Summary: Ms X complains the Council has failed to meet all her needs for care and support. The Council’s records containing conflicting information about how it has been meeting Ms X’s needs. It has also failed to engage with other agencies which have contacted it on Ms X’s behalf. The Council needs to apologise to Ms X, make a symbolic payment, reassess her needs and update her care and support plan.

The complaint

1. The complainant, Ms X, complains the Council has failed to meet all her needs for care and support.

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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’. If there has been fault which has caused significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
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:
• considered the complaint and the documents provided by Ms X;
• discussed the complaint with Ms X;
• considered the comments and documents the Council has provided in response to my enquiries;
• considered the Ombudsman’s guidance on remedies; and
• invited comments on a draft of this statement from Ms X and the Council, for me to consider before making my final decision.

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What I found

What happened

5. Ms X is blind and has other physical disabilities which affect her mobility and her ability to lift and hold things. She uses a walking frame inside the home and a wheelchair outside the home. She lives in her own home with support provided by the Council.
6. Ms X’s June 2021 care and support plan said she had a direct payment to help her access the community:
• 2 hours a week for shopping
• 3 hours a week to go to the gym, to an internet café, to medical appointments and to attend day trips
• 5 hours to attend religious services every four weeks
7. The Council reassessed Ms X’s needs in October 2021 in response to a request for another three hours a week to go to a gym. The assessment said Ms X needed support:
• Managing and maintaining nutrition
• Maintaining personal hygiene
• Being appropriately clothed
• Making use of the home safely – Ms X chose not to accept support with this
• Maintaining a habitable home
• Making use of necessary facilities or services in the community
• Taking medication
8. The Council arranged for a care provider to meet Ms X’s need for help:
• Managing and maintaining nutrition – daily visits to prepare meals and feed her
• Maintaining personal hygiene – help with a shower twice a week and with a full body wash on other days
• Being appropriately clothed – daily help getting dressed
• Maintaining a habitable home – one hour a week to help with cleaning
• Taking medication – daily help putting Ms X’s medication in her mouth
9. The Council also gave Ms X direct payments so she could arrange her own support in making use of necessary facilities or services in the community:
• 3 hours a week for shopping and attending medical appointments
• 5 hours a week to visit a gym (including additional 3 hours requested by physiotherapy)
• 5 hours every four weeks to attend a religious service
10. In March 2022 the Council responded to a complaint from Ms X’s advocate. The Council said this support remained in place:
• 3 hours for shopping
• 2 ½ hours to go to the gym (recently increased to 7 ½ hours to incorporate physiotherapy)
• 1 hour for cleaning
• 5 hours a month to attend a religious service
11. It said it had suspended Ms X’s direct payments to prevent a build up of funds as she was not using them (as the care agency had not been able to provide her support and she had then gone into hospital).
12. In September 2022 Ms X told the Council she had only been out three times in the past year (not including shopping and appointments).
13. In December 2022 the Council worked with Ms X to produce a care plan to give to potential personal assistants explaining how she liked to be supported.
14. In January 2023 the Council told Ms X about a social club she could attend on Fridays. Ms X said she wanted to go out in the community to do things she wanted to do, not go to a social club.
15. The Council reassessed Ms X in February 2023. Ms X’s needs had not changed. The assessment said she wanted this support to continue:
• Am: 1 hour five days a week, 1 ½ hours two days a week
• Lunch: 1 hour seven days a week
• Teatime: 45 minutes seven days a week
• Bedtime: 30 minutes seven days a week
• Cleaning 1 hour a week
16. The Council was also providing direct payments to employ personal assistants:
• 3 hours a week for shopping, visiting the bank and medical appointments
• 2 hours a week to visit a gym
• 5 hours every four weeks to attend a religious service
17. The assessment said Ms X had arranged for the Council’s care provider to support her with shopping, medical appointments and attending religious services, but the care provider did not have “extra hours”, so Ms X had not been to a gym for some time. Ms X wanted the Council to pay her direct payments at a higher rate, so she could contract with a care agency, rather than the lower rate for employing a personal assistant. The Council agreed to this. The assessment noted Ms X had had problems recruiting personal assistants, and they had often left at short notice. It also noted the care provider could not support Ms X in the long term.
18. According to the Council’s records:
• The care agency contacted it three times in April and twice in May wanting to discuss Ms X, but there is no evidence of a substantive response;
• A charity contacted the Council twice in April, once in May and once in November on behalf of Ms X, but there is no evidence if a substantive response;
• In June a care co-ordinator said Ms X wanted help going to the gym and visiting the Forest of Dean.
• In August a community support practitioner wanted to discuss Ms X‘s progress. Ms X’s social worker was to contact her, but there is no evidence this happened.
19.  
• In August the Council told Wiltshire Centre for Independent Living Ms X’s direct payment was for 6 ¼ hours a week.
• In October Wiltshire Centre for Independent Living asked if Ms X’s direct payment was being paid at the agency rate and what her client contribution was, but there is no evidence of a response.
• In November a community support worker asked the Council to get in contact, but there is no evidence of a response.
20. Ms X says she needs five to six hours to attend religious services, so she can take part in social activities as well as the services themselves. She says she needs 2 ½ hours to go to a gym and 1 hour to help with paperwork.
21. The Council says Ms X has a surplus in her direct payment account and can use this to pay for any additional support she needs. Ms X says the care provider the Council found for her is unable to provide all the support she needs, which is why she has a surplus in her account.

Is there evidence of fault by the Council which caused injustice?

22. The Council’s records contain conflicting information about the support it has been providing for Ms X. In 2021 it provided 3 hours to go to the gym. In October 2021 it claimed to have increased this by three hours but only provided an extra 2 hours. It is unclear when the Council removed the extra hours, but in January 2023 it only provided 2 hours to go to the gym. This raises questions over whether this is enough time to support Ms X to go to the gym. The lack of clear records is fault by the Council.
23. Others acting on behalf of Ms X have been contacting the Council during 2023, but there is little evidence of the Council engaging with them. That is further fault by the Council. It is clear that Ms X is not satisfied with the support in place for her. That provides grounds for the Council to review her care and support plan.
24. Besides, 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.
25. Over a year has passed since the Council last reviewed Ms X’s needs. A review or reassessment is therefore overdue.
26. The Council says Ms X has a surplus in her direct payment account because she has not been using all the money available to her. It says she can use this surplus to spend as long as she wants going out. Ms X says the care provider the Council has arranged to meet her needs using the direct payments, has been unable to provide people to support her when she wants to go out. She points out that because of her disabilities, she needs help from the Council making use of her direct payments.

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Agreed action

27. I recommended the Council:
• Within four weeks apologises to Ms X, pays her £250 for the time and trouble it has put her to, reassesses her needs and updates her care and support plan, addressing her request for additional support.
28. The Council has agreed to do this. It should provide us with evidence it has complied with the above actions.

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Final decision

29. I have completed my investigation on the basis there has been fault by the Council causing injustice which requires a remedy.

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Investigator's decision on behalf of the Ombudsman