Summary: Mr X complained the Council delayed carrying out a social care needs assessment, wrongly decided he does not have any social care needs and has failed to respond to safeguarding concerns. The Council was at fault for the delay in assessing Mr X’s needs. It has already apologised for this which was an appropriate remedy. There is no evidence of fault in the way it assessed his needs or responded to safeguarding referrals it received.

The complaint

1. Mr X complains the Council delayed carrying out a social care needs assessment and has wrongly decided he does not have any social care needs. He also complains the Council has failed to respond to safeguarding concerns he has raised regarding his treatment by Council officers. As a result, Mr X says his needs are not being met and his mental health has deteriorated.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), 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 have considered the information provided by Mr X and discussed the complaint with him. I have considered information provided by the Council in response to my enquiries and the relevant law and guidance.
5. I gave Mr X and the Council the opportunity to comment on a draft of this decision. I considered any comments I received in reaching a final decision.

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What I found

Relevant law and guidance

Assessing needs

6. 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 all people regardless of their finances or whether the local authority thinks an individual 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.
7. To have needs which are eligible for support, the following must apply:
1. The needs must arise from or be related to a physical or mental impairment or illness.
2. Because of the needs, the adult must be unable to achieve two or more of the following outcomes:
1. Managing and maintaining nutrition;
2. Maintaining personal hygiene;
3. Managing toilet needs;
4. Being appropriately clothed;
5. Being able to make use of the adult’s home safely;
6. Maintaining a habitable home environment;
7. Developing and maintaining family or other personal relationships;
8. Accessing and engaging in work, training, education or volunteering;
9. Making use of necessary facilities or services in the local community including public transport, and recreational facilities or services; and
10. Carrying out any caring responsibilities the adult has for a child.
3. Where an adult cannot achieve these outcomes, there is likely to be a significant impact on the adult’s well-being.
8. Where local authorities have determined that a person has eligible needs, they must meet these needs. When a council has decided a person is or is not eligible for support it must provide the person assessed with a copy of its decision.

Safeguarding

9. A council must make enquiries if it thinks a person may be at risk of abuse or neglect and has care and support needs which mean the person cannot protect themselves. An enquiry is the action taken by a council in response to a concern about abuse or neglect. An enquiry could range from a conversation with the person who is the subject of the concern, to a more formal multi-agency arrangement. A council must also decide whether it or another person or agency should take any action to protect the person from abuse. (section 42, Care Act 2014)
10. Statutory guidance explains safeguarding duties apply to an adult who:
1. has needs for care and support (whether or not the local authority is meeting any of those needs);
2. is experiencing, or at risk of, abuse or neglect; and
3. as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect. (Care and Support Statutory Guidance, paragraph 14.2).

What happened

11. The following is a summary of what has happened between April 2022 and September 2023. It does not include all contacts between Mr X and the Council.
12. In April 2022 Mr X requested an assessment of his care needs. The Council allocated Mr X’s case to Officer 1 who contacted Mr X to complete an overview needs assessment. Officer 1 contacted an advocate in late May 2022 who had supported Mr X previously to arrange the needs assessment. They arranged to meet with Mr X and his advocate in early June.
13. The advocate was not able to negotiate stairs so could not access Mr X’s property, so Officer 1 sought to arrange an alternative venue.
14. Officer 1 noted they tried to call Mr X three times to confirm they would attend in person the next day with the advocate attending on zoom but got no answer. Mr X says the Council is aware that he will not answer calls from a withheld number as this causes him anxiety. Officer 1 asked the advocate to update Mr X.
15. Mr X contacted the Council to request a new allocated worker. He was unhappy with officer 1 and raised issues including they regularly got his name wrong, had contacted an advocate without checking if the person was acceptable to Mr X and had refused to give their full name and contact details.
16. When Officer 1 visited Mr X’s property, he did not open the door. Officer 1’s manager spoke with Mr X and agreed to reallocate Mr X’s case.
17. The Council allocated officer 2 to Mr X’s case in mid-June 2022. Officer 2 emailed Mr X to advise they would call him the next day at 3pm. Mr X refused contact with officer 2 because officer 2 emailed rather than calling him on the phone.
18. A manager, manager Z, called Mr X in late July to discuss how the review of his social care needs could best be progressed. Mr X said he did not want contact from officer 2. Mr X wanted his concerns about the behaviour of an officer from the Council’s Housing Department to be investigated through the Council’s formal safeguarding procedures. Manager Z explained the threshold of safeguarding enquiries was not met as Mr X did not have ongoing care and support needs and could safeguard himself by contacting senior managers in the Housing Department with issues about housing or by contacting emergency services. Manager Z also reminded Mr X of the Council’s formal complaints procedure. The manager agreed to consult colleagues about getting Mr X a new case worker. Mr X wanted calls made to him to come from a not withheld number as a reasonable adjustment due to his disability. Manager Z said this would be done as far as possible but was not always an option in every instance.
19. In August 2022, the Council allocated officer 3 to Mr X’s case. They arranged to meet with him. Mr X advised he wanted an advocate present for his needs assessment so officer 3 made a referral to an advocacy service for Mr X.
20. Officer 3 arranged a meeting date with Mr X’s advocate for September 2023. There was some confusion about advising Mr X of this date and when officer 3 visited Mr X on the date arranged, Mr X asked that they leave. Mr X says this visit led to him having a panic attack. Mr X requested the allocation of a new social worker but later agreed to work with officer 3 again. However, officer 3 left the Council shortly after and so the Council agreed to arrange support from someone else.
21. In late January 2023 Mr X’s legal representative wrote to the Council to complain about the delay in carrying out the needs assessment. They requested an apology and that Mr X be allocated a new social worker and advocate.
22. In March 2023 officer 4 visited Mr X with an advocate to carry out a needs assessment.
23. Manager Z wrote to Mr X’s representative in April 2023 in response to his complaint. They apologised to Mr X for the distress and frustration caused while waiting for his needs to be reviewed. They noted two officers were assigned to Mr X’s case, but Mr X wanted no further contact from them. Mr X was then upset about how a joint visit by officer 3 and Mr X’s advocate was set up which led to Mr X having a panic attack. Another officer was appointed who carried out the assessment in March 2023, following helpful mediation between the legal representative and a lawyer in the Council between October 2022 and February 2023. They acknowledged there was a considerable delay in arranging the reassessment and apologised for this.
24. In April 2023 officer 4 completed their assessment. They concluded he had emerging needs and would benefit from preventative input on a short term basis to maximise his independence. They noted the social prescribing service or health and wellbeing link worker service may be able to offer support in those areas. Officer 4 made referrals to both areas, but both felt they could not support Mr X. Officer 4 noted Mr X declined support from a carer to access the community.
25. They noted Mr X was clear he would be unwilling to pay for care services and so would not consider the option of privately funded care to manage his household refuse. They concluded Mr X did not have eligible unmet needs under the Care Act. He was not struggling to meet two or more Care Act outcomes but had emerging needs as he struggled to develop and maintain personal relationships. His ability to access the community was also limited but Mr X did not have unmet needs in that area as he did not want to access the community at this stage. They noted Mr X would benefit from mental health support as this appeared to be his primary need. Mr X agreed to a referral to the Mental Health Team and Mr X’s doctor agreed to contact him about this as it would be for the doctor to decide if a referral was appropriate.
26. In June 2023 officer 4 updated the needs assessment following communication between Mr X’s legal representative and the Council.
27. Mr X’s legal representative complained to the Council in June 2023 due to errors in the assessment which were corrected through correspondence with the Council’s legal team, and with concerns about the outcome.
28. The Council responded to Mr X’s legal representative in August 2023. It acknowledged areas of the assessment needed rewording and this was carried out. It apologised for this. It did not uphold his concerns about other advice given.

Safeguarding referrals

29. The Council received two safeguarding referrals for Mr X in April 2022 with concerns of neglect. At the time the Council was arranging to assess Mr X’s needs.
30. In June 2022 the Council received two further safeguarding alerts. These related to the Mr X’s unhappiness with the action of the Council’s Housing Department which Mr X said made him feel suicidal. The Ambulance Service attended Mr X and assessed Mr X had mental capacity and that he reported he no longer felt suicidal but frustrated. Mr X declined a referral to mental health services but was encouraged to call the mental health crisis line whenever he felt in crisis.
31. A Council officer spoke to Mr X. They noted when asked if he intended to harm himself Mr X reported he wanted compensation from the Council. The officer discussed de-escalating Mr X’s mood through talking therapies or through a GP referral. When asked if he consented to a referral to Mental Health Services Mr X ended the call. The officer followed up the call with a letter, signposting him to organisations.
32. Between November 2022 and September 2023 the Council received 11 safeguarding referrals for Mr X, eight of which were from the emergency services. Most of the concerns related to Mr X’s treatment by the Council’s Housing Department which he reported left him feeling suicidal. Others related to concerns about neighbours and because Mr X wanted help accessing a dentist.
33. The Council closed the safeguarding referrals as they did not meet the safeguarding threshold and Mr X had previously been advised to raise concerns about the Housing Department with senior officers in Housing. The records show officers made follow up calls to Mr X with information about support he could access for his mental health in the case of an emergency. The Council also updated Mr X’s legal representative that he should call his GP, mental health services or the Samaritans if he was having a mental health crisis. The Council also liaised with a dental service and suggested Mr X’s GP may want to refer Mr X to the domiciliary dental service.

Findings

Needs assessment

34. There was a significant delay in the Council carrying out Mr X’s needs assessment. Initially this was because Mr X had concerns regarding the actions of officers 1 and 2 between May and August 2022 including the way they communicated with him. There was then a breakdown in communication with officer 3 when arranging a home visit in September 2022. However, between October 2022 and February 2023 there were delays in the Council contacting Mr X, responding to his queries and in progressing the assessment. This was fault and caused Mr X frustration. The Council has already acknowledged this and apologised to Mr X in its complaint response of April 2023. This was appropriate.
35. It is not the Ombudsman's role to decide what, if any, care and support a person needs. That is the Council's role. The Ombudsman's role is to consider if the Council has followed the correct process for establishing a person's needs and if it acted correctly when this process was complete.
36. Officer 4 met with Mr X and his advocate. They later amended the needs assessment to reflect the comments received from Mr X and his representative. There is no evidence of fault in the way the Council assessed Mr X’s needs.

Safeguarding

37. The records show the Council considered the safeguarding referrals it received but it did not consider any of the safeguarding referrals raised met the threshold for a formal safeguarding response. It considered Mr X did not have care and support needs, was not at risk and was able to safeguard himself. The Council did however contact Mr X when concerns were raised to check on his welfare and advised Mr X of how to seek mental health support or suggested Mr X contact his GP. The Council was not at fault.
38. The safeguarding referrals often refer to issues and concerns Mr X has about support provided by the Council’s Housing Department. The Council is not at fault for not treating these as safeguarding concerns. If Mr X has concerns about the behaviour of officers, it is open to him to report these to senior housing officers or to complain through the Council’s formal complaints process and then to the Housing Ombudsman Service. The records show Mr X has previously been advised of this by the Council.

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Final decision

39. I have completed my investigation. The Council was at fault for the delay in completing Mr X’s needs assessment. It has already apologised for this which was an appropriate remedy. There is no evidence of fault in the way the Council assessed Mr X’s needs or responded to safeguarding referrals it received.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman