mrs X knew of a shop that would sell memory sticks then went to establish if there was petty cash to enable them to go and buy one.
53. In addition, Officer 6 referred to the information Officer 7 had given Mrs X about an ISF and suggested this may meet the outcomes she was seeking. Officer 6 asked Mrs X to agree to a support planning meeting so that this could be progressed. They advised the Council would not provide any support or agree a new personal budget until the assessment and support planning process had been completed. It would then only be effective from the date it was completed and would not be backdated.
54. Mrs X was unhappy with this response and contacted the Council again and requested a meeting with Director of Service. She considered she was being manipulated into an unacceptable and unviable situation and wanted a meeting to address this. Officer 6 advised the Director would not meet with Mrs X and that a meeting with him was not necessary to progress her case. Officer 6 reiterated they felt an ISF may meet Mrs X’s current assessed needs and stated wishes. It was therefore essential that Mrs X met with officers to agree the next steps.
55. At the end of May 2019, the Council responded to Mrs X’s outstanding complaints. The Council confirmed it had raised Mrs X’s concerns about the carer’s conduct with them. Although the carer’s recollection of the events was different to those described in Mrs X’s complaint, the carer had apologised for any distress.
56. In relation to Mrs X’s complaint about Officer 1, the Council acknowledged Mrs X had lost trust in Officer 1 but did not uphold her complaint. It considered Officer 1 had acted appropriately by sourcing an alternative care provider.
57. Mrs X has not met with officers to discuss support planning and does not currently receive a support package. Mrs X has asked the Ombudsman to investigate her complaint. She asserts the Council’s actions have prevented her from receiving an appropriate support package and that this is affecting her health and wellbeing.
58. In response to my enquiries the Council states it has made every effort to engage with and provide care and support to Mrs X but has been faced with numerous barriers and difficulties. It considers it has offered a number of reasonable alternatives to meet her assessed needs. This includes offering an ISF which would have enabled her to recruit a personal assistant as she has requested. However, Mrs X has continued to decline meetings to conclude her support plan.
59. The Council states that as a result of Mrs X’s approach and complaints about individuals it has had to remove a number of officers who were involved in supporting her. The Council then made the exceptional decision of appointing a Senior Social Worker to complete Mrs X’s assessment, supported by a Head of Service. It states this is not common practice and was intended to support Mrs X to ensure she had a completed assessment and support plan whilst also supporting and protecting its staff.
60. The Council believes that Mrs X has purposely placed barriers in the way in an attempt to prevent the assessment and support plan from being completed appropriately and for her direct payment to be reinstated. The Council will not offer a direct payment to Mrs X due to previous issues with her direct payments.
61. Mrs X disputes the Council’s assertions and states the Council has engaged in a character assassination of her to cover up its service failings.

Analysis

62. Mrs X complains the Council’s has prevented her from accessing an appropriate care and support package to meet her assessed needs. But the evidence suggests it has attempted to work with Mrs X to reassess her needs and prepare a support plan.
63. The reassessment took longer than we would expect to complete, with periods of up to a month between the meetings. I note this was in part to allow for a referral to the ROVi following the second meeting, but it is unclear why there was a four-week period between the first and second meeting
64. While I consider the reassessment should have been completed quicker, the information provided suggests the Council was not solely responsible for the length of time taken. It is clear Mrs X has a difficult relationship with the Council and seems to have lost faith in its ability to support her. She did not respond to Officer 1’s offer of a reassessment in April 2018 and did not want to start a new assessment when she met Officers 4 and 5 in August 2018. Mrs X has also raised concerns about the conduct of several officers and asked from them to be replaced. This has inevitably delayed the process.
65. On balance I consider the delays in completing the assessment were in part due to fault by the Council. However, as Mrs X has also contributed to this delay, and will not engage in support planning, I do not consider the Council’s actions have caused Mrs X a significant injustice.
66. The Council has investigated Mrs X’s concerns about officers but has not upheld them. It in turn has raised concerns about Mrs X’s own interactions with officers. Mrs X disagrees with the Council’s findings, and firmly believes officers have acted inappropriately and in a manner that is detrimental to her. I am unable to resolve this issue based on the information available.
67. Our investigations are evidence based and we cannot accept one person’s word against another’s. Mr and Mrs X and the Council’s officers have given differing accounts of conversations and behaviours at meetings, including during discussions of Mrs X’s needs and later the purchase of a memory stick. I recognise that both Mr X and the officers will have made notes of the meetings. These notes will record their differing perceptions of the discussions, but they would not help to resolve the disagreements over what was said or done. In the absence of any audio recordings of these conversations I am unable to confirm what was said or the nature and tone of any comments during these discussions.
68. Mrs X also complains the Council has dismissed her requests and refused to allow her to be involved in her care and support package. And has not allowed her to use an external agency to manage her payments and recruit a PA. Mrs X has previously done this through direct payments, but the Council no longer consider this an option in Mrs X’s case. The Council has confirmed Mrs X’s options for support are either an ISF which would allow her to reinstate a PA, recruited through a Council contracted care agency; or support through a contracted care agency.
69. We have previously investigated Mrs X’s complaint about the Council’s decision that she could no longer have direct payments and determined the Council was not at fault. I will not revisit this decision as part of my investigation of Mrs X’s current complaint.
70. The Council has attempted to arrange a meeting with Mrs X to discuss these options and draw up a support plan, but she has declined. Without Mrs X’s involvement in this process the Council cannot complete the support plan or finalise her personal budget. The Council has advised Mrs X it will not provide any support or agree a new personal budget until the support planning process had been completed. Based on the information available, I do not consider the failure to complete Mrs X’s support plan or provide care is due to fault on the part of the Council.

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Final decision

71. The delays in completing Mrs X’s reassessment were in part due to fault by the Council, but this has not caused Mrs X a significant injustice. The failure to finalise Mrs X’s support plan or provide her with a support package is not due to fault on the part of the Council.

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Investigator's decision on behalf of the Ombudsman

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