Summary: Miss X complained about a lack of care and support provided by the Council and its care provider to vulnerable occupants of supported living accommodation on the street where she lives. There was no fault in the assessment process or in the care and support provided. However, the Council did accept there was a delay finding suitable new accommodation for one of its service users. It agreed to provide Ms X a personal remedy for the impact of the delay.

The complaint

1. Miss X complained about a lack of care and support provided by the Council and its care provider to vulnerable occupants of supported living accommodation on the street where she lives.
2. Miss X and other residents suffered ongoing disturbances and noise nuisance, as well as dangerous incidents involving smashed windows and fireworks set off in the property.
3. Miss X would like a single point of contact at the care provider so residents can report issues. She would also like the care provider to review its actions, offer training to staff, and improve its communication and complaint handling.

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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. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), as amended)
6. We normally name care homes and other care providers in our decision statements. However, we will not do so if we think someone could be identified from the name of the care home or care provider. (Local Government Act 1974, section 34H(8), as amended)
7. 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

8. As part of the investigation I have considered the following:
• Mrs X’s complaint and supporting information.
• Documents provided by the Council and its comments in response to my enquiries.
• The Care Act 2014.
• The Care and Support Statutory Guidance.
9. The nature of some of the information sent by the Council means I cannot refer to it directly. This is because it contains personal and confidential information about third parties.
10. Miss 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

Law and guidance

Assessment

11. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person 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.
12. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.

Care Plan

13. 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 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.

Choice of care homes

14. The Care and Support and Aftercare (Choice of Accommodation) Regulations 2014 set out what people should expect from a council when it provides or arranges a particular type of accommodation for them. Where the care planning process has determined a person’s needs are best met in a care home, the council must provide for the person’s preferred choice of accommodation, subject to certain conditions. This also extends to shared lives, supported living and extra care housing settings.
15. The person has the right to choose between different providers of particular accommodation provided:
• the accommodation is suitable to meet the person’s needs;
• to do so would not cost the council more than the amount specified in the person’s personal budget for the particular accommodation;
• the accommodation is available; and
• the provider of the accommodation is willing to enter into a contract with the council to provide care at the rate specified in the person’s personal budget on the council’s terms and conditions.

Service agreement between the Council and the care provider

16. ‘If the care provider reasonably forms the view that because of personal incompatibility it is no longer able to accommodate a particular service user, it may terminate his or her placement by giving not less than three months’ written notice…In such event the Council will try and place the service user elsewhere before the expiry of the notice.’
17. ‘If parties agree that the provider can longer meet the service user’s needs the placement shall terminate and the parties shall work cooperatively to assist the service user to an alternative service provider. The provider shall provide a minimum of four weeks’ written notice…and will use all reasonable endeavours to accommodate the service user until the Council has found alternative provision.’

Care provider rules for licensees

18. ‘You must not engage in any form of violent or aggressive behaviour, whether physical or verbal, towards other residents, visitors or our staff.’
19. ‘You must not engage in any form of unlawful discrimination towards another resident or member of our staff.’

What happened

20. I have detailed below some of the key events leading to Miss X’s complaint. This is not intended to be a detailed account of what took place. I have included details of some incidents which Miss X is already aware of. Some confidential third-party information has been omitted.
21. Miss X lives next door to a property which houses people with varying care and support needs so they can live independently. Care workers visit the property during the day to support residents. Residents receive a package of care and support based on their needs. The property is run by a private care provider who also work with the Council. I have not named the care provider so as not to identify anyone involved in this complaint.
22. One of the residents, who I will refer to as Resident A, received a package of care and support commissioned by the Council. After the Council assessed Resident A’s needs, it identified the property next door to Miss X as a suitable placement.
23. Shortly after Resident A moved in, Miss X started to experience noise nuisance from loud music in the early hours.
24. The care provider issued Resident A with written warnings about his behaviour in December 2019 and January 2020. Later in January, the care provider served Resident A with a notice to quit (NTQ) the accommodation after further behavioural issues which amounted to a breach of tenancy rules.
25. The Council looked for a new placement for Resident A. Resident A rejected two possible new placements and then refused to engage in the process or consent to sharing their details with other care providers.
26. Miss X reported further noise nuisance from loud music in February and March 2020.
27. Resident A agreed to reconsider one of the possible placements. Unfortunately, the COVID-19 pandemic then struck, and the care provider could not take new residents.
28. The NTQ remained in place, but no suitable accommodation was available. A potential new placement withdrew its offer in July 2020 because of concerns about risk management.
29. In August 2020, there was an incident involving Resident A throwing glass bottles out of a window.
30. In October 2020, the care provider told the Council the placement was no longer suitable for Resident A.
31. Miss X reported noise nuisance from loud music in November and December 2020. She also reported an incident over the Christmas period where Resident A broke a window, causing glass to fall onto Miss X’s property.
32. Miss X reported more noise nuisance caused by Resident A playing loud music in January 2021.
33. Later that month, the police attended following an incident involving Resident A’s behaviour towards care provider staff.
34. The Council reviewed Resident A’s needs in March 2021. It then looked for a specialist placement with a care provider who could better meet Resident A’s individual needs.
35. The police attended in June 2021 when Resident A set off fireworks from inside his bedroom. The police arrested Resident A later in June after more behavioural issues.
36. After looking at emergency accommodation, the Council found a new longer-term placement which Resident A agreed to.
37. Miss X complained to the Council in August 2021. She expressed concern about the care and support the care provider gave to vulnerable adults. She said incidents in the property affected its occupants as well as local residents. She also said she met with care provider managers, but they would not take responsibility. She asked the Council to confirm and provide evidence it followed proper procedures.
38. The Council sent its final complaint response in October 2021. It said:
• The care provider undertook thorough assessments before accepting Resident A.
• The Council considered several options, and the chosen placement was considered most suitable. It said self-determination also played a part for people who have capacity.
• The care provider does not staff the property 24 hours a day as residents do not need that level of care and supervision. Out of hours support is available and staff respond as soon as they can.
• In circumstances where an individual’s behaviour is extreme, or puts others at risk of harm, it is necessary to call the police.
• It is now clear the environment and support were not suitable for Resident A’s needs. This was due to the complexity of Resident A’s needs rather than poor or negligent care.
• It was satisfied the care provider tried to address and mitigate Resident A’s behaviour. It contacted the Council as soon as problems arose and held multiple meetings with Resident A and the Council, as well as involving other agencies.
• Resident A has mental capacity and remains responsible for their own actions, despite having care and support needs.
• It recognised the impact Resident A’s behaviour had on the community and the potential risk posed. It started to look for alternative accommodation as soon as it was aware Resident A needed to move.
• It failed to address this within a reasonable timeframe resulting in a lengthy delay before it placed Resident A into more suitable accommodation.
• The process took longer as there was a limited supply of specialist accommodation available for Resident A’s needs. It apologised for the impact the delays had on Miss X.

My investigation

39. Miss X told me she considers Resident A’ behaviour resulted from a lack of support and failure (by the Council and care provider) to intervene. She also considers they were not meeting the assessed needs of residents.
40. Miss X wanted confirmation the Council and care provider carried out all relevant and necessary assessments, considered the mental capacity of residents, and considered the impact on the local community.
41. In response to my investigation, the Council told me that before it arranges a supported living placement for someone, it will assess their needs under the Care Act 2014 and produce a support plan. It then looks to match a person’s needs to potential accommodation placements.
42. The Council accepted there were delays finding new supported living accommodation for Resident A. It said the COVID-19 pandemic contributed to the delay.
43. The Council is working to expand its supply of specialist accommodation for people with complex needs.
44. The Council said it worked closely with the care provider since Miss X’s complaint. It ensured the care provider learned from the experience and was clear on the Council’s expectations about managing complaints.

Analysis

45. This was a challenging situation which caused Miss X some distress. She also worried the Council and care provider did not give enough support to service users.
46. I have considered all the records available to me, including Resident A’s needs assessments, care and support plans, and notes. I cannot go into any details about the contents of these documents because I do not have Resident A’s permission.
47. However, the documents confirm the Council and the care provider assessed Resident A’s needs before deciding on a suitable placement. There was no evidence available at the time to suggest the placement was unsuitable.
48. I have also seen evidence of the standard assessment procedure the Council and the care provider follow in finding a placement for a service user. This includes an assessment of needs, producing a care and support plan, and arranging a capacity assessment where necessary. I found this is in keeping with the Care Act 2014 and relevant statutory guidance.
49. On the evidence seen, the Council kept in regular contact with the care provider and Resident A, and between them they continued to offer support. Resident A’s situation was the subject of several meetings and conferences between the Council and the care provider.
50. When Resident A declined offers of accommodation or would not engage in support meetings, which was occasionally the case, the Council and the care provider continued to monitor the situation. Resident A does not lack capacity, so the Council and care provider could not compel them to engage in the process or to accept new living accommodation.
51. The care provider determined it was necessary to involve the police on occasions. This was to protect its staff and other residents. While I appreciate Miss X’s concerns about the impact this had on Resident A, the care provider has a duty to its staff and other residents as well. I therefore do not criticise the actions it took.
52. In addition, it is not the role of the Ombudsman to tell the Council or care provider how best to provide care and support to service users. That is up to the professionals involved in their care. I have not seen evidence the Council or care provider failed to consider Resident A’s well-being, or the well-being of other occupants of the property.
53. Resident A’s behaviour negatively affected others staying in the accommodation and both the Council and care provider staff were unable to find a resolution.
54. The Council and the care provider took the steps we would expect and offered suitable support to Resident A. It is unfortunate Resident A’s situation negatively impacted on neighbours, including Miss X. I recognise Miss X does not consider the Council or the care provider did enough to support Resident A, but I have not seen evidence of fault in that regard.
55. The Council accepted it was responsible for delays finding Resident A suitable new accommodation and it apologised to Miss X for that. However, I am mindful of the impact the COVID-19 pandemic had on the Council’s ability to find suitable new accommodation in 2020. Also, Resident A could be uncooperative and refused some placements the Council considered were suitable. Therefore, while the Council has accepted fault, I accept there was some mitigating factors.
56. The noise nuisance and anti-social behaviour was distressing for Miss X. It occurred, on and off, over a period of about 18 months. While the Council accepts it could have done more to find new accommodation for Resident A, it is not at fault for the noise and anti-social behaviour itself. Resident A has capacity and is responsible. However, if the Council had found a suitable placement sooner, it could have prevented some of the issues.
57. It is not possible, on the evidence available, to say when the Council should have been able to re-home Resident A. I therefore find Miss X has also suffered some uncertainty, on top of the distress.
58. The Council has already apologised to Miss X and offered her a point of contact within its adult social care service for reporting future incidents. It also confirmed it worked with the care provider to ensure lessons are learnt from this complaint. I consider those actions are suitable. The Council should also provide Miss X a personal remedy for distress and uncertainty suffered.

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Agreed action

59. Within four weeks of my final decision, the Council agreed to pay Miss X £200 to recognise the distress and uncertainty caused by the delay finding suitable new accommodation for one of its service users.

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Final decision

60. I have completed my investigation. There was no fault in the assessment process or in the care and support provided. However, the Council accepted there was a delay finding suitable new accommodation for one of its service users. It agreed to provide Ms X a personal remedy for the impact of the delay.

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Investigator's decision on behalf of the Ombudsman