Summary: Mr X complained the Council took too long to carry out an occupational therapy assessment for his child Y. We found delay by the Council which caused avoidable distress and frustration. The Council will apologise and make a symbolic payment to reflect the distress. It has already increased staffing levels in the relevant team and this will minimise the chance of recurrence.

The complaint

1. Mr X complained the Council took too long to carry out a focussed occupational therapy (OT) assessment for his child Y and has still not completed a full assessment. He said this caused a financial loss as he paid for a private OT report and avoidable distress because Y has sensory and behavioural needs that are not met. And the delay prevented an application for a disabled facilities grant (DFG).

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The Ombudsman’s role and powers

2. 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)
3. 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)
4. Under our information sharing agreement, we will share this decision with the Office for Standards in Education, Children’s Services and Skills (Ofsted).

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How I considered this complaint

5. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
6. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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What I found

Relevant law and guidance

7. Our Principles of Good Administrative Practice set out our expectations of councils. We expect them to be citizen focussed. This includes dealing with people promptly.
8. Disabled Facilities Grants are provided under the terms of the Housing Grants, Construction and Regeneration Act 1996. Those councils with housing authorities (district, borough and unitary councils) have a statutory duty to give grants to disabled people for certain adaptations. Before approving a grant, a council must be satisfied the work is necessary, meets the disabled person’s needs, and is reasonable and practicable.
9. DFGs are provided for adaptations the council decides are necessary and appropriate to meet the needs of the disabled person. An OT usually assesses need. Where a borough council is responsible for DFGs (as in this case), the OT may work for a county council. Borough and county councils should work together to provide a well-coordinated DFG service.
10. The Council’s website gives information about its OT service for children and about major home adaptations. It says:
• Before recommending major adaptations, the OT will rule out other options such as equipment, rearranging activities or using alternative techniques and minor adaptations.
• Private OT reports can be used and be sent to the district/borough council. The district/borough council will consult with the Council’s OT service and the latter will provide their comments on the private OT’s recommendations and say whether or not they support the private OT’s recommendations. If the private assessment does not provide the required information, the Council will contact the parent. The website makes it clear that the parent is responsible for paying for the report.

What happened

11. Y is autistic and has sensory and behavioural difficulties. He shares a bedroom with one parent and his older sibling shares a second bedroom with the other parent. Mr X wants to convert the loft into a bedroom and/or sensory room for Y.
12. The Council’s case records include the following emails/contacts between Mr X and the Council’s OT service within the Children with Disabilities Team:

Date Summary

May 2023 Mr X’s request for an OT assessment to support a DFG application for a sensory room

July Mr X’s chasing email and letter from the Council advising Y was on a waiting list. Correspondence from Mr X with supporting information.

November Link to government website with information about DFGs for Mr X

December Further waiting list letter to Mr X.

Feb 2024 Mr X sent photos of Y climbing on furniture at home. The duty OT emailed him with questions about how Y’s needs were met at school and Mr X replied with detail. The duty OT sought information about Y from his school’s OT. The latter is supportive of the request for a sensory room.

May The Council confirmed to Mr X that the wait for an OT assessment was 18 to 24 months from November 2023 (when Y was placed on the list)

September Mr X asked for an update and was told the OT service couldn’t give a timescale due to capacity and demand. Mr X said he was told Y had been added to the waiting list in November 2023. He said he intended to complain. An email from a different member of staff in the OT team said the wait for a full OT assessment was around 24 months.

September The OT service offered Y a focused duty OT assessment at home within the next four months. A manager apologised for the delay. They explained the assessment would consider options to meet Y’s needs and lower the risks highlighted at home. Mr X said a four-month wait was not acceptable and he wanted to make a complaint unless the focused assessment could take place within the next two weeks.

13. The focused OT assessment took place at the end of October. The OT noted the family’s preference for an extension/loft conversion to create an extra bedroom. The report concluded:
• A separate bedroom for Y was desirable, but not essential. The larger of the two bedrooms could be partitioned to create privacy and space or for a sensory space and to reduce the risk reported by the parents
• There was already enough space n the property to meet Y’s sensory and behavioural needs – there is room in the bedrooms, lounge or garden
• Y would benefit from more strategies to support him with behaviour and sleep at home
14. Mr X disagreed with the findings of the focused OT assessment and made a series of comments about it and then complained, using both stages of the Council’s complaint procedure. I have summarised the Council’s responses below:
• It was sorry for the delay in responding to his complaint
• The duty OT team had a high workload in July 2023 and so his referral wasn’t processed until November 2023. The duty OT explained in November that the Council OT would need to recommend a DFG in order for the application to progress
• Y was placed on the waiting list for a full OT assessment in November 2023 with a standard priority as there were not risks identified on the papers available
• In response to his photos in February 2024, the Council liaised with the school and decided to ‘increase Y’s priority’ due to safety concerns.
• There was no guidance for waiting times for social care OT assessments. Caselaw said a wait of more than 12 months is unacceptable.
• It was sorry for the delay in carrying out the focussed assessment. It was due to the 300% increase in referrals since 2020. To address this, it had introduced focused assessments.
• It had provided information about the DFG process and explained the Council did not decide on DFG funding.
• A referral for an OT assessment was not a DFG application and just because a child has an OT assessment, does not mean that the outcome will be a recommendation for major adaptations.
• It offered a symbolic payment of £50 to reflect the delay in assessing Y.
15. Since complaining to us, the district council has approved Mr X’s DFG application relying on the private OT report Mr X funded.
16. The Council told us it has recruited five more staff to work in its children’s OT team. They are due to start in August 2025.

Was there fault and if so did this cause injustice requiring a remedy?

17. Mr X requested an OT assessment in July 2023. The Council didn’t consider (’process’) his request until November because of the duty OT team’s workload. Taking five months to deal with a referral was not timely and was fault.
18. The Council completed a focussed OT assessment in October 2024. While there are no statutory timescales, taking 16 months to complete an assessment is not in line with our expectation that councils are citizen focussed and is therefore fault. It is also longer than the 12-month guideline which has been suggested in a legal case.
19. Mr X has suffered avoidable inconvenience, frustration and uncertainty. The Council has offered a payment of £50 which does not reflect the extent of his distress. The Council’s delay has caused a loss of opportunity to submit an application for a DFG.

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Agreed Action

20. The Council will within one month:
• Issue a further apology. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings
• Makes Mr X a payment of £150 to reflect the injustice set out in paragraph 18
21. The Council should provide us with evidence it has complied with the actions in the previous paragraph.
22. Mr X seeks a refund of the OT report he paid for privately. However, the Council never undertook to pay for the report and information on its website makes it clear that it will not pay for such reports. The Council had recruited additional staff since Mr X’s complaint. This will minimise the risk of recurrence.

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Decision

23. I find fault causing injustice. The Council has agreed actions to remedy injustice.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman