Summary: Ms C complains the adaptations proposed by the Council are not suitable and will not meet her son’s needs. The Ombudsman did not uphold Ms C’s complaint, because he found there was no fault with the process through which the Council reached its decision.

The complaint

1. The complainant, whom I shall call Ms C, complained to us on behalf of her son, whom I shall call Mr X. Ms C complained that she does not agree with the options the Council has put forward to adapt her property, to meet her son’s 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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 Council reached the decision. (Local Government Act 1974, section 34(3), 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 have considered the information I have received from Ms C and the Council. I shared a copy of my draft decision statement with Ms C and the Council and considered any comments I received, before I made my final decision.

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What I found

6. Mr X is a young man and a full-time wheelchair user who lives with his mother, who is his main carer. He receives a care package to support him and his mother. Mr X’s mobility is severely restricted by his medical conditions and needs to be hoisted for all transfers by two carers. When lying/sitting on the bed, he has to be supported by pillows on the left side to prevent him from falling to this side.
7. Mr X lives on the ground floor. The Council extended the property 15 years ago, which included a bedroom (extension 2.4m x 2.7m) and en-suite bathroom facilities (wet floor shower/toilet). Mr X has a ceiling track in his room and has automated door controls for his bedroom door and the front door.
8. Mr X spends most of his day in bed, when he is at home, using his phone or watching TV. Mr X says that lying on his bed provides him with relief as he finds it uncomfortable to sit in his wheelchair for long periods of time.
9. As such, Mr X spends long periods in bed, during which he will slide down the bed. His bed is 196cm long and 104cm wide. When he slides down, it creates pressure on his feet, which increases the pressure on his musculoskeletal system & aggravates his postural deterioration.
10. Mr X needs adaptations to the property, because there is not enough space to:
• fit a longer bed
• place a specialist chair for Mr X to use
• enable both of his carers to access both sides of the bed to complete double handed care.
11. As such, Ms C contacted the Council with a request to increase her son’s bedroom.
12. An Occupational Therapist (OT) visited Mr X in February 2018. The OT explained she would need to see how the carers provide Mr X’s support, to come to a view if two carers are needed. Ms C was not happy with this and the Council’s record of the visit state that Ms C was uncooperative.
13. The complex care team transferred Mr X’s case to a different senior OT Practitioner. The Complex Care Team manager and the new OT visited Ms C and her son in March 2018. The OT explained the benefits of a specialist seating chair, but noticed there was no space in the bedroom and limited space in the lounge to put this. The officers saw that an extension to the side of his bedroom would only create an extra 50cm, which would not be enough. The assessors explained the Council would need to carry out a manual handling review to assess how both carers help Mr X. The review took place the following day.
14. Another visit took place in June 2018 by the OT, a Grants Officer and a senior surveyor, to determine if it would be possible to create the extra bedroom space within the existing building. The visit explored the following options:
1. Option 1: Install a through lift and move Mr X’s bedroom to the first floor. Convert one of the other bedrooms on the first floor into an en-suite. The OT expressed concerns about this option, including the lift taking away useful space. Ms C said she would not agree to this option, because she was concerned about how her son can leave his room in an emergency. It was agreed, after extensive discussions, that this would not be the preferred option.
2. Option 2: Extend Mr X’s current bedroom outwards to the side. However, this was not a reasonable option, because it would need extensive work and would only create an extra 50cm, which was not enough.
3. Option 3: Extend Mr X’s current bedroom into the kitchen as well as to the rear by two metres along the width of the back of the home. This would create a 70cm increase to the side. The extension to his room would create space for an armchair, standing frame, power wheelchair and furniture. The extra space would also allow carers to operate on both sides of the bed with ease. However, this option would exceed £30K and there would have to be a charge against the property.
15. Mr X’s case went to the Housing Options Panel in July 2018. The minutes of the meeting state that:
• An extension was not agreed, because the panel felt the existing space should be sufficient to create additional space for the carers and the chair.
• The preferred option was: Extending the bedroom into the kitchen. The kitchen units that would be removed, should be put in the rear of the through lounge, not currently used as seating / dining area. The chimney could be removed to create space in the lounge for the chair, with a ceiling track hoists installed to transfer Mr X between his bed and the chair. The two unused bedrooms on the first floor could be used to store / re-site any items from downstairs.
• Alternatively, the Council could also explore the feasibility of option 1 further. The report provided to the panel said this option was not recommended by the OT.
16. Following the meeting, the OT visited Ms C to discuss the panel’s decision. Ms C was unhappy with the Council’s decision and submitted an appeal. The meeting of the appeal panel took place in November 2018. The members of the appeal panel were not part of the decision made in July 2018. The appeal panel decided that an extension was not needed and both options supported by the Housing Options Panel would meet Mr X’s needs.
17. The Council wanted to organise a feasibility visit by a lift company to explore if the first-floor option would be viable. However, Ms C did not agree for this visit to take place.
18. Ms C and her son want an extension to the bedroom, in line with option three identified in June 2018 (see paragraph 12 – point 3). Ms C says she has obtained quotes from builders and this would cost around £25-35,000. Ms C says an extension will provide more space for her son’s equipment, carers and his furniture. It will also allow her son appropriate access to the garden from his bedroom, instead of via the kitchen which is unsafe for him (see paragraph 20 a&b below). The Council’s options will also require the removal of the fireplace, which she is not happy with.
19. However, the Council has said that it needs to consider providing equipment and adaptations within the existing property, before it can consider an extension. Extending into the kitchen will increase the width of the bedroom by 72cm, which will be sufficient to enable carers to provide the care. The team who administer the Disabled Facilities Grant, which includes surveyors, have advised that the extension preferred by Ms C would cost around £80,000. Each option will enable Mr X to have independent access to the garden.

Option 1: reconfigure the internal ground floor layout to provide a larger bedroom space

20. Ms C and her son say they do not want to site the kitchen in the rear lounge and remove the chimney breast:
1. If the Council puts their kitchen units in the lounge area, it would not be safe to cook in that area. Making hot foods left on work surface could cause a problem.
2. Having the kitchen as part of the living room area is not ideal. Her son has visual memory difficulties when he is in his wheelchair, which affects his ability to observe spatial awareness when at home or out and about. He tends to crash into walls, doors, furniture and work surface. He also gets confused with his left and right.
3. The carers will be passing through the kitchen to go into his bedroom which can cause issues with regards to odours and contamination of food, with part of the kitchen being close to his wet room.
4. There will not be enough space to accommodate a specialist seating system within the bedroom.
5. She will need to get rid of furniture (bookshelves etc) to make space, which she does not want to part with.
6. There will be less communal space for visitors and less space remaining downstairs to fit all of his equipment, including: an armchair, his manual wheelchair and his standing frame.
21. The Council says:
1. Cooking will continue to take place in the existing part of the kitchen and therefore poses no additional risk to Mr X. Mr X does not need to be in the kitchen area. The cooker and other equipment that Ms C is concerned about could stay in the current kitchen; it does not have to be in the extended part of the kitchen.
2. Ms C did not raise this as an issue during any of the visits. Also, none of the OTs observed this during their visits. Mr X’s wheelchair Therapist/clinician has advised that he has never seen any evidence of spatial awareness difficulties experienced by Mr X at home. He confirmed that Mr X is a competent driver and is already manoeuvring his wheelchair within tight space and turning circles when at home. Any new lay out in the property will require a period of adjustment for Mr X and his mum to get used to as the current layout of the property has been the same for many years.
3. Many ground floor bedrooms are next to or close to a kitchen area. The current kitchen is already close to the bedroom and bathroom. Extending the kitchen into the lounge has been proposed at the far side of the room (furthest away from Mr X’s bedroom) The shower and toilet are currently at the end of the bedroom. There is a door that can be closed both to the bathroom and the bedroom. The suggested reconfiguration of the ground floor will not contravene building regulations.
4. The proposal is to install a ceiling track hoist to enable Mr X to move between his bed and an armchair, which will be positioned in the lounge.
5. There is enough space in the house to store any items, because the property has 3 to 4 bedrooms and only two occupants.

Option 2: install a through floor lift to access bedroom and accessible bathroom facilities on the first floors.

22. Ms C and her son say:
1. This option will isolate him. Socialising will be difficult with his bedroom being upstairs, as most of the guests sit in the sitting room area.
2. He is anxious about the possibility of a fire/emergency. If there would be a fire, he could not use the lift and it would be hard to carry him down the stairs.
3. His independence will be restricted. He uses his electric bedroom door for privacy when he needs to shut his doors. The electric doors also enable him to leave his room independently. It will not be possible to install this system on the first floor, as it is built within the framework of the doorway. It will require new doors costing around £10.000.
4. The intercom to let people in and out of the house is located downstairs.
5. There is not enough landing space for him to use the landing in his wheelchair, which can be very dangerous.
6. His carers will have to use the stairs all the time. This can be difficult as one of his carers has a limp and this could be difficult for him.
7. Having a lift in the front living room area will not be aesthetically pleasing and will take up living space.
8. The value of the house will go down due to the small bedroom being converted into a wet room.
23. The Council says:
1. Guests could be entertained in either the bedroom or the lounge, as the lift will give access to both floors and rooms.
2. This would be addressed through a manual override (which does not need electricity), smoke detectors, and flooring with fire retardant properties. The Council has not yet been able to initiate a fire safety check. However, any adaptation will meet the appropriate building and fire regulations.
3. If and when there is confirmation that a vertical lift is technically feasible, the Council will look at Mr X being able to open and close his bedroom door through an automated opening system if needed. Mr X will be able to leave his bedroom via the lift.
4. The intercom for opening/closing doors can be moved to the first floor, to accommodate the current level of independence.
5. The recommended adaptations for the lift, remove the need for Mr X to use the landing, as he will have an en-suite bathroom.
6. The carers will only have to go up and down once during a visit. If needed, they can use the lift.
7. The lift can be kept upstairs to enable the space downstairs to be used. The Council was unable to confirm the technical feasibility of this option, because Ms C has refused a feasibility visit to take place.
8. This is difficult to predict. The property could be put back to its original layout without too much difficulty or cost. It would remain a 3-bedroom property with a bathroom on each floor. If being considered for sale it is possible that another family with similar needs may want to purchase it.
9. Moving upstairs will increase the size of his bedroom from 2.4m x 2.7m to 3.1mx4.2m. This should be large enough to enable a chair in the room. However, this needs to be explored through a feasibility visit, which Ms C has not allowed.

Assessment

24. This is a decision for the Council to take on the merits of the case. The Ombudsman cannot substitute his judgement on what would be right for what a council has decided. He must consider whether there was fault in the way a council reached its decision.
25. I found the Council carried out an assessment, which captured Mr X’s needs. It subsequently undertook further visits to establish how these needs could be met by adapting the property.
26. The Council has considered the concerns from Ms C and her son and explained how these can or will be addressed. It is clear that Ms C feels the options proposed by the Council are not as good as extending the property at the back. However, when deciding how best to meet an individual’s needs, the Council is entitled to consider its available resources, in addition to the client’s stated preferences. As such, the Council is entitled to consider the most cost-effective way in which a person’s needs can be met, if this option will meet the identified needs in an appropriate manner.
27. I therefore found there was no fault with regards to the way through which the Council made its decision. Without fault, I will not question the merits of that decision (see paragraph 3 above).
28. Ms C has recently agreed for the Council to organise a feasibility visit to determine if the first-floor option is viable. Based on the outcome of this visit, the Council should organise a meeting with Ms C and her son to discuss whether she wants to go ahead with the option(s) put forward by the Council.

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Final decision

29. For reasons explained above, I did not uphold Ms C’s complaint.

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Investigator's decision on behalf of the Ombudsman