Summary: Ms X complained the Council failed to support her adequately as a carer and is abusing public funds by paying charities to provide inadequate services to carers. The Council has already agreed it was at fault when the Charity which carries out carer’s assessments on its behalf failed pass on information provided by Ms X and Mrs B about their financial situation. It has offered to repay them the costs of the care, which is satisfactory to remedy the injustice this caused.

The complaint

1. Ms X complained the Council:
1. failed to provide her with adequate carer’s services and assessments from 2016 onwards in relation to her role as a carer to her mother, Mrs B;
2. delayed in dealing with her complaint;
3. is abusing public funds by paying charities to provide services to carers which are inadequate and then failing to monitor these charities; and
4. harbours a toxic culture towards carers and marginalises them, in order to save the state money.
2. In relation to carers’ charities Ms X complains they:
1. have a toxic attitude towards carers;
2. are opportunists who capitalise on legislation and vulnerable people and councils so they can benefit financially; and
3. deliberately marginalise carers to save state money.
3. Ms X says the treatment of unpaid carers pushes them into a reliance on benefits.
4. Ms X said that as a result she and Mrs B have experienced mental, emotional and physical trauma. They have been isolated and unable to contribute to society and their community. Their relationship has been damaged and they have both experienced a loss of dignity and autonomy. Ms X says she has also lost out financially.
5. Ms X would like her complaint to help make some changes to stop “the abuse of poorer people, carers and public funds”. She would also like to see the practice of councils commissioning charities to carry its duties to stop.

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What I have investigated

6. I have investigated the complaint in paragraph 1a) from July 2018 onwards and explain why I have not looked at earlier events in paragraphs 9 - 11.
7. I have investigated the complaints in paragraph 1b), 1c) and 1d).
8. I have not looked at the complaints made in paragraph 2. I explain why at the end of this decision statement.

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The Ombudsman’s role and powers

9. 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)
10. I have seen no good reason why Ms X did not pursue her complaints earlier. She contacted her MP about her situation in July 2017 who complained on her behalf to the Council. The Council responded in October 2017 and the MP sent Ms X a copy of its response. Ms X took no further action at the time.
11. Ms X complained again to the Council in July 2019. I have exercised my discretion to investigate the matters she complained about from September 2018. This is slightly longer than the 12 month period before she complained to the Ombudsman but it is when Mrs B was due her annual care plan review and Ms X again requested support and these events are relevant to what happened later.
12. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), as amended)
13. We cannot investigate the actions of bodies such as charities, unless they are acting on behalf of a council. (Local Government Act 1974, sections 25 and 34A, as amended)
14. 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)
15. 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)
16. Under the information sharing agreement between the Local Government and Social Care Ombudsman and the Care Quality Commission (CQC), we will share this decision with CQC.

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How I considered this complaint

17. I spoke to Ms X and considered her view of her complaint.
18. I made enquiries of the Council and considered the information it provided. This included copies of Mrs B’s care plan and financial assessments, Ms X’s carer’s assessments, complaints correspondence, Mrs B’s case files and the Council’s monitoring arrangements with the Charity.
19. I gave Ms X and the Council an opportunity to comment on my draft decision.

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What I found

The law

Adult social care assessments

20. The Care Act 2014 and Care and Support Statutory Guidance 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.
21. The assessment determines what the person's needs are and whether any of these are eligible for support from the council. Where councils have determined that a person has any eligible needs, they must meet those needs.
22. The person's needs and how they will be met must be set out in a care and support plan. The care and support plan should consider what needs 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. The plan must also include the outcomes the carer wishes to achieve, and their wishes around providing care, work, education and recreation where support could be relevant.

Carers’ assessments

23. Where an individual provides care for another adult and it appears the carer may have any needs for support, local authorities must carry out a carer’s assessment (Care and Support Statutory Guidance paragraph 6.16).
24. Carers’ assessments must seek to establish not only the carer’s needs for support but must also consider the outcomes that the carer wants to achieve in their daily life, their activities beyond their caring responsibilities, and the impact of caring upon those activities. This includes considering the impact of caring responsibilities on a carer’s desire and ability to work and to partake in education, training or recreational activities, such as having time to themselves. This impact should be considered in both a short-term immediate sense but also the impact of caring responsibilities over a longer term, cumulative sense (Care and Support Statutory Guidance paragraph 6.19)

Background

25. Ms X’s mother, Mrs B, has physical health conditions. She and Ms X live together. Since 2015, Ms X has cared for her on a full-time basis.
26. In 2016 Ms X contacted a local carers’ charity (the Charity). The Council commissions this Charity to carry out carers’ assessments on its behalf. The Charity carried out a carer’s assessment with Ms X. Following this, the Council made Ms X a one-off payment of around £300 to help towards the costs of a break from her caring role.
27. In May 2017, the Council completed Mrs B’s initial social care assessment. This stated Mrs B needed a morning visit from carers for half an hour on Monday to Friday to meet her eligible needs. In July 2017, the Council carried out a financial assessment. This determined Mrs B was able to afford to pay for the costs of her care.
28. In August 2017, the Charity’s case files record Ms X contacted the Charity and said she was paying for Mrs B’s care but there had been a change in her financial circumstances and she was now in severe financial difficulties. The notes record the Charity employee advised Ms X that Mrs B needed a financial reassessment.
29. The Charity phoned Ms X later the same day to arrange this on behalf of the Council and then again six days later. The Charity received no response to either call and so closed the case two days later.
30. Ms X contacted her MP who complained to the Council on her behalf. The Council responded in October 2017. It said it told Mrs B in her financial assessment that if she could provide copies of bills relating to the mortgage, council tax and utilities, the Council might be able to take these into account when determining Mrs B’s contribution. The Council informed the MP it would reassess Mrs B’s contribution if she thought it was wrong.
31. Ms X did not pursue her complaint at this time. She and Mrs B stopped Mrs B’s care package because they did not feel they could afford to make the contributions.

Events I am investigating – September 2018 onwards

32. In September 2018, Mrs B was due her annual review of her care plan. This did not take place.
33. On 9 October 2018, Ms X phoned the Charity. The case files note Ms X said she did not feel she was being supported and Mrs B had received little care over the last three years. Ms X said when the Council did put some care in place in 2017, she and Mrs B were unhappy with it and cancelled it. Ms X said while care was provided, she had to pay for it. The files record the assessor advised her to contact the Council to say she was at crisis point and could no longer support Mrs B.
34. On 11 October 2018 the Charity carried out Ms X’s carer’s assessment by telephone.
35. The assessment recorded Ms X stated she had lost her social network and was struggling to find time to eat properly or look after the house. Ms X said she wanted a break from her caring responsibilities. Ms X also said she would like to be able to work again knowing her mother was fully supported.
36. Following the assessment, Ms X received a one-off payment of £328 so she could “have a break from caring knowing her mother is fully and correctly supported”.
37. Ms X contacted the Charity again about her carer’s assessments and a staff member informed her it had carried these out annually over the previous three years. Ms X made a subject access request because she said she was not aware she had received any carer’s assessments.
38. Once she had received the documentation, Ms X said her carer’s assessments demonstrated they were a “tool for marginalisation and not help or support”. She said she had not had a face to face assessment since 2016 and the other assessments were just copied and pasted from the original one. She said “This is simply fraud and dereliction of duty”.
39. On 29 July 2019, Ms X complained to the Council. Her complaints are detailed in paragraphs 1 - 2 of this decision statement.
40. Ms X had her annual carer’s assessment in September 2019. The wording in the assessment was almost identical to the 2018 assessment and again contained a statement from Ms X which said she would like to be able to work again knowing her mother was fully supported. Ms X was awarded £340 to allow her “to have a break from caring knowing her mother is fully and correctly supported”.
41. Ms X said the Council asked to meet with her to discuss her complaints. She met with a Council Officer in October 2019 and went through the problems she had had over the last four years. She said the Officer told her that the Council had failed her and it would get back to her with an outcome.
42. Ms X heard nothing from the Council and so chased it on 11 December. The Council provided its response on 18 December 2018. It apologised for its delay in responding. It acknowledged Ms X and Mrs B were financially disadvantaged in relation to the provision of Mrs B’s care and that as a result they had stopped the care package. The Council said it needed to “ensure that where we are aware of carers experiencing financial problems, due to the cost of the care for the person for whom they care… there must be a robust process to ensure that this information is appropriately shared with social care staff”.
43. The Council offered to reimburse Mrs B for the £1,192 she had paid towards her care before they had stopped the package and waive the outstanding fees of £183 she owed.
44. In its complaint response the Council also provided Ms X with information about how it had commissioned the Charity to provide services and explained how it measured performance against set targets. It stated the procurement process it had used was in line with industry standards and the contract was measured against the specifications within the procurement documentation.
45. Ms X remained unhappy and complained to the Ombudsman.

My findings

Method of carrying out Ms X’s carer’s assessments

46. The Charity carried out assessments with Ms X in 2018 and 2019 by telephone. There is nothing in the legislation to say carer’s assessments must be carried out face-to-face. There was no fault in the method used by the Charity.

Mrs B and Ms X’s assessments

47. Mrs B’s annual review of her care plan was due in September 2018. The Council failed to carry this out and this is fault. As a result, this led to a missed opportunity to discuss any financial concerns Mrs B and Ms X were experiencing and the reasons they had stopped Mrs B’s care.
48. The Care and Support Statutory Guidance states carers’ assessments must consider the outcomes that the carer wants to achieve in their daily life, their activities beyond their caring responsibilities, and the impact of caring upon those activities. Ms X had carer’s assessments in 2018 and 2019. These recorded Ms X’s caring role had led to her social network disappearing and prevented her from working, something she said she both wanted and needed to do financially. The Charity failed to refer the case to the Council to determine if she was willing and able to provide the support. Instead, it simply provided her with an annual payments of around £300 each year. This was not in line with the statutory guidance and is fault.
49. As a result, the Council again missed an opportunity to look holistically at Mrs B and Ms X’s situation.
50. The failures identified above caused both Ms X and Mrs B distress. They felt the Council has not listened to their needs or provided the support they required.
51. The Council has already agreed to repay the money Ms X and Mrs B spent on Mrs B’s care package and to waive the outstanding amount. This amounts to around £1,350 and is satisfactory to remedy the injustice the Council has caused them. However, if the Council has not already done so in the last 12 months, it should now arrange to carry out a joint social care and carer’s assessment as a matter of urgency to ensure Mrs B and Ms X have the right support in place to meet both their needs.

Commissioning of the Charity to provide carers’ assessments

52. Ms X believes the Council is abusing public funds by paying charities to provide services to carers which are inadequate and then failing to monitor these charities. She believes this is leading to toxic culture which marginalises carers. She wants to see the practice of councils commissioning charities to carry its duties to stop.
53. We provide a free service but must use public money carefully. We may decide not to start or continue with an investigation if we believe we cannot achieve the outcome someone wants.
54. It is not the role of the Ombudsman to question how councils spend their budget or whether they provide services in-house or via a third party. This means we have no power to achieve the outcome Ms X wants which is for councils to stop commissioning charities. Although there was fault in how the Charity and Council communicated with each other in Mrs B and Ms X’s case, this does not equate to an abuse of public funds. Nor does it mean the way the Council monitors the Charity is inadequate. What it means is that something went wrong in this specific case. In situations such as these, we will make a recommendation for the Council to review its processes to ensure similar fault does not occur again. This is a proportionate response in this case and that is what I have done.

Complaint handling

55. The Council took around five months to deal with Ms X’s complaint. It has already acknowledged it took too long and apologised to Ms X. This is sufficient to remedy the injustice this caused her.

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Agreed actions

56. Within one month of the date of the final decision the Council has agreed to contact Mrs B and Ms X to arrange a joint carer’s and social care assessment.
57. Within three months of the date of the final decision the Council has agreed to review its arrangements with the Charity to ensure Charity staff are aware of when to refer cases to adult social care for further consideration.

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Final decision

58. There was fault leading to injustice. The Council has agreed to my recommendations and so I have completed my investigation.

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Parts of the complaint that I did not investigate

59. I have not investigated Ms X’s complaints in paragraph 2. We do not have the jurisdiction to look at the actions of charities, other than where they are providing a service on behalf of the Council.

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Investigator's decision on behalf of the Ombudsman