South Tyneside Metropolitan Borough Council (18 003 815)

Category : Adult care services > Other

Decision : Not upheld

Decision date : 05 Dec 2018

The Ombudsman's final decision:

Summary: There is no fault by the Council when restricting Miss B’s contact or assessing her care needs.

The complaint

  1. The complainant, whom I shall refer to as Miss B, complains that the Councils decision to restrict her contact with Council officers is unreasonable.
  2. Miss B also complains the Council is not providing her with sufficient support to meet her needs.

What I have investigated

  1. I have investigated Miss B’s complaint from July 2016. The final section of this statement contains my reason for not investigating the rest of the complaint.

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The Ombudsman’s role and powers

  1. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
  2. 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

  1. I read the complaint made by Miss B and discussed the complaint with her.
  2. I considered the Council’s comments about the complaint and any supporting documents it provided.
  3. I gave the Council, Miss B and her representative the opportunity to comment on my draft decision.

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What I found

  1. Miss B complains the Council has restricted her access to Council Officers by telephone.
  2. The investigator for Miss B’s previous complaint to the Ombudsman found the Council restricted contact in 2014, 2105 and 2016. The investigator considered the Council’s view that Miss B's contact was affecting its staff and disrupting the service it provided was reasonable and found no fault in the restriction of contact.
  3. The Council has a policy on unreasonable and/or persistent complainants. The Council’s policy sets out options for managing a complainant’s involvement. These could be placing time limits on telephone conversations, restricting phone calls and restricting communication to a certain named member of a team. The policy says the Council should write to the complainant explaining the decision, what this means for contact, how long restrictions will last and how the decision can be reviewed.
  4. In this the case the Council has written to Miss B on several occasions to explain the restrictions it has placed on her communication with the Council.
  5. The last letter to Miss B about her contact was sent by the Council on 12 July 2018. This letter detailed over 70 calls Miss B had made to the social work service in one week. The Council said that Miss B had made these calls, despite an earlier letter to say the Council would only accept one call a day. The Council said the out of hours service covers all the borough and her actions potentially placed other more vulnerable people at risk if social workers could not respond to calls. The Council said it was putting in place further contact restrictions. This meant that any calls Miss B made, other than one call a day to her social worker, would be politely terminated. Miss B could also make one call per week to the housing manager. The letter said the restrictions would be reviewed in 6 months and told her of how she could appeal the decision.

My analysis

  1. The Council has applied the restrictions on Miss B’s contact with the Council in line with its policy. It has written to her, explained the restrictions, given a date for review and told her of her right of appeal.
  2. Given the large amount of phone calls Miss B made to the Council, I can find no evidence of fault in its decision her contact was unreasonable and should be restricted.

Complaint about care needs

Key facts

  1. If a service user has assessed care needs she may choose to receive direct payments so she can arrange the care herself. A service user in receipt of direct payments may find her own personal assistants or may get carers from care agencies.
  2. Miss B has a degenerative condition which limits her mobility. She has a history of falls. Miss B also suffers from severe anxiety which causes pain in her stomach and chest.
  3. Over the last 2 years Miss X has had over 5 advocates from different services which have contacted the Council on her behalf, as well as her daughter.
  4. Miss B received direct payments to pay for her assessed care needs. In her previous complaint to the Ombudsman, no fault was found in the Council’s decision to reduce Miss X’s care to 10 hours per week in April 2016.
  5. In August 2016, Miss B’s family who had been providing care to her withdrew their support. The Council contacted Miss B. The file notes show that an officer sent her copies of CV’s of carers but Miss B told her she put them in the bin. The Council also offered to arrange Miss B’s care for her rather than make direct payments to her.
  6. The Council carried out a care assessment in April 2017. This assessment was carried out without Miss B’s co-operation. Miss B did not want the advocate to attend. The social worker used the following information when carrying out the assessment:
    • Previous assessments and file notes.
    • Miss B’s hospital doctor and G.P.
  7. The assessment concluded that Miss B had been getting direct payments but no formal support had been in place since August 2016. The assessment noted that Miss B had the capacity to make decisions for herself. She could shop online to get food delivered, manage her personal care, obtain support from others (family or paid help) with heavy domestic tasks, move around her home with a stairlift and walking trolley and administer her own medication. The report noted that Miss B chose not to engage with services and continued to make capacitated decision which may have a detrimental impact on her physical and mental well being. The assessment concluded that no services should be provided.
  8. In March 2018 a new assessment of need started. The meetings were held at Miss B’s home, with her daughter present for some of them.
  9. Miss B was informed by telephone that she would be entitled to 3 hours personal care and 4 hours for social activities from a service commissioned by the Council, rather than direct payments. Miss B did not agree to this so the Council offered the 7 hours via direct payments on 27 April 2018.
  10. At the end of April 2018, Miss B became unwell. The Council offered a period of short term respite care at home starting 30 April. On 1 May 2018 Miss B complained about the service.
  11. On 4 May 2018 a review of Miss B’s care was carried out. A short term arrangement with 3 calls of 30 minutes daily, along with 2 times 45 minutes for bathing support in the evening per week was put in place. After an incident, the care provider needed to send 2 carers per call but the records show Miss B then declined care.
  12. On 8 May 2018 Miss B went into hospital and the file notes show the Council started to search for a care provider for 3 times daily calls and 2 times bathing calls.
  13. On 21 May 2018 the Council offered Miss B short term respite care or the hospital at home service until the care provision could start on 28 May. Miss B refused this and left hospital.
  14. Miss B cancelled the care package on 11 June 2018. After several meetings, the Council offered Miss B the commissioned care package for 7 hours support and then direct payments for the 7 hours support. At the time of writing this report, the Council was due to meet with Miss B to finalise the agreement.

My analysis

  1. Miss B has capacity to make decisions on her care and has been supported by advocates and her daughter.
  2. The evidence shows that Officer visited Miss B, involved her advocate and her daughter, and sought information from other professionals involved in her care when she refused to co-operate with the assessment. The Social Worker noted that Miss B had not used 10 hours care per week for some time and had been managing without this level of care. I have seen no evidence of fault in the way the Social Worker reassessed Miss B. I cannot, therefore, criticise the Council's decision to cancel her care to 10 hours per week.
  3. After Miss B went into hospital, her care needs were reassessed. The Council has offered 7 hours care per week, via direct payments. I appreciate Miss B wants more care hours, but as I have seen no evidence of fault in the way the Social Worker assessed Miss B I cannot criticise the decision. I note the Council has offered temporary respite care or short term care in the interim.
  4. It is not clear to me what more the Council can do for Miss B. She is not willing to allow the Council to organise her care through agencies or consider short term/respite care.
  5. The Council is putting in place direct payments so she can organise her own care. This has taken longer than usual, partly because of Miss B’s illness which required hospital care and partly because Miss B has not engaged with the assessment process. I cannot identify any fault or failure by the Council.

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Final decision

  1. I have completed my investigation of this complaint as I have found no fault by the Council. This complaint is not upheld.

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Parts of the complaint that I did not investigate

  1. I have not investigated Miss B’s complaint before July 2016, as this was looked at in her previous complaint to the Ombudsman.

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Investigator's decision on behalf of the Ombudsman

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