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London Borough of Waltham Forest (19 011 284)

Category : Adult care services > Transition from childrens services

Decision : Upheld

Decision date : 05 Nov 2020

The Ombudsman's final decision:

Summary: Miss X complained the Council failed to plan for her son, Mr F’s transition from children to adult care services. The Council was at fault. It failed to forward plan for Mr F’s transition to adult care services in line with statutory guidance. It meant Mr F missed out on a whole year of respite care and short break hours which were an assessed need. The Council agreed to pay Miss X a total of £1350 to remedy the significant distress, uncertainty and time and trouble this caused her and Mr F. It also agreed carry out a review of its procedures to prevent recurrence of the faults identified.

The complaint

  1. Miss X complains the Council failed to plan for her son, Mr F’s, transition from children to adult care services. Miss X says this led to Mr F missing a whole year of respite services, despite it being an assessed need. Miss X the failing caused her significant distress, stress uncertainty and time and trouble.

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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)
  3. Under the information sharing agreement between the Local Government and Social Care Ombudsman and the Office for Standards in Education, Children’s Services and Skills (Ofsted), we will share this decision with Ofsted.

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How I considered this complaint

  1. I spoke to Miss X about her complaint.
  2. I considered the Council’s response to my enquiry letter.
  3. I considered the Care and support statutory guidance.
  4. Miss X and the Council had an opportunity to comment on my draft decision. I considered comments before I made a final decision.

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What I found

Moving from children’s social care to adult social care

  1. Until the age of 18, services for children and young people with long term health conditions are provided by child health and social care services. From the age of 18 they are usually provided by adult services. Between the ages of 16 and 18, the child will start a transition to adult services. For children with an education, health and care plan, transition planning should begin when a child is in year 9 at school.

Transition assessments

  1. A transition assessment must be conducted for all those who have likely needs, however the timing of this assessment will depend on when it is of significant benefit to the young person or carer. When a child or young person approaches their 18th birthday, they may ask the Council for a transition assessment. A parent or carer may also ask for an assessment on behalf of the child or young person. The Council has a duty to carry out this assessment.
  2. The transition assessment should support the young person and their family to plan for the future by providing them with information about what they can expect. All transition assessments must include an assessment of:
    • Current needs for care and support;
    • Whether the child or young person is likely to have needs for care and support after they turn 18;
    • If so, what those needs are likely to be and which are likely to be eligible needs.
    • The outcomes the young person or carer wishes to achieve in day-to-day life.
  3. Statutory guidance says transition and planning should be carried out so there is no gap in provision or care and support.

What happened

  1. Miss X has a son, Mr F, who has autism and other learning disabilities. Mr F has an Education, Health and Care (EHC) Plan and received care and support from the Council’s children’s services. This included 52 nights respite care and 100 short break hours each year.
  2. Mr F was due to turn 18 in February 2018 and transition to the Council’s adult care services. Records show the Council highlighted this fact in July 2017 and discussed in December 2017 carrying out a Care Act needs assessment of Mr F’s needs.
  3. Miss X contacted the Council in January 2018. She was concerned that that the process to transition Mr F to adult services had not started. Miss X was concerned there was no adult respite in place for Mr F as the current arrangements were for children only.
  4. The Council carried out Mr F’s needs assessment at the end of March 2018, over a month after he turned 18. The Council identified Mr F’s care and support needs which included a continued package of overnight respite. The Council took Mr F’s case to its Preparing for Adulthood Panel to identify appropriate support services for Mr F. The panel referred the matter to the Council’s Community Learning Disability Team. Records show the Council submitted Mr F’s proposed package to its funding panel in July 2017.
  5. Miss X contacted the Council twice in August 2018 asking it for an update on whether funding was agreed. Miss X said she had had no respite in place for Mr F for 6 months which was causing both her and Mr F distress. The Council apologised for the delay and said it would update her as soon as possible.
  6. Miss X contacted the Council again in September 2018 to escalate the matter. Miss X reinforced that Mr F had turned 18 in February and he was still without an appropriate post 18 care package.
  7. Records show the Council got back to Miss X at the end of September 2018 and confirmed Mr F’s package of care. The agreed package included 26 overnight respites and 100 short break hours. Miss X asked the Council when the overnight respite care was likely to start. Records show the Council asked its brokerage service to look for an appropriate respite placement for Mr F.
  8. Miss X chose Mr F’s overnight respite placement in November 2018, however by the end of December the Council had still not arranged the appropriate funding for Mr F to begin using it. Miss X wrote to the Council to explain how this was impacting on her. She told the Council she was exhausted without the respite breaks. Miss X formally complained to the Council about the matter.
  9. The Council responded to Miss X at stage 1 in February 2019. It apologised for the delay in arranging Mr F’s package of care. It said there were delays in referring Mr F’s case to panel following his needs assessment. It then said there were further delays in arranging assessments following the identification of the respite placement. The Council said it had changed its process to ensure it reviewed care packages for young people in a timely manner to ensure they were agreed before they left education.
  10. Mr F’s overnight respite began in March 2019.
  11. Miss X complained to the Ombudsman about the matter in October 2019. Miss X said she had escalated her complaint to stage 2 but had no response. The Council said it had no record of receiving Miss X’s stage 2 request. We asked the Council to respond to Miss X at stage 2.
  12. The Council contacted Miss X with its final response and offered her £600 to compensate her for the delay and time and trouble she had experienced during this matter. It apologised again for the delay in arranging Mr F’s package of respite care. It said it would backdate 21 nights respite which Mr F missed during 2018 and carry them over to use before the end of March 2021. The Council said there was no evidence she incurred any financial loss or had to pay for Mr F’s respite herself; therefore it considered its offer was appropriate.
  13. Miss X remained unhappy with the Council’s final response and us to consider the matter.

My findings

  1. The Council did not start planning for Mr F’s transition to adult services until just before his 18th birthday and it did not carry out an assessment of his needs until after he had turned 18. That is not in line with statutory guidance and is fault.
  2. Mr F has an EHC Plan, therefore the Council should have started planning for Mr F’s transition when he was in year 9. It did not and that was fault.
  3. The guidance says the transition to adult services should be carried out so there is no gap in provision or care and support. The Council’s failure to plan for Mr F’s transition to adult services in line with statutory guidance meant there was a significant gap in his provision, specifically his respite entitlement. The Council experienced delays in referrals, decisions about funding and then arranging the placement once the package of respite was agreed. Had the Council started the transition process in line with statutory guidance, it is likely Mr F’s would have moved to adult services with a package of care already in place.
  4. Mr F was without appropriate respite for a whole year. He also missed out on 100 hours of short breaks which he was entitled to. The identified faults however also caused Miss X significant distress, uncertainty and the time and trouble chasing the matter and complaining to us. This injustice would not have arisen had the Council planned for Mr F’s transition in line with statutory guidance.
  5. The Council has accepted fault in this matter and has offered Miss X a remedy. Its offer to backdate 21 missed nights of respite and carry those forward to use before March 2021 is appropriate. However, the Council should consider extending this time limit if Mr F was unable to use them because due to matters related to Covid-19. The Council also offered Miss X a payment of £600. However, in my view this does not adequately remedy the significant injustice this caused Miss X for the period Mr F was without the respite he was entitled to.

Agreed action

  1. Within one month of the final decision the Council agreed to:
    • pay Miss X £1200 to acknowledge the impact on her mental and physical health and the significant distress and uncertainty she was caused by the lack of respite and short breaks in place for Mr F between March 2018 and March 2019. The payment also recognises the impact the lack of consistent overnight respite had on Mr F during that period.
    • pay Miss X £150 to acknowledge the time and trouble caused by needing to chase the matter with the Council during 2018 and for needing to complain to us.
    • reiterate its offer to backdate 21 missed nights of respite for Mr F to use before March 2021. If Mr F is unable to use any of these because of Covid-19 it should carry them over to use as soon as practically possible.
  2. Within three months of the final decision the Council agreed to carry out a review of its child to adult care services policy to ensure it complies with statutory guidance to prevent recurrence of the faults identified in this matter.

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Final decision

  1. I have completed my investigation. I have found fault and the Council agreed to my recommendations to remedy the injustice caused by those faults.

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Investigator's decision on behalf of the Ombudsman

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