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London Borough of Lambeth (17 018 419)

Category : Adult care services > Transition from childrens services

Decision : Upheld

Decision date : 04 Mar 2019

The Ombudsman's final decision:

Summary: There was fault in the way the Council provided a care plan for Ms C and the way it managed a change in carers. The Council has agreed to apologise to Ms C and her mother, Mrs B, offer Mrs B a meeting, provide a yearly care plan in line with the academic year and pay £200 for the distress caused by the fault.

The complaint

  1. Mrs B complains on behalf of her adult daughter, Ms C. She says the Council:
    • Refuses to provide Ms C with a yearly care plan and instead agrees a plan for a few weeks every time there is a holiday.
    • Changed care providers without considering Ms C’s needs.

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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. 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 have discussed the complaint with Mrs B and I have considered the documents she and the Council have sent, the relevant law and guidance and both sides’ comments on the draft decision.

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What I found

  1. The Care Act 2014 says councils have 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 and a personal budget which calculates the costs of those services.

Key events

  1. Ms C has a learning disability and physical disabilities including poor motor skills and a visual impairment. She is 20 years old and has an educational health and care plan as she continues to attend education.
  2. Ms C has been attending a residential placement for 38 weeks a year from September 2017. She lives at home with her parents and two brothers when she is not at school. She receives care and support from the Council during that time.
  3. I have focussed my investigation on Mrs B’s complaint from May 2017 until May 2018. The Council provided 8 care plans and 5 assessment or review assessments during that period.
  4. I have considered the care plans and the communications between Mrs B and the Council about the plans.
  5. Mrs B emailed the Council on 30 June 2017 asking what the plans would be for July 2017. She felt the previous plan did not set out clearly what Ms C’s eligible needs were and how they would be met. She said the Council had never explained what the costs were that it had agreed to fund. The care provider for May 2017 had to be found at short notice and there had been no forward planning. She still did not know what the plans for July were. She said she wanted annual agreement for the support. She wanted to know why this was not possible.
  6. The Council gave a reply explaining that the plan set out Ms C’s eligible needs but that some of those needs were met by the family. It apologised for some of the lack of clarity in some of the plan and agreed to change it.
  7. Mrs B emailed the Council on 12 July 2017. She said that a lot of her questions had not been answered. The Council had not explained what the indicative costs were of supporting Ms C on a monthly or annual basis. It had not explained why it could not provide a plan for a year and why, instead it made funding requests two or three weeks before the support was meant to start.
  8. The July 2017 assessment said Ms C needed support 24 hours a day, 7 days a week. There are two care plans dated 18 and 20 July 2018 which said that, when Ms C was at home, the Council would provide support from 7 until 18.30, Monday to Friday. The detail was slightly different depending on what activity Ms C wanted to do. A typical day was:
    • Two hours support with personal care and breakfast in the morning.
    • One hour support for travel to Centre K in the morning. Centre K supported young people with learning disabilities.
    • Three and a half hours support in the evening to escort Ms C back home in the evening and stay with her until her parents got home.
  9. If centre K was not open, Ms C would be supported by a carer all day and had a choice of leisure activities. The personal budget was £528 or £743 a week.
  10. Mrs B emailed the Council on 9 October 2017 asking for confirmation that the support had been put in place for the half term which started on 20 October 2017. She continued to email in the following days. She emailed again on 16 October 2017 and said she was concerned that it was only four days away and Ms C still did not know who would be picking her up on 20 October 2017. The support was then confirmed later that day.
  11. There are two plans for October 2017. Both plans said Ms C would be supported from 7 until 18.45 with similar arrangements as the July 2017 plans. The personal budget was £161 a week in the first plan and was not calculated in the second plan.
  12. Mrs B emailed the council on 8 November 2017 asking whether the Council had organised support for the half term holiday in February 2018. She received a reply that the social worker had left and a new social worker had to be allocated.
  13. Mrs B emailed the Council again on 23 November 2017. She was concerned that a new social worker had not started yet. She said the Council had still not provided a long-term care plan for Ms C but gave her piecemeal amendments each time she needed support when she was at home. She was worried that neither agency K nor agency L had been contacted to provide support for February.
  14. The manager contacted Mrs B on the same day. He said that the reason why the yearly support plan could not be agreed was that the funding panel needed various actions such as a mental capacity assessment to be followed up.
  15. The January 2018 plan said Ms C would be supported from 7 until 18.45. The arrangement was similar to the previous plans. The personal budget said the weekly cost was £3,020.
  16. The May 2018 plan said Ms C would be supported from 7.45 until 18.45. As there were no planned activities, the Council put in support of 11 hours a day to support Ms C in a range of leisure activities. The personal budget said the weekly cost was £3,743.
  17. I made enquiries to the Council as part of this investigation.
  18. The Council acknowledged that the weekly figures in the personal budgets were sometimes not accurate. It said the form added up the cost automatically. Therefore, the figure was a sum of all the costs for the period that the care plan covered rather than the weekly cost. It said it was aware of the error and was amending its assessments and care plans to resolve the issue.

The Council provided a care plan in December 2018 which sets out the care and support and the personal budget until August 2019.

Analysis

  1. Mrs B wanted a care plan that set out how the Council would meet Ms C’s needs over the year. She pointed out that Ms C’s learning disability and her personality meant that she needed stability and predictability in her care. She said the Council was not providing this and this was unfair on Ms C and the whole family who were unable to plan their time when Ms C was at home.
  2. The Council said the reason it did this was to ensure that Ms C’s wishes were heard.
  3. Ms C’s main objection was the lateness of the planning and this was partly caused by the fact that the Council had to seek approval from its funding panel for each individual plan for each holiday just before the holiday.
  4. The Council should have provided Ms C with a long-term care plan from May 2017 to May 2018 and its failure to do so was fault. The Council knew the dates of the residential placement, the weeks when Ms C was at home and how many hours support she needed every day. The Council knew that Centre K was open for 6 weeks a year and this could be incorporated into the plan.
  5. I appreciate that the plan may not have all the detail but the information the Council had was sufficient to plan for the year and to obtain budget approval from its funding panel for the year. The Council could then make more specific arrangements further in advance as much as possible as it would not have to approach its funding panel each time.
  6. Ms C and the family have suffered an injustice as a result of the fault. Ms C had the uncertainty of not knowing what her plan for the weeks at home was and this was distressing for her, particularly as her disability means she needed stability and predictability. The fault has also impacted on her family who were unable to plan ahead.
  7. I note the Council has provided a longer-term care plan and personal budget in December 2018.
  8. Mrs B also complained about the change in carers. She said care agency L met Ms C’s needs better as it had a limited pool of carers who Ms C was familiar with. The Council introduced agency M without giving the family a chance to respond. Ms C did not know the carers who would be supporting her and this was difficult for her in light of her disability.
  9. The Council said it chose agency M because it was too late in contacting agency L and because agency M was cheaper. It said agency M could meet Ms C’s needs.
  10. I accept that the Council can take financial constraints into consideration when making a decision. Therefore, I agree that it can use a different agency if it is cheaper and meets the needs of the person. However, the Council should have considered the impact this would have on Ms C and should have asked for her views. It should have considered the way the move to a different agency was managed. The Council failed to do this. Ms C had not met her new carers and did not know who they were until she met them. This was distressing for Ms C, as her disability meant that it was difficult for her to manage change.

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Agreed action

  1. The Council has agreed to take the following actions within two months:
    • It will apologise to Mrs B and Ms C for the fault.
    • Offer a meeting to Mrs B to discuss the care plan and any outstanding complaints.
    • The Council is working with agency M to limit the number of carers who provide care and support to Ms C. There is an agreement in place that Ms C is provided with their names and photos prior to providing care. The Council will continue to monitor and review this.
    • It will pay Mrs B and Ms C £200 for the distress caused by the fault.
  2. The Council has provided a care plan and personal budget from December 2018 to August 2019. It will provide a yearly care plan and personal budget from September 2019 to August 2020 to fit in with the academic year.

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Final 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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