Summary: Miss X complains the Council has not met a need for respite care identified in her mother’s, Mrs Y’s, carer’s assessment. The Council is at fault. It did not make sufficient efforts to arrange respite care for Mrs Y between April and September 2017 and delayed in chasing up the agreed respite provision between July and September 2018. The lack of respite care is likely to have caused Mrs Y increased carer stress. The Council has agreed to apologise to Miss X and Mrs Y, and pay Mrs Y £250 to acknowledge the undue stress caused.

The complaint

1. Miss X’s mother, Mrs Y, is a carer for her other daughter, Miss Z. The Council has assessed Mrs Y as needing 19 nights respite care a year. Miss X complains that since a respite arrangement broke down in March 2017, Mrs Y has only had three nights respite care. This has had a negative impact on her health. She wants the Council to meet the identified need and provide regular respite care for her mother.

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The Ombudsman’s role and powers

2. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended). I have decided there are good reasons to investigate what has happened since January 2017. This is when the established respite arrangement broke down and Miss X says the Council has failed to provide regular respite for her mother since then.
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. I read Miss X’s complaint and spoke with her about it on the phone. I considered information she sent me.
6. I made enquiries of the Council and considered the information it sent me.
7. Miss X and the Council had the opportunity to comment on a draft of the decision. I considered their comments before making my final decision.

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What I found

8. The Care Act 2014 sets out the legal framework for the assessment and provision of care and support for people with eligible needs and their carers.
9. Where an individual provides care for another adult and it appears the carer may have any level of needs for support, the Council must carry out a carer’s assessment.
10. The assessment must consider the outcomes the carer wants to achieve in their day to day life, their activities beyond their caring responsibilities and the impact of the caring on those responsibilities.
11. If the Council identifies the carer has eligible support needs, it must meet them. The law says when a Council cannot meet all or some of a carer’s needs for support, it must as far as it is feasible, identify another way to do so.
12. When an adult refuses a carer’s assessment, the Council does not have to complete one.
13. Supported living is a care arrangement which enables people with disabilities to live as independently as possible, in their own home, with a package of support.

What happened

14. Miss X’s mother, Mrs Y, provides care for her other daughter, Miss Z. Miss Z has a health condition which causes learning disabilities and challenging behaviour.
15. The Council completed a carer’s assessment with Mrs Y in March 2015. This identified Mrs Y as having eligible support needs. It said Mrs Y needed 19 nights respite care a year to support her in her role caring for Miss Z.
16. In January 2017, the established respite arrangement broke down. The respite provider told the Council it could no longer meet Miss Z’s needs.
17. In February 2017, Mrs Y attended a meeting for a review of her carer’s assessment. However, the Council officer left the Council without documenting this meeting, so there is no record. The Council has apologised to Mrs Y and her family for this.
18. In February 2017, the respite provider reaffirmed it could no longer meet Miss Z’s needs for respite. The next period of planned respite was in March 2017. The Council social worker spoke to Miss X to say due to the short notice, it could not arrange another respite provider. Instead, it offered Mrs Y respite care for Miss Z within the home. Miss X said Mrs Y would not accept this and declined the offer. Miss X says she declined this due to the short notice, not because she was against the idea of respite provision within Mrs Y’s and Miss Z’s home. She says the Council made no further offers of respite provision within the home.
19. In April 2017, the social worker completed a reassessment of Miss Z’s needs. The records show the social worker discussed the option of Supported Living with the family. It says the reason for the discussion was “to recognise the need for her to be able to increase her independence and reduce her reliance on her parents given their advancing age.” The social worker told Mrs Y and Miss X that an option for a supported living placement for Miss Z had become available in the local area. The records say Mrs Y and Miss X both agreed this was an option worth considering and pursuing. Miss X says she told the social worker they should continue to pursue respite provision for Mrs Y at the same time.
20. In June 2017, the social worker visited Mrs Y for further discussion about the option of supported living. They left some written information for Mrs Y to consider. Mrs Y is recorded as saying that if Miss Z was happy with this option, then she was too. The social worker agreed to talk to Miss Z about it to gather her views.
21. In June 2017, the social worker spoke to Miss Z’s other sister, Miss W. The records show she also agreed supported living was a good option to consider. Miss X says her sister also told the social worker to continue looking for respite care options.
22. The social worker met with Miss Z. They discussed supported living with her and what it would be like. The record said Miss Z showed interest in finding out more.
23. The social worker met twice more with Miss Z to discuss supported living and showed her a video to aid her understanding. They arranged for Miss Z to visit the accommodation and to meet the other residents with whom she would be living. Miss X says Miss Z did not understand the supported accommodation was a permanent arrangement and not respite care.
24. In July 2017, the social worker rang Mrs Y with an update. They discussed planning a transition for Miss Z to move to the supported accommodation. The records say Mrs Y agreed with this in principle. Miss X says the Council pressurised her mother during phone calls to agree to this.
25. Mrs Y rang the social worker later that month. She said she did not want Miss Z to move to the supported accommodation. She expressed doubts about Miss Z’s understanding of the proposal and ability to make an informed decision. She said when she talked to Miss Z about it, Miss Z thought it was an option for respite.
26. The social worker spoke to Miss X. Miss X told the social worker both her and her sister Miss W considered the option of supported living worth exploring. Miss X says she thought the process would take many months if not years of planning.
27. At the end of July, the social worker met with Mrs Y, Miss X and Miss W. The meeting records acknowledged that respite had initially been requested, but all agreed that when the supported living option became available, it was worth exploring. The records show all agreed Miss Z needed an advocate and more time to make the decision.
28. In September 2017, Miss X and Miss W contacted the social worker. They requested an update. They expressed concern current discussions were about supported living and not respite options. They said the family had not discussed the option of supported living with Miss Z and they did not want this.
29. The supported living provider decided it could not meet Miss Z’s needs and could not offer her supported living accommodation. The next day the social worker emailed Miss X and Miss W to tell them this. They said they would arrange a meeting with Mrs Y to discuss respite care.
30. Miss W met with the social worker. Miss W said Miss Z was not coping with recent disruption to her day care service. Miss W told the social worker not to pursue respite options at this time, but to concentrate on stabilising the day service support.
31. Miss X wrote to the Council. She said disruption in the day care service was causing uncertainty and distress. She said the family had asked for respite, not supported living, and now even the supported living option had fallen through.
32. The Council replied saying it would continue to work to find a solution and explore respite options and other longer-term solutions. It said it must work with external care providers and sometimes decisions were made which were out of the Council’s control.
33. In October 2017, Miss X made a formal complaint to the Council. She complained the Council had offered supported living accommodation and not respite care, as the family had requested. Miss X said she thought the Council had not fulfilled its duties under the Care Act 2014.
34. In October 2017, Miss W emailed the social worker for an update. The social worker replied saying they were still working to resolve the disruption to the day care service. The email said, as discussed, they were working to stabilise the day care service before looking at options for respite.
35. In October 2017, the social worker offered respite in a respite centre out of area. Miss W replied to say she did not think this was a suitable option but would discuss it with Mrs Y and Miss Z. Miss X says this was never a formal offer of respite and their request for more information was not responded to. Records show both Miss X and Miss W told the social worker they would discuss the option in the family. Miss X said she would get back to the social worker, but I cannot see that she did this. Miss X says she did not respond as the social worker did not reply to the request for more information. The Council said the family did not take up this option.
36. In November 2017, the Council responded to Miss X’s formal complaint. It said it was unfortunate the supported living provider decided it could not meet Miss Z’s needs. It apologised but said the Council could not be held responsible for the decisions of another agency. It upheld Miss X’s complaint that by trying to address Miss Z’s long-term needs, Mrs Y’s needs for respite care may have been overlooked. It apologised for this. It said the Council was continuing to pursue care options.
37. In December 2017, the Social Work team manager met with Miss X to discuss the case. Following the meeting the team manager emailed the service manager to highlight the limitations of respite options in the area. They agreed to explore other respite options and said Miss Z would be allocated a new social worker in the new year.
38. The Council allocated Miss Z a new social worker in February 2018. The social worker discussed respite provision with Miss Z’s day care provider. The care provider said they could provide two-night respite breaks every four weeks in one of their properties between May and October 2018.
39. In April 2018, the social worker confirmed this plan with Mrs Y and the care provider. The Council said it agreed with the care provider it would arrange the dates for respite directly with Mrs Y. Miss X says the care provider told Mrs Y the property was not ready, and it would let her know when respite could start. Miss X says the care provider did not do this.
40. In July 2018, the social worker rang Mrs Y. Mrs Y said she had had no recent discussion with the care provider about respite care. The social worker said they would contact the care provider for an update. I have seen no evidence that they did this.
41. In September 2018, Miss X emailed the Council asking for an update regarding the respite. The social worker rang Mrs Y again. Mrs Y said the service provider had not contacted her about arranging respite. The social worker apologised and emailed the care provider to ask why it had not contacted Mrs Y to arrange respite care.
42. In October 2018, the Council spoke to the care provider. The care provider said Mrs Y was reluctant to communicate with them and had not contacted them about arranging respite. It also said Miss Z was currently not agreeing to attend respite and it would not proceed without her agreement. It said it was difficult to arrange respite as Mrs Y would not communicate with them. Miss X says the care provider never told her of its concerns.
43. The social worker rang Mrs Y to update her and said they were discussing a respite option with the day care provider and exploring other respite options.
44. During October 2018, the social worker contacted 10 other different care providers to try and source respite care.
45. In November 2018, the social worker arranged a meeting with Miss X, Mrs Y, the day care provider and the social work manager. The day care provider said respite had been arranged and then not taken up. It said Miss Z had not agreed to respite and had declined to go. The day care provider offered more dates for respite up until Christmas and Mrs Y agreed these dates.
46. In November 2018, the day care provider served notice saying it was cancelling the contract providing day care services for Miss Z from the end of February 2019.
47. In December 2018, the social worker sourced a new care provider who agreed to provide day care and future respite care. The social worker held a meeting with the new day care provider, Mrs Y and Miss Z. Mrs Y requested it delay the start of any respite arrangements until after the new day care service was established from March 2019.

Analysis

48. When the respite arrangement broke down in February 2017, the Council offered Mrs Y the option of respite care in her home. Miss X declined this saying Mrs Y would not accept it. The Council acted appropriately to offer an alternative respite option to the family and the decision to decline this was Miss X’s choice.
49. When the option of a supported living placement became available in April 2017, the social worker discussed this with Miss X and Mrs Y. The records show they both agreed that supported living was an option worth pursuing. Miss X says she told the social worker she should also continue seeking respite care for Mrs Y. The Council responded to this in its complaint response.
50. The Council upheld Miss X’s complaint that by trying to address Miss Z’s long-term needs, Mrs Y’s needs may have been overlooked. The Council has apologised for this.
51. The Council was at fault. It failed to pursue respite care options for Mrs Y whilst it was exploring the supported living option for Miss Z. Mrs Y continued to care for Miss Z during this period without the Council meeting her assessed need for respite. I cannot now know what options may have been available at that time or whether Miss X and her family would have accepted them. However, this left Miss X with a sense of uncertainty over whether other respite options may have been possible, and Mrs Y is likely to have experienced increased carer’s strain due to the lack of respite.
52. In June 2017, Mrs Y told the social worker if Miss Z was happy with the proposal for supported living, she was happy for the social worker to pursue this option. The social worker discussed it with Miss Z, and Miss Z showed interest in finding out more. It was not fault for the Council to continue to pursue this option.
53. In July 2017, Mrs Y, Miss X and Miss W all said they agreed for the social worker to continue working towards Miss Z moving to supported living. Although Miss X says her mother was pressurised into agreeing, I have seen no evidence of this. I cannot know now exactly what was said and the Council will now have deleted the recordings of phone calls in line with its data retention policy. When later that month, Mrs Y rang the Council to say she no longer wanted Miss Z to move to supported accommodation, the Council acted appropriately to call a meeting to discuss it further. The minutes say all agreed Miss Z needed an advocate and more time to make the decision.
54. The supported living provider later decided it could not meet Miss Z needs. This decision was out of the Council’s control. The Council cannot be held accountable for decisions taken by external service providers.
55. In September 2017, there was disruption in Miss Z’s day care support. The family asked the Council not to pursue respite options at this stage, until the day care support was stabilised. The Council acted according to the family’s expressed wishes. The Council did offer one respite option out of area. Records show the family told the social worker they would discuss this option within the family but did not confirm they agreed to it. The Council could not proceed without the family’s agreement and this is not fault.
56. The social worker made arrangements for respite care between May and October 2018 but arranged for the care provider to agree the dates with the family. The care provider did not do this, and the family did not contact the care provider to discuss it either. The Council is not responsible for the actions of the care provider. The Council became aware the care provider had not contacted Mrs Y in July 2018. It told Mrs Y it would contact the care provider to find out why but did not do this until September 2018. This two-month delay in chasing up why the care provider had not contacted the family to arrange the respite care is fault.
57. The social worker then explored several other respite options and arranged some respite dates for November and December 2018.
58. At a meeting in December 2018, Mrs Y then requested any respite care be delayed until after Miss Z had settled into a routine with the new day care provider. This was Mrs Y’s decision to make.
59. There is fault in the Council’s actions. The Council has accepted it may have overlooked Mrs Y’s needs whilst pursuing the option of supported living. It has already apologised for this. There was also a two-month delay between July and September 2018 in contacting the care provider to chase up the agreed respite care. This led to uncertainty for Miss X and her family over whether respite could have been sourced earlier and is likely to have caused increased carer stress for Mrs Y.

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Agreed actions

60. Within one month of the final decision, the Council has agreed to:
• Write to Miss X to apologise to her and Mrs Y for the uncertainty caused by the delays in pursuing respite options;
• Pay Mrs Y £250 to acknowledge the increased carer stress likely to have been caused by the delays.

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Final decision

61. I have completed my investigation. There is fault in the Council’s actions. The Council has agreed actions to remedy the injustice caused.

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Investigator's decision on behalf of the Ombudsman