London Borough of Harrow (21 008 112)
Category : Children's care services > Disabled children
Decision : Upheld
Decision date : 30 Mar 2022
The Ombudsman's final decision:
Summary: Mr X complained that the Council failed to meet his family’s need for respite from the care of his disabled son and that its communication had been poor. The lack of respite has had a negative impact on the family. We find the Council is at fault and this has caused injustice. It has agreed the recommended ways to remedy this. Therefore we are closing the complaint.
The complaint
- The complainant, who I refer to as Mr X, complained that the Council failed to meet his family’s need for respite from the care of his disabled son. Specifically, he complained that:
- since 2020 the family’s assessed need for 12 days’ overnight provision and daytime provision in the school holidays/Saturdays) have not been consistently met; and
- his son’s (B’s) needs are greater than the current assessed need; and
- the Council’s communication has been poor.
- Mr X states that his family has suffered stress due to the lack of provision and he has lost confidence in the Council. He requests a fresh review of the care package, support in identifying a suitable daytime provider and compensation.
The Ombudsman’s role and powers
- 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)
- 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)
How I considered this complaint
- I spoke to Mr X and considered information provided by him and the Council. I shared my draft decision with Mr X and the Council and considered their comments before finalising my decision.
- 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.
What I found
Councils’ duties and respite care
- Local authorities have a duty to safeguard and promote the welfare of children within their area who are in need by providing services appropriate to the child's needs. (Children Act 1989, section 17). A disabled child is a child in need.
- Councils carry out assessments of the needs of the child to determine which services to provide and what action to take. If a parent carer of a child in need requests it, the local authority must assess whether the parent has support needs and, if so, what those needs are. This is known as a parent carer assessment.
- As part of their services to families, councils must offer carers of disabled children short breaks from caring to help them look after their children at home. (Children Act 1989, Schedule 2, paragraph 6)
Statutory complaints procedure
- For complaints about many areas of children’s services, there is a statutory, three-stage complaints procedure local authorities must follow. Complaints about the quality or appropriateness of a service, delay in decision-making or provision of a service, non-delivery of a service and the quantity, change or cost of a service should usually be dealt with by the statutory process.
What happened
- Mr X’s son B, who is now a teenager, is severely disabled. He is non-verbal, has disturbed sleeping patterns, is not toilet-trained and sometimes behaves in a challenging way. He is considered a child in need, which means he and his family receive support services from the Council.
- In 2018 the Council carried out an assessment of B’s needs and recommended 12 days of overnight respite. It also said B’s daytime respite provider, Provider Z, should offer fortnightly Saturday respite and a playscheme three days per week in the school holidays.
- In early 2020 the overnight respite provider, Provider D, advised Mr X that it had no availability. Mr X told me he tried to arrange an alternative but was unable to do so. He said he asked social workers to assist in finding an overnight provider, but they were also unable to help.
- Mr X contacted the Council in September 2020 to say he had been unable to book respite with Provider D. The Council contacted the provider which confirmed it had no vacancies and advised Mr X to call the provider in December to see if spaces were available. Mr X asked if days could be rolled over to 2021 if no places were available in December. The Council did not answer this question.
- In the same month Mr X contacted the Council to say the Saturday club run by Provider Z was ending for children of B’s age. He asked if the Council was providing an alternative. The Council spoke to Provider Z which confirmed B would be unable to access the service after October. The Council told Mr X that B may be able to use an outreach service on Saturdays after this date.
- In December 2020 Mr X called the Council to say Provider D still had no vacancies and that B was now unable to access Z’s Saturday club. Mr X asked for his case to be reviewed. The Council recorded that Mr X was “upset and disappointed at the lack of support”.
- The Council allocated Mr X a social worker to assist him in accessing provision. In mid-December, the Council’s records state that the social worker completed a “virtual home visit” and carried out an assessment. The social worker also contacted the overnight provider who said it was waiting to hear from Mr X with his preferred dates for the respite. However, the provider was then unable to offer any respite.
- During a conversation in January 2021, the social worker agreed with Mr X to contact the provider again with a view to arranging respite around Easter. It said the social worker suggested a carer could visit the family at home in the interim, but Mr X declined this as it would involve the family staying at home.
- The social worker’s assessment report recorded that Mrs X was finding the demands of B’s care difficult and both parents were unhappy about the lack of night-time respite. The report recommended that a suitable night-time respite package be identified and that the case be reviewed after this.
- In early February Mr X emailed the social worker for an update. He said Provider Z had advised B could not attend that week and asked what arrangements there were for B in the following week, which was half term. He complained that the Council was doing too little to help.
- The social worker contacted Mr X to say she was still waiting for a response from Provider D about the Easter respite request and that she was looking for alternatives. The social worker also contacted Provider Z who offered daytime respite on a Monday and Tuesday in half term.
- In April Mr X made a formal complaint to the Council. He complained about his inability to take up respite at Provider D and that from 2020 Provider Z had been unable to consistently accept his son. He said his wife was in “dire need” of respite. The Council re-allocated the social worker to the case. She located a new overnight provider, Provider U, in the same month which accepted B.
- Mr X asked that the 12 days’ overnight respite he had been unable to use in 2020 be rolled over for use in 2021. Alternatively, he asked that he be compensated for the missed respite provision of 2020. In May the Council’s panel denied the request.
- In the same month a paediatrician wrote a letter to B’s GP, copied to the Council. The letter stated that B’s parents were struggling to care for him as he had grown stronger and bigger. The paediatrician asked the Council to consider assessing them for additional support at home. The Council told me the letter was available to the panel.
- In July the Council reviewed B’s care needs. The report concluded B’s care needs had not changed and there had been no significant change in his carers’ capacity to meet his needs. It said the new Provider U was meeting the family’s needs and that the family was happy with the provision.
- Mr X told me he was not informed of the social worker’s assessment report or that a review had been carried out until September 2021. The records show that on sight of the report he told the social worker that he felt 12 days was inadequate and requested a further review. He said he had explained this to her during a January telephone conversation.
- Mr X also said that, while B was able to access Provider Z during the holidays, he was not getting the agreed provision as Z had stopped accessing some services. The social worker said she would clarify what support Z was offering and potentially explore alternatives.
- Mr X told me the demands his son places on the family have increased since the assessment of 2018 as he has grown older and stronger. At the same time, Mr X’s own ability and his wife’s ability to meet his son’s needs had diminished with their increasing age and ill-health. He requests a fresh review of the care package. He also told me he had lost confidence in the social worker, as he felt he had been discussing the family’s unmet needs for two years with no adequate action.
- The Council told me Mr X had not previously highlighted his age and ill-health and that it would now carry out an assessment of both parents.
Analysis
- Overnight respite: The Council has stated that the providers it commissioned to offer respite care were forced to accept reduced numbers of children during the Covid-19 pandemic. It said it contacted the provider and sought an alternative and was not at fault.
- In my view the Council should have made a concerted effort to seek an alternative provider in August as it was clear then that Provider D had no vacancies and no guarantee of provision opening up in December. There is no evidence that this was done. An alternative was not arranged until February 2021.
- Mr X provided evidence about the impact the lack of respite caused his family. This is injustice. The Council attempted to mitigate the injustice to some extent by offering temporary domiciliary care in January 2021, which Mr X declined. I have recommended the Council pays Mr X £500 for the injustice caused.
- Daytime respite: Mr X consistently complained that, while B was able to access some daytime support, his needs were not being fully met as Provider Z had stopped providing certain services. There is no evidence the Council acted on this complaint beyond a promise to investigate the promise of outreach. I have recommended the Council pays Mr X £300 for the injustice caused and for its poor communication on this issue and supports Mr X to find an alternative daytime provider.
- Assessed need: Mr X requested a review of the family’s needs in 2020. There is no evidence that the Council asked Mr X if his needs had changed during the assessment. He was not given an opportunity to comment on it until eight months later. Neither was he given an opportunity to contribute to the July review or comment on it. There is no evidence that the paediatrician’s letter was taken into account during the Council’s review. This is injustice to Mr X, whose needs were not fully taken into account. I have recommended that the Council carry out a fresh assessment/review and establish whether the current night-time and day-time respite is meeting the family’s changing needs. I have also recommended that the Council pay Mr X £500 for failing to carry out an adequate review and failing to communicate with him adequately about the assessment and review.
- Complaints handling: The Council did not use consider Mr X’s complaints through the statutory three-stage process. His complaint was not considered properly. I have recommended the Council pays £200 to remedy the injustice caused.
- I also recommend the Council apologises for the faults identified in this statement.
Agreed actions
- The Council has agreed that, within one month of my final decision, it will:
- pays Mr X in total £1,500;
- supports Mr X to find an alternative day time provider;
- carries out a fresh assessment/review and establish whether the current care package is sufficient and meets the family’s needs; and
- apologises to Mr X for the faults identified in this report.
Final decision
- I have completed my investigation with a finding of fault by the Council, causing injustice. The Council has agreed the recommended ways to remedy the injustice. I have therefore completed my investigation and am closing the complaint.
Investigator's decision on behalf of the Ombudsman