Summary: Mr X complained the Council discriminated against him by failing to correspond and provide documentation, including his care plan, in large print. Mr X also complains the Council has failed to provide appropriate care under an interim care plan. He states the Council's actions left him with no option but to stop using Council arranged carers, and he has incurred costs in safeguarding himself from carers. The Council’s failure to take account of its duties under the Equality Act and correspond with Mr X in large text from the outset is fault and has caused Mr X an injustice. However, there is no evidence of fault in the way the Council has assessed Mr X’s care needs or investigated his concerns about the care provided or the actions of carers.

The complaint

1. The complainant, whom I shall refer to as Mr X complained the Council discriminated against him by failing to correspond and provide documentation, including his care plan, in large print.
2. Mr X also complains the Council has failed to provide appropriate care under an interim care plan. He complains:
• a carer assaulted him with a door,
• another carer tried to poison him and his partner; and
• the Council send a male carer to support him, despite being aware this was not appropriate; and
• carers are not required to be vaccinated for COVID-19.
3. Mr X states the Council's actions left him with no option but to stop using Council arranged carers, and he has incurred costs in safeguarding himself from carers.

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The Ombudsman’s role and powers

4. 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)
5. 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

6. As part of the investigation, I have:
• considered the complaint and the documents provided by Mr X;
• made enquiries of the Council and considered the comments and documents the Council provided;
• Mr 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

Key facts

7. Mr X and his partner moved to the Council’s area in March 2021. Mr X also complained about the Council’s action in relation to his partner, but as we do not have his partner’s consent for Mr X to raise these issues, they do not form part of this investigation.
8. On 23 March 2021 the Council received a referral for a Care Act assessment for Mr X. Mr X also requested a referral for occupational therapy (OT) equipment and help maximising his finances. The Council completed an assessment over the telephone on 30 April 2021. The outcome of this assessment was that Mr X was eligible for support.
9. The Council prepared a care and support plan dated 7 May 2021. This set out a package of care involving two calls each day to support Mr X with personal care, washing, dressing, and undressing, meal preparation, prompting medication and grooming. The care and support plan noted carers were to clean and tidy as the went along and to ensure Mr X was safe before leaving. The plan also noted that Mr X had a private cleaner who visited weekly.
10. The care and support plan states that in light of information from a multi- agency review meeting a male care was considered more appropriate.
11. Over the following weekend Mr X raised over 20 safeguarding concerns. The Council’s notes state it considered Mr X’s reports, some of which were historic, but none of which would constitute a safeguarding investigation. The Council passed details of the issues Mr X raised to the social worker assessing Mr X’s care and support needs.
12. Mr X raised continued to raise a multitude of safeguarding concerns over the following few days relating to various issues. The Council noted the concerns but did not consider they were safeguarding related or required further action.
13. Mr X also complained that council officers had discriminated against him as they did not use point 16-20 text in emails. Mr X has a visual impairment and could not read the small text. Mr X complained a social worker had also visited him and asked him to sign a care and support plan which he could not read as it was not in point 20 text.
14. The Council’s response confirmed it had reviewed all entries on Mr X’s file since he moved to the borough and could not identify any incidences of discrimination. It considered officers had engaged appropriately and had screened Mr X’s various concerns. The Council noted Mr X had submitted 22 separate concerns between 8 and 10 May 2021. It had screened these concerns, but none reached the threshold for further safeguarding enquiries.
15. The Council also confirmed that there was now a note on Mr X’s file regarding correspondence being sent in the correct font size.
16. A care agency began providing the care package on 13 May 2021. On 19 May 2021 the care agency gave seven days’ notice of their intention to end the contract. The Council’s records state the care workers had refused to go back as they did not feel safe due to some of Mr X’s remarks and conduct. Mr X had repeatedly declined care and told the agency he no longer wanted their service. The Council spoke to Mr X who agreed to a change of care agency.
17. The Council reviewed Mr X’s care and support plan and recommended reducing the package of care to just one visit each day, in the morning. The care agency contacted the Council again on 24 May 2021 to advise that Mr X had again refused care and would not allow carers access. Carers had not seen Mr X that day. Mr X had allowed the carer to enter the property the previous day but had not allowed the carer to provide services.
18. Mr X contacted the Council to complain a carer had tried to poison himself and his partner. He also complained that although he had made it clear he could not accept care from a male carer or this care agency, the agency had sent a male carer again. Mr X also continued to raise safeguarding concerns, primarily in relation to his partner.
19. The Council wrote to Mr X on 2 June 2021 confirming that his package of care had been cancelled from 28 May 2021. It noted that following his assessment Mr X was eligible for support services and it had put provision in place, but Mr X did not allow the carer to provide the support. The Council advised Mr X he could contact social services if his circumstances changed.
20. On 10 June 2021 Mr X raised a further safeguarding concern. He reported:
• A carer had tried to poison him;
• A carer had pushed a door on him, causing him an injury which led to him going to hospital. Mr X had reported this incident to the police, but the police could not take it further and advised him to get CCTV. Mr X asked for help installing it.
• Mr X had cancelled his care package but now needed care.
21. The Council considered this met the threshold for safeguarding enquiries. Officers visited Mr X to discuss his concerns and what he wanted to happen. The Council also asked the care agency to investigate the allegations. In addition, the Council contacted the hospital for details of Mr X’s attendance and contacted the police for details of any action taken.
22. The investigation concluded there was no evidence available to support Mr X’s allegations. The Council’s records state Mr X accepted it would be difficult to prove his allegations in the absence of any witnesses or corroborating evidence. He agreed he would be happy with the offer of a joint social work and occupational therapy holistic assessment of his care and support needs. The Council wrote to Mr X with it conclusions in July 2021.
23. The Council also wrote to Mr X responding to his complaints and the issues he had raised as separate safeguarding concerns. The Council noted Mr X had declined to allow carers into his home and had told the Council he had his own private arrangement for care. The Council considered arranging a CCTV rig was Mr X’s personal choice, and the Council was not responsible for the costs. As Mr X had now agreed to a joint visit from the social worker and OT, the Council would contact him to arrange an appointment.
24. In relation to Mr X’s concerns about male carers, the Council noted Mr X had not told the social worker during the assessment that he did not want male carers. As the care package had now ended, male carers were not visiting Mr X’s home. The Council also explained that it had an overarching duty to safeguard visiting care staff. In some situations where the risks have not been fully assessed, the Council would not send lone female carers to attend male customers. In addition, the Council confirmed it could not require carers to accept the COVID-19 vaccination.
25. The Council was satisfied that officers had maintained an appropriate level of contact with Mr X, including email correspondence and telephone contact. It was also satisfied it had screened and responded to every safeguarding concern Mr X had raised. Given the volume of Mr X’s contacts, the Council asked Mr X to only contact a single named officer. The Council noted that Mr X had not specified during his initial assessment that he required correspondence in font size 16. It again confirmed it had updated its systems to ensure future correspondence was in the correct format.
26. A social worker and OT visited Mr X in August 2021 to carry out the joint reassessment. Following this assessment, the OT agreed to make a referral for a community alarm; order a toilet frame with a raised seat; and liaise with charities and services to assist Mr X.
27. The Council states the social worker is still actively involved, but has been unable to complete the assessment as:
• Medical evidence to support Mr X’s numerous diagnoses is unavailable. It states Mr X’s GP is waiting for information from other health authorities.
• Mr X later insisted a Care Act Advocate was necessary. The Council arranged for an advocate and the assessment is due to be completed following a visit on 13 October 2021. And
• Mr X makes frequent contact to discuss his concerns about other agencies.
28. In response to my enquiries the Council states it remains of the view Mr X carries out all activities of daily living independently. It does not consider there was a delay in assessing Mr X’s care needs or in implementing a care and support plan. It states it put a package of care in place based on Mr X’s self-reported assessment of his needs. Mr X then denied access to carers to his property. The Council states Mr X has been offered a comprehensive reassessment and has ben unable to supply evidence to corroborate the medical diagnoses he claims to have.
29. In relation to Mr X’s concerns about the format of the care and support plan, the Council states that after Mr X informed the Council he needed text in font 14-20 it has provided all correspondence in that format. It has also added a note to Mr X’s file to alert staff to the need for text in font 14-20.
30. The Council has responded to the draft decision and asserts it was aware of and had recorded Mr X’s need for large print on its system from his first contact on 23 March 2021. It states it is unaware of any incidents where correspondence was sent to Mr X in small text. The Council also disputes forcing Mr X to sign a support plan he could not read. It states it is not part of its process to ask service users to sign plan documents.

Analysis

31. The reasonable adjustment duty is set out in the Equality Act 2010 and applies to any body that carries out a public function. Its aim is that, as far as reasonably possible, people who have disabilities should have the same standard of service as non-disabled people.
32. Service providers have to consider removing or preventing obstacles to people with disabilities accessing their service. If the adjustments are reasonable, they must make them.
33. The duty is ‘anticipatory’. This means service providers cannot wait until a disabled person wants to use their services but must think in advance about what disabled people with a range of impairments might reasonably need.
34. There is no indication in Mr X’s initial contact with the Council that he requested reasonable adjustments in the form of communication in font 14-20. However, the Council’s records do note that during this initial conversation on 23 March 2021 Mr X informed the Council he is visually, sight and memory impaired. The Council then included this information in the referral for a care needs assessment.
35. Given that the Council was aware of Mr X’s impairments from the outset I would have expected it to clarify and confirm with Mr X whether he needed any adjustments in the service it provided. The Council asserts it was aware and had recorded adjustments in the form of large text on Mr X’s file from the outset. However the documentation does not support this. The Council’s contact form records Mr X’s communication requirements as large print, with a start date of 30 March 2021. This is not the date Mr X first contacted the Council, and it is unclear how or where else this is recorded on the Council’s system.
36. An entry in Mr X’s case records for 6 May 2021 records that Mr X had complained about receiving correspondence in small text. And that a note had now been put on the file for all correspondence to be in large text. This suggests there had not previously been a clear record of Mr X’s communication needs on the file. References to adding a note to Mr X’s file in the Council’s responses to Mr X’s complaint and to my enquiries reinforce the view that this information was not recorded on Mr X’s file from the outset.
37. I consider the Council was at fault for failing to take account of its duties under the Equality Act and in not corresponding with Mr X in large text from the outset.
38. I recognise that following Mr X’s complaint, the Council now corresponds with Mr X in large text and has noted the need for this on Mr X’s file so that all officers are aware. Had the Council done this at the outset Mr X would not have experienced difficulties in reading the Council’s correspondence or his care and support plan, or the distress and anxiety this caused.
39. The Council assessed Mr X’s care needs and implemented a care and support plan. Mr X was unhappy with the carers and the service provided and often refused to allow the carers access to his home, or to provide services. This meant Mr X was not receiving support/ had to arrange his own support, but this was Mr X’s decision, and not due to fault by the Council. There is no evidence of fault in the way the Council investigated Mr X’s complaints and safeguarding concerns. Many of Mr X’s concerns did not met the threshold for safeguarding enquiries, but where they did the Council investigated and found there was no evidence to substantiate the allegations.
40. Mr X was unhappy the care agency had sent male carers to support him. There is no evidence he had informed the Council this was inappropriate or that he had asked not to be supported by male carers during the assessment or before the care package started. Mr X has now been reassessed, and if appropriate, the Council will prepare a care and support plan. We would expect the Council to take account of Mr X’s requests while also balancing these with its duty to safeguard care staff.

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Agreed action

41. The Council has agreed to apologise to Mr X and pay him £150 in recognition of the difficulties and distress he experienced as a result of the Council’s failure to correspond with him in large text from the outset.
42. The Council has also agreed to provide reminders/training to ensure that staff understand the Council’s anticipatory duty to make reasonable adjustments as set out in the Equality Act 2010 and take positive proactive steps to ensure disabled people can access services.
43. The Council should take this action within one month of the final decision on this complaint.

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Final decision

44. The Council’s failure to take account of its duties under the Equality Act and correspond with Mr X in large text from the outset is fault and has caused Mr X an injustice. However, there is no evidence of fault in the way the Council has assessed Mr X’s care needs or investigated his concerns about the care provided or the actions of carers.

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Investigator's decision on behalf of the Ombudsman