Knowsley Metropolitan Borough Council (23 013 452)

Category : Adult care services > Safeguarding

Decision : Upheld

Decision date : 17 Dec 2025

The Ombudsman's final decision:

Summary: Mr X’s main complaint is that the Council failed to properly assess his needs in July 2023 and then failed to respond to his complaint about the assessment. We find that the Council did not follow the correct process as it failed to send a copy of Mr X’s assessment to him and then deleted the assessment. The Council also did not respond to Mr X's complaint about the assessment. However, the Council’s offer of a re-assessment soon after Mr X complained, has mitigated a lot of the injustice Mr X suffered because of the fault.

The complaint

  1. Mr X says:
    • The Council failed to properly assess his needs in July 2023.
    • The Ombudsman had told the Council in a previous decision that the Council should employ an independent social worker to carry out the assessment and the Council failed to do so.
    • The Council failed to pay him £300 the Ombudsman had ordered to pay him.
    • The Council agreed to re-assess his needs, after the July 2023 assessment but the Council delayed completing this assessment.

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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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
  2. 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(1), as amended)

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What I have and have not investigated

  1. I have not investigated the following complaints.
  2. Mr X complained that the Council had redacted some of the documents he had obtained through a subject access request. The Information Commissioner’s Office (ICO) is best placed to investigate complaints about access to information and I have therefore not investigated this complaint. Mr X has made a complaint to the ICO about the redaction.
  3. Mr X also made complaints about one of the social workers’ fitness to practise and wanted disciplinary action against the social worker. The focus of an Ombudsman’s investigation is on the actions of the Council as a whole. The Ombudsman does not recommend disciplinary actions against individuals nor is it a regulatory body.

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How I considered this complaint

  1. I have spoken to Mr X. I have considered the evidence that he and the Council have provided, the relevant law, policy and guidance and both sides’ comments on the draft decision.

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What I found

Law, guidance and policies

  1. The Care Act 2014 and the Care and Support Statutory Guidance 2014 (CASS Guidance) set out the Council’s duties towards adults who require care and support.

Assessment, care plan and personal budget

  1. The Council has a duty to assess adults who have a need for care and support. If the needs assessment identifies eligible needs, the Council will provide a support plan which outlines what services are required to meet the needs.

Eligibility

  1. The threshold for eligibility is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing. Council must consider whether:
    • The adult’s needs arise from a physical or mental impairment or illness.
    • As a result of the adult’s needs the adult is unable to achieve 2 or more of the specified outcomes.
    • As a consequence of being unable to achieve these outcomes there is a significant impact on the adult’s wellbeing.

Outcomes

  1. The outcomes are:
    • Managing and maintaining nutrition
    • Maintaining personal hygiene
    • Managing toilet needs
    • Being appropriately clothed
    • Being able to make use of the home safely
    • Maintaining a habitable home environment
    • Developing and maintaining family or other personal relationships
    • Accessing and engaging in work, training, education or
    • Making use of necessary facilities or services in the local community
    • Carrying out caring responsibilities for a child.

Assessment of needs

  1. The CASS Guidance says the assessment process must be person-centred throughout, involving the person and supporting them to have choice and control.
  2. Following their assessment, individuals must be given a record of their needs assessment. 

Self-assessment

  1. The assessment process can take different forms and this includes ‘supported self-assessment’. A supported self-assessment is an assessment carried out jointly by the adult with care and support needs or carer and the local authority. Once the person has completed the assessment, the local authority must ensure that it is an accurate and complete reflection of the person’s needs, outcomes, and the impact of needs on their wellbeing. 
  2. Whilst it is the person filling in the assessment form, the duty to assess the person’s needs, and in doing so ensure that they are accurate and complete, remains with the local authority. 

Fluctuating needs

  1. The CASS Guidance says some people have fluctuating needs. It notes that the conditions of the individual at the time of the assessment may not be entirely indicative of their needs more generally, so local authorities must consider whether the individual’s current level of need is likely to fluctuate and what their on-going needs for care and support are likely to be.
  2. Local authorities must consider an individual’s need over an appropriate period of time to ensure that all of their needs have been accounted for when eligibility is being determined. 

Disagreement about the care plan

  1. If the care plan cannot be agreed with the person, the local authority should state the reasons for this and the steps which must be taken to ensure that the plan is signed-off.
  2. If a dispute still remains, and the local authority feels that it has taken all reasonable steps to address the situation, it should direct the person to the local complaints procedure.

Background to the complaint

  1. Mr X is an adult man who has autism, attention deficit hyperactivity disorder, anxiety and continence issues.
  2. Mr X previously complained to the Ombudsman about four assessments of his needs which the Council had carried out. The Ombudsman investigated his complaint and said there was no fault in the assessments which were carried out in July and October 2022 and January 2023. The Ombudsman said there was fault in the assessment dated May 2023 because the assessment was not carried out in person and the Council did not consult with a person who had expertise in autism.
  3. To remedy the fault, the Ombudsman recommended (and the Council agreed) that the Council should:
    • Pay Mr X £300 within one month of the decision.
    • Carry out an in-person review of Mr X’s needs for care and support by a social worker trained in autism. The review should take place as soon as possible once any ongoing mental health clinical assessments had concluded.

What happened

Assessment – 6 July 2023

  1. A social worker and student social worker visited Mr X on 6 July 2023 to carry out the assessment of his needs. Mr X was supported by his advocate. The social worker’s notes of the meeting said:
    • Mr X asked the social workers whether he could record the meeting. He was advised to take notes instead after the social worker obtained a senior practitioner’s advice on the matter.
    • Mr X had completed a self-assessment and he gave a copy to the social worker.
    • ‘The meeting didn’t go ahead as planned because [Mr X] kept interrupting. [Mr X] felt that I did not understand what he was saying…The more I questioned [Mr X], the more he became agitated. He remained agitated despite the fact that I had apologised to him before the meeting started that some of the questions to him would be intrusive.’
    • ‘In the end, both [Mr X] and his advocate felt that I had failed to acknowledge what [Mr X’s] needs were despite the fact that I explained to them that the information he had provided to me was inadequate and not representative of his genuine care needs.’
    • ‘Before we left [Mr X’s] home, I did mention to him that he would not be pleased with the result of this assessment because I was unable to determine what his care needs were.’
    • ‘[Mr X] was not pleased with the information and mentioned that he would be consulting his lawyer and the judge.'

Mr X’s complaint – 9 July 2023

  1. Mr X complained about the assessment on 9 July 2023 and said:
    • The social worker did not recognise mental disabilities as disabilities.
    • The social worker did not understand autism and ADHD and did not understand how the conditions affected Mr X’s daily life.
    • The social worker had told him that, if a person could walk for 20 metres, then they would not be considered as disabled in England and would not receive Personal Independence Payment.
    • The social worker attacked him, ‘attempting to pick apart what I said’ and spent the entire meeting ‘talking and shouting over me.’
    • The social worker did not accept his diagnosis of ADHD and said she would enter it as ‘suspected’ ADHD. Mr X explained to the social worker that it was not the condition that determined his need for support but the impact on outcomes.
    • The social worker had preconceived notions about Mr X and his needs and missed a lot of relevant information from him about his conditions and daily struggles. The social worker did not attempt to gain this information but spent the entire meeting ‘on the attack’.

Decision regarding assessment – 11 July 2023

  1. The social worker discussed Mr X’s assessment with their manager on 11 July 2023. The note said the social worker had ‘completed a social care needs assessment, outcome is that [Mr X] is not eligible for care and support under the Care Act 2014.’ The social worker was going to complete the written assessment and send it to Mr X.

Meeting – 18 August 2023

  1. In August 2023, the manager held a meeting with Mr X to discuss his complaint.
  2. Mr X explained that, just because he was physically able to perform a task, did not mean he was mentally able to do so.
  3. Mr X said that his previous needs assessment had identified that he had eligible needs but these were met by friends and family. The later assessment said he had no needs.
  4. Mr X said he needed respite care due to his home environment as there were trains that passed his home which were really loud and he also did not always get on with his mother. He felt trapped at home and needed the respite. The manager said respite care was provided to the carer (in this case his mother). Mr X said that his understanding of respite care was that it ‘was for short breaks for the person with a disability.’
  5. Mr X said that he had not received any care and support since April 2023 and he said this had resulted in a deterioration in his mental health.
  6. During the meeting it transpired that the Council had not sent a copy of the most recent assessment to Mr X. The manager said he was not sure why this happened but the manager offered his copy to Mr X. I spoke to Mr X about this and Mr X said that, by then, he was so upset by the meeting, he could not accept the copy.
  7. The outcome of the meeting was that the manager agreed to further investigate Mr X's complaints about the assessment. The manager said that this would take some time to complete as he would need to speak to the relevant professionals who had been involved with Mr X. The manager said he would keep in contact with Mr X.

September 2023 to April 2024

  1. The manager and Mr X spoke on 27 September 2023 and the manager suggested a different approach to undertake the assessment. He suggested the social worker should get to know Mr X over a period of time as this would enable the social worker to carry out a more accurate assessment of Mr X’s needs. Mr X was initially open to this idea but then disagreed as he said he needed an independent social worker, not a social worker employed by Knowsley Council.
  2. Mr X continued to complain about the assessment and said his mental health was declining. On 11 October 2023, Mr X said he had been in hospital following an overdose and was being treated for psychosis. He said he wanted the Council to use a previous assessment as a basis for the care plan. He did not want another assessment by a Knowsley social worker.
  3. The Council paid the remedy from the Ombudsman’s decision, £300, to Mr X on 14 November 2023.
  4. Mr X came to the Ombudsman on 24 November 2023 and asked the Ombudsman to investigate 4 complaints. He said the Council:
    • Redacted pages of his information access request without reason.
    • Failed to respond to his complaint.
    • Failed to pay him the financial remedy the Ombudsman had stated in its decision.
    • Failed to provide an independent social worker to carry out his assessment in July 2023, as stated in the Ombudsman’s decision.
  5. On 7 December 2023 Mr X said he wanted to work with social services again.
  6. The social worker rang Mr X on 8 December 2023 and said he would start the assessment. The social worker said he would get to know Mr X over a period of time before he completed the assessment. He said it was very important that Mr X was listened to and his thoughts and feelings were accurately recorded during the assessment process.
  7. Mr X received a diagnosis of ADHD in February 2024.
  8. The social worker visited Mr X on:
    • 20 December 2023
    • 19 January 2024
    • 31 January 2024
    • 14 February 2024
    • 28 February 2024
    • 26 March 2024
  9. The social worker involved the mental health professional, who supported Mr X in his mental health needs, and Mr X’s advocate in the visits.
  10. The social worker completed the assessment on 19 April 2024. The social worker addressed each outcome and whether Mr X needed support to achieve the outcome. The social worker included the level of support Mr X’s family provided. The social worker concluded that Mr X needed a low level of support from the Council to achieve the following outcomes:
    • Managing personal hygiene.
    • Being appropriately clothed.
    • Maintaining nutrition.
    • Use the home safely.
    • Maintaining a habitable environment.
  11. The care plan said Mr X was entitled to 3 half day sessions at a day centre and 10 hours per week from a personal assistant.
  12. The social worker considered Mr X’s request for respite care, but said Mr X was not asking for respite care, but rather for a holiday paid for by the Council. The social worker said had not identified a ‘need’ for this, but said this was more a ‘want’. Mr X said he knew other people with autism who had received ‘respite breaks’, but the social worker said they may have a different level of needs. Mr X disputed that he was not eligible for respite, based on his needs.
  13. The Council’s manager responded to Mr X’s complaint on 16 February 2024. The Council said:
    • Mr X had received 5 assessments and had complained about every assessment the Council had carried out.
    • In response to the complaint about the July 2023 assessment, the manager said: ‘I am aware of your dissatisfaction with this assessment and its outcome’ and said he had proposed a new assessment with a different approach.
    • This new assessment had been started and was ongoing.
    • In response to his request for respite care, the manager said Mr X had explained his reasons why he felt he needed respite care (to have a break from the noise of the railway line and the anxiety and stress which he said was caused by the Council’s assessment process) during the meeting in August 2023. The manager said the Council was unlikely to provide respite on this basis but he would wait until the further assessment was completed before coming to a final conclusion.
  14. On 26 September 2024 Mr X escalated his complaint to stage 2 of the complaints procedure. He said:
    • He never received a response to his complaint about the July 2023 assessment.
    • He had been discouraged to carry out a supported self-assessment.
    • He had not been given reasons why respite care had been denied and how he could appeal the decision.
    • The Council had then delayed his current assessment (after July 2023) for another year.
  15. The Council responded to the complaint in October 2024 and said:
    • The re-assessment of Mr X’s needs (April 2024) had now been completed and had not identified a need for respite care.
    • Respite care was provided to enable carers to have a break from their caring role, particularly in cases where the caring role had a significant impact on the care and the person cared for had extensive needs, for example, where they could not be left on their own. Mr X did not have that level of needs. Mr X could go on holiday if he chose to and could have some support during that time.
    • Mr X gave the social worker a copy of his self-assessment in July 2023 and, during the more recent assessment, the social worker gave Mr X opportunity throughout the process to give his views. Mr X was encouraged to present his views in written format in future assessments.

Further information

  1. I asked the Council to send me a copy of the July 2023 assessment. The Council said the social worker ‘initially started to complete the assessment document but did not complete the assessment document fully as [Mr X] complained about the assessment. Eventually (in February 24) she cancelled this assessment document on the LAS system so it was never completed so we have not provided this to the Ombudsman.’
  2. I noticed that Mr X attended the day centre sometime after the May 2023 assessment (which said he had no eligible needs) and before the April 2024 assessment (which said he had eligible needs). I asked the Council for clarification.
  3. The Council said: ‘Our records show we have paid a direct payment to [Mr X] to attend [the day centre] consistently since August 2022.  This direct payment has not been stopped or suspended at any point.  At various times [Mr X] may have chosen to not attend his allocated days and some adult social care staff may have discussed the possibility that his needs could be met another way however we have continued to pay the direct payment for this support.  In April 2024 [Mr X] agreed with his then social worker to use some of his direct payments to pay for personal assistant support, while reducing his attendance at day services down to half of his previous level of attendance (from 3 days to 3 half days) this plan continues to be active.’

Analysis

  1. The Ombudsman does not carry out assessments of a person’s needs nor does it say what their care plan should be. That is the role of the Council. I have investigated whether there is any fault in the way the Council carried out its duties. I have done so by comparing what the Council should have done, in line with the law, guidance and policies, and what it has done.
  2. In terms of the July 2023 assessment, the Council failed to provide Mr X with a copy of his assessment and this was fault. I accept that Mr X complained about his assessment as soon as he had received verbal feedback about the outcome, but that did not mean that he was not entitled to receive a written copy of the assessment.
  3. On the contrary, it meant the Council had an even greater duty to ensure that it sent a copy of the assessment to Mr X. I cannot see how Mr X could properly complain about the assessment if he had not received the assessment and therefore could not see how the social worker made the decision.
  4. I am also concerned about the fact that the Council’s manager had a copy of the assessment at the meeting in August 2023 whereas Mr X had not been sent a copy. This put Mr X in a disadvantaged position. I note that the manager offered to share his copy with Mr X during the meeting which mitigated some of the injustice to Mr X, but I accept that Mr X said that, at that stage, he was too upset to read the assessment. In any event, receiving a copy at the meeting would never be the same as receiving a copy before the meeting so that Mr X could have prepared for the meeting.
  5. There was then further fault in the Council’s decision to delete the assessment from its system in February 2024. The Council knew that the assessment was subject to a complaint by Mr X so I do not understand why it would delete the assessment.
  6. As a result, the Ombudsman is unable to fully investigate Mr X’s complaint about the assessment. I cannot say whether the Council properly considered Mr X’s needs and outcomes in line with the Care Act and CASS Guidance during the assessment.
  7. I have investigated Mr B’s complaint that the Council refused to allow him a reasonable adjustment (recording the visit) without good reason during the visit on 6 July 2023.
  8. It is up to the Council to decide whether an adjustment is reasonable or not. But if the Council decides that an adjustment is not reasonable, it must explain its reasons for this decision. I have not been able to find any evidence on how the Council made the decision about the reasonable adjustment so this was fault.
  9. In terms of Mr X’s complaint that he was dissuaded from providing a self-assessment, I cannot add much more than the Council’s comments. I note that Mr X gave a copy of a self-assessment to the social worker during the visit in July 2023, but, of course, it is impossible to say how the social worker considered the self-assessment without a copy of the assessment itself.
  10. I would point out, however, that a self-assessment does not mean that a person can make the final decision on the assessment or the care plan. That would always be the Council’s decision.
  11. In terms of Mr X’s complaint about the delay in the assessment after the July 2023, I note the following. The Council agreed to re-assess Mr X, soon after the meeting in August 2023, but the assessment was not completed until April 2024. However, the passage of time is, not in itself, fault.
  12. I note that Mr X did not want to engage with the Council’s social worker until December 2023 so therefore any delay between August/September 2023 to December 2023 is not fault by the Council.
  13. The social worker then started the assessment in December 2023 but said he would carry out the assessment over a period of time. I am of the view that this was a good proposal. Mr X’s needs fluctuated and he had complained about previous assessments. The Council suggested a different approach which was a longer assessment over a period of time in the hope that this would capture Mr X’s needs better. This proposal demonstrated good practice and was in line with the advice given in the CASS Guidance.
  14. The social worker completed the assessment over 4 months. The records showed that the social worker visited Mr X six times during that time, always accompanied by Mr X’s mental health worker, and sometimes Mr X’s advocate. This meant the social worker had to find dates which everybody could attend. It also allowed the social worker to take account of the fluctuating nature of Mr X’s underlying conditions. So overall, although 4 months is a long time, I cannot say that this was fault.
  15. In terms of the complaint that the Council should provide Mr X with respite care, I make the following comments. I agree with the Council that the term ‘respite care’ is used to provide respite to informal carers, for example, where a person is cared for by family members and the aim of the respite is to give informal carers a break. So respite care is not, generally speaking, provided to meet the needs of the cared for person but rather to assist the carer.
  16. However that does not mean that the Council is prohibited from providing temporary care away from the home (for example a few weeks residential care in a care home), if that is needed to meet a person’s needs, but it may not be called ‘respite care.’ But the Council would only have a duty to do so if it had identified an assessed need to achieve an outcome. The Council has not identified a need for Mr X to have temporary care away from the home in its assessment in April 2024.
  17. In terms of the assessment in April 2024, I note that the social worker visited Mr X over several months. The social worker involved Mr X, his advocate and his mental health professional in the assessment. The social worker assessed Mr X’s ability to achieve outcomes and set out clearly what support family members provided. I know that Mr X feels that the care plan did not include all the things he wanted (particularly in relation to respite care), but the Ombudsman cannot question the merit of a decision if there is no fault in the way the decision was made.
  18. I have also considered Mr X’s other complaints.
  19. In terms of Mr X’s complaint about the delay in his complaint response, I note that the Council has already upheld this complaint and has apologised to Mr X. Mr X complained in July 2023 and the Council responded in February 2024. I appreciate that the Council wanted to carry out a thorough investigation into the complaint but a delay of 7 months is too long so I agree there was fault in that respect.
  20. I also uphold Mr X’s complaint that the Council never properly responded to his complaint about the assessment in July 2023. I cannot say, from the February or October 2024 responses whether the Council upheld the complaint or not.
  21. Mr X complained that the Council failed to pay the £300 remedy recommended by the Ombudsman in the previous decision. I do not uphold that complaint as the Council has provided evidence that it has paid the £300, although I agree it took the Council longer than one month agreed in the decision.
  22. Mr X also complained that the Council had not complied with the Ombudsman’s remedy because the Council failed to provide an independent social worker. I have set out the Ombudsman’s remedy in paragraph 22. The remedy did not include a requirement that the Council would provide an independent social worker. Therefore, I do not find fault in this respect.
  23. However, I note that the investigator stated elsewhere in the decision statement that, given Mr X’s mistrust of the Council, the Council may wish to consider whether a social worker from another local authority would be best placed to carry out the assessment. So I understand why Mr X hoped that the Council would provide an assessment by an independent social worker, although this was not the actual remedy that had been agreed.

Injustice

  1. When the Ombudsman finds fault, it then considers whether a person has suffered an injustice because of the person and, if the person has suffered an injustice, how the injustice can be remedied.
  2. I found fault in the process relating to the July 2023 assessment (failure to provide the assessment document and then deletion of the document). This meant Mr X could not see how the assessment came to the conclusions that it did, nor could he complain about it. That left him with the uncertainty whether the assessment was carried out properly and I accept this would cause distress.
  3. The Council, however, agreed to re-assess Mr X soon after the meeting with Mr X in August 2023. A re-assessment is one of the main remedies the Ombudsman recommends when it finds fault with an assessment so Mr X’s injustice was remedied to a large extent by the Council’s quick offer of a re-assessment.
  4. Also, even if I had found fault with the July 2023 assessment, I could not speculate what the care plan would have been. I also note that the Council continued to pay the direct payments to access the day centre from August 2022.
  5. Mr X has, however, suffered an injustice by the Council’s failure to respond to his complaint about the July 2023 assessment. By not providing a response, Mr X was left with the impression that he was not listened to and that the Council did not understand his concerns. Mr B has also said that the fact that the manager had a copy of the assessment during the meeting in August 2023 but Mr B did not have a copy was procedural unfairness and contributed to his distress and confusion at the time.
  6. Also, if fault had been found, the Council could have explained to Mr X what lessons it had learned from the complaint response so that it could address the issue in future assessments.
  7. So I accept that this fault caused distress to Mr X. In cases such as this one, where the main injustice is distress, we can offer a small symbolic sum to reflect the distress. I recommend the Council pay Mr X £150.

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Action

  1. The Council has agreed to take the following actions within one month of the final decision. It will:
    • Apologise to Mr X in writing for the fault I have identified.
    • Pay Mr X £150 as a symbolic payment for the distress he suffered.
    • Remind relevant staff to provide a copy of the assessment and care plan to the assessed person, regardless of any dispute.
    • Ensure relevant staff understand the Council’s duty to make reasonable adjustments and know how to identify, record, and act on a request for reasonable adjustments. It will provide training or guidance as needed.
  2. The Council should provide us with evidence it has complied with the above actions.

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Decision

  1. I have completed my investigation and found fault by the Council. The Council has agreed the remedy to address the injustice.

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Investigator's decision on behalf of the Ombudsman

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