Summary: Ms X complains there were failings in the way the Council monitored the package of social care provided to Mr Y by a care provider. This led to Mr Y living in an unsuitable property due to its disrepair and issues with management of his finances causing distress to Mr Y’s family. Once the Council became aware of the issues it took appropriate action and moved Mr Y to more suitable accommodation. We have found no evidence of fault in the way the Council considered these matters so have completed our investigation.

The complaint

1. I have called the complainant Ms X. She complains on behalf of Mr Y there are failings in the way the Council monitored the package of social care being provided to Mr Y by a care provider. In particular Ms X says the property he lived in was unsuitable due to its state of disrepair and she had concerns about the management of his finances. Ms X says this caused his family distress and concerns the Council has neglected Mr Y.

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The Ombudsman’s role and powers

2. The Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service but must use public money carefully. We do not start or may decide not to continue with an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• any injustice is not significant enough to justify our involvement, or
• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome.

(Local Government Act 1974, section 24A(6))

3. If we are satisfied with an organisation’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

4. I have read the information submitted by Ms X and spoken to her about the complaint. I considered the Council’s comments on the complaint and the supporting documents it provided.
5. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Legal and administrative background

6. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). 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. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
7. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months. Councils should consider a light touch review six to eight weeks after agreeing and signing off the plan and personal budget. They should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. Councils must also conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one.

Background information to the complaint

8. Mr Y has a profound learning disorder and other medical conditions. He needs 2:1 care at all times from skilled experienced staff as he has challenging behaviour and can present as a risk to himself, others and property. Mr Y has a sister, Ms Z and Ms X is their cousin.
9. Under section 117 of the Mental Health Act 1983, councils, and Clinical Commissioning Groups (CCGs) have a joint duty to provide after-care services to people who have been detained in hospital for treatment under certain sections of the 1983 Act. Mr Y has been previously detained under the mental health act, so the Council and relevant CCG jointly commissioned his care and support as section 117 aftercare funding. The Council confirms it makes all decisions about Mr Y’s care and accommodation have been made in joint consultation with the CCG.
10. Mr Y has a care and support plan and in early 2019 Mr Y moved to supported living care at a house in a different council area I will refer to as council B. This was due to previous care placements in the Council’s area breaking down as local care providers could not meet his needs and Mr X detained under the mental health act. Ms Z was involved in the multi-disciplinary meetings and Best Interest meetings when the decision was made to move Mr Y to the house. It was agreed a care provider I will refer to as Company C would provide the support Mr Y needed with carers living in the property with him. The house is owned by a landlord.
11. The Council’s records note visits by social workers to see Mr Y at the property and telephone calls to Company C during 2019. The Council considered Mr Y settled well and was happy and content. Ms Z also noted in her contact with the Council she was happy with how Mr Y was being cared for with the placement going well.
12. A social worker visited Mr Y in January 2020 with all reported well at the placement. The social worker carried out further telephone and video calls to Mr Y and Company C during 2020 because of the Covid-19 pandemic and being unable to visit in person. The social worker called Company B in January 2021 and visited Mr Y in February 2021. It was reported again that all was well although it was recommended the property need some redecoration. The Council noted the family had visited Mr Y during his time and raised no concerns.
13. Following a Care Planning Approach (CPA) review in February 2021 it was agreed by the Council and CCG Mr Y’s case would move to being monitored with just an annual review each year. This was due to his behaviours being stable and his medication reduced. So, Mr Y no longer had a designated social worker but remained open to the adult social care team.
14. The Council confirms Mr Y received two social worker visits over 2020 and 2021. These were in accordance with its Care Act 2014 duties that service users must be reviewed annually.
15. Mr Y’s finances were managed by his care providers as his Corporate Appointees. This meant they could be responsible for making and maintaining any benefit claims for Mr Y and managing the spending of the benefit.

Events leading to the complaint

16. In January 2022 Ms X and Ms Z visited Mr Y at his property. They complained to the Council about the poor condition of the property, his safety and only one support worker looking after him. They raised concerns about how Company C managed Mr Y’s finances. Although Ms X and Ms Z had no concerns about the personal care Mr Y received from Company C, they wanted Mr Y to move back to Shropshire to be nearer his family. Ms Z reported the situation at Mr Y’s property and his finances to the safeguarding service at council B.
17. Ms X formally complained to the Council in February 2022. Ms X included her concerns that:
• The accommodation was unsuitable, structurally in disrepair and condemned with rubbish in the back garden.
• Mr Y’s weekly allowance of £150 was paid into his carer’s personal bank account and Mr Y did not appear to be receiving any benefits.
• Mr Y’s mobility car was stolen in 2019 and not replaced.
• Company C were not regulated by the Care Quality Commission (CQC).
• Mr Y’s carer could not produce a copy of Mr Y’s care plan when asked.
• The Council funded Company C to provide 2:1 support to Mr Y but he had been receiving care from a single carer for the past 10 months.
• The Council had neglected Mr Y’s care package and he did not have an allocated social worker.
18. The Council responded to Ms X and Ms Z ‘s concerns and appointed a social worker to Mr Y. It liaised with council B’s safeguarding team and arranged a joint unannounced visit to the property in February 2022. The officers found the property not up to standard, Mr Y’s risk assessments not fit for purpose and needed updating. Mr Y’s medicine charts were not being used properly and his finances not managed properly leading to a risk of financial abuse. The safeguarding officer recommended the Council source alternative care provision for Mr Y as a matter of urgency.
19. The officers met with Company C who alleged Mr Y caused the property damage due to his behaviour. And it was about to move Mr Y into temporary accommodation while it repaired the property. The officers disputed that all the issues were caused by Mr Y, and it had not been consulted about a temporary move for Mr Y.
20. The Council held a multi-disciplinary meeting to discuss the concerns raised, create an action plan, and agree who would take each action. The action plan included Company C carrying out property repairs. The social worker updated Ms X and contacted the CCG to allocate a worker due to the joint funding of Mr Y’s care.
21. The Council held a safeguarding strategy meeting in March 2022 attended by professionals including Mr Y’s social worker, mental health worker and CCG. A safeguarding officer from council B chaired the meeting. The meeting agreed the Council and CCG would continue to monitor the situation closely and work towards a plan of moving Mr Y. This needed a new Best Interest decision to facilitate the move involving Ms Z. Meanwhile the Council would remain working with Company C to make the property a safe living environment for Mr Y.
22. The social worker and officer from the CCG carried out a further unannounced visit to see Mr Y in March 2022 due to the safeguarding concerns. The officers found Company C had carried out some property repairs and updated documents. They reported Mr Y as settled, happy and at ease with his carers.

The Council’s response to Ms X’s complaint

23. The Council responded to Ms X’s complaint in March 2022. It explained a social worker last visited Mr Y in February 2021. There were no concerns, so the Council moved Mr Y to an annual review of his case with no designated social worker. Following Ms X and Ms Z’s concerns the Council allocated Mr Y a new social worker and responded to the complaints raised.
24. The Council confirmed it had applied to become Mr Y’s Corporate Appointee in February 2020 so it could manage his benefit claims and how these were spent. Company C had previously acted in this role and continued to manage Mr Y’s money. The Council set up a bank account for Mr Y with a bank card and liaised with Company C about managing Mr Y’s finances. It agreed a weekly budget for Mr Y and Company C needed to apply to the Council if Mr Y required further funds.
25. The Council confirmed it was checking with the DWP Mr Y was receiving benefits he was entitled to and investigating Company C’s previous management of Mr Y’s accounts. The Council found Company C did not tell it Mr Y’s mobility car had been stolen in November 2019. Mr Y’s insurers had closed the case and written off the car as Mr Y’s lease was due to end in December 2019. Mr Y owed a small amount to the insurance company which the Council arranged to pay.
26. The Council explained Company C was registered with the CQC when it commissioned the service for Mr Y in 2019 and the Council carried out due diligence then to check its registration. The CQC is the statutory regulator of care services. Company C deregistered with CQC later wrongly believing it was not providing personal care. The Council was unaware of Company C’s actions as the CQC had no responsibility to tell the Council of its de-registration.
27. The Council immediately approached Company C for an explanation as it was required to tell the Council of any changes in its circumstances. The Council worked with Company C and the CQC to resolve the matter as Company C applied for registration again. The Council confirmed Company C’s suspension and no further contract would be placed with them until it provided evidence of its re-registration. However, the Council was satisfied Mr Y was well cared for and his assessed Care Act needs were being met.
28. The Council explained the landlord had not condemned Mr Y’s property. But the landlord advised Company C to move Mr Y into temporary accommodation and carry out repairs. The Council was unaware of this until January 2022. It was working with Company C and landlord to immediately make the property safe while looking at other options for Mr Y.
29. The Council confirmed Company C sent photographs of fire alarms in place and the relevant fire risk assessment for Mr Y’s property. The Council advised it was carrying out a full audit of Mr Y’s finances and would investigate if it found any anomalies. The Council could not share any further information with Ms Z because she had no legal authority to be advised of Mr Y’s finances.
30. The Council found no care plan or risk assessments at Mr Y’s property at the unannounced visit in January 2022. Company C explained it was because they were being updated and it sent copies to the Council, but these had errors in them The Council told Company C it was unacceptable and to update them. This has now been done. The Council confirmed these have been checked in subsequent visits and found to be on site, updated and relevant to Mr Y.
31. The Council explained it and the CCG funded Mr Y to have 2:1 staff at all times. Company C advised the Council this has been the case apart from two occasions in December 2021 due to last minute staff sickness. The Council confirmed there had been two carers looking after Mr Y on its unannounced visits. The Council said social care closely monitored Mr Y through visits since 2019 and it made telephone calls to Company C and Mr Y during the Covid-19 pandemic. The Council said social care officers attended Mr Y’s CPA reviews. So, it did not uphold the complaint it had neglected Mr Y’s care. The Council acknowledged the property was currently in an unsuitable condition. But Company C had carried out several repairs and tidied up the house with the Council continuing to resolve this.
32. Ms X remained unhappy with the Council’s response and made further complaints about the condition of the property, Mr Y’s current financial situation and the working conditions of the carers. Ms X alleged Company C provided false photographs of repairs carried out and smoke alarms in place. Ms X said her concerns were supported by a further report from the safeguarding officer at council B who reported the same issues about Mr Y’s situation. Ms X asked the Council to take immediate action to move Mr Y.

Events from April 2022

33. The Council held a multi-disciplinary and Best Interest meeting in April 2022. It agreed the social worker should carry out a search to find an alternative care provider and accommodation for Mr Y.
34. Officers spoke to Ms X and Ms Z to discuss their concerns, the agreed actions and search for new accommodation for Mr Y. The Council confirmed the Covid-19 pandemic had presented it with some issues. But Company C had not given it cause for concern while providing support for several individuals commissioned by the Council and CCG. So, it had no evidence it needed be more vigilant of Mr Y’s situation after moving him to be monitored by annual review.
35. The Council told Ms X it had put more scrutiny in place since the safeguarding concerns identified issues. This included home visits by social workers. And an agreement with council B’s safeguarding team to visit frequently to maintain an overview being nearer to Mr Y’s property. The Council noted that while Ms X and Ms Z raised issues about the house and paperwork there had been no concerns about the standard of care by Company C’s carers.
36. The Council accepted the smoke alarm photographs provided by Company C were false but had been taken in trust. The Council confirmed it resolved the matter with smoke alarms now in place. These had been tested by officers on a visit.
37. The Council apologised it was taking time to find alternative options for Mr Y, but explained it was proving difficult due to the national housing shortage and availability of suitable care providers. The Council said it continued to be a challenge to support Mr Y’s move back to Shropshire. But all agreed it needed to be achieved as soon as possible while recognising the lack of viable options available. And the support Mr Y needed to transfer to a new home with new support workers.

New accommodation for Mr Y

38. The social worker found a property within the Council’s area and discussed its suitability with the housing provider. The Council secured the accommodation for Mr Y in May 2022. Officers held a further CPA meeting including Company C to discuss Mr Y’s medical health and needs. Company C advised it had a new management in place and updated Mr Y’s ABC charts, risk assessment and care plans as recommended by the Council. Officers updated Ms Z about the meeting.
39. A nursing team from the CCG visited Mr Y in June 2022. They reported Mr Y’s care plans at the property were detailed, risk assessments fully documented, and medication charts completed. Also, Company C were holding monthly team meetings and staff supervision to ensure all staff felt comfortable in supporting Mr Y. The nursing team were happy with the current plans and noted a big improvement from the previous visit.
40. A social worker visited Mr Y at the end of June 2022 with Ms Z to help him sort out his room ready for a moving date. The social worker noted all documents in Mr Y’s folder including the care plan, his medical conditions, and a risk assessment helpful in understanding the risks and challenges for Mr Y.
41. Mr Y visited the new accommodation in July 2022 to meet the care team on site and moved in a week later. Mr Y is being supported by Company C who are now registered with CQC, while the Council finds an alternative care provider. The Council has lifted Company C’s suspension. The Council confirms Ms X and Ms Z agreed to Company C continuing to provide Mr Y’s care. The Council says Mr Y has been settled into his new accommodation and appears to be benefiting from being closer to his family.

Current actions

42. The Court of Protection appointed the Council as Mr Y’s Deputy for Property and Finance in June 2022. This means the Council has full control of Mr Y’s finances and it is now able to access information about Mr Y’s finances. The Council is currently investigating the management of Mr Y’s finances by his previous care provider and Company C including the mobility car. Council B’s safeguarding investigation remains open while the Council is investigating Mr Y’s financial situation.

My assessment

43. The Council’s documents show it carried out due diligence when it commissioned Company C to provide a care package for Mr Y in 2019 and the company were registered with the CQC at that time. It was for Company C to advise the Council of its change in circumstances as required by its contract, which the company did not do. Once the Council became aware it took appropriate action.
44. The evidence shows the Council did monitor Mr Y’s care while at the property. This was through visits and telephone calls by social workers to Company C and Mr Y during 2019, 2020 and 2021. A social worker last visited Mr Y in February 2021 and there were no comments raised about Mr Y’s care or property. A CPA review meeting in 2021 decided to move Mr Y to annual review inspections by the Council. This is a decision it is entitled to make.
45. It is unfortunate the situation with Mr Y then deteriorated before Mr Y’s annual review. But I cannot say it is due to any fault by the Council or that it neglected Mr Y’s care. This is because it considered the placement was stable. The Council would expect Company C, family members or health professionals to raise any issues if needed before the annual review. The documents show that no concerns were raised after February 2021 until January 2022.
46. Once the Council received Ms X and Ms Z’s complaints about the condition of Mr Y’s property and management of his finances, the evidence shows it has taken appropriate action. This is through liaising with council B’s safeguarding team, the CQC and drawing up an action plan for Mr Y and Company C. The Council has now found Mr Y accommodation nearer to his family in Shropshire which is the outcome Ms X and Ms Z were seeking.
47. The Council is continuing to investigate the concerns about Mr Y’s finances , benefits, and possessions. And as it now has deputyship for Mr Y it can manage his finances. I do not consider that further investigation by me will achieve anything more for Mr Y, Ms X and Ms Z or that it will lead to a different outcome.

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Final decision

48. I am completing my investigation. There is no evidence of fault by the Council. And once it became aware of Ms X’s concerns it has taken appropriate action.

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Investigator's decision on behalf of the Ombudsman