• The complaint
• The Ombudsman’s role and powers
• How I considered this complaint
• What I found
• Agreed action
• Final decision

The Ombudsman's final decision:

Summary: Mrs X complains that the Council has failed to provide an appropriate bed for her disabled son and failed to properly support her daughter. She also complains about the Council’s complaint handling and that it has failed to remove an inaccurate social care assessment from the family’s case file. The Council is at fault in that its communications over the bed were inadequate. It has also delayed in provision of the bed. This has caused injustice. It has agreed a financial remedy and an apology.

The complaint

1. The complainant, who I refer to here as Mrs X, says the Council:
   • 1. Unreasonably delayed provision of an adjustable cot bed for her disabled son. Mrs X seeks provision of the bed without further delay;
     2. Failed to adequately assess and support her daughter, including via provision of a specialist worker. Mrs X feels prompt assessment and support could have mitigated her daughter’s mental health decline;
     3. Has a judgmental attitude towards working parents, with staff making negative comments. Mrs X seeks assurance the Council will not question her employment status again; and
     4. Failed to remove an inaccurate social care assessment from the family’s case file; and
     5. Stage 2 investigators failed to contact her during their investigation despite stating they would do so. One member also made an inappropriate comment during the Stage 3 panel meeting. Mrs X says this caused her to lose trust in the process.

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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. 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)
3. 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 spoke to Mrs X and considered information provided by Mrs X and the Council. I shared my draft statement with Mrs X and considered Mrs X’s comments before finalising my decision.

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What I found

1. Mrs X and her partner have a 10-year old son, Z, who has complex physical needs. Their 12-year old daughter, Y, has autism, complex emotional needs and suffers from anxiety. Both parents work full-time.
2. In 2020 Mrs X made a series of complaints to the Council. These were investigated, but not upheld, at Stage 2. The Stage 3 panel recommended an independent person carry out further exploration of two complaints, both concerning assessment of Y. Mrs X rejected this recommendation. In March 2021 she came to us.
3. I agreed to investigate the Council’s assessment of Y from late 2019 onwards. I decided not to investigate further back than this as the complaint could have been made sooner. I also agreed, following provision of further evidence by Mrs X, to investigate the Council’s response to complaints about Z’s bed. I did not investigate the other complaints heard at Stage 3 because it is unlikely I would reach a different outcome.

Complaint 1 – failure to provide an appropriate bed to Z

1. In 2019 a specialist occupational therapist said that Z needed a new bed. In March 2020 the therapist put forward three options, including a floor bed and cot bed, detailing the pros and cons of each. She said that the cot bed was more costly than the others and therefore a case would need to be made as to why it was more suitable than the others. The therapist asked Mrs X for her thoughts and said she would be “led by you as [Z]’s parents”. Mrs X rejected the option of the floor bed on grounds that it was too unsafe for Z. Mrs X’s preferred option was a specialist cot bed.
2. The therapist said she would need to complete a risk assessment and send this to management, adding, without further explanation: “I am not sure they will agree to this sort of bed” and that the usual option would be a hospital bed “which may not be safe”.
3. After Mrs X chased for a response on the bed in July 2020, the therapist replied: “In an ideal world I would have an answer for you today on the cot bed but unfortunately things take time to be agreed… alternatively if you change your mind about trying the floorbed … let me know… This may be an option more suitable to the future (or not) – you know [Z] best after all.”
4. In the same month the therapist advised her manager that the floor bed was “the least restrictive option” and that she was concerned that if she suggested this the family would refuse. Her fellow occupational therapist advised the manager that following conversations with the first therapist he recommended a floor bed. He stated that both therapists felt the cot bed would not be in Z’s best interests.
5. In late August 2020 Mrs X received a letter from the therapist that, having taken into account Council criteria on bed provision and the perspectives of a multi-disciplinary team, the decision was to provide a floor bed as this was the least restrictive option. The letter proposed a trial of the bed and suggested the therapist visit the property as soon as possible to ensure the room was safe for Z. Mrs X refused to trial the floor bed and reiterated her feelings about its safety.
6. Mrs X complained to the council. She felt that the correct bed had been denied due to funding. In 2021, after the 3-stage complaints process had ended and following a visit from the Council which concluded Z’s room was unsafe for a floorbed, the council asked the occupational therapist for a fresh appraisal of Z’s bed options. Her appraisal was completed in June and recommended the cot bed. The Council approved the cot bed the same month.
7. In response to my enquiries the Council said it was not able to conduct a home visit earlier as Mrs X had not allowed entry prior to June 2021. Mrs X accepted that she had denied entry in August 2020 but said this was because her daughter was too unwell for visitors. She complained that the cot bed had still not been delivered.

Analysis

1. The occupational therapist’s communications with Mrs X gave a misleading impression of her professional views. She prepared a list of options with pros and cons and did not make a recommendation to Mrs X, instead giving her the impression that Mrs X would have the final decision. She continued to give this impression in further correspondence, suggesting that she was supportive of the choice of a cot bed but that cost may be an obstacle.
2. Meanwhile the therapist’s communications with her managers indicated that she felt a floor bed was most appropriate as it was the least restrictive option, but that Mrs X refused to be convinced of this. It is unsurprising, given the correspondence, that when Mrs X was informed of the Council’s final decision, she believed that it was not based on the therapist’s recommendation, but cost. She then refused to co-operate with a home visit.
3. In my view the therapist should have made a firm recommendation in March 2020 rather than suggesting to Mrs X that the decision lay with her when this was not the case. Had Mrs X been advised that a cot bed may be approved if a home visit established the floor bed was unsuitable, she is likely to have agreed to a home visit sooner. In summary I find that the Council is at fault. Its misleading communications with Mrs X lead to a significant delay in deciding on the most suitable bed. Having approved the cot bed in June 2021, it has still not been delivered. This is injustice to Z.
4. There has also been injustice to Mrs X in that she has been misled about the therapist’s views and has spent unnecessary time and trouble on the complaint. I recommend a payment of £500 to remedy the distress caused to Z and Mrs X. I also recommend that any further delay in provision of the bed be remedied at £150 per additional month of delay following my final decision.

Complaint 2 – lack of support provided to Y

1. Mrs X says the Council failed to adequately assess Y during a visit to the family home in October 2019. Complaints about the social worker were upheld but no social care assessment was then made. An offer of a specialist support worker was withdrawn. Y was hospitalised the following year and only then received a disabled child’s social care assessment. Mrs X feels that more prompt assessment and support could have mitigated her daughter’s mental health decline.
2. The Council stated that in July 2019 Y’s needs were considered in Z’s care plan. This mentioned that support to Z was allowing Y’s parents to spend time with her and that her mental well-being had improved. It said support was offered to Y in relation to her anxiety following a home visit in November 2019 and that Y’s needs were considered again in March/April 2020 when Z’s needs were reassessed. The information it had did not indicate additional social work intervention was required for B. The Council provided evidence that a social worker had suggested working with B in place of a specialist worker who was unknown to B. Miss X did not register an objection to this at the time.
3. Y was not initially accepted by NHS child and adolescent mental health services (CAMHS). Y was diagnosed with autism in early 2020 and hospitalised due to mental health in May 2020, following a period of time off school due to Covid-19. The Council’s understanding is that Y’s hospital admission was linked to anxiety about returning to school.

Analysis

1. Based on the evidence seen to date the Council is not at fault. There is no evidence to suggest that Y’s mental deterioration could have been prevented by more social care support.

Complaint 3 – a judgmental attitude to working parents

1. Mrs X told me a Council staff member had advised in a meeting in September 2020 that she had a choice of staying at home to look after Y. Mrs X felt this was indicative of a judgmental attitude to working parents.
2. The staff member concerned has told me that during the meeting concerned, options for Y’s care were discussed. As Y had indicated she did not want professionals in the home, these options included both parents working part-time or one becoming a full-time carer as well as Y entering a residential care home. The staff member recalled that Mrs X’s partner was upset by this and suggested that what the staff member had said was not legal.

Analysis

1. The Council was not at fault for presenting Mrs X with options to consider for managing Y’s care, including the option of becoming a full-time or part-time carer.

Complaint 4 – failed to remove an inaccurate social care assessment

1. Mrs X complains that a social care assessment started in 2019 has not been removed from the family’s case file. The assessment was begun in October 2019 but was halted after Mrs X made a complaint and the complaint was upheld. The Council has told me that it will correct any factual accuracies in the assessment and record any difference in opinion but will not remove the document.
2. In response to my draft decision Mrs X complained that she had not been provided with a copy of this document and asked that the Council apologises for not providing it. I suggested to Mrs X that she ask for the document via a Subject Access Request, which is a statutory procedure for obtaining personal information from public authorities. I have also suggested to the Council that it consider providing the document to Mrs X.

Analysis

1. The Council is not at fault in refusing to remove a document from the file, which provides a record of its interactions with the family. It has offered to correct any inaccuracies and record any differences of opinion Mrs X holds, which in my view was the correct course of action.

Complaint 5 – panel members failed to contact Mrs X and made an inappropriate comment.

1. Mrs X says she was told that the investigators would contact her, but they did not do so. The Stage 3 process concluded that the investigators may not have considered all of Mrs X’s concerns as they did not speak to her. It recommended the Council appoint a separate independent person to speak to Mrs X and take note of any additional information she felt should have been considered. Mrs X declined this offer as she was unhappy that the information would then be presented to the original investigators. She told me she would have been happy with two new investigators.
2. In relation to the behaviour and comment of one of the independent panel members, the Council states that this was witnessed by other panel attendees. It said the panel chair intervened immediately after the comment was made to avoid escalation. The Council said it had discussed Mrs X’s concerns with the individual involved and set out its expectations on behaviour, use of appropriate language and body language and that he accepted that the points being raised required consideration on his part.

Analysis

1. The Council offered to remedy the lack of investigator communication during the complaints process by offering a separate independent person to speak to Mrs X. She declined this offer because of the involvement of the original investigators in the process. In my view the Council’s offered remedy was an appropriate one and nothing would be achieved by further investigation.
2. The Council is not responsible for comments during a meeting by an independent person. It has taken action since to ensure the person concerned behaves more appropriately in future. There is no evidence of fault by the Council.

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Agreed action

1. That Council has agreed that within one month of my final decision it will:
   • 1. Apologise to Mrs X;
     2. Pay £500 to Mrs X to remedy distress caused to Z and Mrs X arising from the Council’s poor communications and for the delay in providing a suitable bed; and
     3. Arrange delivery of the cot bed as soon as possible, and that for every full month the delivery is delayed following my final decision, it will pay a further £150 remedy to Mrs X.

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Final decision

1. I have completed my investigation with a finding of fault by the Council which caused injustice to Z. The Council has agreed an apology and a financial remedy.

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Investigator's decision on behalf of the Ombudsman

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