Summary: The Council was not at fault for how its adult social care service handled Mr X’s home visits, his financial assessment or his mother’s correspondence. It was, however, at fault for how it handled his direct payments and his mother’s complaints. It was also at fault for a delay in telling Mr X and his mother that Mr X had a new social worker, which caused them uncertainty. The Council has agreed to apologise.

The complaint

1. Mrs Y complains about the social care support the Council provided to her son, Mr X. She says:

1. The Council delayed the completion of a financial assessment in 2023.
2. The Council failed to set up Mr X’s direct payments properly in December 2023, which caused further delays.
3. The Council removed Mr X’s access to an advocate in March 2024.
4. The Council failed to respond to Mrs Y’s correspondence after February 2024.
5. Mr X’s social worker failed to visit him for (at least) six months after being allocated his case in October 2023.
6. The Council failed to handle Mrs Y’s complaint about Mr X’s social care assessment, financial assessment and direct payments properly.
7. The Council agreed, in its initial response to Mrs Y’s complaint, to allocate a new social worker to Mr X’s case. But, by the time of her complaint to the Ombudsman three months later, this had still not happened.

2. Mrs Y says the above matters have contributed to the Council’s failure to meet Mr X’s needs.

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The Ombudsman’s role and powers

3. 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)
4. 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)
5. We cannot investigate a complaint if someone has appealed to a tribunal about the same matter. We also cannot investigate a complaint if in doing so we would overlap with the role of a tribunal to decide something which has been or could have been referred to it to resolve using its own powers. (Local Government Act 1974, section 26(6)(a), as amended)
6. The First-tier Tribunal (Special Educational Needs and Disability) considers appeals against council decisions regarding special educational needs. We refer to it as the Tribunal in this decision statement.
7. 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(1), as amended)

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What I have and have not investigated

8. As Mrs Y complained to us in September 2024, any complaint about events from before September 2023 is late under the terms of the Local Government Act. I cannot investigate such complaints unless there are good reasons.
9. At the point of starting my investigation of Mrs Y’s complaint, it appeared that the process of Mr X’s financial assessment spanned from July to December 2023. Although the start of the assessment (July) was outside our 12-month time limit, the decision (December) was within it. I considered this good reason to exercise our discretion and to investigate the whole assessment period.
10. However, since receiving Mr X’s records from the Council, I have become aware that there were actually two financial assessments: one which took place from July to August, and a second which took place from September to December.
11. The first of these assessments was completed entirely outside our time limit, and, in the absence of any evidence which suggests that Mrs Y could not have complained about it earlier, I have excluded it from my investigation.
12. I have also excluded Mrs Y’s complaint about the removal of Mr X’s advocate. This is because the decision to stop the provision of advocacy was in Mr X’s educational, health and care (EHC) plan (a statutory support plan which set out the provision he needed for his special educational needs). Mrs Y appealed the plan to the Tribunal and specifically contested the removal of the advocate.
13. The courts have established that if someone has appealed to the Tribunal, we cannot investigate any matter which was part of, was connected to, or could have been part of, the appeal. (R (on application of Milburn) v Local Government and Social Care Ombudsman [2023] EWCA Civ 207)
14. The period we cannot investigate starts from the date the appealable decision is made. If the parent or young person goes on to appeal, then the period that we cannot investigate ends when the Tribunal comes to its decision, or if the appeal is withdrawn or conceded.
15. Due to the restrictions on our powers to investigate where there is an appeal right, there will be cases where there has been past injustice which neither we, nor the Tribunal, can remedy. The courts have found that the fact a complainant will be left without a remedy does not mean we can investigate a complaint. (R (ER) v Commissioner for Local Administration, ex parte Field) 1999 EWHC 754 (Admin)
16. This means that, even though the Council conceded Mrs Y’s appeal and ended up reintroducing Mr X’s advocacy provision three months after stopping it, I cannot look at the decision to stop it, or any injustice arising from the three months he was without it.

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How I considered this complaint

17. I considered evidence provided by Mrs Y and the Council as well as relevant law, policy and guidance.
18. Mrs Y and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Complaint A: Financial assessment delays

The Council’s ‘Charging for community-based care’ leaflet

19. In order to work out how much an adult can pay towards the costs of their care, the Council will complete a financial assessment.
20. Although the Council does not set a timescale for these assessments, it aims to do them “as quickly and efficiently as possible”. To help it do that, it completes most assessments over the telephone.

What happened

21. In early September 2023, Mrs Y contacted Mr X’s social worker. She told her that there would soon be a reduction in Mr X’s financial assets which would make him eligible for financial support from the Council. She asked the social worker to arrange a financial assessment.
22. This reduction happened in mid-September. Mrs Y notified Mr X’s social worker, and, again, asked for a financial assessment.
23. The social worker (who had been off work sick) contacted Mrs Y two weeks later. She said she had asked the Council’s finance team about this but had not heard back. She suggested that Mrs Y contact them directly. Mrs Y agreed to do so.
24. Three weeks later, in late October, Mrs Y provided the Council’s finance team with evidence of Mr X’s reduced financial circumstances. The Council arranged a telephone financial assessment for mid-November.
25. Immediately following the financial assessment, the Council wrote to Mrs Y and told her Mr X would no longer have to contribute towards the costs of his care. It then followed this up with a further confirmation letter in mid-December.
     

My findings

26. It is true that Mrs Y began asking Mr X’s social worker for a new financial assessment at the beginning of September 2023 (over two months before the assessment was completed). But Mr X’s records show that:
• His financial situation did not change until mid-September.
• His social worker responded to Mrs Y two weeks later – after a period of sickness – advising Mrs Y to contact the finance team directly.
• Mrs Y then took three weeks to do so.
27. I do not consider the two-week period it took the social worker to respond to
    Mrs Y to constitute a significant delay, particularly as she had been ill. And, when Mrs Y provided the new evidence to the Council’s finance team, the assessment was completed without delay.
28. For these reasons, I have found no fault with how the Council handled Mr X’s financial assessment.

Complaint B: Direct payments

Care and support statutory guidance

29. Direct payments are made to people to meet their needs. They give people choice by enabling them to commission their own care and support.
30. Councils must have clear and swift processes in place to respond to requests for direct payments. In all cases, the consideration of the request should be concluded in as timely a manner as possible.

What happened

31. Mrs Y completed a direct payment request form for Mr X in early October 2023, and she sent it to the Council.
32. In mid-December – four weeks after it completed its financial assessment – the Council wrote to Mrs Y, saying Mr X’s direct payment would be £16.97 per week.
33. The Council says that this rate was for one hour of support a week, “instead of the agreed 4 hours”.
34. In January 2024, Mrs Y told the Council that Mr X’s direct payment rate was not high enough, as he spent over £50 per week on social activities.
35. The Council agreed an increase to £52 per week, and shortly afterwards (later in January), the Council reviewed Mr X’s care and support plan and agreed that he should receive £73.52 per week.
36. Mrs Y then filled in a new direct payment form in February. But, in early April, the direct payment had still not been changed. She contacted the Council about this.
37. The Council corrected the payment and backdated it to October 2023.
38. The Council says Mr X had a significant amount of money (almost £4k) left over in his direct payment account when he turned 18 in March 2023, and this money remained available to him throughout the period his direct payment was too low.
39. The Council also says the sole withdrawal from Mr X’s direct payment account around this period came in May 2024, six weeks after the payment had been corrected.

My findings

40. Although there is no set timescale for a council to deal with a direct payment request, it should do so without delay.
41. The Council took four weeks to make a decision on Mr X’s direct payments after it completed its financial assessment. This was not a significant delay.
42. However, the Council then set up Mr X’s direct payments incorrectly. It provided funding for one hour a week instead of four hours. Although Mrs Y raised this with the Council in January 2024, the matter was not resolved until April.
43. This meant the payments were wrong for over three months, for which the Council was at fault.
44. However:
• There were funds available in Mr X’s direct payment account throughout this period (due to a previous surplus in the account).
• Mrs Y did not attempt to make any withdrawals from the account while the payments were wrong (and, in fact, did not notice for three months).
• The Council backdated the payments once it eventually corrected them.
45. For these reasons, there was no obvious injustice to Mr X, and I will not recommend that further action be taken.

Complaint D: Mrs Y’s correspondence

46. Although I do not intend to reproduce it all here (particularly as I refer to some of it elsewhere in this decision statement), there is substantial evidence on Mr X’s records that the Council responded to Mrs Y’s correspondence.
47. There is one exception. In April 2024, Mrs Y emailed Mr X’s social worker’s manager and asked for an update on a joint letter to the child and adolescent mental health service about Mr X’s care co-ordinator.
48. Two days later, the Council acted on Mrs Y’s email by contacting the health service about the care co-ordinator; however, it did not tell Mrs Y that it had done so.
49. In the context of all the correspondence I have reviewed – and bearing in mind Mrs Y’s complaint that the Council completely failed to respond to her correspondence from February 2024 onwards – this was a very minor issue which did not meet the threshold of maladministration. I will neither find fault with the Council on this point nor recommend any remedial action.

Complaint E: Social worker visits

The Council’s website

50. The Council will conduct in-person assessments of people’s needs (when this is the first assessment).
51. Reviews of those assessments (and care and support plans) may be conducted in person or may be over the telephone.

What happened

52. In October 2023, Mr X’s social worker went on extended leave. She gave Mrs Y the name of her colleague, who would be covering Mr X’s case while she was away.
53. In January 2024, the Council updated Mr X’s care and support plan. The only provision he received from the Council was direct payments.
54. The Council tried to visit Mr X in February to discuss an ongoing dispute about advocacy. But Mrs Y refused the visit, saying it had failed to offer reasonable adjustments to engage Mr X. She asked what the Council intended to do about this, as “[Mr X] hasn't seen a social worker for at least 4 months now and I suspect quite a lot longer”.
55. The Council told Mrs Y it would be happy to make reasonable adjustments, and it asked her to suggest a date and time which would be convenient for a visit.
56. Mrs Y did not respond.
57. The Council held a multi-agency meeting in March to discuss Mr X’s case. His social worker could not attend, but her manager attended instead.
58. In August, after the Council had allocated a new social worker to work with Mr X, she contacted Mrs Y to discuss arrangements for reviewing Mr X’s assessment. After an exchange of correspondence, the visit took place in late September.

My findings

59. Social workers for adult clients do not generally visit them with the same frequency as children’s social workers may do. There are no statutory requirements for regular visits.
60. Instead, social workers generally visit adult clients when this is deemed necessary. According to the Council’s website, this includes when conducting needs assessments. Reviews may be conducted in person, or they may be over the telephone.
61. In Mr X’s case:
• His care and support plan said the only service he received was direct payments. There is no suggestion that he should have been receiving regular visits from a social worker for other reasons.
• The Council gave Mrs Y the opportunity to arrange a visit if she (or Mr X) wanted one.
• It also arranged and attended meetings to discuss Mr X’s care.
• It then visited Mr X in order to start his reassessment.
62. As there is no suggestion that the Council’s approach to Mr X’s visits failed to meet the expectations of the statutory guidance or its own website, I have found that it was not at fault.

Complaint F: Complaint handling

63. Regulation 14 of the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 gives councils a maximum of six months to respond to complaints about adult social care.
64. The Council’s website says it will respond to stage 1 complaints within four weeks, and stage 2 complaints within five weeks (although this can be extended to 13 weeks, and, if it is, the Council will contact the complainant to explain why).
65. I do not intend to reproduce Mrs Y’s extensive complaints here. Although broadly along similar lines to the complaint I am investigating, there were additional elements which, for various reasons, have not formed part of my investigation.
66. Having considered the complaints Mrs Y made and the Council’s responses, I am satisfied that there was no fault in the stage 1 response. Although Mrs Y disagreed with it and felt it was inadequate, it addressed the main points she made and offered ways to improve the Council’s handling of Mr X’s case (such as a new social worker).
67. However, the Council took seven weeks to respond to Mrs Y’s stage 1 complaint, which was a short delay. And it did not respond to her stage 2 complaint at all – although it wrote a response, it sent it to a misspelled email address. This meant she did not get a final response within the statutory six-month timescale.
68. This amounted to a mishandling of Mrs Y’s complaints, for which the Council was at fault.
69. The Council has already apologised to Mrs Y for the stage 1 delay. It should also apologise for its failure to issue the stage 2 response.

Complaint G: New social worker

70. In June 2024, in the Council’s response to Mrs Y’s first complaint, it told her it would allocate Mr X’s case to a new social worker.
71. There was no delay to this reallocation – in fact, according to Mr X’s records, it had already happened in May, prior to the Council’s complaint response. At the point that the case was reallocated, the Council noted that it would conduct a review of Mr X’s needs assessment.
72. However, the Council then did not contact Mrs Y about this review until late August – almost four months later. During this period, Mrs Y was unaware that the Council had found a new social worker for Mr X’s case.
73. I have not seen any good reason why there was such a gap between the Council agreeing to conduct a review of Mr X’s assessment (and telling Mrs Y about the new social worker), and it then getting in contact about the review.
74. This amounted to fault by the Council, which will have caused Mr X and Mrs Y some uncertainty. The Council should apologise.

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Action

75. Within four weeks, the Council has agreed to apologise to Mr X and Mrs Y for the delay in notifying them that Mr X had a new social worker, and for its failure to send them a final response to their complaint. We publish guidance which sets out what we expect an effective apology to look like. The Council will consider this guidance when writing to Mr X and Mrs Y.
76. The Council will provide us with evidence it has made this apology.

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Decision

77. There was some fault in how the Council delivered Mr X’s social care support and responded to Mrs Y’s complaints. This caused them some injustice, which the Council will now take action to address.

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Investigator's decision on behalf of the Ombudsman