• The complaint
• The Ombudsman’s role and powers
• What I have and have not investigated
• How I considered this complaint
• Relevant legislation, guidance and policy
• What I found
• Action
• Final decision

The Ombudsman's final decision:

Summary: Ms D complained the Council failed to carry out an occupational therapy assessment when her son, Mr J, transferred from children’s to adult’s social care services. We have found the Council significantly delayed completing an occupational therapy assessment. This delay caused Ms D avoidable frustration, uncertainty and distress. It affected the housing priority afforded to the household, creating significant uncertainty about whether Ms D missed suitable housing opportunities. The delay also means the household will live in accommodation that poses risks to their wellbeing for longer than they otherwise would have. The Council agreed to apologise and backdate Ms D's housing priority to the point Mr J transitioned to adult care services. The Council agreed to pay a financial remedy in recognition of the avoidable distress and risk of harm caused by the delay. The Council also agreed to review the case with senior officers and write to Ms D to set out its proposal for making a direct offer of suitable accommodation.

The complaint

1. Ms D complained the Council failed to carry out an occupational therapy assessment when her son transferred to adult social care services. The Council then failed to carry out this assessment over many years, despite several requests.
2. Because of this, Ms D said the household has lived in an unsuitable environment for a prolonged period, without receiving the necessary support. Ms D’s son has not had access to essential equipment, affecting his health, development and independence. The health and independence of other members of the household has also been affected. Further, the situation has caused Ms D avoidable distress and frustration.

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The Ombudsman’s role and powers

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)
4. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
5. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
6. 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(i), as amended)

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What I have and have not investigated

7. Part of Ms D’s complaint concerns matters that occurred more than 12 months before she brought her complaint to the Ombudsman. Paragraph 4 sets out the Ombudsman’s jurisdiction to investigate late complaints.
8. I have exercised discretion to consider matters from October 2021, the point at which Mr J transitioned from children’s services to adult services. This is because the Council accepted fault in how it followed up an OT assessment as part of this transition. Because events from this period are directly relevant to injustice Ms D and Mr J experienced later, it is necessary to consider this earlier fault as part of my investigation. I have not considered any matters prior to October 2021.

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How I considered this complaint

9. I discussed the complaint with Ms D and considered information she provided.
10. I considered information the Council provided about the complaint.
11. Both Ms D and the Council were able to comment on a draft version of this decision. I considered any comments received before making a final decision.

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Relevant legislation, guidance and policy

Allocations

12. Every local housing authority must publish an allocations scheme that sets out how it prioritises applicants, and its procedures for allocating housing. All allocations must be made in strict accordance with the published scheme. (Housing Act 1996, section 166A(1) & (14))
13. The Council publishes its allocations scheme on its website. The Council’s scheme has four priority bands, with Band 1 priority affording the highest priority and Band 4 the lowest.
14. The criteria for awarding Band 1 priority includes:
    • Circumstances in which an applicant, or a household member, has severe mobility issues, is housebound and unable to leave accommodation without assistance that results in a high level of risk to themselves or their carer. There would also be an assessed need to move to more suitable accommodation.
    • Circumstances where wheelchair users cannot use their wheelchair within their current accommodation and require a wheelchair-suitable property.
    • Circumstances where the accommodation is severely affecting the applicant’s health.
15. The Council operates a choice-based lettings scheme which enables housing applicants to bid for available properties which it advertises.
16. The Ombudsman recognises that the demand for social housing far outstrips the supply of properties in many areas. The Ombudsman may not find fault with a council for failing to re-house someone, if it has prioritised applicants and allocated properties according to its published lettings scheme policy.

Transition from children’s to adult care services

17. When a child reaches 18 years of age, they are legally an adult and responsibility for meeting their needs moves from the council’s children services to its adult services. The legal basis for assessing their needs changes from the Children Act 1989 to the Care Act 2014. However, councils can decide to treat a children’s assessment as an adult assessment and can also carry out joint assessments.
18. The assessment must identify all the young person’s needs for care and support and identify the outcomes the young person wishes to achieve. The assessment should also consider whether the carer is able to continue in their caring role after the young person turns 18.
19. The guidance says professionals should work together to share information and build new relationships in advance of transition from children’s to adult services. It also says councils should have a clear understanding of their responsibilities, including funding arrangements.
20. After completing the transition assessment, the council must give an indication of which of their needs are likely to be “eligible needs” under the Care Act 2014, and which are not.
21. If transition assessment and planning is carried out as it should be there should be no gaps in the provision of care and support. However, if adult care and support is not in place when the young person turns 18, the council must continue providing the services under children’s legislation until it is in place or until it decides the young person does not have “eligible needs”.

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What I found

Key events

22. Below is a summary of the key events leading to this investigation. It is not an exhaustive chronology of every exchange between parties. Where necessary, I have expanded on some of these events in the “analysis” section of this decision statement.
23. Ms D lives with her son, referred to as Mr J in this statement. The Council’s assessments of Mr J reflect that Mr J has a profound physical disability, is a full-time wheelchair user, and requires care in all environments. Ms D and other members of the household provide day-to-day care for Mr J in the home.
24. In October 2021, Mr J transitioned from children’s social care services to adult social care services. As part of this transition, a children’s occupational therapist (OT) prepared a summary of Mr J’s circumstances. This summary noted:
    • 1. Ms D’s property was not wheelchair accessible. Due to the split-level layout of the property, Ms D carried Mr J up and down stairs multiple times throughout the day, to help him transfer around the property.
      2. The property could not be adapted to install a stairlift, or a through-floor lift, to help with transfers.
25. In November 2021, Mr J’s new social worker completed an initial assessment of Mr J and the household. This showed Mr J had several eligible health needs. It also noted that Ms D was carrying Mr J up and down stairs multiple times per day. This was a risk, given Ms D also had existing health issues. The report said Ms D had been seeking a move to more suitable accommodation for a long time.
26. Mr J’s social worker left the Council shortly after completing the assessment. In January 2022, the Council allocated Mr J’s case to a new social worker.
27. In March 2022, Ms D and the Council exchanged correspondence about Mr J’s transition to adult social care, the need for an in-person assessment, and the need for OT involvement. Mr J’s social worker said they would find out which OT service within the Council would help. Ms D expressed frustration at the delay. She asked the Council to update the summary provided by the children’s OT for accuracy.
28. In April 2022, the Council provided Ms D with an amended summary. This again confirmed the property could not be adapted and there were no adaptations in place to support Mr J’s needs. The Council records show Ms D contacted the Council by phone in April and May 2022 to follow up on arranging an OT assessment. Ms D also expressed frustration about a lack of contact from their social worker.
29. The Council’s records show it received an OT referral from Mr J’s GP. The Council’s records show it tried to contact Ms D by phone in May and June 2022 without success, though I understand Ms D disputes this.
30. The Council’s records state it contacted Ms D by phone in July 2022 to discuss the OT referral. The notes state Ms D declined to discuss the referral over the phone, as she wished to speak with an OT directly. The Council’s records say the referral was closed with no further action.
31. I understand the Council assigned Mr J’s case to a new social worker in around August 2022.
32. In October 2022, Mr J’s new social worker carried out a home visit. Afterwards, Ms D wrote to the social worker to provide details of Mr J’s equipment in the home and asked if they could follow up on the OT referral. In November 2022, Mr J’s social worker sought advice about moving the case forward. This included whether the Council could explore a move for the household, as there was a risk of Ms D or Mr J falling in the home.
33. In April 2023, I understand the Council allocated Mr J’s case to a new social worker. The reallocation notes stated that housing was a particular concern for the household.
34. Later that month, the Council said it received a referral for an OT assessment, to determine what moving and handling equipment would be suitable to support Ms D. The referral was allocated to an OT, who sought advice on whether another OT service, which dealt with complex needs, should take on Mr J’s case. This led to internal discussion about which team should lead on the referral. This uncertainty continued into July 2023, when the OT was eventually directed to close the referral until it was decided which team would lead. I have seen no evidence the Council then decided which service would lead.
35. In October 2023, Mr J’s social worker visited Ms D at home. Ms D told the social worker the OT issues had implications for Mr J’s college attendance. The social worker noted the property presented a risk due to its layout, with there being no practical way for Mr J to be supported to the front door. The social worker told Ms D they would follow up with the OT service.
36. Between November 2023 and January 2024, Ms D and the Council exchanged emails about several points of concern, including the lack of OT assessment. In December, Mr J’s social worker confirmed there was no OT team allocated to Mr J’s case. On 30 January 2024, Mr J’s social worker said they had made a new OT referral.
37. In March 2024, Ms D wrote to the Council to set out the current situation. She reiterated the risks professionals had identified in the home. She emphasised the impact on Mr J’s development and wellbeing. She also said she was unable to access her bidding account to bid for suitable properties, being restricted to two-bed properties. The Council completed a social care reassessment for Mr J, essentially noting a continuation of the same circumstances. The assessment noted the Council’s OT services had rejected past referrals, a matter that had been escalated to senior officers.
38. In April 2024, Ms D complained to the Council about the continued lack of OT assessment. The Council’s OT service contacted Ms D by phone to discuss the situation.
39. On 23 April 2024, the Council responded to Ms D’s complaint:
    • 1. The Council accepted it had not progressed Mr J’s case in a timely manner.
      2. It said previous OT referrals were declined due to the need to identify the most appropriate service.
      3. It said an OT had now contacted Ms D. The Council said it would shortly complete an assessment to explore equipment and rehousing options.
40. On 1 May 2024, an OT completed an assessment of the household. The OT’s report confirmed:
    • 1. Mr J was a full-time wheelchair user.
      2. The property could not be adapted for wheelchair use and the family carried Mr J up and down the stairs frequently, causing risks for everyone.
      3. Major adaptations that could make the property accessible were not possible.
      4. The household needed a ground-floor property, with outside space. There also needed to be sufficient space for Mr J’s supporting equipment. The report noted that much of this equipment remained in boxes due to a lack of space, meaning Mr J could not use it.
      5. The household should remain in their local area to be close to support networks and services.
41. On 19 May 2024, the OT provided a copy of their completed report to the Council’s housing services. The housing services increased Ms D’s priority from Band 2 to Band 1, with a three-bed need. This change was effective from 9 May 2024, the date of the OT’s completed report. The Council also helped Ms D resolve issues with her bidding account.
42. On 12 June 2024, the Council responded to Ms D’s stage two complaint. In sum, the Council largely reiterated its previous explanations. It said its current procedure did not meet expectations and it had made improvements. The Council offered Ms D £200 in recognition of the distress, inconvenience and frustration experienced.

Analysis

Did the Council act with fault?

43. The Council’s assessment from November 2021 showed Mr J had several eligible needs. It also found the accommodation could not be adapted and posed risks to Ms D and Mr J’s health. This firmly established a clear need for a detailed OT assessment of the property. However, the Council did not complete this OT assessment until May 2024.
44. A review of the Council’s records shows multiple reasons for this:
    • 1. Once his previous social worker left, allocating a new social worker to Mr J took time. Following this, Mr J’s allocated social worker changed frequently. This led to a loss of momentum while professionals familiarised themselves with Mr J’s circumstances and established new relationships. This often led to progress stalling, with actions being repeated or duplicated. Other matters, such as Mr J’s care and support package, were given significant attention. However, despite Ms D’s repeated requests, the impact of the property and the need for an OT assessment drifted.
      2. There were delays in allocating OT referrals, once they were made.
      3. Once allocated, referrals were frequently closed without action, or further delayed while professionals disputed or clarified ownership. The evidence available reflects a lack of collaborative work between professionals in different services, leading to a disjointed approach. Paragraphs 30 and 34 set out specific examples.
      4. The Council’s communication with Ms D throughout this period was inconsistent. This led to further repetition and delay.
45. The Council told the Ombudsman it accepted there were significant flaws in the procedures then in place. It said it accepted there had been:
    • 1. A poor understanding of referral pathways.
      2. A lack of communication between internal and external services.
      3. A lack of direction and decision-making within the OT service.
      4. Poor awareness of the impact the delay would have on Mr J and Ms D.
46. I agree with the Council’s own assessment. I have found the Council at fault for the prolonged delay in completing an OT assessment for Mr J and Ms D.

Did the Council’s faults cause an injustice?

47. The Council told the Ombudsman it accepted there had been a direct link between its failure to provide an OT assessment and a deterioration in Ms D’s wellbeing, causing avoidable frustration. It said it believed it had missed clear opportunities to address Ms D’s concerns. I recognise the Council has accepted the avoidable frustration caused, which is welcome. However, there remains significant unaddressed injustice for Ms D and Mr J.
48. The Council increased the household’s priority to Band 1, with a three-bed need, effective from the 9 May 2024. The Council told the Ombudsman this increase in priority reflected the time the household had lived in accommodation that did not meet their needs. It also accounted for the increasing risk to their health as Mr J got older.
49. I am not persuaded by the Council’s explanation. The Council increased the household’s priority on receipt of the OT’s report. The OT’s report showed the household would qualify for Band 1 priority, in line with the criteria set out in paragraph 14. It was therefore the completed OT report that led to an increase in the household’s priority.
50. On the balance of probabilities, if the Council had completed the OT assessment in 2021, as it should have, its findings would likely have been the same as they were in 2024. This is because the social care assessment completed in November 2021 identified the same concerns and risks, and Mr J’s circumstances did not change over time. I therefore find Ms D’s household would have qualified for Band 1 housing priority, with a three-bed need, when Mr J transitioned to adult services in October 2021, had the Council completed the OT assessment then. That Ms D’s household has not benefit from this priority throughout this period is an injustice.
51. I asked the Council how many properties Ms D’s household would have been eligible for, if it had awarded Band 1 priority in late 2021. The Council told me it had allocated 19 three-bedroom properties since December 2021. However, it said it was not possible to say whether any of these properties would have been suitable for Mr J’s complex needs. These properties may have had an unsuitable layout, been impossible to adapt, been in the wrong location, or been unsuitable for another reason. I note an OT’s view would also be relevant in any allocation made.
52. Given these multiple factors, I cannot say, even on the balance of probabilities, whether Ms D’s household missed a specific housing opportunity between October 2021 and May 2024. This causes significant uncertainty, which is an injustice to Ms D’s household in itself.
53. The Council told the Ombudsman it would make Ms D’s household a direct offer of suitable accommodation. It said it anticipated having access to suitable accessible properties soon and it would assess Ms D’s household’s needs against these properties when they became available.
54. I note the Council’s proposed remedy and believe it would potentially address the injustice caused. That said, the Council has yet to identify a suitable property, and it is unclear how long it will take to do so. I have recommended the Council take additional steps to address the injustice to Ms D’s household in the meantime.
55. While we cannot say Ms D’s household missed a specific housing opportunity between October 2021 and May 2024, the Council’s delays will prolong the overall time taken to find suitable alternative housing. This means Ms D and Mr J will live in accommodation that professionals have said poses a risk of harm to them both, for longer than they otherwise would. This avoidable risk of harm is an injustice to Ms D and Mr J. I have recommended the Council act to recognise this injustice.
56. The faults identified in this case could cause injustice for other individuals, if left unaddressed. The Council told the Ombudsman it has acted to improve its response to OT referrals. While there was still a demand on its service, it said it prioritised referrals by risk and identified any possible escalating need. It said it had put in place more resources to manage its waiting lists. It also said it had created a specific transitions team, with staff able to co-ordinate care pathways for young people moving into adult services. The Council said it would review Mr J’s case with staff in its social care and housing services, to identify lessons it could learn.
57. I recognise the steps the Council has already taken and those it proposes to take. I have addressed these further in my recommendations.

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Action

58. I have carefully considered the Ombudsman’s Guidance on Remedies when making the following recommendations.
59. Within four weeks of the final decision being issued, the Council has agreed to:
    • 1. Provide a written apology to Ms D and Mr J for the faults and injustice identified in this statement. The Council should have regard to the Ombudsman’s guidance on “Making an effective apology", set out in our Guidance on Remedies document.
      2. Backdate Ms D’s housing application so the Band 1 priority and three-bed need are registered from October 2021, the point that Mr J transitioned into adult services.
      3. Pay Ms D a total of £1300 in recognition of the injustice experienced. This is broken down as follows:
         1. £500 in recognition of the avoidable frustration, uncertainty and distress experienced. This would include the £200 the Council previously offered, if this has not yet been paid.
         2. £800 in recognition of the avoidable risk of harm to Ms D and Mr J, arising from the Council’s delays.
      4. Write to Ms D to set out its proposal for a direct offer of accommodation, for Ms D to consider.
      5. Review the findings of the Ombudsman’s investigation with senior officers to identify wider points of learning and improvement. The Council should provide the Ombudsman with a written summary of its conclusions and any actions it identifies.
60. The Council should provide us with evidence it has complied with the above actions.

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Final decision

61. I have completed my investigation with a finding of fault, causing injustice. I have made recommendations to remedy the injustice caused.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman

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