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Royal Borough of Greenwich (21 005 129)

Category : Adult care services > Other

Decision : Upheld

Decision date : 29 Mar 2022

The Ombudsman's final decision:

Summary: The Council refused to fund adaptations to a specialist bed. Consequently, Ms X does not have a bed that meets her needs.

The complaint

  1. Ms X complains the Council refused to fund the adaptions needed to a specialist bed provided by the Council. Consequently, she does not have a bed that meets her needs.

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The Ombudsman’s role and powers

  1. 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)
  2. 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)
  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 have:
  • considered the complaint and the correspondence between Ms X and the Council, including the Council’s response to the complaint;
  • made enquiries of the Council and considered the responses;
  • taken account of relevant legislation;
  • offered Ms X and the Council an opportunity to comment on a draft of this document, and considered the comments made.

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What I found

Relevant legislation

  1. The social care authority has a duty under the Care Act 2014 to meet the assessed eligible needs of a disabled adult. When it decides a disabled person needs home aids/adaptations, the Ombudsman does not consider this duty ends until the needs are met. This responsibility cannot be passed on to another organisation.

Background

  1. The events in this complaint began in 2017. Although Ms X did not complain to us until early 2021, I have considered the events from 2017 because the decisions taken by the Council later flowed from the events in 2017 and Ms X has been pursuing her concerns throughout this time.
  2. This statement it is not meant to be an account of everything that happened from 2017 onwards, it covers the substantive points only.
  3. Ms X is in her seventies, she has poor physical health and mobility difficulties. Following an assessment by the Council’s Occupational Therapist team she received a specialist bed in 2017. The bed was trialled for 14 days and was deemed suitable at the time.
  4. Ms X contacted the Occupational Therapist (OT) on 16 March 2017 to say the bed was too high, she also informed the bed company. The bed company made a cushion to go under Ms X’s feet. This is confirmed in the Council’s records.
  5. The records dated 22 March 2017, show the Council was aware Ms X had contacted the bed company to ask it to make an adjustment to the footplate on the bed.
  6. I have had sight of a letter from the bed company to the Council dated 9 May 2019 which gives an overview of its involvement with Ms X and the Council from 2017 onwards.
  • 8 March 2017 - Ms X called the company in tears. It arranged for a representative to visit Ms X. It also advised her to contact the OT.
  • 3 April 2017 - Ms X called the bed company in tears again complaining of pain in her legs. She said she no longer had an OT, and the Council would not help her. The bed company telephoned the Council. It said there was no OT assigned to Ms X because she had a bed in situ, and it made no appointment to visit Ms X.
  • 19 April 2017 - Ms X called again in distress.
  • 26 June 2017 - Ms X called again in distress, the company agreed to collect the bed for modification, 2 inches were taken off the bed.
  • 1 February 2018 - MPs X called again complaining of pain in her legs. The company contacted the OT – a joint visit was arranged for 7 February 2018. (The Council records confirm this visit).
  • 20/21 February 2018 - Ms X contacted the company in distress. It took the decision to take another 2 inches off the bed.
  1. The bed company heard no more from Ms X until 13 September 2018, when she contacted it to ask for the footboard to be taken off the bed. It agreed and the footboards were removed. When the bed was returned to Ms X she found it too short. She reported this to the company on 24 September 2018.
  2. Ms X contacted the Council the same day to ask for an OT review. She said the bed had been modified by the bed company and was now too short. The Council advised Ms X to make a new referral to the OT team, which she did on 16 October 2018, and she was added to the OT waiting list.
  3. The Council allocated an OT to review the situation with the bed, and Ms X’s sleeping arrangements. The OT visited Ms X along with a representative from the bed company. The OT reported Ms X’s feet were hanging off the end of the bed. Both the OT and the representative from the bed company concluded that 2 inches needed adding back to the length of the bed.
  4. In October 2018 the Council made the decision that no more alterations would be made to the bed.
  5. The bed company reminded the Council it tried to contact it in April 2017 without success, leaving it to make decisions about the best way forward. It went ahead and altered the bed because it did not want to leave Ms X in need or distress.
  6. I have had sight of a letter from the bed company sent by email to the OT on 20 December 2018. The letter confirms a conversation between its representative and the OT and gives a breakdown of the cost of repairing the bed, the total cost being £1,193.75.
  7. The OT discussed the matter with her manager. A decision was taken to offer Ms X an alternative bed. I have seen no evidence which shows how the Council came to a decision that another bed would meet Ms X’s needs. The OT contacted Ms X on 21 January 2019. Ms X declined the offer and said her son would pay for the modification.
  8. The records show further contact between the OT and Ms X, including another home visit on 2 February 2019. The OT liaised with her manager. Ms X was again offered a replacement bed, which she declined. The OT was advised to close the case. Ms X was informed.
  9. Ms X made a verbal complaint on 4 April 2019.
  10. The Council records of 4 April 2019 summarise the situation, Ms X “...requested they [bed company] shortened the bed platform as she considered the bed was too long. The client does not appear to have sought authorisation for this from RBG OT… RBG has contacted [bed company] who confirmed they visited and altered the bed at the clients request and do not consider that they require permission of the purchasing service to complete this - despite it being a loan item. The client has been offered a review assessment of the bed by an OT - she has declined. The client has been offered a standard profiling bed - standard length, client has declined”.
  11. I have had sight of numerous internal emails between Council officers in June 2019, which appear to have been accidently copied to Ms X. One such email dated 4 June 2019 says “Please let me know who will signing this off… Thank you for your email of 25 April 2019 which has been passed to myself to investigate… I am sorry that you were not happy with your bed and that the alterations between yourself and [bed company] have made the situation worse. The Occupational Therapy Service was not aware of any of these alterations until November 2018 and did not authorise them. The Local Authority cannot therefore pay for the repairs… We also owe her an apology because of the time taken to complete the complaint process”.
  12. The OT contacted the bed company to discuss the modifications and met with a representative on 21 November 2019 to discuss matters further.
  13. I have had sight of the Council’s complaint letter to Ms X dated 11 December 2019, in which the author acknowledges “...there may have been some issues in the ease of contacting the OT service as your case was closed. However I cannot see any evidence that either you or [bed company] actually contacted the OT service before making adaptations to the bed”. Consequently, the Council did not consider it reasonable that the Council return the bed to its original state.
  14. In 2020, the Council allocated a different OT. This officer visited Ms X for the first time on 21 January 2020. Ms X gave an overview of events, she said the bed had initially been too high which had made it difficult for her to place her feet on the floor. The bed had been adjusted but when it came back the length was too short. When the Council refused to pay for further adjustment her son had volunteered to pay for the adjustment, but he lost his job and was no longer able to afford it.
  15. The OT told Ms X there was no guarantee a further adjustment would make the bed more suitable for her. A bed transfer assessment was completed. The OT recorded “Bed seems short for [Ms X] as her foot slightly hangs out of it… [Ms X] keen for her bed to be adjusted and this has been investigated in the past OT to liaise with OT supervisor on how to take case forward”.
  16. The records show the OT discussed the situation with her supervisor. She reported the bed was too short. Another joint visit with the bed company was arranged “…to identify the history of the modifications and what needs to be done”.
  17. The visit took place in February 2020. Ms X said she had not slept in the bed since it had been modified and that she was sleeping on the sofa. She requested a further adjustment be made to add length to the bed. The OT concluded the bed was too short and recommended the foot end be adjusted.
  18. The records show further discussion between the OT and the bed company in April 2020 about the need to adjust the height of the bed.
  19. An email on 23 July 2020 from the OT to Ms X said “As discussed on the phone, I presented the option for the bed to be altered to my supervisor (name) who initially made the recommendation for the bed to be ordered for you. However, [name] was not in agreement for this bed to be altered for the following reasons:
  • Bed was altered twice without OT authorization
  • No guarantee if this bed is altered it will be able to meet your expectation
  • [name] is concerned that you would still be dissatisfied with the product
  • She fears that even without further modification, the issue will remain unresolved.
  1. Ms X says she understood the bed was on loan and that she had been told to contact the Council if she had any issues, which she did in 2017 without success, so she contacted the bed company directly.

Analysis

  1. The Council was aware there were issues with the bed in 2017. Mrs X and the bed company both reported the matter to the Council and asked for OT involvement, both were told there was no OT allocated. The Council should have allocated an OT to review the situation, its failure to do so resulted in the bed company going ahead with alterations without agreement on what was needed. Had there been OT involvement it is possible the issues arising from the modification could have been avoided.
  2. The Council’s subsequent refusal to approve further modification of the bed was based on the fact the first modification was done without its approval. I cannot see how such approval could have been obtained if no OT was allocated. I note Ms X was not even added to a waiting list for an OT, so it is unsurprising she accepted the bed company’s offer to alter the bed.
  3. The Council is aware the bed is now too short. The OT assessment confirms the bed is too short for Ms X and needs lengthening. The Council’s refusal to undertake this necessary alteration is fault.
  4. The Council offered Ms X an alternative bed and when she refused it closed the case. This is fault, firstly there is no evidence to show an alternative bed would meet Ms X’s needs, and the Council’s duty to meet Ms X’s needs did not end because she refused the alternative.
  5. Ms X’s son offered to pay for the modification to the bed whilst he was working, this offer was later retracted when he lost his job. It was not acceptable for the Council to accept such an offer. The offer was made out of desperation. Service users and their family should not be expected to pay for services to which they are entitled.
  6. The Council says it tried to assist Ms X with offers of various aids and home adaptations, but she refused. She is entitled to do so, but from the evidence I have seen, she has over a number of years, continued to ask for the Council’s assistance with the bed. It is not acceptable that Mrs X has struggled with a bed that is not meeting her needs for more than five years and there is still no end in sight.
  7. I also note the Council accidently copied Ms X into internal emails about how it should deal with her. This was careless and caused Ms X distress for which it should apologise. I note one those emails refers to having to apologise to Ms X for the delay in dealing with her complaint.
  8. The Council’s handling of the whole matter has been poor. It has taken a rigid approach and its basis for refusing further modification is unfair and unreasonable. This has left a vulnerable woman without a suitable bed causing her unnecessary distress.

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Agreed action

  1. The Council will, within four weeks of the final decision:
  • apologise in writing to Ms X for the faults identified in this statement and the impact on her;
  • pay her £1000 to recognise her distress, inconvenience, loss of dignity and independence;
  • arrange for a named Occupational Therapist to be responsible for undertaking a full OT review of Ms X’s needs;
  • arrange a meeting with bed company to identify the modifications needed, agree an action plan and timescales to complete the work;
  • monitor progress and liaise with the bed company and any other organisation involved until the Council is satisfied Mrs X’s needs have been met.
  • provide evidence of the above to this office

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Final decision

  1. The Council refused to fund adaptations to a specialist bed. Consequently, Ms X’s needs are not met.
  2. The above recommendations are a suitable way to settle the complaint.
  3. It is on this basis; will be closed.

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Investigator's decision on behalf of the Ombudsman

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