Summary: Mr B is autistic and has support needs. He complains about how the Council moved him from supported living accommodation to his own flat and says this does not meet his needs. He says he is isolated, and his support has been cut which is making his depression worse. There was no fault by the Council. The landlord asked Mr B to move. The Council has ensured his needs are met.

The complaint

1. Mr B complains about how the Council has handled aspects of his care. In particular, Mr B says:
• He was put under pressure to move to different supported accommodation. Nobody discussed this with him first, and he was not given any support as to what he could do to improve in his existing accommodation so that he could stay.
• The new accommodation does not meet his needs. The staff are not trained in autism. The location is less central so that he can no longer get to his support group in the evening.
• The Council did not offer him an advocate.
• The staff were abusive and too critical. There was a safeguarding investigation but he does not know what the outcome was or what happened next.
• His care and support hours were cut and he does not know why, different staff come to support him, they use his toilet when they have agreed not to, and the carers wrongly accuse him of not engaging.

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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. 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)
4. The Ombudsman cannot investigate the actions of the housing association. Where local councils provide services themselves, or arrange or commission care services from social care providers, even if the council charges the person receiving care for the services. We can by law treat the actions of the care provider as if they were the actions of the council in those cases.

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How I considered this complaint

5. I considered the information provided by Mr B. I have considered the Council’s response to my enquiries and the case notes, correspondence and care assessment documents from the Council’s files. I have also considered the safeguarding documents. Both parties have had the opportunity to comment on a draft of this statement. The Council has confirmed that it has not had nay comments. I gave Mr B longer to respond to take account of his needs, but he has not sent any comments on my draft statement.

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What I found

The law and guidance

6. Sections 9 and 10 of the Care Act 2014 require local authorities to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to all people regardless of their finances or whether the local authority thinks an individual has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
7. The Care Act 2014 gives local authorities a legal responsibility to provide a care and support plan. The care and support plan should consider what the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. The Council should review the plan regularly to ensure it is meeting the person’s assessed needs and at least every 12 months.
8. A council must make necessary enquiries if it has reason to think a person may be at risk of abuse or neglect and has needs for care and support which mean he or she cannot protect himself or herself. It must also decide whether it or another person or agency should take any action to protect the person from abuse or risk. (section 42, Care Act 2014)

What happened

9. Mr B is autistic and he has depression and anxiety. He lived in supported living accommodation, sharing a house with other residents. The house was rented from a housing association. Mr B was receiving eight hours of support from a care provider daily to help him live independently and motivate himself to carry out personal care and household tasks.

The move from his first supported living accommodation

10. In early 2017, it became clear that Mr B’s behaviour was jeopardising his tenancy. He had several aggressive altercations with another resident, he disturbed them by cooking during the night, and he was leaving mess and rubbish around the house.
11. The case notes show that the Council’s social worker (SW), a social work assistant and their manager spoke to Mr B about this several times. The care provider tried to support him to improve his communal living skills. It helped him source some better furniture to store his belongings. The carer provider also drafted a simple contract with rules for Mr B to abide by. But he would not sign this or abide by the rules. Mr B did not always come to the scheduled meetings at his home. The carers tried to support Mr B to live peacefully with the other residents and to take responsibility for his own actions, but this was not successful. The case notes show that the SW and Mr B exchanged emails regularly, in which the SW would remind Mr B how to word his grievances so that he was not offensive about other members of staff, and that he had to make better choices about his behaviour.
12. Mr B was sending several emails a week making allegations against staff and residents. The Council agreed Mr B should send all his concerns in one email once a week to his SW. The SW spent the day with Mr B going through what was expected of him and what he could expect of the care staff.
13. The Council made clear to Mr B that his behaviour was putting his tenancy at risk and that he would not be able to go back to live with his parents. The case notes show that the Council started to look for alternative accommodation for Mr B and spoke to him about that. The Council had a meeting with Mr B and found another place for him to live. The case notes say that Mr B was reluctant to move. But that when he went to visit the new home, he liked it and wanted to visit again, and then changed his mind.
14. The case notes show that the Council kept in touch with the home manager and care provider. The care staff agreed they could support Mr B if his behaviour improved as he had said he did not want to move. Unfortunately, Mr B continued to make numerous complaints and allegations about the staff. He had also contacted the Police, and then retracted his allegations. Mr B had also started blocking the toilet and making a mess with toilet paper in the communal parts of the house.
15. As Mr B’s behaviour did not significantly improve, the housing association emailed Mr B in July 2017 to warn him that his tenancy was at risk. It asked to meet with him to discuss this. The Council found Mr B a flat, which he visited but he did not like the location. The housing association hand delivered a final written warning to Mr B. He decided to move to the flat and emailed his SW. The Council’s SW and the care staff helped to arrange the move. However, the case notes show that after Mr B had moved his belongings and signed the tenancy agreement, he became unsure. Mr B moved to the new flat but then said that he had been moved against his will and he had not agreed to this. He wanted to go back to the previous shared home. The Council told him that he could not move back there.
16. The Council investigated Mr B’s concerns. It also made referrals to the community mental health service. The Council says he and his family were fully included in move and he knew why it was needed.
17. There is no fault by the Council. It worked with the care provider and Mr B to make sure he could continue to live in the shared house, but this was unsuccessful. Mr B decided to move to the flat having seen it and after discussing this with his SW. The housing association had given him a final warning and his behaviour was not improved. Mr B would not have been able to continue living in the shared house in any case. The Council found alternative accommodation for him and supported him to move there.

That the new flat does not meet Mr B’s needs

18. The case notes show that Mr B made allegations about the care staff from when he moved to the flat. He also told the SW that he felt isolated there. The SW arranged to meet with Mr B. The SW also arranged a professionals’ meeting to discuss the allegations and how to support Mr B. The Council agreed to help Mr B move again.
19. The Council reviewed Mr B’s needs and how these were being met regularly with him. This often took several attempts as Mr B would agree to a meeting with the SW but refuse to come out of his room and request the meeting be moved.
20. Mr B’s needs are assessed and the support he receives is via the same care provider that supported him at the shared house. There is no evidence that the support and the flat does not meet his needs.

The reduction of hours, staff training, using Mr B’s toilet and whether Mr B engages with care staff

21. The Council assessed Mr B’s needs and then reviewed regularly how the care was meeting these. The files show that the Council changed the hours to better suit Mr B’s typical day, so that eight hours were provided but started later in the day.
22. The Council met on 23 November 2017 to discuss Mr B’s support hours. Mr B refused to attend the meeting. The care provider told the Council that Mr B would often send the staff away and he was not using his support hours. He was seeing to all his needs without support except that he was not maintaining the flat. The Council decided to reduce Mr B’s support hours. The SW explained why it had done so and also suggested that he use the hours to look at moving again if he had decided he did not like the flat. The care provider was concerned this would negatively impact on Mr B and so the Council did not reduce his hours.
23. The Council arranged again for a mental health assessment, as Mr B had told the Council he wanted to harm himself and also was urinating in bags and bottles and leaving these in the flat. The Council decided that it would look for a short-term placement for Mr B in a residential home so that it could get a more accurate picture of his needs and mental health.
24. The mental health team had already assessed his needs and decided that he did not have mental health needs. The Council gave the mental health team some more information about Mr B and possible mental health concerns.
25. In March 2018, the Council again decided to reduce Mr B’s support hours because he was not getting out of bed or using these. Mr B himself had told the Council that he was staying in bed and the support workers confirmed this too. The Council explained to Mr B in an email why it was reducing his hours. It made clear that he was expected to get himself out of bed in the morning and did not need care staff to do this. The Council also suggested he see his GP in case his depression had worsened.
26. Mr B’s mother contacted the Council to ask that his hours are not reduced, the Council explained the reasons why to her. The care provider also told the Council that although it understood it could not be fund a carer to be there while Mr B was in bed, it worried that his mental health would deteriorate if his hours were cut. The Council again decided not to cut the support hours.
27. Mr B had complained several times about his SW and so the Council allocated a different worker.
28. The Care Provider has also responded to my enquiries it says:
• staff do not use his toilet and are happy to use facilities in a nearby supermarket. If a carer does need to use the toilet urgently, this would only happen with Mr B’s consent;
• All staff are trained to professionally recognised standards including with regard to autism.
• The hours of support have recently been increased to encourage Mr B to engage more in activities. The review of the care plan revealed that Mr B was not using all his hours and was not engaging with staff.
• Care given is beyond that set out in the care plan to make sure Mr B’s flat is sanitary when he chooses not to use the toilet.
29. Mr B says the staff do not engage with him.
30. There was no fault in how the Council considered reducing Mr B’s support hours. The Council is required to make sure the care plan is meeting Mr B’s needs. It decided based on information from Mr B and from the care staff that he was not using the care provided. The case notes are clear that the Council explained this properly to Mr B and considered his views on this, those of the care provider and his parents when it reviewed its decision and decided not to reduce the hours. In the event, the Council did not reduce Mr B’s hours.
31. It is open to the Council and the care provider to decide that Mr B is not engaging with the staff and this is evident from the fact that he was not using the support hours provided. Moreover, this did not affect Mr B significantly as it did not reduce the support provided and the Council and care staff continued to work with Mr B to meet his needs.
32. The care staff are suitably trained and qualified. The staff refute that they use Mr B’s toilet without his consent and I have no reason to disbelieve them

The safeguarding investigation

33. Mr B made several accusations against staff and sometimes withdrew these. The Council’s files show that it referred all these matters to the safeguarding team.
34. On 7 August 2018, Mr B sent the Council audio recordings of two care staff responding to Mr B inappropriately and unprofessionally including swearing at him. The care provider suspended the workers and later dismissed them. The Council agrees that the staff were abusive to Mr B.
35. The Council conducted a safeguarding investigation but Mr B would not meet with the relevant staff about this. The care provider gave Mr B extra support at that time and made sure he understood the staff had been dismissed. The Council also discussed service improvements with the care provider to make sure this did not recur.
36. There was no fault in how the Council dealt with the allegation, and Mr B was informed of the outcome.

Advocacy

37. The Care Act is clear that the Council must arrange for an independent advocate to assist the involvement of a person in the assessment process if they have substantial difficulty being involved and if there is no one available to support them and represent the person’s wishes.
38. The Council agrees that it did not offer Mr B an advocate. It says he did not meet the criteria for advocacy services and that his family and the care staff could help him and represent his views.
39. Mr B was supported by his mother to complete the Council assessments of his needs in 2016 and 2017.
40. The Council’s review of Mr B’s needs of May 2018 does say that he would like an advocate but is happy to complete the assessment without one and can do so with the support of the care staff and his family.
41. The Council is not at fault because it was able to decided that Mr B had other people to help him and to represent his views.

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Final decision

42. I have completed my investigation. There was no fault by the Council or the care provider acting on its behalf.

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Investigator's decision on behalf of the Ombudsman