Summary: Mr B complained the Council discharged his father in to his and his mother’s care despite them not agreeing to care for him. He said this put his mother at risk of harm from abuse and physical injury. He complained the Council did not provide support or respite. He said caring for his father meant he had to give up his job and negatively impacted his well-being. The Council apologised for its delay arranging to review Mr B’s carers assessment. We found no other fault by the Council and consider its apology a suitable remedy for the injustice to Mr B and Mrs C by its delay.

The complaint

1. The complainant, who I shall refer to as Mr B, complained for himself and his mother that the Council discharged his father into their care despite them not agreeing to care for him. He said this put his mother at risk of harm from abuse and physical injury. He complained the Council did not provide support or respite. He said caring for his father meant he had to give up his job and negatively impacted his well-being.

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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 an injustice, 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 considered:
• Mr B’s complaint and the information he provided;
• documents supplied by the Council;
• relevant legislation and guidelines; and
• the Council’s policies and procedures.
5. Mr B, Mrs C and the Council can comment on this draft decision. I will consider their comments before making a final decision.

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What I found

Legislation and guidance

6. The Care Act 2014 section 42 requires councils to make enquiries, or to ask others to make enquiries, where they reasonably suspect that an adult in their area with care and support needs is at risk of abuse or neglect and cannot protect himself/herself.  The purpose of the enquiry is to establish what, if any, action is required. Safeguarding duties apply to family carers experiencing intentional or unintentional harm from the adult they are supporting.
7. The Care Act 2014 defines a carer as someone who ‘provides or intends to provide care for another adult’ (but not as a volunteer or contacted worker). Where it appears to the council that a carer may have needs for support (whether currently or in the future), a carer’s assessment must be offered. Carers’ assessments must seek to establish not only the carer’s needs for support, but also the sustainability of the caring role itself, which includes both the practical and emotional support the carer provides to the adult. Factored into this must be a consideration of whether the carer is, and will continue to be, able and willing to care for the adult needing care.
8. Councils can charge for care and support services they provide or arrange. However, it must provide intermediate care, including reablement, free of charge for up to six weeks. Councils may use their discretion to offer this free of charge for longer than six weeks where there are clear preventative benefits.

What happened

9. This chronology includes key events in this case and does not cover everything that happened.
10. Mr B lives with his mother and father, Mr and Mrs C. Mrs C receives support from a mental health team. Mr B is a carer for his mother.
11. In February 2021, Mr C was admitted to hospital. Mr C was bedbound. When the hospital started discharge planning, Mr C told the hospital he wanted to return home. He said he paid privately for two daily domiciliary care visits and did not want any extra support. The hospital considered Mr C to have capacity to make this decision.
12. Mr B told the Council he did not want his father to return to the family home. He said his father was emotionally and financially abusive to his mother. He said he and his mother could not look after Mr C and doing so would put their mental and physical health at risk. The Council told Mr B it could not stop Mr C returning to the family home or force him to accept extra support. It also told Mr B it would be Mrs C’s choice to provide Mr C with support.
13. The hospital discharged Mr C in February 2021. He was readmitted the following day.
14. Mr B made a safeguarding referral for Mrs C. He said Mr C was domestically abusive. The Council held a multi-agency strategy meeting and started a safeguarding enquiry. It decided to:
• Visit Mrs C to offer support.
• Complete a domestic abuse risk assessment (DASH).
• Work with Mrs C to create a safety plan.
• Offer Mrs C an advocate.
15. The Council visited Mrs C twice in March 2021. It asked her if she wanted an advocate. She declined and said she wanted Mr B to support her. She told the Council she was worried she would not be able to look after Mr C when he was discharged from hospital, and she could not afford to pay for carers. The Council completed a domestic abuse risk assessment (DASH). Mrs C disclosed her husband could be verbally aggressive. The Council told her she could go into respite when Mr C was discharged.
16. An occupational therapist assessed Mrs C at home. The therapist had concerns about Mrs C’s safety when going up and down stairs. The therapist suggested installing a stair rail, Mr B said Mr C would be angry if this happened. The therapist suggested the family use an alert system so Mr B knew when Mr C was asking for support so he could help his mother.
17. The Council held a multi-agency threshold discussion. The Council said it was worried Mr C had been verbally aggressive towards Mrs C during their life together and this had increased as he lost his independence. It was concerned Mrs C would risk her own physical safety to support Mr C. It recorded that Mrs C lacked mental capacity to make an informed decision about having contact with her husband and caring for him. Attendees decided the Council and the Police would undertake a joint safeguarding investigation.
18. The Council met with Mr B and his sister to discuss their concerns. It shared advice from its legal department about their options, including applying for an injunction to stop Mr C returning home. Mr B and his sister said they would apply for an injunction. Mr B said they sought legal advice and were advised they could not take out an injunction on their mother’s behalf.
19. The Council arranged for Mr C to have a care package of four visits a day from a domiciliary care agency. Two carers would attend each visit. Mr C agreed to pay for the morning and evening visits. The Council said it would pay for the lunch and tea visits under reablement for a period of assessment. The Council shared this information with Mr B and confirmed he and his mother would not have to provide Mr C with any care. It told Mr B when Mr C would be discharged.
20. Mr C was discharged to his home in May 2021. The ambulance crew raised safeguarding concerns because Mr B did not want to let Mr C into the house and Mrs C appeared anxious. The Council spoke to Mr B and Mrs C. Mr B said it had been OK, but he was worried the situation was unsustainable.
21. The Council completed a second mental capacity act assessment for Mrs C in June 2021. The Council asked Mrs C if she wanted support for an advocate, she chose to be supported by her son, Mr B. It assessed whether she had capacity to decide to live with Mr C in their home or to leave. The Council discussed Mrs C’s situation and her options and decided she had capacity to make this decision. Mrs C told the Council she was staying away from where Mr C was in bed and was not helping with his care
22. The Council discussed Mrs Cs options with her, including moving out, and the support it could offer. It said it could arrange for her to have extra support in the home. Mrs C declined because she was worried about the cost. The Council said it could arrange for her to have support to access the community or attend day services. She said she did not want to. Mrs C and Mr B said they would consider a sitting service for Mr C but did not think Mr C would agree to pay for it. The Council suggested Mr B, as Power of Attorney for Mr and Mrs C, split their finances. The Council advised Mrs C if she wanted to move out, it could help her to find alternative accommodation. Mrs C said she wanted to say in her home. The Council completed a safety plan with Mrs C. The actions for the Council were to continue to monitor the situation, offer Mrs C extra support in the home if she wanted it, and support her to find new accommodation if she decided to leave.
23. A carer’s assessment was carried out with Mr B by an organisation on the Council’s behalf. He shared he was worried about the impact on him, and his mother, of his father being cared for at home. He was concerned his mother would be at risk because of the demands his father puts on her, and because he refused to have any adaptations to the home they both faced safety issues. He said he had to give up work because he felt he could not leave his mother alone for her own safety. He advised he was not getting any respite to pursue his own interests. The organisation decided he did not have any unmet needs it or the Council needed to support.
24. The Council reviewed Mr C’s care plan. He said he would cancel domiciliary care visits at lunch and tea if he had to pay for them. The Council used its discretion to continue to fund these visits to safeguard Mrs C.
25. Mr B’s manager raised concerns with the Council about his mental health. Mr B gave the Council consent to speak to his sister about giving him extra support, which it did. The Council advised Mr B, Mr C could go into respite if he agreed to it and it could put in reablement support for Mrs C following an upcoming operation. Mr B told the Council Mr C would not go into respite. The Council suggested Mrs C go into respite instead, but Mr B did not think this would work. Mrs C agreed the Council could provide an hour a day of reablement support following her operation. The Council gave Mr B information about a meal delivery service, Mr B did not think this would help.
26. The Council met with Mr C and Mrs B in November 2021 to close the safeguarding enquiry. It said:
• Mrs C was not to go into the room where Mr C was.
• Mrs C was to leave the room if Mr C became verbally aggressive and abusive.
• The Council would offer Mrs C support to relieve Mr B of some of his care duties.
• The Council would support Mrs C to find new accommodation if she decided to leave.
27. Mr B said he was unhappy the Council allowed Mr C to return home. He said he would have preferred it if the Council had supported his mother to take an injunction out against his father to stop him from returning home. Mrs C said she felt safe in her home.
28. In February 2022, Mr B complained to the Council. He said he and his mother told the Council they were not willing or able to look after his father in May 2021 and despite this, he was discharged from hospital into their care. He told the Council caring for Mr C meant he had to give up work and negatively impacted his mental health.
29. The Council responded to Mr B’s complaint in March 2022. It explained when his father was discharged from hospital, it assessed him as having the capacity to make choices about his care and accommodation and he chose to return to the family home. The Council said Mrs C could make decisions about her safety and protection and it offered support which she declined. It told Mr B while it was working with the family to overcome the fact Mr C was refusing to pay for domiciliary care, it had arranged for a care agency to continue to provide it. The Council apologised that it delayed reviewing Mr B’s carers assessment. It offered to arrange a visit to complete this.
30. Mr B was unhappy with the Councils response. He queried its wording of the letter and said it suggested the Council did not consider Mr C’s behaviour coercive and controlling. The Council explained it did not have evidence that Mr C was coercive and controlling and therefore could not confirm this was the case.

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Analysis

31. This was and continues to be a difficult situation for everyone involved. Mr B and Mrs C both expressed concerns and experienced distress at having to live with Mr C. However, Mr C decided he wanted to return to the family home, had capacity to make this decision and owned the property. Therefore, the Council could not prevent him from doing so.
32. The Council listened to Mr B and Mrs C’s concerns about the impact of Mr C living and receiving domiciliary care in the home they share. It developed Mr C’s care plan on the understanding Mr B and Mrs C would not provide any care. When the Council asked Mr C to pay for all four domiciliary care visits and he refused, the Council used its discretion to continue to fund two of these visits to safeguard Mrs C.
33. The Council offered Mrs C respite, support to access the community, assistance at home and help to find alternative accommodation. The Council considered whether Mrs C had capacity to make decisions about her welfare and in June 2021 decided she did. From then on, it was her decision whether to accept support offered. The Council gave Mr B information about support it could offer the family and details of local support services. Again, it was Mr B and the family’s choice whether to access this. The Council also encouraged Mr B and his sister to seek legal advice to see whether they could get an injunction to prevent Mr C living in the home.
34. Mr B was unhappy the Council did not state as fact that his father was coercive and controlling. The Council explained it could not do this because it did not have any evidence other that Mr B and Mrs C’s reports. Although the Council did not make a statement of fact about Mr C being coercive and controlling, it took their concerns seriously, offered the family a range of support and put measures in place to safeguard Mrs C.
35. The Council accepted it delayed reviewing Mr B’s carer’s assessment, apologised and offered to arrange a visit to do so. I consider the Council’s apology and offer to undertake the review a suitable remedy for any injustice caused by the delay.

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Final decision

36. I have completed my investigation and uphold Mr B's complaint. There was fault by the Council which caused injustice to Mr B. I am satisfied the Council has taken action to remedy that injustice.

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Investigator's decision on behalf of the Ombudsman