Summary: The Ombudsman will not investigate this complaint that the Council will not allow the complainant access to its Learning Disability Service. This is because there is insufficient evidence of fault by the Council. In addition, the Ombudsman cannot question the clinical judgement of health professionals.

The complaint

1. The complainant, whom I refer to as Mrs X, complains that the Council will not give her access to the Learning Disability Service (LDS). Mrs X says she has struggled to cope since losing support from the service.

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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’. We provide a free service, but must use public money carefully. We may decide not to start an investigation if we believe it is unlikely we would find fault. (Local Government Act 1974, section 24A(6), as amended)
3. We investigate complaints about councils and certain other bodies. We cannot investigate the actions of NHS staff. (Local Government Act 1974, sections 25 and 34A, as amended)

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How I considered this complaint

4. I read the complaint and the Council’s response. I considered the assessment report written by health professionals and information about who can access the LDS. I invited Mrs X to comment on a drat of this decision.

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What I found

Learning Disability Service

5. The service is for people with global learning difficulties. The Council defines global learning disability by using globally recognised criteria. The Council may do an assessment to find out whether someone has a global learning disability.

What happened

6. Mrs X used to be supported by the LDS. In 2018 she withdrew from the service. She was struggling to cope so, a few months later, tried to re-engage.
7. The Council arranged for Mrs X to have assessments. The assessments were carried out by a psychologist and nurse. The conclusion of the health professionals was that Mrs X does not have a learning disability. The health professionals wrote a report in September 2018 which said “Mrs X does not meet the criteria for global learning disability and therefore is not eligible for a service from LDS. She is able to function above the learning disability range and is independent in most areas of adaptive functioning.” In reaching this conclusion they noted that Mrs X has five GCSEs and a GVNQ. They also noted that she can travel independently, has good writing and communication skills, has arranged assessments for adaptations in her home, and can remember instructions about taking medications. The report suggests Mrs X did not try to answer every question correctly.
8. The Council decided Mrs X could not use the service again because she does not meet the definition of having a learning disability. It said it was previously unaware that Mrs X had passed exams and it now had the findings of the clinical assessments.
9. Mrs X disagrees with the Council’s decision. She says she got four E’s and one B in the GCSEs and the B was in an exam for her native language. She says she struggles to cope and is distressed by comments in the report that she deliberately produced low scores. The Council is aware of the grades Mrs X achieved but says it would not expect someone with a learning disability to be able to take exams and show fluency in two languages.

Assessment

10. I will not start an investigation because there is insufficient evidence of fault by the Council.
11. The LDS is open to people who have a global learning disability. Mrs X has been assessed by health professionals who decided Mrs X does not have a learning disability. As Mrs X has not been diagnosed with a learning disability there is no suggestion of fault in the Council’s decision that she cannot access the service.
12. Mrs X disagrees with the findings of the clinical assessments. But, I cannot question the clinical judgement of a psychologist and I cannot ask the Council to admit Mrs X to the LDS when there is no evidence she has a learning disability. Both the health professionals, and the Council, explained why they had decided Mrs X does not have a learning disability and why having four GCSE grade E’s is not sufficient to show she qualifies.

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Final decision

13. I will not start an investigation because there is insufficient evidence of fault by the Council and I cannot question the clinical judgment of health professionals.

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Investigator's decision on behalf of the Ombudsman