Sefton Metropolitan Borough Council (17 008 609)

Category : Adult care services > Transition from childrens services

Decision : Upheld

Decision date : 01 Jun 2018

The Ombudsman's final decision:

Summary: The Council was at fault in how it managed C’s transition from children’s to adult services. Although the Ombudsman has not found fault in the single accommodation choice offered, and there was no gap in provision, there were delays and changes to plans which will have added to C’s uncertainty and distress. The Council has agreed to apologise to Dr B for how it managed the transition, and to make a payment of £500 to recognise C’s injustice.

The complaint

  1. The complaint is about how the Council managed a young person’s transition from children’s to adult services. I refer to the young person as C.
  2. C does not have the capacity to make a complaint to the Ombudsman, so her mother has made the complaint on her behalf. I refer to her mother as Dr B.
  3. Dr B complains that there was no evidence of long-term planning for C’s transition to adult services, even though C needs structure, routine and time to adjust, and became anxious. She also says the Council did not involve her in its planning, and did not offer any choice about accommodation or education.

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What I have investigated

  1. I have investigated Dr B’s complaints about the transition process, her involvement in planning, and the lack of accommodation choice offered.
  2. The final paragraph of this decision statement sets out why I have not investigated other matters.

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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. The law says we cannot normally investigate a complaint when someone can appeal to a tribunal. However, we may decide to investigate if we consider it would be unreasonable to expect the person to appeal. (Local Government Act 1974, section 26(6)(a), as amended)
  3. SEND is a tribunal that considers special educational needs. (The Special Educational Needs and Disability Tribunal (‘SEND’))
  4. If we are satisfied with a council’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. I considered the information provided by Dr B and the Council. I wrote to Dr B and the Council with my draft decision and considered their comments.

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What I found

  1. I will address each part of Dr B’s complaint, in turn, below.

Lack of transition planning

What happened

  1. On 14 June 2016 the Council completed a pathway plan for C. The plan set out C’s needs and how the Council would meet them up to, and including, her transition to adult services. The plan stated that it would be reviewed before C turned 18.
  2. The Council reviewed the pathway plan on 23 November 2016.
  3. On 25 January 2017 the Council held a professionals’ meeting, in which it noted that C’s anxiety had increased because she was aware she would be moving into another property.
  4. The Council reviewed C’s pathway plan again on 31 January 2017.
  5. In March 2017 the Council identified a property for C to move into, although it did not, at that stage, identify a care provider. C’s carers took her to see the outside of the property on 17 May 2017.
  6. On 25 May 2017 the Council reviewed C’s pathway plan again.
  7. On 14 June 2017 the Council confirmed that C would need to leave her current accommodation – which was a children’s services placement – on 6 July 2017. At this stage the Council had still not identified a care provider to manage C’s transition and provide her care. On 15 June 2017 the Council was told there were no short-term respite vacancies available for the period between C leaving her current placement and moving into her new one.
  8. C turned 18 on 27 June 2017.
  9. On 29 June 2017 one of C’s carers told the Council that C had not seen the inside of the new property, and that much work was still needed to prepare her for the move.
  10. On 5 July 2017 the Council postponed C’s move because it had still not identified a care provider. One of C’s carers told the Council that C was still not ready for the move because she had not visited the property or been introduced to staff and residents. C continued to stay in her children’s placement while the Council found a care provider.
  11. On 10 July 2017 the Council completed its assessment of C’s needs, which it had conducted alongside her pathway plan.
  12. On 19 October 2017 C’s children’s placement gave her 28 days’ notice to leave the property. It did this because C was too old to be living there, even temporarily.
  13. On 20 October 2017 the Council approached its preferred care provider (which, from now on, I will refer to as the Care Provider). It awarded the contract to manage C’s transition and provide care to her to the Care Provider on 15 November.
  14. Although C’s 28-day notice period expired on 17 November 2017, the Council asked her children’s placement to extend the deadline by a week to give the Care Provider the chance to prepare to work with C.
  15. On 27 November 2017 the Care Provider asked the Council to delay C’s move to 11 December 2017. However, at this stage it did not appear that C could stay in her children’s placement for any longer. C’s case note records say the Council conducted a “frantic search for alternatives”, but it did not find any. C’s children’s placement agreed that C could stay there until 11 December.
  16. On 29 November 2017 the Care Provider asked to delay C’s moving date again – to 8 January 2018. It said it needed more time to train its staff.
  17. On 4 December 2017 C’s children’s placement agreed, again, to extend her stay there, until 8 January 2018.
  18. C moved to the new property on 8 January 2018 and began receiving provision from adult services.

Care and support statutory guidance

  1. Section 16 of the guidance – which accompanies the Care Act 2014 – provides instructions to councils on how to manage transitions between children’s and adult services.
  2. Paragraph 16.51 says that, having carried out a transition assessment, a council must indicate which eligible needs a young person will have when they turn 18, to ensure that they understand the care and support they are likely to receive.
  3. Paragraph 16.53 says:

It is critical that families are able to understand what support they are likely to receive when the young person or carer is in the adult system, and that the transition period is planned and managed as far in advance as is practical and useful to the individual to ensure that there is not a sudden gap in meeting the young person’s or carer’s needs.

  1. Paragraph 16.68 says, if adult care and support is not in place on a young person’s 18th birthday, and they have been receiving children’s services (and should be receiving adult services), a council must continue providing the existing services until the adult services are in place, so there is no gap in provision.

Analysis

  1. The statutory guidance accompanying the Care Act 2014 requires that Councils plan for a young person’s transition from children’s to adult services in good time, so they understand what support they will receive.
  2. The Council did start the transition in good time – it started C’s pathway plan a year before her 18th birthday and reviewed it regularly, alongside a needs assessment. It also assigned an adult social worker to C almost a year before her 18th birthday.
  3. However, although the Council planned well in advance, the reality was that, when C’s placement was due to end, there was no new placement for her to go to. The Council had found a property but not a care provider. This meant that, at the stage when C should have transitioned to adult services (or should, at least, have known when this would happen), she had not been prepared for her move, and did not know when it would take place.
  4. The purpose of planning in advance is mainly to make sure there is no gap in provision. If adult services are not in place on a young person’s 18th birthday, councils must continue to provide the children’s services support until the adult support is in place.
  5. In C’s case, the Council did continue to provide her children’s placement until the adult placement became available, six months after her 18th birthday (and six months after she should have moved). C was, it appears, fortunate that the children’s placement agreed to keep extending the deadline for her move, despite her being too old to live there. If it had not done so, then she would have had to move to a short-term placement (thus increasing her instability) or be left with nothing.
  6. Nonetheless, the Council did continue to provide her existing accommodation and support until she moved into her new property – and began receiving support from adult services – in January 2018. This means there was no gap in provision, so her injustice from the delay was not as high as it could have been.
  7. However, another purpose of planning in advance is so a young person can prepare properly for a move, and so they can have a clear picture of what their future care and support will look like.
  8. The Council’s planning meant that Dr B – and C, to the extent of her capacity to understand the process – knew what C’s assessed needs were, and knew what support she would receive. However, they did not know when she would move to new accommodation, or who the new staff and residents would be.
  9. Case notes and other documents in C’s social care file refer to her high anxiety and her need for structure and routine. The case notes record that her anxiety rose because of the proposed move to a new placement. Documents also record that the move would have to be structured so she knew when it would happen, and so she had the opportunity to visit and be introduced to staff and residents at her own pace.
  10. This did not happen. C’s moving date was delayed in July 2017, with no new date proposed until her existing placement gave notice in October. After that the moving date was changed three times. Because of this – and despite the Council starting the transition early – I do not consider that C would have been fully aware of exactly how the transition would work for her until December 2017 – five months after her 18th birthday.
  11. I consider it likely that, because of C’s needs, she would have found the transition to be stressful even if it had happened smoothly, and that her anxiety would have risen anyway. However, this anxiety could have been reduced if she had known a set date on which she would move, and if the moving date and the care provider had been arranged well in advance. This could not happen because of the delays, lack of new staff to introduce her to and changes to the moving date.
  12. As a result, I consider the Council to have caused C an injustice in the form of distress and uncertainty over an eight-month period – from when it identified the property to when it agreed a final moving date (at which point C could start being properly prepared for the move). The Council should apologise for this, and should provide a financial remedy to recognise C’s injustice.

Lack of consultation with Dr B about C’s options

  1. Dr B says the Council failed to work with her properly during the transition, and that it failed to consult her about C’s new placement or listen to her concerns.

What happened

  1. C’s case notes record that the Council met or spoke with Dr B (or her partner) about C’s transition – before her move – in September 2016, October 2016 (twice), December 2016, February 2017, March 2017, April 2017, May 2017, August 2017, October 2017 (twice), November 2017 (twice), December 2017 (three times), and January 2018.
  2. In March 2017 the Council identified a property which, in its view, would be suitable for C. On 3 April 2017 Dr B told the Council she had concerns about the property. She said there would be too many tenants, it was in a ‘deprived’ area, and it was a 27-mile round trip for her to visit, which was too far.
  3. The adult social care (ASC) assessment completed on 15 November 2017 noted that Dr B had voiced concerns about the property, and noted that it was in an unfamiliar location for C and needed some adaptations. However, the assessment said the property would meet C’s assessed, eligible needs.
  4. I can see no evidence of any other property being suggested or considered at any point after the Council identified C’s new property in March 2017.

The Care and Support and After-care (Choice of Accommodation) Regulations 2014

  1. These regulations set out the requirements on councils who are arranging for the provision of accommodation for adults with eligible needs.
  2. Regulation 2 says that, when a council is going to meet an adult’s needs by arranging for the provision of accommodation, and the adult expresses a preference for a particular accommodation, the council must arrange for the provision of that accommodation, provided certain conditions are met.
  3. Regulation 3 says the conditions which must be met are that the preferred accommodation:
    • must be of the same type as specified in the care and support plan;
    • must meet the adult’s assessed eligible needs;
    • must be available; and
    • must be provided on the council’s terms.

Care and support statutory guidance

  1. Paragraph 16.74 of the guidance requires young people and their parents to be fully involved making decisions about their care and support. This includes decisions about the most appropriate time to make the transition to adult services.

Analysis

  1. There is clear evidence that the Council held several discussions with Dr B about C’s transition before her 18th birthday, and included her in its decision-making, even if it did not agree with concerns she had. To that degree, I consider her to have been involved in the transition process up to the point that C was supposed to move properties in July 2017, and I have not found fault with the Council.
  2. After July 2017 the Council made several decisions about how C’s transition was going to take place, and the proposed date of the move changed several times. These date changes happened without Dr B’s involvement; however, the injustice was C’s, and I have analysed this issue elsewhere in this decision statement.
  3. The Council did consult Dr B about its choice of accommodation after it had identified it, and considered her concerns. However, it did not agree that Dr B’s concerns meant the property would not meet C’s needs. It explained why the property would meet C’s needs in its ASC assessment of November 2017. I do not consider the Council to have been at fault in how it assessed C’s needs, or in its consideration of Dr B’s concerns, so it was entitled to make this decision.
  4. The difficulties the Council had in finding a care provider and – at times when it looked like C would have to leave her children’s placement – in finding alternative accommodation, suggest that alternatives were limited.
  5. Nonetheless, if the Council had identified or been presented with an alternative accommodation option which was available and which met C’s needs, then it would have been under the duty to take account of Dr B’s preference, given that C does not have the capacity to make such important decisions about her own future, and she was only 17 at the time (Dr B had parental responsibility).
  6. Having reviewed relevant documents, I cannot see that such an alternative was available. As a result, I have not found fault with the Council’s decision to identify the placement and place C there, even though Dr B had concerns about it.

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Agreed actions

  1. The Council has agreed to write to Dr B and apologise to Dr B and C for the way in which C’s transition to her adult services placement was handled.
  2. The Council has agreed to make a payment of £500 to Dr B in recognition of C’s injustice. Dr B, in consultation with C, should spend this money on something of benefit to C.
  3. These actions should be completed within six weeks of the date of this decision statement.

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Final decision

  1. The Council was at fault in how it managed C’s transition from children’s to adult services. Although I have not found fault in the single accommodation choice offered, and there was no gap in provision, there were delays and changes to plans which will have added to C’s uncertainty and distress. The agreed actions remedy C’s injustice.

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Parts of the complaint that I did not investigate

  1. I did not look at the complaint about the choice of education for C. This is because the school was named on C’s education, health and care (EHC) plan in December 2017, at which point Dr B could have appealed the decision to the SEND Tribunal, which is the body that considers the content of EHC plans. It would not have been unreasonable to expect Dr B to appeal to the Tribunal if she was dissatisfied with the named school on the plan.

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Investigator's decision on behalf of the Ombudsman

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