Rochdale Metropolitan Borough Council (20 010 883)

Category : Adult care services > Other

Decision : Upheld

Decision date : 28 Jul 2021

The Ombudsman's final decision:

Summary: Mrs X complained that the Council did not properly consult and consider the impact of its policy change when it decided to end the Moving On service. Also, that it did not respond adequately to her concerns about this. She says this caused her much stress and anxiety and would like the Council to run the consultation again. We found fault in the Council’s consultation so it has agreed to make sure communication and consultations are satisfactory in future. It has also agreed to apologise to Mrs X and the other users of the service in an accessible format and pay Mrs X £150 for her time and trouble.

The complaint

  1. The complainant, whom I shall refer to as Mrs X, complains that the Council:
    • did not adequately consult, communicate and consider the impact on people before ending the Moving On service.
    • did not respond to Mrs X’s concerns about this adequately.
  2. Mrs X says this caused her much stress and anxiety. She would like the Council to re-run the review of the service and ensure everyone has an opportunity to comment about the impact before deciding its future.

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The Ombudsman’s role and powers

  1. 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)
  2. We may investigate matters coming to our attention during an investigation, if we consider that a member of the public who has not complained may have suffered an injustice as a result. (Local Government Act 1974, section 26D and 34E, as amended)
  3. 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

  1. I considered information from the Complainant and from the Council.
  2. I sent both parties a copy of my draft decision for comment and took account of the comments I received in response.

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What I found

Background

Equality impact assessments

  1. The Equality Act 2010 (the Act) requires local authorities to consider how their policies and decisions affect people with protected characteristics under the Act. The public sector equality duty requires local authorities to have due regard to:
    • eliminating unlawful discrimination
    • advancing equality of opportunity, and
    • fostering good relations between people with and without protected characteristics.
  2. The protected characteristics are:
    • Age
    • Disability
    • gender reassignment
    • pregnancy and maternity
    • race
    • religion or belief
    • sex and sexual orientation.
  3. An equality impact assessment (EIA) is not required but is one way of meeting these obligations and creating a record of the process.

Healthwatch

  1. Healthwatch is a statutory committee of the Care Quality Commission, established under the Health and Social Care Act 2012. Its main statutory functions are to:
    • Provide leadership, guidance, support and advice to local Healthwatch organisations.
    • Escalate concerns about health and social care services, which the local Healthwatch has raised, to CQC. CQC are required to respond to advice from the Healthwatch England Committee.
    • Provide advice to the Secretary of State for Health and Social Care, NHS England and English local authorities, especially where we are believe the quality of services provided are not satisfactory. When Healthwatch gives advice to bodies, they must respond in writing. The Secretary of State for Health and Social Care must also consult Healthwatch England on the NHS mandate, which sets the objectives for the NHS.
  2. Local Healthwatch are funded by and accountable to local authorities. Their main statutory functions are to:
    • Obtain the views of people about their needs and experience of local health and social care services. Local Healthwatch make these views known to those involved in the commissioning and scrutiny of care services.
    • Make reports and recommend about how those services could or should be improved.
    • Promote and support the involvement of people in the monitoring, commissioning and provision of local health and social care services.
    • Provide information and advice to the public about accessing health and social care services and the options available to them.
    • Make the views and experiences of people known to Healthwatch England, helping us to carry out our role as national champion.
    • Recommend to Healthwatch England to advise the CQC to carry out special reviews or investigations into areas of concern.

What happened

  1. Mrs X regularly attended the Moving On service funded by public health and run by the Council. Moving On was a preventative, drop in service for people with acquired disabilities and long term health conditions. It aimed to stop people going into crisis because of their disability. The Council refers to the service as a short term service intended to help people ‘move on’. A charitable organisation used the facilities to run a group which Mrs X attended. Mrs X says the group raised over £25,000 to make an accessible garden for growing their own fruit and vegetables; attendees looked after the garden. They raised money for tables, chairs, cookers, fridges, freezers, woodworking, pots and pans. There were many group activities such as cookery, craft, woodworking, gardening and a luncheon club for older people. She says the service also offered financial support, personal care, anger management, and coping strategies for people with behavioural problems and low self esteem.
  2. In March 2020, when COVID-19 caused the country to go into lockdown, the service closed. Attendees received a few comfort calls from the staff but they stopped after six weeks. Mrs X says staff told her they had been told not to contact attendees any more. The Council said it could find no evidence of this.
  3. In June 2020, the Council began a review of preventative and reablement services including the Moving On service. It says on 15 June it sent letters to all attendees registered with the service, explaining the process. The Council was not aware of all the people using the services and had some difficulty getting this information. It says it sent a further letter before the consultation explaining it would start on 31 August. The consultation ran from 31 August to 14 September and set out the planned changes to the services. The Council advised people to contact adult social care if the changes affected them. The Council says it has continued to take comments and suggestions since the consultation closed and says it extended the consultation twice. Throughout the review, the postal service was significantly disrupted by COVID-19.
  4. Mrs X says a few Moving On service attendees received a letter telling them of the review and that a consultation would take place, most did not. Someone saw the Council was running a consultation about prevention and realised it was about the Moving On service. She says a few people commented but many did realise about the consultation until they received a letter the day it closed at the end of August and some in September. The attendees used a social media group to keep in touch and support each other. Mrs X believed the Council had already decided to close the service and felt it had treated them disrespectfully.
  5. The Council held an online engagement event to replace a face to face session due to the COVID-19 restrictions. This was to set out how the Council would deliver prevention services in future. Mrs X said few who had attended the Moving On service had the confidence or knowledge to attend. Mrs X and members of the group contacted the Council and individual councillors, but the Council did not respond to emails until she contacted the Mayor. Mrs X also says the Council told attendees to ring the adult social care line and ask for an assessment but when they did, the Council told many they did not need one.
  6. In July, the Council completed a partial equality impact assessment (EIA). The assessment notes this policy is not relevant to equality. The form says the current arrangement of services resulted in people experiencing inconsistent and fragmented support or no support at all. The EIA noted 119 people registered with the service, of which 95 people attended the service at least once a week and 75% of the users had been going over one year. The service dealt with 537 requests for information and advice between April and December 2019. It says this information and advice is offered across the voluntary sector and is therefore duplication of services. It also said a review of the outcomes achieved found no evidence of an outcome focus, re-ablement approach or people improving their independence. The EIA concluded this showed the service was not being used as intended and did not “lend itself to a model of re-ablement and promoting independence”. The service did not reflect the ethnicity of the borough and a large proportion of users came from one local area which led to inequality between the localities of the borough. It said the resources could be “developed” to “include use of a range of voluntary organisations and groups that are able to support people in local communities fairly and equitably”. It also said the potential impact was “likely to be positive for all residents across HMR, strengthening prevention and support offers. The group using the Moving On service would be signposted to other groups and have their Care Act eligible needs fully considered. It decided that it did not need to complete a full EIA.
  7. The Council’s record of the consultation says it received 32 responses from people who used the Moving On service. This was out of 34 responses about four services. The other services were STARS, Recovery and Reablement, and Dementia Day Care. It received no responses to the consultation on Dementia Day Care and only one response to each of the other services. Over 50% of people reported regaining independence, also skills around managing finances, housing, family and social skills. Over 80% reported increased socialisation as an achievement. When Mrs X complained, the Council said it had sent the information. It did not extend or re-run the consultation so the people who missed out could contribute. It did not consider whether she had a valid complaint about the way the consultation it had carried out the consultation. It also did not consider whether its communication had been accessible.
  8. The Council decided the centre would remain open and offer a range of activities. These included promoting assistive technology, giving advice and information, carers support and possibly training sessions to support independence. Staff from adult social care to be present for the “various drop in sessions”.
  9. In December, the minutes of a meeting between the charity which ran the Moving On service and the Council, noted the charity had lost its charity status. It was now a community group and could no longer employ people. Staff told the Council they felt someone needed to speak to everyone by phone as it was difficult to explain what was happening in a letter. The Council said the charity had been able to take any items they had bought through fundraising.
  10. Healthwatch Rochdale investigated the matter. It consulted with 42 people and found 36 (86%) said they had not been informed of the consultation though some found out through others. These people advised that they had no opportunity to contribute at the online engagement event. Another 10% were unsure whether they had been informed. People who commented about the lack of information included someone who was blind, one who could not read or write and someone with a brain injury. Another described themselves as “pretty educated” and said it was “all in big words so lots of people would not understand”. 90% of people gave negative responses when Healthwatch Rochdale asked how the new model was explained and whether they had the opportunity to clarify this. Several people also commented that they could not access the online session including one who said they were nervous and needed longer to process information. 100% of the people asked said they did not find the process accessible or in a format to meet their needs. Some people who had contacted the Council said they had not received a response and therefore could not contribute to the consultation. 100% also reported positive experiences of the Moving On service with over 60% reporting it lifted their mood, enabled them to socialise and they learnt new skills. Only 4 people reported that they had alternative arrangements and accessed other services through adult social care. The report noted that letters sent out about the new services had reached more people. The report concluded that it would have been helpful for the Council to reach more people by telephone or other suitable means. Also, that it should have considered the individuals’ needs and considered this when consulting, especially as information about this was available. It made several recommendations.
  11. The Council responded to the Healthwatch Rochdale report. It accepted that its communication could have been better and that COVID-19 had caused difficulties as people were not attending the centre. It also said it would let Healthwatch know about future consultations in future and which groups may be affected.

Was there fault which caused injustice?

  1. The Council was at fault for not enabling more people to engage with its consultation. It did not consider, or provide, more accessible alternatives. On the balance of probability, it was aware of problems with the post, if not when it wrote in June, it should have been evident when Mrs X complained. It was not responsible for this but should have taken action to ensure more people were aware of the consultation and able to contribute. As the Moving On service was a group for people with disabilities, it was likely there would be various communication needs. However, there was no evidence the Council considered this before starting the consultation.
  2. The Council also did not properly consider the implications of the concerns raised by Mrs X. It could then have made more effort to include others. It could not avoid the disruption caused by COVID-19 but this did not excuse it from its public sector equality duty. However, I recognise the difficulties the Council had with both time and financial pressures at such a difficult time, and the effect this had on the process.
  3. The Council’s analysis was also flawed. Its partial EIA stated there was no evidence of an outcome focus, re-ablement approach or people improving their independence. However, over 50% of the people it did contact advised they had achieved an improvement in their independence and regained skills. The responses to Healthwatch Rochdale also reflected a similar view.
  4. A service in one area of the borough is likely to be attended by people nearest that service. It is unlikely to be attended by a similar number of people from across the entire borough, whatever the service, due to the distance. The Council decided that the service be removed from those that did access it and were happy with it. The records did not address whether extending it to other areas might address the imbalance it identified. It also decided the service was duplicated and the other services could fill the gap left by the Moving On Service. The records did not reflect on how the other services achieved against the required outcomes, so it is unclear how it concluded this.
  5. In not completing a satisfactory consultation on the future of the Moving On service and preventative services, the Council was at fault. This caused injustice to Mrs X and the other users of the Moving On service as it left them with uncertainty about the outcome after a satisfactory consultation. The Council also put Mrs X to significant time and trouble pursuing her complaint. The process was stressful for Mrs X and the other attendees but, on the balance of probability, this was due to the prospect of change rather than the way the Council dealt with it. We cannot say the outcome would have been different had the consultation been adequate.
  6. In response to my draft decision, the Council responded positively and acknowledged these faults. It said it could not re-run a consultation because staff had been redeployed and the service no longer exists. It said it would invite Mrs X and the other attendees of the Moving On service to participate in consultations for a current strategic review of services. It has already raised how the review will communicate with different groups with the public health consultant involved in the review.

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Agreed action

  1. To remedy the injustice identified above, I recommended the Council:
    • Apologise to Mrs X and the other attendees of the Moving On service for the uncertainty it caused, ensuring that it makes the apology in individually accessible formats.
    • Pay Mrs X £150 for the time and trouble caused in bringing her complaint.
    • Invite Mrs X and the other attendees of the Moving On service to take part in the current strategic review consultation. This should include face to face options if possible.
    • Ensure that outcomes to consultations properly reflect the information collected.
    • Ensure it always considers individual communication needs when consulting and provides information in an accessible way to all relevant people where possible.
    • Ensure that analysis of information is accurate and properly considered before acting on findings.
    • Complete the first two actions within one month of my final decision and the rest within three months and provide evidence to me. Suitable evidence would include:
      1. a copy of the apology with details of the individual communication formats used.
      2. Confirmation of the payment.
      3. An action plan detailing the remaining actions and progress.
  2. The Council has agreed to these actions.

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Final decision

  1. I have completed my investigation and uphold Mrs X’s complaint that the Council:
    • did not adequately consult, communicate and consider the impact on people before ending the Moving On service.
    • did not respond to Mrs X’s concerns about this adequately.

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Investigator's decision on behalf of the Ombudsman

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