Stockport Metropolitan Borough Council (22 009 307)

Category : Adult care services > Other

Decision : Upheld

Decision date : 09 Mar 2023

The Ombudsman's final decision:

Summary: Mr X’s advocate complained the Council failed to provide Mr X with adequate support in line with his care and support plan and closed his case without informing him. The Council was at fault when it closed Mr X’s case then delayed providing support and failed to inform him when funding for counselling was secured. It has agreed to apologise and make a payment to acknowledge the uncertainty and frustration these faults caused Mr X and refer Mr X for counselling.

The complaint

  1. Mr X’s advocate complained that the Council failed to provide Mr X with adequate support in line with his care and support plan, there was a lack of communication, and it closed his case without informing him. Mr X’s advocate said this this has caused Mr X distress and frustration and meant he was left without adequate support, impacting upon his mental health.

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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. 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

  1. I have considered the information provided by Mr X’s advocate and have discussed the complaint on the telephone with her.
  2. I have considered the Council’s response to my enquiries and the relevant law and guidance.
  3. I gave Mr X’s advocate and the Council the opportunity to comment on a draft of this decision. I considered the comments I received in reaching a final decision.

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What I found

Assessing needs

  1. Sections 9 and 10 of the Care Act 2014 require local authorities to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to all people regardless of their finances or whether the local authority thinks an individual has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
  2. To have needs which are eligible for support, the following must apply:
      1. The needs must be due to a physical or mental impairment or illness.
      2. Because of the needs, the adult must be unable to achieve two or more of the following:
        1. Managing and maintaining nutrition;
        2. Maintaining personal hygiene;
        3. Managing toilet needs;
        4. Being appropriately clothed;
        5. Being able to make use of the adult’s home safely;
        6. Maintaining a habitable home environment;
        7. Developing and maintaining family or other personal relationships;
        8. Accessing and engaging in work, training, education or volunteering;
        9. Making use of necessary facilities or services in the local community including public transport, and recreational facilities or services; and
        10. Carrying out any caring responsibilities the adult has for a child.
      3. Because of not achieving these outcomes, there is likely to be a significant impact on the adult’s well-being.
  3. Where local authorities have determined that a person has any eligible needs, they must meet these needs. When a local authority has decided a person is or is not eligible for support it must provide the relevant person (the adult or carer) with a copy of its decision.

What happened

  1. The following is a summary of key events and does not reference all communication between the Council and Mr X.
  2. Mr X has a diagnosis of autism.
  3. In April 2022 Mr X’s social worker from the Council’s neighbourhood team, completed a needs assessment. Mr X says he was not aware an assessment was being completed and says he was not given a copy. The assessment noted Mr X was socially isolated and unable to access the community independently. It said he had a history of self-harm and self-neglect. It found Mr X required support with accessing the community, developing or maintaining relationships, support with accessing money and shopping and reminders regarding personal hygiene. As a result of the assessment the social worker recommended Mr X attend day services two days a week to reduce isolation, access the local community and make positive new relationships. The social worker took Mr X to view the day service and arranged a trial visit for early May. Following the trial day the social worker noted Mr X had a positive day. The social worker agreed to explore whether they could arrange a regular taxi driver to support Mr X to attend the service.
  4. In early May the social worker contacted Mr X to discuss transport options to the day service. They noted Mr X said he did not know if he wanted to attend and was unhappy at the assessed cost for his contribution to his care. Mr X says because his assessed contribution was higher than a day’s cost at the day centre, he was requesting to attend twice a week.
  5. Two days later Mr X was admitted to hospital after threatening self-harm. Following his discharge, the social worker spoke to Mr X on the telephone then agreed to visit him later that week. They also followed up a referral they had made in February 2022, to the NHS, for counselling for Mr X.
  6. At the visit the social worker discussed the day services. Mr X was unsure if he wanted to go. Mr X expressed concerns about the lack of support he had received in the past from social workers. The social worker noted Mr X said the social worker being there was making him worse and he referred to self-harm. The social worker contacted their supervisor who called 999.
  7. The following day the social worker called Mr X and spoke with his mother. She reported Mr X had been taken to hospital but was now at home. He was not happy with the social worker and other services. The social worker said they would contact Mr X’s GP for an urgent referral. The notes show the social worker did this.
  8. A few days later Mr X’s mother called the Council to speak with the social worker’s supervisor. The records note she wanted to cancel trips to the day centre as Mr X was not currently fit to attend. The supervisor telephoned Mr X who said he wanted a different social worker and would like to pursue the day service although he thought it was expensive. Mr X also referred to counselling which he was not currently having but would like as long as it was with a different counsellor to the one he had previously. The supervisor advised Mr X his GP may be able to refer him to counselling. The supervisor agreed to establish what days he could attend the day service and whether a car scheme could support him to attend.
  9. The following day the supervisor spoke with Mr X’s mother who said she had a discussion with Mr X and he did not want to attend the day service or use the car scheme. The supervisor noted they advised that if Mr X wanted an assessment in future he could make a referral and the Council would explore the day service again. They said the social worker would send him a copy of the assessment and support plan and end their involvement.
  10. In mid-May the NHS emailed Mr X’s social worker. The social worker noted the NHS officer ‘confirmed funding will be in place for [counselling] and pass it over to [the counselling service]’.
  11. The supervisor spoke with the social worker and advised them to close the case following contact with Mr X and his mother. They noted he requested the social worker no longer be involved.
  12. The following day, Mr X’s advocate emailed the social worker to advise they were allocated to his case. The social worker advised they were no longer involved and referred the advocate to their supervisor.
  13. In mid-June the supervisor spoke to the advocate and explained the case was closed as Mr X did not want to pursue day care. The advocate agreed to contact Mr X and to re-refer if he required another assessment.
  14. In late July Mr X’s advocate made a referral on behalf of Mr X.
  15. Around that time Mr X contacted the Council. He was unhappy his advocate had told him his case was closed and he was not getting a new social worker. The following day Mr X’s mother called the Council. She said she was not told the case was closed and believed Mr X would be contacted about getting a new social worker. She said Mr X needed support with shopping and getting out and about. Mr X complained to the Council.
  16. The Council responded to Mr X’s complaint in early August 2022. It noted:
    • Mr X’s social worker had regular contact with him, made a request for counselling and secured funding for this and for two days at a day service
    • The supervisor should have contacted Mr X to establish what he wanted to do rather than close his case following discussion with his mother. It apologised for this. It said it would advise neighbourhood teams of the importance of communication prior to closing a case and the importance of sending a formal closure letter.
    • Mr X’s case was now with the Council’s autism team.
  17. The Council agreed to allocate Mr X a social worker from its autism team. A social worker arranged to meet Mr X in August 2022. The Council says the social worker completed a needs assessment. At a further visit in September 2022 the social worker met Mr X to discuss the possibility of support. They noted Mr X listed a number of organisations who had previously attempted to work with him but it had not worked well. They noted Mr X was happy to consider receiving some support and to consider counselling again.
  18. This social worker left the Council in early October 2022.
  19. Mr X contacted the Council in mid-October with concerns his housing benefit had been stopped as he had been staying at his mother’s. He was unhappy when he was advised the social worker who visited him in September had left. Later that month Mr X threatened to self-harm. The Council allocated Mr X a social worker who arranged to visit him. Over the following few days both the police and ambulance service were called out several times to Mr X. In early November 2022 the Council reinstated Mr X’s housing benefit.
  20. The social worker visited Mr X in November 2022 and completed a needs assessment and support plan. They recommended Mr X receive three four-hour sessions of support per week. The Council has confirmed, in February 2023, that it has identified a support provider.

Findings

  1. It is not the Ombudsman’s role to decide what, if any, care and support a person needs. That is the Council’s role. The Ombudsman’s role is to consider if the Council has followed the correct process in assessing a person’s needs.
  2. Mr X’s social worker assessed his needs and sought to provide support through a day service to meet his needs. There was no fault in their actions. However, the Council then closed Mr X’s case after speaking with his mother, without speaking to him directly. This was fault. At that time Mr X was unsure whether he wished to pursue the day service and had concerns about getting there and I cannot now know, with any certainty, whether Mr X would subsequently have attended the day service at that time. In addition, in closing the case, the Council also failed to consider whether any other support may have appropriate to address his identified care needs.
  3. When Mr X’s advocate was told his case was closed, they spoke to Mr X and re-referred Mr X to the Council. A social worker from the Council’s autism team assessed his needs but then left the service without any support being put in place and it was not until November 2022, when another social worker visited and completed a needs assessment that specific support was proposed.
  4. Mr X now has a support plan in place and the Council had identified a provider to deliver the support to Mr X. I cannot know whether, if this had been identified sooner, what would have happened and whether Mr X would have accepted the support. However, had the Council not closed his case in June 2022 it is likely Mr X would have had access to some support at least three months earlier.
  5. In May 2022 the Council advised Mr X to speak to his GP about counselling. The Council had already referred Mr X for a counselling service and the NHS had confirmed funding was in place. The Council failed to advise Mr X of this or of what he needed to do to take this forward. This was fault. This meant Mr X missed out on the opportunity to pursue this counselling.
  6. The Council has provided me with evidence to show that following Mr X’s complaint it sent a reminder to staff of the need to confirm in writing to service users when it had decided to close their case. This was appropriate to prevent future injustice to others and so no further recommendation is required in this area.

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Agreed action

  1. Within one month of the date of the final decision on this complaint the Council has agreed to apologise to Mr X and pay him £250 to acknowledge the distress, uncertainty and frustration caused by the Council closing his case and the delay in identifying support to meet his needs.
  2. Within two months of the date of the final decision the Council has agreed to contact Mr X and either make a referral for counselling or support Mr X to do so, to replace that he missed out on in June 2022.
  3. The Council should provide us with evidence it has complied with the above actions.

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Final decision

  1. I have completed my investigation. I have found fault causing injustice which the Council has agreed to remedy.

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Investigator's decision on behalf of the Ombudsman

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