Summary: We have upheld Mrs X’s complaint about services to her as a carer and about poor communication and complaint handling. To remedy the injustice, the Council will apologise, make her a symbolic payment and take other action to improve its services described in this statement.

The complaint

1. Mrs X complained Staffordshire County Council (the Council) failed to support her as a carer since she moved home in 2018, including failing to provide access to respite care for her son Mr Y.
2. Mrs X also complained there was no response to her formal complaint about this and about poor communication by social care staff.
3. Mrs X says the Council’s failures have made her feel ignored and unsupported as a carer and have caused her avoidable distress.

Back to top

The Ombudsman’s role and powers

4. 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)
5. 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)
6. 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

7. I considered Mrs X’s complaint to us, the response to her complaint and documents described later in this statement. I discussed the complaint with Mrs X.
8. Mrs X 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

Relevant law, policy and guidance

9. A council must carry out an assessment for any adult with an appearance of need for care and support, applying national criteria to decide if a person is eligible for care. (Care Act 2014, section 9)
10. If a council decides a person needs support, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether they meet any eligibility criteria and sets out how the council is going to meet them. (Care Act 2014, sections 24 and 25)
11. A council must carry out a carer’s assessment where it appears a carer may have needs for support. The assessment must include an assessment of the carer’s ability and willingness to continue in the caring role, the outcomes the carer wishes to achieve in daily life and whether support could contribute to achieving those outcomes (Care Act 2014, section 10)
12. The Act makes clear that the local authority is able to meet the carer’s needs by providing a service directly to the adult needing care. In these cases, the carer must still receive a (carers’) support plan which covers their needs, and how they will be met. (Care and Support Statutory Guidance 2014)
13. The Council has an agreement with Midlands Partnership MHS Foundation Trust (the Trust) to provide some adult social care functions on behalf of the Council, including assessments under the Care Act 2014 and complaint handling for complaints about adult social care services. The Council remains responsible for all services the Trust provides on its behalf. The complaint handling agreement says:
• There will be quarterly reports detailing all the complaints received and the Trust will provide the Council with weekly and monthly reports regarding the status of complaints to provide assurance they are being dealt with effectively, efficiently and professionally
• The Trust will draft complaint responses/reports within the timescales agreed with the complainant and share copies with the Council.

What happened

Background

14. Mrs X moved at the end of November 2018. She is the main carer for her adult son, Mr Y who lives with her and has cerebral palsy (a physical condition affecting movement, posture and co-ordination) and a lung condition. Mr Y has no speech and communicates using an i-pad and sign language. He requires assistance with all activities of daily living and has been receiving social care services for some years.

Key events

15. The case records indicate Mrs X called the social care team in February and March 2019 and left messages for Mr Y’s social worker to contact her. There is no record evidencing the social worker returned her calls.
16. The Council received a form from the Department for Work and Pensions for a welfare benefit for Mr Y in April 2019. It is unclear what this form was for or why it had been sent to the Council. There is a note on Mr Y’s social care file saying the form needed to be completed by the social worker. The social worker sent the form on to Mrs X without completing it.
17. The social worker noted she and Mrs X spoke in April 2019 about an NHS funding assessment. Mrs X told us this call never took place. The records indicate Mrs X phoned a different officer in the social care team two days later and said she was unhappy the social worker was not returning her calls and she wanted to speak to the complaints team.
18. A duty social worker spoke to Mrs X on the same day. Mrs X explained she’d had no contact from Mr Y’s social worker and she wanted her own carers assessment. It appears the duty social worker referred Mrs X to the carers’ hub (its website says it provides carers’ assessments and advice and support for carers, commissioned by the Council and Trust). The duty social worker told Mrs X she could contact the carers’ hub herself directly for an assessment.
19. Mrs X complained to the Trust in May 2019 about the issues she is raising with us and about other issues. The Trust did not respond.
20. Mr Y was allocated a new social worker at the start of June 2019. The social worker was instructed to start a new assessment.
21. Mr Y’s new social worker carried out an assessment of need for Mr Y in June 2019. The outcome was he remained eligible for social care. The assessment noted:
• He received a direct payment (this is a money a council gives a person so they can arrange and pay for their own care and support) which Mrs X managed on his behalf. He had 30 hours of support a week from an agency which supported him to access social activities in the community.
• There was an eligible need for Mr Y and Mrs X to have access to respite care to enable her to have a break. The social worker was seeking approval for funding for two weeks of respite care at a specialist service.
22. The social worker also carried out a review of Mrs X’s needs as a carer. This noted there was a high risk of carer breakdown because Mrs X was providing support 24 hours a day. Mrs X was noted to be stressed, depressed and experiencing financial hardship. The social worker completed a further referral to the carers’ hub. The social worker offered to refer Mrs X for mental health support, Mrs X said she would consider this.
23. Mr Y’s care and support plan described the agreed funding and how this was to be used. It said Mr Y had two weeks respite care booked for September 2019.
24. I have not seen a carer’s support plan for Mrs X.
25. The social worker referred Mrs X and Mr Y to a welfare rights adviser to complete a welfare benefits check to make sure they were receiving the right benefits. The social worker spoke to Mrs X to say she had made the referral and said she was asking the Council for funding for respite care. They spoke again a couple of days later and Mrs X said she had made a provisional booking for respite for Mr Y. They spoke again in the middle of August and the social worker said she was trying to hurry the funding approval process up. The social worker called Mrs X again in the last week of August saying respite funding had been approved.
26. In Summer 2019, the carers’ hub completed a carers ‘triage’ assessment which said Mrs Y would like to look at respite care in the future, then in December 2019 Mrs X rang the carers’ hub to request a full carers’ assessment. This was completed on the phone. Mrs X gave us an annotated a copy of the carers’ assessment form with her notes on it saying she could not understand abbreviations and terminology on the form and she questioned parts of the content of the form. Mrs X told us she was not sure what happened to this form and she was unhappy with the content. The Council has not provided me with a copy of the form and so it appears the carers’ hub did not send the papers to the Trust/Council.
27. Mr Y had two weeks respite care in September 2019.
28. In January 2020, the social worker and a member of staff from the carers’ hub spoke about Mrs X’s request for respite care for later in 2020. The social worker and Mrs X also spoke about respite as Mrs X had asked for two weeks in April/May) The social worker said she expected to get approval for respite funding in early March. Mrs X mentioned she had not had a response to her complaint.
29. The social worker and Mrs X spoke again in the middle of February. The social worker said she was changing roles and Mr Y would get a new social worker. Mrs X said she found the process of getting funding for respite to be frustrating and she wished things were easier.
30. Mr Y’s case was on a list waiting for a social worker to be allocated. The records indicate Mrs X made several calls about this and was told a worker would be allocated as soon as possible. The records indicate a new social worker was allocated in the middle of March.
31. Mrs X complained to us in March. We asked the Council why there had been no response to Mrs Y’s complaint of May 2019. The Council told us the Trust did receive a complaint and referred Mrs Y to its Patient Advice and Liaison Service (PALS) which tries to resolve complaints informally. PALS did receive a response from the Trust but did not send it to Mrs X. The Council told us it would send the complaint response now and apologise for the delay. We told the Council we expected it to do so and we also told Mrs X she could ask us to investigate if she was unhappy with the response.
32. Mrs X contacted us again in September 2020. She said she had heard nothing from the Council or the Trust. She also raised other new issues which we are not investigating. At the end of September, the Trust finally sent Mrs X a response to her complaint. This said:
• It was sorry for the delay which was due to an administrative error.
• It was sorry for the social worker’s lack of contact between November 2018 and April 2019
• The social worker sent blank benefit claim forms with no explanation. As Mrs X was Mr Y’s appointee, she needed to complete the forms.
• A new social worker was appointed due to the breakdown in relationship. She was to complete a new assessment and review how Mr Y’s needs could be met with the most cost-effective respite provision.

Was there fault?

33. When a council commissions another organisation to provide services on its behalf it remains responsible for those services and for the actions of the organisation providing them. The Trust provides social care and complaint handling services on behalf of the Council, but the Council remains responsible for these services. Any fault by the Trust is therefore fault by the Council.

There was a falure to support Mrs X as a carer since she moved home including a failure to provide respite care for Mr Y.

34. Mrs X moved home at the end of 2018 and at the start of 2019 was trying to contact Mr Y’s social worker by phone several times. She received no response until the middle of 2019 when the Trust decided to start a fresh assessment for Mr Y. The Trust should have responded to Mrs X’s contacts promptly and the failure to do so was fault. It meant Mrs X and Mr Y missed out on an opportunity to discuss their concerns and access an earlier date for an assessment.
35. A social worker carried out an assessment of need in the middle of 2019 for Mr Y and identified his eligible needs and drew up a care and support plan. This was in line with sections 9, 24 and 25 of the Care Act 2014 and there was no fault. The social worker also carried out a review of Mrs X’s needs as a carer and identified an eligible need for respite care to give her a break from her caring role. This need was set out on Mr Y’s care and support plan. This is in line with section 10 of the Care Act and in line with statutory guidance which makes it clear that a carer’s needs can be met by providing services to the cared- for person. However, statutory guidance also says a council should provide a carer with a support plan and there is no evidence the Trust or the carers hub drew up a carer’s support plan for Mrs X.
36. I do not uphold Mrs X’s complaint that there was a failure to provide respite care as Mr Y received this in September 2019 and the records suggest arrangements were in place for a further two-week stay in April/May 2020 which could not go ahead because of the lockdown.
37. Information on the carers hub’s website says it provides carers assessments and advice and support for carers on behalf of the Trust and Council. Mrs X had a telephone assessment. There is no evidence the Trust or Council received a copy of the assessment and nobody completed a carers’ support plan for Mrs X. This was not in line with statutory guidance and was fault. Mrs X was also unhappy with the content of the carers’ assessment form which she said was inaccurate. It also contained abbreviations which were not explained. I consider the standard of the carers’ assessment was poor and parts of it were unclear. This was a further fault.

Complaint handling and communication

38. The Trust took 16 months to respond to Mrs X’s complaint which was too long and was fault. After we contacted the Council, it said it would respond in March 2020, but it did not do so until September. While this period was during the first lockdown, the response should already have been issued as it was outstanding by many months. There appears to have been no oversight by the Council in terms of checking the Trust’s overdue complaint responses. The way Mrs X’s complaint was handled was not in line with the agreement between the Trust and Council set out in paragraph 12, which was fault.
39. The Trust accepted communication by staff was poor and I can see in the records that there were numerous telephone contacts from Mrs X that no-one responded to and she had to chase up. The Trust also sent out a benefits form to Mrs X without explaining why. This was all fault, for which the Trust has apologised.

Did the fault cause injustice requiring a remedy?

40. The failure to issue a carer’s support plan for Mrs X may have made no practical difference in terms of what services Mrs X received as a carer and so I do not conclude she suffered injustice. Mr Y already had respite care included in his care and support plan.
41. The poor communication, poor carers’ assessment by the carers’ hub and protracted delay in responding to the complaint caused Mrs X avoidable frustration and the feeling that no-one cared about her needs or struggles as a carer.

Agreed action

42. When a council commissions another organisation to provide services on its behalf it remains responsible for those services and for the actions of the organisation providing them. So, although I found fault with the Trust and with the carers hub, I have made recommendations to the Council.
43. Within one month the Council will:
• Apologise and pay Mrs X £150 for the delay in responding to her complaint for the poor quality carers’ assessment by the carers’ hub and for and poor communication by staff.
44. Within three months, the Council will:
• Review the Trust’s complaint handling processes (including those services delivered by PALS) to ensure all those who complain about social care services receive a prompt response to their complaints.
• Ensure all carers with eligible needs receive a carers support plan.
• Start doing carers’ assessments itself (The Council has decided to stop using the carers hub to do assessments from 6 April). There is already a system in place to check all assessments.

Back to top

Final decision

45. I have upheld Mrs X’s complaint about services to her as a carer and about poor communication and complaint handling. The Council will apologise, make Mrs X a symbolic payment, stop using the carers hub to do carers assessments and review complaint handling processes.
46. I have completed the investigation.

Back to top

Investigator's decision on behalf of the Ombudsman