Summary: Mrs T complains about the Council’s decision to stop day centre provision for her adult son following his move to a residential care home. She also says the Council took over his finances without notifying or consulting her, failed to issue invoices in respect of his contribution towards the cost of his care and failed to respond to her correspondence or keep her informed. The Ombudsman finds no fault on the Council’s part.

The complaint

1. Mrs T complains on behalf of her adult son, Mr R, about the Council’s decision to stop day centre provision following his move into a residential care home.
2. She also complains that the Council has taken over Mr R’s financial affairs without notifying or consulting her; failed to issue invoices in respect of Mr R’s contribution towards the cost of his care; and, since his move to the care home, failed to respond to correspondence or keep her informed.

Back to top

The Ombudsman’s role and powers

3. 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)
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)

Back to top

How I considered this complaint

5. I have considered all the information provided by Mrs T, made enquiries of the Council and considered its comments and the documents it provided.
6. Mrs T and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

7. The Care Act 2014 requires local authorities to carry out an assessment for any adult with an appearance of the need for care and support. The assessment must be of the adult’s needs and the impact on their well-being 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.
8. The Care and Support (Eligibility Criteria) Regulations 2014 sets out the eligibility threshold for adults with care and support needs. The threshold is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how this impacts on their well-being. To have needs which are eligible for support, the following must apply:
1. the needs must arise from or be related to a physical or mental impairment or illness;
2. because of the needs, the adult must be unable to achieve two or more of the following:
• managing and maintaining nutrition;
• maintaining personal hygiene;
• managing toilet needs;
• being appropriately clothed;
• making use of their home safely;
• maintaining a habitable home environment;
• developing and maintaining family or other personal relationships;
• accessing and engaging in work, training, education or volunteering;
• making use of necessary facilities or services in the local community including public transport, and recreational facilities or services; and
• carrying out any caring responsibilities the adult has for a child.

(Care and Support (Eligibility Criteria) Regulations 2014, Regulation 2)

9. If a council decides a person is eligible for care, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether and to what extent the needs meet the eligibility criteria and specifies the needs the council is going to meet and how this will be done. The council should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
10. Statutory Guidance explains a council should review a care and support plan at least every year, upon request or in response to a change in circumstances (Care and Support Statutory Guidance, Paragraph 13.32)

Key facts

11. Mr R has cerebral palsy and severe learning difficulties. He needs to be supported with all aspects of his life. Mr R was living at home with his parents and had been attending a day centre five days a week for many years and overnight respite 36 nights per year. This was to meet his assessed needs for support in ‘developing and maintaining family or other personal relationships’ and ‘making use of necessary facilities or services in the local community, including public transport, and recreational facilities or services’. In addition, Mrs T needed respite from her role as Mr R’s carer.
12. Mr R wanted to move to a residential home but still be able to attend day centre as he enjoys social activities. A suitable placement (‘the Home’) was found and, in November 2016, there was an exchange of emails between the social worker, Officer X, and the Home. They agreed the Home would complete an assessment for Mr R before he moved in. Officer X told the Home that when Mr R moved to the Home his current day care provision would end and all his care and support must be met by the Home.
13. The home completed an assessment and confirmed it was able to meet Mr R’s needs.
14. On 6 December 2016 Mrs T sent an email to Officer X following a conversation about Mr R’s impending move. She said she did not agree with the day centre placement ending when Mr R moved to the Home. She said he needed the social engagement opportunities provided by the day centre which he had attended for some years. She would agree to his attendance being reduced to three days a week but could not agree to his attendance stopping altogether.
15. Officer X replied stating that she would gather evidence at the upcoming annual review and then present the case to the social care panel requesting that Mr R continue his day care provision three days a week highlighting the importance and the impact it would have on him if this provision was stopped completely at the same time as his move to the Home. She said “As discussed I will propose this for 6 months allowing [the Home] to get to know [Mr R] and also to explore local facilities in this time. After six months this provision can be reviewed again depending on the assessed need.”
16. In December 2016 the Council completed an annual review. The review document recorded that Mrs T wanted Mr R to continue attending day care because socialising was a big part of his life and it would impact on him significantly if he was to move out of his home and have to give up day care provision. The document stated that when Mr R moved to the home his attendance at the day centre may be reduced to three days a week if approved at the social care panel.
17. In January 2017 Officer X presented the case to the social care panel. She requested funding for Mr R to continue attending the day centre three days a week and for this to be reviewed in 12 months’ time with the recommendation for the Home to meet all of his social care needs by then. She said the day centre provided access to physiotherapy and yoga which was important for Mr R’s health and it would not be in Mr R’s best interest if he was to stop attending day centre at the same time as having to adjust to moving out of his family home.
18. The panel agreed Mr R would continue to attend the day centre three days a week with a view to the Home working towards supporting him with his social care needs seven days a week after the first 12 months. The panel stated Officer X should review the matter in nine months to allow the Home to explore social care opportunities before day care provision ended at 12 months. The Home should also make a referral to physiotherapy for Mr R to be supported with his health needs after 12 months.
19. Officer X told the Home that day care provision had been authorised for three days per week and it would be required to support Mr R with his social care needs for the days he was not at the day centre.
20. In March 2017 Mr R moved to the Home. He continued to attend the day centre three days a week. This was gradually reduced and, in February 2018, he stopped attending.
21. Mrs T was not happy with the decision to stop the day centre visits and complained to the Council on 30 January 2018. The Council responded on 9 March 2018 but did not uphold her complaint.
22. Mrs T managed Mr R’s finances until October 2019 when the Council acquired appointeeship to manage his finances in her place because of debts that had accrued.

Analysis

The decision to stop day centre provision

23. Mrs T believes Mr R should continue attending the day care centre because the Home cannot meet his socialisation and psychological stimulation needs. She says if she had known the day centre visits would end she would not have agreed to Mr R moving to the Home. She says the assessment carried out by the care provider at the beginning of the placement stated Mr R would continue to attend the day centre five days a week to meet his social needs and the Council accepted this.
24. The care provider’s assessment stated that Mr R attended a day centre five days per week and stated, “it is important that this placement enables him to attend the [day centre]”.
25. However, it is clear from discussions in December 2016 and January 2017 that Mrs T was aware it was always the Council’s intention to reduce Mr R’s attendance at the day centre over a period of 12 months. The plan was that day care would be reduced gradually to help Mr R just to the changes and the Home would take over all his care and support needs after 12 months. This approach was agreed by the social care panel.
26. A review was completed in May 2017 to assess how Mr R had settled into the Home. Mrs T said he had settled well and she had no concerns. Officer X explained the plan was for Mr R to gradually transition from attending the day centre three days a week to being fully supported by the Home with his social care needs. The review document stated that this was to happen by January 2018.
27. An annual review was completed in January 2018 to assess whether Mr R’s care package continued to meet his assessed needs. By this time his attendance at the day centre had been reduced to once a week and was due to end in February 2018. During the review Mrs T said Mr R’s behaviour had changed since his attendance at the day centre had been reduced. She wanted him to continue attending because socialising was a big part of his life and it would impact on him significantly if this was discontinued. The Home manager said if Mr R’s day care ended, they would need additional one-to-one hours to support him with activities of his choice.
28. A further review was carried out in October 2019. The review document stated under the heading “Making Use of Services in the Local Community”” that the outcomes on the previous support plan had been fully achieved. It stated that Mr R was supported to access the community by staff at the Home. Under the heading “Maintaining Family and Personal Relationships” the document stated that this was also fully achieved. Mr R was visited by his parents and had made friends at a sister home which he had visited many times for events and playing computer games. He had a good relationship with staff at the Home who allowed him into the kitchen and would listen to music with him.
29. The Council says that, when it moved Mr R to the Home, it commissioned this service to meet all his needs including ‘developing and maintaining family or other personal relationships’ and ‘making use of necessary facilities or services in the local community, including public transport, and recreational facilities or services’ which were previously met by the day centre and overnight respite. It phased out visits to the day centre over a period of more than 12 months to allow Mr R time to transition and allow the Home time to learn about his likes and dislikes.
30. The Council is satisfied from reviews carried out that Mr R is receiving good quality care that meets his needs well so there is no need for him to attend the day centre. In addition, Mrs T no longer needs respite as she no longer has full-time caring responsibilities for Mr R.
31. Mrs T says the Home cannot meet Mr R’s socialisation needs. Says she raised this issue with Officer X who agreed to apply for funding for the Home to support social activities for Mr R as this had not been included in the commissioning of the service. After Officer X left the service the manager of the Home pursued this and applied for 15 hours extra one-to-one funding for Mr R. But the funding panel declined the request.
32. The Ombudsman is not an appeal body and cannot overturn the Council’s decision about the level of support a person should receive. We do not comment on the merits of decisions properly made even though people may disagree with them. Our role is to consider whether there was any fault in the way the decision was reached and, if so, to recommend a remedy.
33. There is no evidence of fault in how the Council reached its decision to stop the day centre visits. So, there are no grounds to question that decision however much Mrs T disagrees with it.
34. I accept the care provider’s initial assessment stated Mr R should continue to visit the day centre, but the Council stated from the outset that the plan was to reduce day centre visits over a period of 12 months. Both Mrs T and the Home were aware of this. Initially, Officer X told the Home Mr R’s day care provision would end when he moved to the Home and all his care and support must be met by the Home. But it was subsequently agreed that day care would be phased out over a period of 12 months. Officer X explained to Mrs T that this was to allow time for the Home to get to know Mr R and explore local facilities. When the panel considered the case, it stated the situation should be reviewed after nine months to allow the Home to explore social care opportunities before day care provision ended at 12 months. It also stated the Home should make a referral to physiotherapy for Mr R to be supported with his health needs after 12 months. It was therefore clear that responsibility for Mr R’s social needs and physiotherapy would be entirely the Home’s responsibility after 12 months.
35. The Council has completed regular reviews and is satisfied that all Mr R’s needs are being met at the home.
36. Mrs T says two other residents at the Home with similar needs to Mr R continue to attend a day centre. The Council has explained that these are legacy arrangements which will be reviewed in due course with a view to these individuals’ care homes meeting all their needs. It is no longer the Council’s practice to place an individual in day care if they live in a residential home. It says all new residential placements since 2016/2017 meet all the individual’s needs without the use of day centres. Its view is that providing day care in addition to the support provided at the residential home would be double funding and, with financial pressures and scarcity of resource, the capacity is needed for young people transitioning from school who live at home and would otherwise have no social interaction at all.
37. I am satisfied with the Council’s explanation.

Failure to issue invoices

38. Mrs T was managing Mr R’s finances when he moved to the Home because he has no capacity to do so himself.
39. In April 2017 the Council wrote to Mrs T explaining it would carry out a financial assessment to determine the amount of Mr R’s contribution towards the cost of his care. It explained it would charge an assessed contribution from the date the placement started. Officers attempted several times to arrange a visit to Mrs T to collect the information it needed to complete the assessment but were unable to do so. So, the Council completed an assessment based on the information it held for Mr R’s non-residential care fees.
40. On 15 June 2017 the Council wrote to Mrs T confirming Mr R’s assessed contribution towards his care fees was £91.60 per week from 24 March 2017. It enclosed a copy of the assessment and a direct debit form for Mrs T to complete if she wished to pay by direct debit.
41. The Council sent invoices every four weeks in respect of Mr R’s residential care charges and for the cost of meals at the day centre.
42. On 30 October 2017 the finance team wrote to Mrs T attaching a statement showing outstanding invoices totalling £3474.46.
43. Mrs T says she did not receive any correspondence from the Council so, in November 2017 she sent an email to the finance team querying the amount of Mr R’s weekly contribution towards residential care. The finance team responded confirming his contribution was £91.60 per week.
44. Mrs T responded asking whether the charge should be paid from Mr R’s benefits. The finance team explained the charge was not taken directly from his benefit and that it would send an invoice every four weeks for £366.40 which had to be paid from Mr R’s bank account.
45. Mrs T responded to this email and was therefore aware how much the weekly charge was. But she says she still did not receive any invoices and did not know how much was outstanding. So, on 8 December 2017 she contacted the Council asking whether she could set up a standing order for future payments and whether invoices could be sent to her by email. The Council advised her she could set up a standing order with her bank. It agreed to send future invoices to her by email.
46. The Council sent Mrs T an invoice by email on 16 January 2018.
47. On 21 January 2018 Mrs T wrote to the finance team explaining that, from 22 January 2018 she would no longer have access to her existing email account and asked for all correspondence be sent to her new email address because “there seems to be an ongoing problem with letters from finance. This has been an ongoing occurrence with invoices for his day centre meals and respite care invoices as well. Please advise me of the full amount outstanding.”
48. The Council continued to send invoices to Mrs T by email but did not use her new email address.
49. The Council wrote to Mrs T regarding the outstanding invoices on 20 December 2018 and again on 1 and 28 February 2019 by post.
50. Mrs T sent an email to the Council on 2 January 2019 stating “I write in relation to the outstanding debt in relation to the above to request copy invoices of the amounts as I have not received any invoices from yourselves documenting the amount you claim are outstanding. Whilst I am aware that there is some outstanding, I do not have any invoices and do not know exactly how much is outstanding. Soon as I receive the invoices, I will tender payment in full”.
51. On 5 June 2019 Mrs T wrote to the Council again requesting invoices stating, “no contact has been made with myself and no invoices sent to me despite my previous letter requesting the same”. She requested that the invoices be sent to her at her email address so she could settle the amount outstanding.
52. The Council says it did not receive these letters.
53. The Council has provided copies of the invoices it sent by post. They were correctly addressed so there was no fault on the Council’s part. There is no evidence as to why Mrs T did not receive the invoices.
54. I find the Council was at fault in failing to send invoices to the correct email address following Mrs T’s request in January 2018. But I do not consider this caused her a significant injustice because the Council had also sent correspondence by post and sent an invoice to the correct email address on 16 January 2018. It had also discussed the charges with Mrs T. She was therefore aware of the weekly payment and how to pay.

Appointeeship

55. The Council’s letter of 1 February 2019 referred to the outstanding debt. It said it had received no payment in respect of Mr R’s care fees since he became a permanent resident at the Home and, unless payment was received within seven days, it would begin proceedings to recover the debt and apply for appointeeship to stop the debt increasing.
56. The letter of 28 February 2019 said the Council had received no reply to its previous letter and no payment. So, the debt had been referred to the legal team to take recovery action and apply to the Department of Work and Pensions for appointeeship of Mr R’s benefits to ensure future invoices were paid.
57. The Council proceeded to obtain appointeeship.
58. Mrs T wrote to the Council on 5 August 2019 saying the Home had told her the Council had obtained appointeeship for Mr R. She asked why it had not contacted her about the arrears. She referred to her letters of January and June 2019 and said she had received no response.
59. The Council replied on 19 August 2019 confirming that invoices and reminders were sent to her on a four weekly basis and enclosed copies of some of the most recent letters. It explained it had not received the correspondence referred to by Mrs T and every effort had been made to communicate with her while she was Mr R’s appointee.
60. I find the Council was not at fault in applying for appointeeship in view of the outstanding fees. It wrote to Mrs T on 1 and 28 February 2019 by post warning her it would do this if the debt was not cleared. It was unaware Mrs T had not received these letters.

Failure to respond to Mrs T’s correspondence or keep her informed

61. Mrs T says that, since Mr R moved to the home in March 2017, the Council has failed to respond to her correspondence or keep her informed.
62. The Council says it has responded to all complaints or queries relating to care management. In particular, Mrs T sent a formal complaint to the Council on 30 January 2018 about the ending of Mr R’s day service. It responded on 9 March 2018.
63. Mrs T made a subject access request (SAR) on 16 July 2019 stating she had a court-appointed deputyship. The Council responded asking for a copy of the court order but Mrs T did not reply. Mrs T says she is still Mr R’s representative despite the fact his financial affairs are now being dealt with by the Council. She therefore says the Council should have responded to her request.
64. Mrs T wrote to the Council on 5 August 2019 regarding finances. The Council responded on 19 August 2019. It also responded to Mrs T’s emails regarding finances between October 2017 and January 2018.
65. I do not uphold this complaint. There is evidence that the Council responded to Mrs T’s correspondence and kept her informed. If Mrs T remains dissatisfied with the Council’s response to her SAR she should contact the Information Commissioner’s Office. The Information Commissioner is better placed to deal with this aspect of her complaint.

Back to top

Final decision

66. I do not uphold Mrs T’s complaint.
67. I have completed my investigation on the basis that I am satisfied with the Council’s actions.

Back to top

Investigator's decision on behalf of the Ombudsman