Summary: Mr S and Ms M complained the Council mishandled a safeguarding referral, failed to fully respond to a complaint and failed to complete a carer's assessment, causing distress. The Council is not at fault for how it handled the safeguarding enquiry, the complaint response, and carers assessment. It is at fault for delay in responding to the complaint.

The complaint

1. Ms M and Mr S complained the Council mishandled a safeguarding referral and failed to fully respond to a complaint. This has caused them both distress. Mr S also says the Council failed to do a carers assessment on him. They would like the Council to apologise, respond in full to their complaint and pay them compensation.

Back to top

The Ombudsman’s role and powers

2. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)
3. 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)

Back to top

What I have and have not investigated

4. I have limited my investigation to the Council’s handling of the safeguarding investigation and complaint and not the content of them.

Back to top

How I considered this complaint

5. As part of the investigation I have considered the following:
• The complaint and the documents provided by the complainant.
• Documents provided by the Council and its comments in response to my enquiries.
• The Care Act 2014 and the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009.
6. Mr S and Ms M and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

Back to top

What I found

Relevant legislation

7. 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;
• 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.
8. 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)
9. 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.
10. 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)
11. An adult with possible care and support needs or a carer may choose to refuse an assessment. In these circumstances councils do not have to carry out an assessment. Where a council identifies that an adult lacks mental capacity and that carrying out a needs assessment would be in the adult’s best interests, it must do so.

The Council’s policies and procedures

Safeguarding procedures

12. The Councils safeguarding adults’ procedure is available online.
13. The policy refers to section 42 of the Care Act and says ‘The Local Authority must make (or cause to be made) whatever enquiries it thinks necessary to enable it to decide whether any action should be taken…’.
14. The flowchart explains the procedure the Council must follow when it receives safeguarding concerns:
• The Council must assess and address any immediate risks.
• The Council will gather information. This includes contacting the person who raised the concern; using internal sources and partnering agencies to gain background information; and contacting the adult.
• Decide whether to progress to enquiry stage. The concern is screened to establish if it meets the statutory criteria in section 42(1).
15. If the Council decides the case meets the criteria for an enquiry, it will:
• Gain the view, consent and desired outcome of the adult (the enquiry can range from a conversation with an individual to a formal multi-agency involvement).
• Agreement as to what enquiries are needed and who will do them.
• Make enquiries.
• Gather and share information, for example with the police and CQC.
• Support the adult to achieve resolution.

The Council will then decide if a safeguarding plan is needed.

Complaints procedure

16. The Council’s complaint process for adult social care is available online. It says it will acknowledge the complaint within three working days and decide who will respond. The Council will offer to discuss the complaint and explain how it will be investigated and respond within ten working days. If the Council is unable to resolve the issue and the complainant is not happy with the response, it will signpost them to the Ombudsman.

What happened

17. I have summarised below the key events; this is not intended to be a detailed account.
18. Mr S has brought this complaint for himself and his mother, Ms M. Ms M has medical conditions. Mr S and Ms M live together.
19. In late November 2022, Ms M was unwell and received medical attention from the ambulance service.
20. In early December, the housing association responsible for the property where Ms M and Mr S live made raised concerns about Ms M. The Council screened this under its safeguarding procedures.
21. In the middle of December, the Council’s safeguarding officer telephoned Ms M. They explained they had received a safeguarding concern which they wished to discuss. Ms M passed the phone to her son. The safeguarding officer explained they could not discuss the matter with him. The call ended.
22. The same day, Mr S made a complaint to the Council about the telephone call. He said the safeguarding allegation was a lie and it had distressed his mother.
23. The following day the safeguarding officer telephoned Ms M and advised her of the safeguarding concerns. Ms M said she was fine and did not agree with the concerns.
24. Before Christmas, the safeguarding officer emailed Ms M’s doctor asking if they had any safeguarding concerns. The doctor said they had no concerns.
25. The Council’s notes show a referral from the ambulance service recorded on the system at the end of December. It explained the medical reasons for their attendance and expressed concern that Ms M was becoming isolated because of her medical issues. The ambulance crew thought Ms M may benefit from referral to other departments and possibly a care package.
26. In late January, the safeguarding officer spoke to Mr S. The Council’s notes show the safeguarding officer considered Mr S understood the safeguarding role and accepted they needed to get Ms M’s views on this. He agreed the safeguarding officer could visit. He also said his mother would benefit from a care package and referred to the recent attention from the ambulance crew.
27. At the end of January, the Council responded to Mr S’s complaint. It referred to the conversation the safeguarding officer had with Mr S and explained the case was about an allegation of coercion. It said the Council needed to speak to Ms M alone, and if she provided consent, the matter could also be discussed with Mr S. The letter said Mr S had confirmed the officer could visit Ms M and they would also like to discuss a package of care for Ms M. The letter considered Mr X had withdrawn his complaint and outlined the next stages if Mr S was not happy with the response.
28. Mr S responded to the Council. He said he was not happy with the response, asked extra questions and asked for the visit to be postponed. Mr S said he and his mother were unwell. He said he had not withdrawn the complaint.
29. At the beginning of February, the safeguarding team manager emailed Mr S and referred to previous correspondence, said the safeguarding concern had been registered and the Council wanted to ensure Ms M could make her own self-determined and informed decisions. They needed to meet with Ms M privately to discuss the concerns at first and Mr S could be present at any further conversations. They said the officer would still attend ‘as part of our duty of care we must directly assess the situation…’
30. The safeguarding officer visited on the day arranged. They could not make contact with Mr S and Ms M.
31. Mr S emailed the Council a few days later and said he and his mother were upset that safeguarding officers visited their home when he had explained the visit could not take place. He asked for future correspondence with his mother to be in writing through him. The safeguarding officer emailed an apology the same day for the distress caused.
32. The safeguarding officer contacted the doctors surgery and arranged to meet Ms M at her next appointment to discuss the safeguarding concerns. Ms M did not attend her appointment.
33. The safeguarding officer sought advice from a senior manager in the middle of February who said to contact the police and organise a joint welfare visit. The manager was worried that officers had not had sight of Ms M and not spoken to her since the early phone call in December.
34. The following day, the safeguarding officer visited Ms M but she was not at home.
35. In late February, the safeguarding officer booked a joint visit with the police. The safeguarding officer met with Ms M who said she did not need care or support.
36. At the end of February, the safeguarding officer requested to close the section 42 enquiry. The records show ‘A home visit was completed for this enquiry with a view of completing a care assessment however adult at risk declined assessment and stated that she is able to complete all daily tasks. Her son also supports this…’. The manager approved the decision and approved the closure of the safeguarding inquiry.
37. In the middle of June, Mr S complained to the Council and asked for a response in line with the regulations. He said the letter was further to the complaint from the end of December and extra letters in February. Mr S listed 17 concerns and sought a thorough investigation of the concerns listed. The next ten pages provided background to the case and the final seven pages were specific questions asking for a response. The letter asked for an apology.
38. In late July, the head of service responded to Mr S’s complaint. The letter explained under the Care Act, the Council must make enquiries when it receives safeguarding concerns. The Council must engage with the adult to share information, obtain their views, and determine what they would like to happen. The Council accepted the matter has caused distress to both Mr S and Ms M and apologised. They offered to meet with Mr S and Ms M to apologise and discuss their concerns, especially as they said the allegations were erroneously made.
39. Mr S responded in August and said he and his mother required a full written response to the complaint before agreeing to a meeting.
40. In September, the service director responded to Mr S. It referred to previous correspondence regarding the complaint and the Council’s responses. It listed the 17 concerns and responded to these. The letter apologised for the distress caused and reiterated Mr S and Ms M could attend the office to discuss the complaint further.
41. Mr S emailed the Council and said he and his mother were not happy with the response. The Council replied and said it had responded to the full extent intended in its previous letter and had offered to meet with them to discuss further. The offer remained open.
42. Mr S and Ms M complained to the Ombudsman in December 2023.

Analysis

Mishandling of safeguarding referral

43. As set out above, where a council receives a safeguarding referral, it must make enquiries if it there are concerns that an individual is at risk of abuse or neglect and is not able to protect themselves against this. The Council received a safeguarding referral from the housing association and a separate referral from the ambulance service expressing concern about Ms M’s welfare. The safeguarding officer was concerned about Ms M’s welfare and decided to make enquiries. Under the legislation the Council must make safeguarding enquiries where concerns are raised. The safeguarding officer was right to do so. The Council is not at fault.
44. The Council needed to ensure Ms M was safe and well. The safeguarding officer telephoned her but the call was cut short without addressing the concerns. Further telephone calls and visits were unanswered or cancelled and attempts to contact Ms M through her doctor failed. After several failed attempts, the safeguarding officer referred the matter to their manager who advised to arrange a joint visit with the police. While I understand this may seem heavy handed to Mr S and Ms M, I can also understand why the Council were concerned for Ms M’s safety. They had not spoken to her since December and had not seen her at all and had exhausted other methods. The Council had no other way of checking on Ms M. The Council’s priority was to ensure her safety, this was achieved by attending with the police. I do not find the Council at fault.
45. Mr S said the safeguarding referral from the housing association was maliciously made. In the first instance, the Council was right to follow its procedure and consider the referral as it did. Its priority must be the safety of Ms M. The Council has since said it will investigate Mr S allegations further and has offered to discuss this with him. I do not find the Council at fault.
46. In its complaint response, the Council accepted and acknowledged the matter had caused significant distress to both Mr S and Ms M and apologised for this.

Failed to respond to complaints

47. Mr S complained to the Council at the end of December 2022. Under the regulations and the Council’s own policy, it should have confirmed receipt within three working days and responded within ten working days. The Council sent its first response in January 2023. This is outside the timeframe, this is delay. The Council also delayed responding to Mr S’s later correspondence about the complaint. This is fault.
48. Mr S complained to the Council several times about similar issues. The Council identified these were repeat cases and added later complaints to the earlier file. Considering the complaints were similar, I consider this a sensible approach. The Council responded to Mr S and sent further responses to the complaint. The Council is not at fault for how it dealt with the complaints.
49. The Councils final response to the complaint lists the 17 concerns raised by Mr S and Ms M and responds to these in turn, according to their request. I find this a suitable way of dealing with the main concerns. The Council is not at fault.
50. Mr X complains the Council did not respond to his complaint in full and refers to the six pages of specific questions which remain unanswered. I understand Mr S is frustrated; he has questions; the Council has not provided him with answers. It has however offered to meet with Mr S and Ms M to discuss their concerns in person. While I understand Mr S’s complaint that he has not received a full written response, I do not consider it would be a proportionate or appropriate use of the Councils time, considering the size of the request, especially when it has offered an alternative mechanism. The Council is not at fault.

Failed to offer a carers assessment

51. Following the visit in February, it was clear Mr S and Ms M did not want the Council involved. Ms M declined an assessment. The records do not show the Council offered a carers assessment to Mr S, or that he requested one.
52. Following receipt of Mr S’s complaint, the Council said it was willing to conduct a carers assessment for Mr S. It is up to Mr X to accept this if he wishes to do so. An individual may refuse and assessment and, in these cases, the Council does not have to carry out an assessment. The Council is not at fault.

Summary of fault causing injustice

53. The Council is at fault for delay responding to the complaint. This has caused Mr S and Ms D distress.

Back to top

Agreed action

54. Within four weeks of my final decision, the Council agreed to apologise to Mr S and Ms M for the delay in responding to their complaint.

Back to top

Final decision

55. I have completed my investigation. The Council is not at fault for how it handled the safeguarding enquiry, the complaint response and carers assessment. It is at fault for delay in responding to the complaint.

Investigator’s decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman