Summary: Mrs X complained the Council conducted a biased investigation into allegations made by a hospital regarding her son, Y’s, safety and wellbeing. She says this resulted in the Council enforcing a child protection plan which was unnecessary and caused her family distress and emotional upset. There was fault when the Council delayed completing the initial assessment within the required timescales. This caused a delay implementing a child protection plan for Y. The Council has agreed to remedy this by reminding its staff of the statutory timescales for completing assessments following safeguarding referrals.

The complaint

1. Mrs X complained the Council investigated allegations made by a hospital in a biased manner.
2. She also complained the Council enforced a child protection plan which was unnecessary.
3. She said this has caused her family distress and emotional upset.

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The Ombudsman’s role and powers

4. 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)
5. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
6. 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)
7. 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

8. I contacted Mrs X and discussed her view of the complaint.
9. I made enquiries and considered the Council’s submission, which included correspondence shared between Mrs X and the Council, the child and family assessment, the section 47 enquiry, child protection conference minutes and Y’s child protection plan.
10. I wrote to Mrs X and the Council with my draft decision and gave both the opportunity to comment before I made my final decision.

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What I found

Law and statutory guidance

11. The Children Act 1989 requires local authorities to investigate if there is reasonable cause to suspect a child in their area is suffering or likely to suffer significant harm. They must decide whether to take action to safeguard or promote the child’s welfare.
12. Anyone with concerns for a child’s welfare should make a referral to the local authority children’s social care.
13. When a council receives a referral about a child who may be at risk, it should make initial enquiries of agencies involved with the child and family and assesses the information. The Council has 45 working days to complete this assessment. An assessment might decide no further action is required, that the child is in need or the child needs protection.
14. Where the initial assessment shows a child is suffering or is likely to suffer significant harm, the council should hold a strategy discussion or meeting. The Council may decide to carry out enquiries in line with section 47 of the Children Act 1989.
15. “Working together to safeguard children 2018," says the assessment should be child-centered, focusing on the action and outcomes for children and hearing their voice, where appropriate. It should involve the family and identify strengths and protective factors as well as risks to the safety and welfare of the children.

Social workers have a statutory duty to lead assessments and carry out enquiries in a way which minimises distress for the child and family. The social worker may interview the child’s parents and gather information about the child and their family history to determine the level of risk the child is likely to face if they remain in their environment.

16. If the information gathered substantiates the concerns raised for the child’s safety, the social worker must arrange a child protection conference within 15 working days of the strategy meeting.
17. A child protection conference decides what action is needed to safeguard the child. This may include recommending that the child should be subject to a Child Protection Plan. A Child Protection Plan is a plan drawn up by the Council. It sets out how the child can be kept safe and what support they will need.
18. The parents of the child should be told the reason for the plan and what they can do to ensure the child is kept protected.
19. Regular reviews of the plan are needed to see whether the plan is meeting the expected outcome and minimising risk to the child.

Background

20. Mrs X’s son, Y, is of secondary school age. He was born with an ongoing serious health condition. He receives most of his treatment at hospital A and specialist treatment at hospital B, when necessary.
21. Mrs X and her family became known to the Council in 2012 when Y was admitted to hospital B with an infection. The Council received a referral from the hospital after records indicated Mrs X had been physical with Y. The Council completed an assessment, decided Y was not at risk and no further action was taken.

What happened

22. After a long period of stability, Y became ill in mid-2018 and was admitted to several hospitals including hospitals A and B, with health issues related to his condition. Mrs X has explained she took Y to different hospitals because she did not agree Y was fit to be discharged and felt he required further treatment.
23. On 14 May 2018, the Council received a safeguarding referral from one of the hospitals Y visited. The referral said Mrs X was demanding in her interactions with hospital staff, and was observed using emotive language in front of Y. Hospital B also contacted the Council to advise Mrs X was verbally and physically aggressive towards staff and told Y to drink less fluid so he would receive IV fluids. Mrs X disputes this and says she has only ever asked for treatment Y needed. She also says she bought Y several bottles of water and energy drinks when he was at the hospital.
24. The Council then received a referral from Mrs X, when she contacted it and said a doctor from hospital B had assaulted Y and forced him to walk around when he was not physically fit to do so. She said each of the hospitals she had taken Y to had discharged him when he was still ill.
25. The Council decided to start an initial assessment on 17 May 2018.
26. In early June 2018, Mrs X took Y to another hospital after he became unwell. Whilst she was there, she had a disagreement with the medical professionals who saw Y and would not agree for him to be discharged despite the medical team advising that he was medically fit.
27. In August and September 2018 the social worker carried out visits to Y and Mrs X. Mrs X explained she felt the hospitals were not listening to her and it was her parental right to take Y to a different hospital if she felt this was necessary. Mrs X also revealed she had stopped taking Y to certain medical appointments against medical advice because she did not agree with the treatment Y was receiving. Y was resistant to talking with the social worker and would not engage with her.
28. Following this, the Council received two more referrals from hospitals reporting there had been a significant deterioration in the relationship between Mrs X and the medical professionals who were treating Y. Medical professionals also expressed concerns regarding Mrs X’s behaviour and Y’s wellbeing.
29. On 17 September 2018, the Council held a strategy meeting and decided to begin section 47 enquiries. A Council social worker spoke with teachers at Y’s school and medical professionals who had treated Y during the investigation. After receiving referrals from two health professionals who were concerned for Y’s health, the Council began a section 47 enquiry in 17 September 2018. A Council social worker spoke with teachers at Y’s school and medical professionals who had treated Y during the investigation.
30. The social worker completed the assessment on 18 October 2018.
    The investigation concluded Y was not at immediate risk from Mrs X; however, medical professionals said they were concerned Y did not have a medical team to oversee his treatment and some of Mrs X’s actions had prevented Y from receiving the treatment he needed. They also expressed concern Mrs X had asked for pain relief and would not allow Y to be discharged from hospital when there was no evidence Y was in pain, causing him to spend longer in hospital than necessary. They said Mrs X sometimes used language in front of Y which was negatively impacting him.
31. The social worker wrote in the assessment that she had struggled to discuss the matter with Mrs X because she was resistant to the medical team’s advice on how to manage Y’s health. The investigation concluded Y was vulnerable and a child protection conference should be held to create a safeguarding plan for him.
32. The child protection conference was held on 22 October 2018. Mrs X, Y’s teacher and medical professionals were in attendance. Mrs X expressed her unhappiness with the way she had been characterised in the assessment and maintained she had taken Y to different hospitals because he was not being treated properly.
    The conference reviewed the social worker’s report and admissions from Y’s school and his health records.
33. The social worker reported that Mrs X was meeting Y’s basic needs and there was evidence of emotional warmth between them. However, both the social worker and Y’s teachers felt there was an issue with Y feeling unable to open up to adults. A medical professional also expressed concern that Mrs X was using language in front of Y which was influencing how he felt about his condition.
34. It was agreed at the conference that Y should be made subject to a child protection plan under the category of “neglect,” because he did not have a primary care team in charge of monitoring his health. It was felt a child protection plan was also needed due to the large number of referrals received from the hospitals. The Council felt Mrs X did not understand the impact her behaviour had on Y and was not willing to co-operate with medical professionals.
35. The conference concluded Y should have a designated primary care team, he should be protected from exposure to adult conversations and a social worker should meet with Y to discuss his wishes and feelings around his treatment.
36. Y’s child protection plan was finalised shortly after the conference and required Mrs X to ensure she did not discuss Y’s health in front of him. It required her to attend an appointment at hospital B and allow a social worker to visit her home to talk to Y. Mrs X was also required to attend core group meetings with the Council every six weeks to discuss Y’s progress.
37. The Council held a further child protection conference in January 2019. Mrs X said she was unhappy with the Council’s involvement with her family life.
    The conference concluded Y’s conversations with the social worker indicated he was still being exposed to adult conversations which were making him resistant to expressing his true views. The Council was also concerned Y still did not have a specific care team at a designated hospital. A further review was scheduled for June 2019 to observe Y’s progress.
38. In June 2019, the child protection conference heard from Y’s social worker and a medical professional. The conference heard that Mrs X had been co-operative with the Council, had shielded Y from adult conversations and taken Y to all necessary medical appointments. It was also noted that Y clearly expressed he did not feel the Council’s involvement with his family was necessary. The Council decided to end Y’s child protection plan as Y was progressing well and no longer deemed to be at risk.
39. Mrs X complained to the Council shortly after the conference. She said the Council should not have begun the investigation because the hospital had made false allegations.
40. The Council responded to Mrs X in July 2019 and advised it could not investigate her complaint because her issue was with the hospital’s conduct. The Council explained it had a duty to investigate cases where children were thought to be in danger.
41. Mrs X persisted in asking the Council to investigate her complaint. The Council logged her complaint at Stage 1 of its complaints process and responded in November 2019.
42. The Council maintained its decision to enforce Y’s child protection plan and told Mrs X it acted in line with the law. The Council invited Mrs X to escalate her complaint to Stage 2 if she was not happy with its response.
43. Mrs X told the Council it had not understood her complaint. She wanted the Council to confirm which evidence it used to instigate the child protection plan and said the Council failed to properly communicate with her. She was also unhappy the Council failed to inform her the case was closed in June 2019.
    The Council apologised for this.
44. The Council wrote to Mrs X at Stage 2 of its complaints process in January 2020. The Council apologised for the delay in responding to Mrs X’s complaint and again advised Mrs X that a large part of her complaint related to the hospital’s conduct, which it could not comment on.
45. The Council explained it made Y subject to a child protection plan because he had been admitted to hospital several times within a short period and Mrs X had withdrawn him from two hospitals against medical advice. The Council referred to the Children Act 1989 in support of its decision. The Council confirmed the hospital was concerned Y was not being monitored by a medical health professional. The Council also said the hospital reported Mrs X had been verbally and physically abusive towards staff. The Council referenced the meetings Mrs X had attended as well as the calls and emails she had received from the Council. The Council was satisfied it had kept her informed on the case’s progress and did not uphold her complaint.
46. Mrs X was not satisfied with the Council’s response and continued to contact it regarding the case and the child protection conference. She said most of the panel members agreed to close the case, so she did not understand why the Council was pursuing the investigation. The Council repeated its previous comments.
47. Mrs X referred her complaint to the Ombudsman because she remained unhappy. She has also raised a complaint to the NHS regarding the hospital’s conduct.

Findings

The Council’s investigation into safeguarding concerns

48. Mrs X complains the Council conducted a biased investigation into the safeguarding concerns raised by several hospitals.
49. The law requires the Council to investigate referrals which indicate a child in its area is suffering or likely to suffer significant harm. Y had not visited hospital for several years before attending multiple hospitals in a short period of time. The hospitals reported that Mrs X was demonstrating challenging behaviour and disregarding medical advice. The Council had a responsibility to take this seriously considering Y’s history. The Council carried out an initial assessment and then a section 47 enquiry after receiving information from a range of medical professionals indicating Y was at risk for several reasons. It also took Mrs X’s views on board and incorporated them into the reports. The evidence shows the Council carried out a balanced investigation which is in line with legal requirements. There is no evidence of bias on the Council’s part.
50. Mrs X disagrees with the Council’s decision to make Y subject to a child protection plan. The Council based its decision on information it collated from the social worker and her interactions with Y. It put actions in place and kept the plan in place when it did not appear those actions had been carried out or completed. At the child protection conference in June 2019, the Council heard from Mrs X and the social worker and was satisfied Y was no longer at risk and ended the plan. The evidence shows the Council followed the correct process. It is not the Ombudsman’s role to question the merits of a decision which was correctly made.

Timescales to complete the initial assessment

51. The law says councils must complete an initial assessment in 45 days. The Council took 154 days. This is a considerable delay and is fault.
52. We would expect the Council to act in a timely manner to address any safeguarding issues it becomes aware of. The evidence indicates the Council delayed completing the initial assessment which in turn delayed Y being made subject to a child protection plan. The fact Y required a child protection plan indicates he was a vulnerable child in need of support and oversight from the Council. The Council’s delays meant this was not put in place in a timely manner which put Y at unnecessary risk of harm. The Council should make service improvements to prevent this from happening again in the future.

Council’s handling of Mrs X’s complaint

53. When Mrs X raised her complaint to the Council, it initially said it would not investigate, stating that the complaint was outside its remit. Whilst most of Mrs X’s complaint relates to actions carried out by the hospital, Mrs X was also complaining about the Council’s decision to launch the investigation. The Council did not address this until Mrs X pressed the Council for a fuller response. There was therefore some delay in the Council addressing Mrs X’s complaint. The Council has acknowledged and apologised for this. However, the Council clearly explained why it began safeguarding proceedings and cited the correct legislation governing its actions. I am therefore satisfied Mrs X understood the Council’s rationale, even if she was not in agreement. The Council’s apology is sufficient to remedy any injustice it caused Mrs X.

Agreed Action

54. Within one month of the date of my decision, the Council has agreed to remind relevant staff of the statutory timescales for completing assessments following a safeguarding alert.
55. The Council will provide the Ombudsman with evidence it has completed this recommendation.

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Final decision

56. There was fault in the Council’s actions. I have made a recommendation to remedy this and the Council has agreed. I have therefore completed my investigation.

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Investigator's decision on behalf of the Ombudsman