Summary: Mr and Mrs Y complained on behalf of their adult son, Mr X, the Council failed to properly assess his care and support needs and to provide adequate care and support to meet his needs. The Council was not at fault.

The complaint

1. Mr and Mrs Y complain on behalf of their adult son, Mr X, the Council failed to properly assess Mr X’s care and support needs and to provide adequate care and support to meet his needs. It placed him in two unsuitable supported living placements and in emergency accommodation without adequate support. This impacted on Mr X’s behaviour and mental health and caused them anxiety and distress.

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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 decision was reached. (Local Government Act 1974, section 34(3), as amended)
4. 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 to consider events back to September 2017 as this is when Mr X moved into accommodation A and there is sufficient information available to make a sound decision regarding this.
5. 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

6. I have considered the information supplied by Mr and Mrs Y and have spoken with Mr Y on the phone. I have considered the Council’s response to my enquiries and the relevant law and guidance including the Mental Capacity Act 2005, the Care Act 2014 and the Care and Support Statutory Guidance.
7. I gave Mr and Mrs Y and the Council the opportunity to comment on a draft of this decision and considered their comments in reaching a final decision.

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What I found

Legal and administrative background

8. 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
9. 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. When preparing a care and support plan the local authority must involve any carer the adult has. The support plan may include a personal budget which is the money the council has worked out it will cost to arrange the necessary care and support for that person
10. Under the Mental Capacity Act 2005, a person must be presumed to have capacity to make a decision unless it is established that they lack capacity. A person should not be treated as unable to make a decision:
• because they make an unwise decision;
• based simply on their age, their appearance, assumptions about their condition, or any aspect of their behaviour; or
• before all practicable steps to help the person to do so have been taken without success.

What happened

11. Mr X is in his twenties. He has a learning difficulty, Asperger’s syndrome and an attachment disorder. Mr X previously lived with his parents Mr and Mrs Y who struggled to manage his behaviour.
12. In September 2017 the Council arranged for Mr X to live in a supported living placement at accommodation A to enable it to assess his needs and to improve his independence as he had never lived alone before. This was initially agreed for 13 weeks with a view to reducing the support and to enable Mr X to live more independently. Accommodation A had 24 hour support available and Mr X received an additional 15 hours of one to one support from a care agency. Accommodation A carried out a risk assessment and identified ways to support Mr X to avoid self-neglect, withdrawal/depression, and anti-social and inappropriate behaviour.
13. The Council reassessed Mr X’s care needs in November 2017. The review noted he felt secure and supported at the placement. The assessor noted Mr X ‘requires to continue to live in a supported environment that meets his needs but also equips him with skills that are required to live outside of this environment’. The review noted Mr and Mrs Y felt that Mr X was in the right placement to meet his needs. Mr and Mrs Y dispute this comment.
14. The review noted Mr X continued to need support to ensure he contributed to cleaning and tidying shared spaces, support with understanding finances and budgeting, prompting to carry out personal care tasks, to develop his social skills, and support and guidance with finding work or to go to college. Over time, Mr X did not always engage with the support provided.
15. In February 2018 Mr X was arrested following an allegation made by another resident at accommodation A. Mr and Mrs Y met with Council officers, police representatives and staff from Accommodation A. They noted Mr X had not broken the rules of the tenancy but it had been difficult to support him. Mr X joined the meeting. He said he was happy at Accommodation A. As part of his bail conditions he was not allowed to return to live there. Mr and Mrs Y agreed to accommodate Mr X short term. The Council also funded two nights bed and breakfast accommodation as an emergency placement for Mr X.
16. In mid February 2018, the Council held a professionals’ meeting with staff from accommodation A, Mr X’s support workers from the care agency and the police. This noted Mr X was accepting and engaging with support at that time. He continued to receive 2 hours a day support from the care agency. He also received support from a work coach to look for employment and an hour a week support from a key worker with an organisation who support individuals with multiple and complex problems. Staff from accommodation A considered the placement was not working as there were too many people for Mr X to deal with and Mr X was manipulating other residents. Mr X’s support workers were happy to continue to support him in the community.
17. The Council’s housing team accepted Mr X could not return to accommodation A at that time but did not feel it had appropriate temporary accommodation for Mr X. Mr X was on the Council’s housing register but had not yet successfully bid. The Council was pursuing the option of respite at accommodation B. Mr X’s allocated worker and the Council’s housing team, agreed to explore what housing options were available for Mr X. The allocated worker agreed to explore with Mr X the appropriateness of accommodation A and to discuss a positive move on. When the bail conditions were lifted, accommodation A carried out a risk assessment which concluded for Mr X and others to be safe at accommodation A, he would require 24/7 waking support. Mr X stayed with Mr and Mrs Y.
18. In March 2018 a Council social worker assessed Mr X’s capacity to manage his finances, to decide where he wanted to live, and to understand the consequences of his behaviour and actions. Mr X was supported by a worker from the care agency. The Council officer found Mr X had capacity to decide where to live, to make financial decisions and to understand the consequences of his behaviour. They noted Mr X acknowledged he spent money unwisely. He felt he would benefit from support to manage his finances and had insight into the risk of not having money available. He showed insight into the risks of living at home or in bed and breakfast accommodation. He showed insight into his mental health and how it affected him and he had some strategies in place to deal with this. At the end of April 2018 Mr X gave up his tenancy at accommodation A.
19. Mr X left his parents’ house then spent some time staying with friends. During this time Mr X did not maintain regular contact with the Council and did not use all the support it offered. His allocated worker then supported Mr X with accessing emergency accommodation through the Council’s housing team.
20. In May 2018, the Council’s housing team provided Mr X with some temporary bed and breakfast accommodation as an emergency placement due to his homelessness. The Council reassessed Mr X’s needs in May 2018 while he was in temporary bed and breakfast accommodation. He continued to have 14 hours a week one to one support available but regularly declined to accept it. Mr X lost the emergency placement after an incident involving other residents. The Council’s housing team advised its social services team that because of this it had ended its housing duty to Mr X.
21. Mr X privately funded some bed and breakfast accommodation with the support of Mr and Mrs Y. The Council’s social services team then funded some emergency bed and breakfast accommodation for Mr X until early June when a supported living placement at accommodation B, in a self-contained flat, became available. Accommodation B completed a risk assessment and identified ways to avert risks.
22. The Council reassessed Mr X’s care and support needs. At the assessment it noted Mr X struggled to plan ahead. He continued to need support with budgeting, managing his tenancy, identifying work or voluntary opportunities and developing daily routines. Mr X continued to receive 14 hours per week of one to one support at accommodation B. This was to support him with budgeting, settling into the accommodation, structuring his days and week, exploring work and voluntary opportunities and with decision making. The Council also provided him with information on voluntary support services and charities who could assist and provide Mr X additional support if he needed it.
23. The Council reviewed Mr X’s placement at the end of June 2018. It consulted Mr X’s support workers and key worker. At that time Mr X’s engagement with staff was fluctuating. He had not engaged with staff to actively look for regular activities in the community and had not used any of the additional contacts/voluntary support services suggested by the Council. Mr X’s engagement with support staff was fluctuating. Staff supported Mr X to comply with his tenancy agreement and prompted him to complete household tasks.
24. At the review Mr X wanted his support reduced to 7 hours a week. He was not engaging with support staff every day. The Council agreed to this with a view to increasing Mr X’s engagement with support workers but would review it in five weeks.
25. In the summer of 2018 Mr X was remanded in custody and later received a custodial sentence. He surrendered his tenancy at accommodation B. The allocated worker carried out a review in early August 2018. This noted that although Mr X expressed that he required support, he struggled with committing to activities and jointly planned tasks. He did not seek support from staff when felling distressed and did not engage with staff who offered to talk things through. Mr X’s support was terminated. The allocated worker noted Mr X would require a new referral to the Council’s adult social care prior to his release.

Findings

26. The Council assessed Mr X’s eligible social care needs, and carried out reviews when Mr X’s situation changed, in 2017 and 2018 in line with the Care Act. It considered Mr X’s views and sought input from his support workers. There is no evidence of fault in how this was done.
27. The Council assessed Mr X’s capacity and decided Mr X had capacity to make decisions regarding where he lived, managing his finances and understanding the consequences of his behaviour. The capacity assessments were carried out by an independent social worker with a support worker from Council funded care agency present. As there is no evidence of fault in the way the Council carried out these assessments, I cannot question its view that he had capacity. Mr X made unwise choices but that in itself does not mean he lacked capacity to make those choices.
28. It was Mr X’s choice not to engage fully with the support the Council arranged. The Council arranged supported accommodation for Mr X and one to one support hours to meet his assessed needs. Mr X did not always engage with the support offered and did not comply with the tenancy agreements or rules of behaviour expected at the placements. The failure of these placements was not because of fault by the Council. When the Council’s housing team ended its duty to Mr X, the Council’s adult care services arranged emergency accommodation while trying to arrange more settled accommodation for Mr X. The Council took appropriate action and there is no evidence or fault in the way it sought to support Mr X with accommodation.
29. Mr and Mrs Y may have felt pressurised to accommodate Mr X but that is not as a result of fault by the Council. Mr X asked the Council to approach Mr and Mrs Y. It also accommodated Mr X in bed and breakfast accommodation while waiting for a supported living placement to become available.
30. As the Council followed the correct procedures, based its decisions and support on its assessments, and sought Mr X’s views, there was no fault.

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Final Decision

31. I have completed my investigation. The Council was not at fault.

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Investigator's decision on behalf of the Ombudsman