Medway Council (22 002 267)

Category : Adult care services > Safeguarding

Decision : Upheld

Decision date : 23 Nov 2022

The Ombudsman's final decision:

Summary: Mrs C complained the Council failed to provide suitable care support and supported accommodation to Mr X for over 14 months. She said it caused delays and its social workers lied and failed to respond to her. We found the Council caused delays to assess Mr X’s care needs and place him in a suitable accommodation. Its social workers made errors and failed to respond to some reasonable enquiries from Mrs C. The Council agreed apologise to Mrs C and Mr X and may payment to remedy the injustice its faults caused.

The complaint

  1. The complainant, whom I shall refer to as Mrs C, complained on behalf of herself and her brother-in-law (Mr X) about the Council’s handling of Mr X’s care and housing support since Summer 2020. She said:
    • it had caused delays in assessing and providing Mr X’s care support, and providing him with a suitable accommodation;
    • it had failed to complete a carers assessment for her and provide her family with enough support;
    • its social worker failed to provide agreed support for Mr X, and lied about when referrals had been made; and
    • its social worker and the Council repeatedly failed to respond to her communication in a timely manner.
  2. Mrs C said, as a result, Mr X had experienced distress and a loss of care provision. She experienced distress due to having to provide support for Mr X, and uncertainty due to the Council’s handling. She also said she had time and trouble to bring her concerns to the Council’s attention.

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The Ombudsman’s role and powers

  1. 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)
  2. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
  3. 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)
  4. 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

  1. As part of my investigation, I have:
    • considered Mrs C’s complaint and the Council’s responses;
    • discussed the complaint with Mrs C and considered the information she provided;
    • considered the information the Council provided in response to my enquiries; and
    • considered the law and guidance relevant to the complaint.
  2. Mrs C and 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

Relevant law and guidance


  1. 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.
  2. 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.

Carer’s Assessment

  1. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
  2. As part of the carer’s assessment, the council must consider the carer’s potential future needs for support. It must also consider whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)

Care Plan

  1. 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 needs 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. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
  2. It is the Council’s duty to provide the assessed care support. This may include;
    • accommodation in a care home or in premises of some other type; or
    • care and support at home or in the community.
  3. There is no defined timescale for completing the plan but it should be completed in a timely fashion, proportionate to the needs to be met.

The Council’s complaint procedure

  1. Councils should have clear procedures to deal with social care complaints. Regulations and guidance say they should investigate and resolve complaints quickly and efficiently. A single stage procedure should be enough. The council should include in its complaint response:
    • how it considered the complaint;
    • the conclusions reached about the complaint, including any required remedy; and
    • whether it is satisfied all necessary action has been or will be taken by the organisations involved; and
    • details of the complainant’s right to complain to the Local Government and Social Care Ombudsman.

(Local Authority Social Services and National Health Service Complaints (England) Regulations 2009)

  1. The Council’s Adult Social Care complaint Policy says it will acknowledge a complaint within three working days and aim to resolve it informally at first. It will provide its formal complaint responses within 20 working days. If there are delays, the Council will inform the complainant.
  2. There is no second stage in the Council’s complaints process, but a complainant can ask for further clarification to their complaint or complain to the ombudsman.

What happened

  1. Mr X had lived all his life with his mother, who had supported and shielded him. In Summer 2020 Mr X’s mother died.
  2. Mr X brother, and sister-in-law (Mrs C) started supporting Mr X. This included applying for benefits, getting him a phone, help to attend appointments, and providing some care, emotional and budgeting support.
  3. In August 2020, Mrs C also contacted the Council’s Social Services for help with Mr X’s care support needs and housing, as Mr X’s mothers’ property were to be sold under probate.
  4. At the time, Mr X had no formal assessment for his medical conditions. Mrs C told the Council she believed he could manage some of his needs independently, but he could not live independently as he had learning disabilities, anxiety, depression and autism, along with some physical disabilities too. She also said he could not stay in the property as he could not use the bath, the heating was not working, and it was too big for him.
  5. The Council triaged Mr X and found his main needs were for housing. A housing application was registered for Mr X and it put him on the waiting list for a Care Needs Assessment. It advised Mrs C to seek private accommodation or private sheltered accommodation for Mr X. Alternatively, Mrs C could evict him and apply for homelessness as he was unlikely to be housed under the Housing’s Allocations Policy.
  6. In October 2020 Mrs C asked the Council to assess Mr X’s care needs and provide support with housing urgently as she had been unsuccessful in finding any accommodation for Mr X due to affordability. She said professionals who had worked with Mr X, including a mental health charity, a care navigator, and a learning disability nurse, all suggested Mr X housing and care needs had to be considered urgently.
  7. Shortly after, the Council’s Housing Team decided Mr X did not meet the criteria under the Council’s Allocations Policy. The Council also started Mr X’s Care Needs Assessment. It completed Mr X’s Care Plan in February 2021 which set out he had needs for support in almost all areas. The support the Council put in place was for a Shared Lives carer to provide support to Mr X in his home for a short period.
  8. Following the Shared Lives support, the carer provided the Council with an assessment of Mr X’s needs. She found he was able to live independently with a minimal level of support to address his physical care needs and help with budgeting.
  9. The Council’s allocated social worker left the Council, and a new Social Worker was allocated.
  10. In spring Mrs C arranged for Mr X to see a learning disability specialist for an assessment. This found he may not have a learning disability, but it was close, and his IQ was lower than most people. He suggested a best interest decision may be appropriate for Mr X. She asked the Council to consider the assessment, provide a care act advocate for Mr X and progress his housing situation.
  11. In response, the Council Social Worker told Mrs C:
    • it did consider Mr X vulnerable, but this was mainly due to his housing situation, as his care needs could be met with adaptations;
    • it had considered shared living, but Mr X did not want to share kitchen and other facilities.
    • she explained it Mr X had capacity and a best interest decision was therefore not appropriate;
    • she did not believe a care act advocate was required as Mrs C was supporting Mr X, he had capacity and were able to share his views and wishes, and he was happy for Mrs C to continue supporting him; and
    • she could advice Mrs C about the housing situation but would write a letter to support Mr X’s application for supported housing.
  12. Mrs C asked the Council to consider supported living for Mr X and included the Social Workers letter. She also told the Council she could not continue to support Mr X with his health appointments, medication, budgeting and other support due to her personal circumstances.
  13. The Council’s allocated social worker left the Council, but no new social worker was allocated to his case.
  14. Mrs C asked the Council several times over the following month to allocate a social worker to Mr X, as she was unable to provide support for him. When this was not done, she complained to the Council.
  15. Shortly after, Mrs C agreed to put her complaint on hold as the Council allocated a social worker to Mr X’s case, and the Council agreed to provide a small package of care for Mr X, which was delayed as the Council struggled to find a care provider which could deliver the care. Its best practice panel would also consider Mrs C’s request for supported accommodation.
  16. In Autumn 2021, the Council’s best practice panel declined Mr X referral for a supported living accommodation. It advised its housing team should be approached for a supported accommodation with floating support through its Housing Team, which could be further supported with care support through its Adult Social Care.
  17. A further Care Needs Assessment was completed which found Mr X needed more support, which was set out in his Care Plan.
  18. Mr X’s Social Worker completed the referral through the Council’s Housing Supported Accommodation Team. But the outcome was he was not entitled as the service were for individuals with substance abuse or past offenders, and Mr X’s specific support needs could not be met in such accommodation.
  19. The Social Worker found possible placements for supported living with a provider. She presented this to the Council’s best practice panel, and the support was authorised. Mrs C was informed about the outcome.
  20. Mrs C asked the Social Worker for updates over the following month on several occasions but could not get a response. Then over a month later, the Social Worker made the referral for the authorised supported living accommodation.
  21. Mrs C was unhappy with the Council’s delays in supporting Mr X, and how it and its social workers had handled her case. She asked the Council to reopen her complaint.
  22. The Council acknowledged her complaint and asked the Social Worker to contact Mrs C.
  23. Mrs C told the Social Worker about Mr X’s upcoming health appointment and asked her to attend these with him. She also asked why it was taking so long to place Mr X in a supported living accommodation.
  24. The Social Worker confirmed she would bring Mr X to his appointments, and shared information about the possible supported living placements, which he and Mrs C could visit. Mrs C and Mr X visited the proposed placements and found one to be suitable.
  25. However, the Council’s Social Worker sought an alternative placement as the proposed placement would only accept Mr X with a package of support far more than his needs, which would be restrictive for him.
  26. Mrs C and Mr X viewed further supported living placements arranged by the Social Worker, and agreed one was suitable.
  27. The Social worker and the supported living provider set out a care package for Mr X, which the Council’s best practice panel agreed to.
  28. Mr X moved into the supported living accommodation in January 2022, and in March 2022 the Council Client Affairs Team became a deputy to manage his finances.

Mrs C’s complaint and the Council’s responses

  1. Mrs C complained to the Council in Autumn 2021. She said:
    • it had caused delays in assessing and providing Mr X’s care support, and providing him with a suitable accommodation;
    • it had failed to complete a carers assessment for her and provide her family with enough support;
    • its social worker failed to provide agreed support for Mr X, and lied about when referrals had been made; and
    • its social worker and the Council repeatedly failed to respond to her communication in a timely manner.
  2. The Council responded to Mrs C’s complaint in October 2021. As Mrs C remained dissatisfied with how it had handled her concerns, it provided a further response a month later which explained its view. It found:
    • 14 months was not a satisfactory timescale for Mr X to be waiting for suitable shared living accommodation. It apologised and said it would take steps to expedite any outstanding actions;
    • its Social Worker had not lied or tried to deceive Mrs C regarding referrals, but she had failed to complete the actions due to a complex and heavy workload. It agreed the delay this caused was unacceptable and apologised;
    • there had been delays in its placement team and for carers to start providing support to Mr X. It apologised and explained its Social Worker was not aware of the Council’s issues in sourcing carers at the time;
    • its Social Worker had not arranged an appointment as promised, and apologised; and
    • it had not completed a carers assessment for Mrs C as its Social Worker believed Mr X would be moved on much sooner, and therefore not require Mrs C’s support. However, due to the delays this had not happened, and Mrs C could have a carers assessment now.
  3. Mrs C was not satisfied with the Council’s responses and asked it to consider her complaint again. When she did not receive a further complaint response, she asked the Ombudsman to consider her complaint.
  4. In response to our enquiries, the Council explained some delays were due to COVID-19 sickness, staff vacancies, and home working. It acknowledged:
    • the changes in three different social workers on Mr X’s case contributed to the delays;
    • there had been a delay in the Council arranging for Mr X’s finances to be managed from Summer 2021 to March 2022 due to an error by its Social worker, and had provided her with training on its system; and
    • it should have completed a carers assessment with Mrs C when it became clear Mr X’s housing or care support would not be resolved quickly.

Analysis and findings

  1. Mrs C’s complaint includes matters which occurred since Summer 2020. Her complaint is therefore late. However, I have found it appropriate to exercise my discretion to consider her complaint as she has continued to raise her concerns with the Council, and Mr X’s accommodation was not resolved until late 2021.

Did the Council cause delays?

  1. Mrs C asked the Council for help to meet Mr X’s care needs and housing needs in Autumn 2020. At the time, he did not have a formal diagnosis for any of his disabilities which impacted his ability to live and manage independently.
  2. Based on the evidence available, it appears to have been commonly agreed:
    • Mr X was capable of managing independently for some of his day-to-day needs, but he could not do budgeting, managing a household and general planning without support or prompting. However, this was if he was in an accommodation in which adaptations could be made or had a level access shower and no stairs; and
    • he needed some form of supported accommodation, which would limit the amount of care support he required to meet his needs.
  3. The Council also agreed it was unacceptable for it to have taken over 14 months to properly assess and arrange a suitable supported, or shared, living accommodation for Mr X. I found:
    • it took the Council until February 2021 to complete Mr X’s Care Act Assessment and set out his needs in his Care Plan. While I understand the Council had a waiting list, we normally expect for such assessments to be completed within 4 weeks. The Council was therefore at fault for the delay of five months until this was completed;
    • the Council’s social workers caused some delays due to errors and failing to complete referrals to progress Mr X’s case;
    • the was a lack of understanding within the Council as to which department would be responsible for ensuring Mr X were placed in an accommodation which met his needs. It was not until after the Housing, Sheltered Accommodations Team, and the Best Practice Panel all had declined to support Mr X that this was properly considered;
    • it took the Council from Spring 2021 when Mrs C told the Council she could no longer support Mr X until May 2022 to arrange for its Financial Affairs Team to support Mr X with managing his finances. While such process can take some time to arrange, the delays caused were due to its Social Worker’s error. This was fault.
  4. I acknowledge the Council’s difficulties due to COVID-19 sickness, staff vacancies, two social workers allocated to Mr X’s case leaving the Council, and to find a suitable and available shared living accommodation for Mr X. In addition to, the challenges around Mr X’s limited medical information about his conditions. Some delay was therefore outside the Council’s control. However, it was at fault for causing substantial delays throughout the process, which caused Mr X and Mrs C distress and uncertainty.

Did the Council fail to provide care support?

  1. Due to the delay in completing the Council’s Care Act Assessment he did not receive care support from the Council until the temporary Shared Lives support in March 2021. Mrs C therefore had to provide some support for Mr X, despite having told the Council she could not manage this due to her personal circumstances.
  2. In early 2021, the Council found Mr X only needed some limited support, which was based on the information available at the time, including the information it received from the short-term Shared Lives support.
  3. I cannot see how the Council could reach its conclusion Mr X had no needs for further support at that time. In reaching my view I am conscious his Care Plan stated he could manage many parts of his daily living independently, but he had eligible needs for support in all the areas of need due to his learning disabilities, lack of social skills, and his difficulties in managing the facilities in his home. As Mr X was still in his home and there was no solution to his housing situation at the time, he should have been provided with more care support to meet his identified needs.
  4. While, I cannot say what or how much support should have been provided. It appears appropriate this support would have been similar to the care support the Council put in place in Summer 2021.
  5. I am therefore satisfied Mr X did not receive appropriate care support from September 2020, when the Council should have assessed his needs, to July 2021 when some care support was put in place. The impact this caused him was limited due to Mrs C providing some support. However, this therefore caused her time and distress as she had to continue to provide some support for Mr X, at a time where she felt unable to do so.

Carer’s assessment

  1. Mrs C told the Council several times since 2020 she was struggling to support Mr X, and she could not manage this due to her own personal circumstances.
  2. The Council has agreed it should have offered and provided a carers assessment for Mrs C. However, it explained it believed this would not be necessary as Mr X was expected to move into some form of supported accommodation early on in the process.
  3. It took over 14 months for Mr X to be moved into a suitable shared living accommodation. During much of this time, Mrs C had to provide support for Mr X. The Council should therefore have completed a carers assessment for her to determine what support and help she needed to manage this, even if this was intended to be short term.
  4. While I cannot say what support Mrs C may have received, or if this would have been helpful to her, I am satisfied the lack of the assessment and offer of support caused her some distress, and she felt the Council did not listen to her.

Social workers communication and referrals

  1. The Council agreed its social workers caused errors and delays in progressing Mr X’s case regarding his accommodation and managing his finances. It also acknowledged its communication could have been better at times.
  2. I have not found enough evidence the Council’s social worker intentionally lied about making a referral. However, it is clear this did not happen when it was supposed to, which caused a delay.

The evidence shows Mrs C was in regular contact with the allocated social workers, in most cases she received responses to her requests. However, there were periods where she did not receive any responses, calls were not returned, and the Council’s Duty Team could also not give her the information or answers she needed. I therefore found the Council at fault for failing to ensure there was appropriate cover for its social worker, its social worker returned calls, or records were properly kept updated to ensure its Duty Team could share information when Mrs C called. This caused her some distress and uncertainty.

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Agreed action

  1. To remedy the injustice the Council caused to Mrs C and Mr X, the Council should, within one month of the final decision:
      1. apologise in writing to Mrs C and Mr X;
      2. pay Mr X £300 to acknowledge the distress the lack of care support and delayed shared living accommodation caused him over a 14-month period;
      3. pay Mrs C £750 for the distress and uncertainty its unnecessary delays caused her, and the additional support she had to provide for Mr X until his care support and accommodation was put in place; and
      4. pay Mrs C an additional £250 for the unnecessary time and trouble she had to pursue her complaint;

In total the Council should therefore pay £1,300.

  1. Within three months of the final decision the Council should also:
      5. remind its social workers to respond to reasonable communication from service users or their representatives without delay, complete agreed actions, and keep records up to date. This is to avoid delays and to enable the Council’s Duty Team to respond to enquiries when its social workers are unavailable;
      6. remind its social workers to offer and complete carer’s assessments without delay where family members, or other persons, are providing care for a service user. This includes circumstances when is becomes clear the care support may not be resolved in the short term, or the carer shares concerns about continuing to provide the care support;
      7. remind its staff of the importance of ensuring Care Act Assessments are completed, and appropriate support to meet the needs identified are be put in place without delay;
      8. review how the Council supports service users who has been assessed to have eligible care needs and needs some form of supported accommodation, to ensure all staff understands the process and which service is responsible for meeting care and accommodation needs.

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Final decision

  1. I have completed my investigation with a finding the Council was a fault which caused an injustice to Mr X and Mrs C.

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Investigator's decision on behalf of the Ombudsman

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