Summary: Mrs X complained about how the Council dealt with her request for support to help her care for her child following an operation. We do not find the Council was at fault in the ways Mrs X alleges, but there are flaws in its process for carrying out parent carer assessments. The Council has agreed to review the process.

The complaint

1. Mrs X complained that the Council failed to deal properly with her request for support to care for her child following his operation. She says the Council:
1. cancelled the assessment of need when the surgery was postponed;
2. refused to carry out an assessment after the surgery took place;
3. failed to provide the help she needed when her child returned home from hospital, including failing to provide direct payments at the level needed or help with carers; and
4. closed the case prematurely so she had to ask several times for it to be re-opened.
2. As a result she says she did not get the amount of help she needed at the time she needed it, causing distress and difficulties for the family in providing care for her children.

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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 cannot question whether an organisation’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, sections 26(1), 26A(1) and 34(3), as amended)
4. 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. 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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How I considered this complaint

6. I discussed the complaint with Mrs X and considered the information she provided. I considered the information the Council provided in response to my enquiries. I considered relevant law, policy and guidance. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Support for children in need

7. 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. A disabled child is a child in need. (Children Act 1989 section 17.)
8. Local authorities undertake assessments of the needs of the child to determine which services to provide and what action to take. Statutory guidance ‘Working Together to Safeguard Children’ (‘Working Together’) outlines an assessment framework for councils to use. Assessments should look at:
• the child’s developmental needs, including their health and educational needs and their family and social relationships;
• the parents’ or carers’ parenting capacity; and
• family and environmental circumstances such as family history, income, housing, social networks and access to community support.
9. The expectation of ‘Working Together’ is that an assessment which identifies significant needs will generally lead to the provision of services, but it not the case that there is a duty to meet every assessed need.

Support for parent carers

10. Councils must provide a range of services aimed at helping family carers of disabled children to provide care by giving them breaks from caring. These services must include a range of daytime care, overnight care and leisure activities. This range of services must be set out in a ‘short breaks statement’ and include details of any eligibility criteria. (Children Act 1989, Schedule 2 paragraph 96, and Breaks for Carers of Disabled Children Regulations 2011)
11. The Council’s short breaks service is called ‘Aiming High’. It offers short breaks for children and young people with special educational needs and disabilities to spend time away from their families and give their family carers a break. It may take the form of daytime, weekend or holiday activities or funding through direct payments to attend these activities.
12. If a local authority considers that a parent carer of a disabled child may have support needs, the local authority must assess whether the parent has support needs and, if so, what those needs are. The council must also carry out an assessment if the parent carer asks for one. This is known as a parent carer assessment. The local authority may combine the assessment with an assessment of the needs of the disabled child. The assessment must consider:
• whether the parent carer has needs for support in relation to the care which he or she provides or intends to provide;
• whether the disabled child cared for has needs for support;
• whether those needs could be satisfied (wholly or partly) by services which the authority may provide under section 17; and
• whether or not to provide those services. (Children Act 1989 section 17ZA)
13. The information the Council provides for the public on parent carer’s assessments says they will consider issues arising because of the parent’s caring role such as:
• any difficulties providing the care and the effect on the carer’s physical health or mental wellbeing;
• difficulties they may have doing things with their other children;
• barriers in accessing education or employment.
14. If the assessment finds there is a need for support, the Council may provide services or direct payments so the parent carer can pay for support themselves. Services offered may include access to Aiming High short breaks.
15. Carers of adults with care and support needs are also entitled to a carer’s assessment under the Care Act 2014 where it appears to the council that the carer has a need for support. When assessing the needs of the adult receiving the care councils must consider whether their needs mean they are unable to achieve certain outcomes set out in law.

Statutory children’s social care complaints process

16. The law sets out a three-stage procedure for councils to follow when looking at complaints about children’s social care services. At stage 2 of the procedure, councils appoint an independent investigator and an independent person who is responsible for overseeing the investigation. If a complainant is unhappy with the outcome of the stage 2 investigation, they can ask for a stage 3 review by an independent Review Panel.

What happened

Background

17. Mr and Mrs X have two children with special educational needs and disabilities, Child A and Child B. Both children have been diagnosed as autistic. Child A has physical disabilities which required surgery. The family receive support through Aiming High activities for the children and an Aiming High Short Breaks Scheme grant of £1,000 per child to enable Mrs X to have some respite from her caring responsibilities. The family use these funds to employ Personal Assistants (PA’s) to support the children and take them out on activities.
18. The Council started a Child and Family Assessment at the end of July 2019 following a recommendation by a Special Educational Needs and Disabilities Tribunal. The assessment concluded that the parents were meeting all the children’s needs and there were no safeguarding concerns identified. Mr and Mrs X declined an offer of Early Help support. In early October the Council closed the case after sharing the outcome of the assessment with Mr and Mrs X.
19. In February 2020 the Council completed a carer’s assessment of Mrs X. The conclusion was that Mrs X’s caring responsibilities were not greater than would normally be expected for a parent with children of Child A and B’s ages, and the family had access to Aiming High activities and short breaks funding. The Council closed the case after discussing the outcome of the carer’s assessment with Mr and Mrs X. The Council says they agreed with the decision.

Events from October 2020

20. In October 2020 Mrs X contacted the social worker who had carried out the assessment earlier in the year. She asked whether the family could receive any extra support as Child A was due to have an operation the following week. Mrs X explained that her son would be immobile for at least six weeks after the operation as he would be in a cast. The hospital would provide a hoist and other equipment, but the hoist needed two people to operate. Mrs X said she would need a carer for when Mr X went back to work after two weeks’ leave. The Council decided it needed more information from the health bodies involved about what help the family would need. Mrs X confirmed she would like a formal referral made to children’s social care. The Council sought medical advice and advice from the Occupational Therapy (OT) service.
21. The operation was cancelled on the day it was due to take place. Mrs X told the Council and said the operation was likely to be rescheduled in the next 28 days.
22. Towards the end of October Mrs X gave the Council the date in November when the surgery was due to take place. The Council was still trying to obtain advice from health bodies. When Mrs X asked about progress with the assessment, the social worker told her as the operation was cancelled the Council had not made the referral for the assessment. She said it was still waiting for health advice. The Council advised Mrs X there would be a hospital discharge planning meeting and in the meantime she should consider her own support network.
23. There was further correspondence between Mrs X and the social worker as Mrs X tried to clarify what support the Council would provide. She also objected to the referral being cancelled. She said the process should start now and not wait for advice from health as she had already explained what equipment would be provided. She said she had no network of family or friends who could help. The Council maintained it would be difficult to assess needs without input from health about Child A’s needs following the operation. However it asked Mrs X if she wanted the child in need assessment to start now and if she wanted a carer’s assessment.
24. Mrs X confirmed she would like these assessments and gave the revised date for the operation towards the end of November. The Council decided that as a child with disabilities Child A met the threshold for a child in need assessment. It allocated a social worker who contacted Mrs X. The record of the assessment notes it started on 19 November, a few days before the operation.
25. Following Child A’s operation the Council learned the hospital had not held a discharge planning meeting or made a referral to the community OT team. It contacted the OT service who said it would provide a hoist and assess whether Mrs X could manage it on her own. The family was likely to need community OT support for six weeks. The social worker discussed the lack of a discharge meeting with colleagues in the health service who said they did not consider one was necessary. The Council’s view was that one would have been beneficial.
26. At the end of November the allocated social worker visited the family following Child A’s return home to gather information for the assessment. Mrs X explained their support needs and the lack of any family or friends who could provide support. The social worker saw the equipment provided by the hospital and confirmed both parents had been trained to use the hoist.
27. Following the visit Mrs X contacted the Council to confirm her support needs. She explained Mr X had been on leave but would be returning to work shortly and so she would need help. The Council agreed to make direct payments so Mrs X could employ a PA for three hours a day for four days a week when Mr X was at work. It offered its usual standard hourly rate. It also said the family “could potentially be able to top the hours up with your left over money from Aiming High if required”. The Council also provided home to school transport for Child B so Mrs X could care for Child A.
28. Mrs X responded to the offer saying she needed more help on certain days of the week because of Mr X’s shift pattern. She also said she wished the referral had been accepted months ago as she was concerned she would have difficulty finding a PA. This was based on her past experience when she had found the information the Council provided about available PA’s was out of date. Also she did not know whether any of the adult care PA’s also worked with children. Mrs X disagreed with the idea that she should use the Aiming High money to provide care for Child A. She said that money was for respite and she might need to use it later in the year. The Council noted in its records that it “explained this is her choice to use the left-over money from this year and it was an option for her to top it up as she is requesting more hours than the local authority are providing”.
29. Nevertheless the Council reviewed the support package and agreed to increase the hours offered to accommodate Mr X’s shift pattern. It provided Mrs X with a list of PA’s from Adult Social Care and a link to a list for those who work with children. It also circulated an advertisement to current PA’s.
30. Around a week later the social worker checked with Mrs X how she was managing. Mrs X explained she was having difficulty finding PA’s to cover some of the times she needed. The social worker agreed both she and Mrs X would contact care agencies to try and find suitable PA’s, but this was unsuccessful. Mrs X then told the Council about an agency she knew which had carers available but charged more than the standard Council rate. The social worker said she would speak to her manager about this and also confirmed she was completing the Child and Family Assessment.
31. At the point when Mr X returned to work in December, the Council agreed the extra funding so Mrs X could employ PA’s from the agency she had mentioned. There was then further contact from the social worker over the next few days to see how Mrs X was managing. In mid-December the social worker visited the family again. The notes of the visit show the social worker observed Mrs X was very tired and not getting any respite. They also say the carer’s assessment would be completed in January 2021.
32. There were some problems with PA visits later in December as Mrs X had COVID-19 symptoms and was waiting for a test and, then a carer was temporarily unavailable due to injury.
33. In January 2021 the social worker visited again and continued with the carer’s assessment for Mrs X.
34. The Council made a decision on the Child and Family Assessment in late January 2021. This said the purpose of the assessment was to explore what extra help and support the family needed during the period of Child A's recovery after discharge from hospital up to when he started receiving physiotherapy support. The assessment was therefore time-limited. It said an appropriate package of care was put in place to ensure the parents had support to meet Child A’s extra care needs while he was still in his cast. Now that he had had his cast removed and was receiving help from the Community OT and physiotherapist, there was no long term need for continued involvement from the Children with Disabilities Team.
35. In early February the social worker visited and told Mrs X the Council would be closing the case. After further virtual visits from the social worker, the Council sent Mrs X a copy of the carer’s assessment in mid-March and then closed the case.
36. The form used for the carer’s assessment is headed ‘Adult Social Care - Care & Support – Carers Assessment’. It shows the Council looked at a range of factors including:
• the care and support needs for both children as well as Mrs X’s caring responsibilities towards another adult family member;
• the family’s involvement with community health services such as OT and physiotherapy;
• welfare benefits received in relation to the children’s disabilities and carer’s benefits;
• the impact on Mr and Mrs X of their caring role in terms of their ability to have leisure time or take part in activities outside the home.
37. The record shows Mrs X said she did not have a chance to get time off from her caring role and she would like more access to PA’s who could look after the children so she could have a break. The conclusion of the assessment was that if Mr and Mrs X could not achieve the outcomes set out there was “likely to be a significant impact on the carers wellbeing”. It noted that if Mrs X “is not able to receive some respite from her caring role then it is likely this will cause her additional stress and anxiety and may lead to burn out”. It noted home life was more demanding currently because of Child A’s slow recovery from his operation and difficulties because of the COVID-19 pandemic in being able to access other support in the community. The recommendation was for the family to continue with the existing support they had, using the Aiming High Short Breaks funding. It said other help, such as a cleaner, could be paid for privately, while if they wanted discounted gym membership they could ask their GP.
38. Mrs X replied saying she disagreed with the outcome of the carer’s assessment and the decision to close the case as she said both her children were children in need. She said she needed more support. The Council’s response was that the assessments had identified the level of needs for the family and the care package in place was appropriate to meet those needs, along with the other support services the family was using. The Council confirmed this was its final decision.
39. In mid-March 2021 Mrs X made a formal complaint to the Council about minutes of a Special Educational Needs and Disabilities (SEND) Panel meeting. The only reference to social care support relates to a comment in the minutes which Mrs X objected to. This was about whether the family’s needs met the threshold for a child in need assessment, rather than Early Help. In response to the complaint at stages 1 and 2 of the Council’s complaints procedure, the Council confirmed it had now carried out a child in need and carer’s assessment.
40. In October 2021 Mrs X complained to the Council about lack of social care support. She challenged the decision to end the child in need plan and refuse to re-open the case and re-assess the family’s needs, particularly in light of a change of circumstances for Child B. She also complained that the amount the Council offered as an hourly rate for PA’s was too low. The Council put the complaint through the statutory complaints procedure. It is currently at stage 3.

Analysis – was there fault causing injustice?

41. The first three parts of the complaint are about the Council:
• cancelling the assessment of need when the surgery was postponed;
• refusing to carry out an assessment after the surgery took place; and
• failing to provide the help Mrs X needed when Child A returned home from hospital.
42. I recognise it was frustrating for Mrs X that the referral was delayed once the operation was postponed. However it is for the Council to decide how to prioritise its work. The Council says the assessment related to the care Child A would need following surgery and was heavily reliant on information from health colleagues. I cannot say the decision amounts to fault. In any event the Council decided on the support it would provide, and the funding was in place for when Mr X returned to work. This was the point when Mrs X said the support was needed.
43. I also recognise the difficulties Mrs X had in finding PA’s to cover all the times when she needed help. But I cannot say these difficulties would not have occurred if the assessment had been started earlier, particularly during the COVID-19 pandemic. When Mrs X made the Council aware of the difficulties she was having, it responded quickly to increase the number of hours offered and agree top-up funding.
44. It might have helped with advance planning if there had been a hospital discharge meeting, but that would be a matter for Mrs X to raise with the hospital.
45. I agree with Mrs X that the Aiming High funding and the request for support with care needs for Child A following his operation were for different purposes. In my view it was not appropriate to suggest using the respite care funding for the care and support needed for Child A in recovering from his operation. There is evidence in the records that a Service Manager in the Early Help team took a similar view. However the Council’s suggestion did not prevent it agreeing to the hours and rate of pay Mrs X asked for. So while she found it upsetting, it did not have an impact on the support provided.
46. The question of the Council’s overall policy on hourly rates is being considered in the other complaint currently going through the statutory children’s social care complaints procedure.
47. I have not seen evidence that the Council refused to carry out a Child and Family assessment once the operation took place. It confirmed it had agreed to carry out an assessment and it did so.
48. However in my view there is evidence of delay in starting the carer’s assessment. Mrs X confirmed she wanted one at the same time as she asked for the child in need assessment. The two assessments could have been combined. Yet the carer’s assessment did not take place until January 2021.
49. Also the form the Council uses for parent carers assessments under the Children Act 1989 is one designed and intended for carers of adults under the Care Act 2014. So the criteria considered for deciding whether the carer has a need for support are those required in an assessment of adult carers. This is a point the independent Investigating Officer also picked up on at stage 2 of the investigation of Mrs X’s other complaint.
50. The outcome of the carer’s assessment was not to provide any extra support on top of the Aiming High grants the family were already getting. So the delay in carrying out the assessment did not result in a loss of support. Nor could I conclude in this case that the use of the Adult Social Care form affected the outcome of the assessment. It was a detailed assessment looking at the impact of Mrs X’s caring role on her well-being, taking account of existing support. It looked at the issues required in a section 17 parent carer’s assessment as set out in paragraph 12 above.
51. The fact that there was no recommendation for any extra support implies a conclusion that the needs could be satisfied wholly or partly by services already provided under section 17. But this is not stated explicitly. Also the fact that the Council has a separate procedure using the adult social care form may be the reason the child needs and parent carer’s assessments are not combined. This may lead to delay and extra time and effort for the family in having to undergo two separate assessments. So I consider there are some flaws in the process.
52. The stage 2 investigator in the later complaint suggested it may be beneficial to use a Children with Disabilities specific format for completing parent carers assessment that could also be used in child in need assessments. The aim would be to avoid repeating assessments unnecessarily. The Council response to the stage 2 report was to refer to updated information on its website about support for children and to a review of the Children with Disabilities service. However there was no response specifically on the parent carers assessment process.
53. The fourth part of Mrs X’s complaint was that the Council closed the case prematurely so she had to ask several times for it to be re-opened. Mrs X has since clarified that she did not make several requests for the Council to re-open the case in the time period I am considering. The question of later refusals to re-open the case and carry out a further assessment is being dealt with in the investigation of the other complaint.
54. Mrs X provided evidence that she wrote back to the Council in March 2021 disagreeing with its decision to close the case. The Council confirmed it had reviewed the decision and that was the final outcome. Mrs X did not make a complaint about the decision at that point. In response to my draft decision Mrs X said she did not complain because she felt the Council’s statement that it had provided a final decision implied she could not complain. She said the Council did not tell her she could make a complaint and so she feels she was prevented from complaining. However the Council’s complaints procedure is set out on its website, including how to complain about children’s social care decisions. Mrs X made a formal complaint about the SEND Panel meeting minutes around the same time as the Council told her it had made a final decision on closing the children’s social care case. So there is evidence she was aware of how to complain, and I do not consider the Council prevented her from complaining.
55. If she had complained she would have been able to go through the statutory children’s social care complaints procedure, which could have considered the outcome of the assessments in a way that the Ombudsman cannot, as shown by the stage 2 report on the later complaint. The Ombudsman can only look at the process by which the Council reached the decision and consider whether any flaws in the process are likely to have affected the outcome. In this case there is evidence the Child and Family assessment covered the range of factors outlined in the Working Together guidance, included checks with other relevant agencies, such as health and education, and gave reasons for its conclusions. So I do not find fault with the assessment process.

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Agreed action

56. I have not found that flaws in the parent carers assessment process affected the outcome in this case. But I can make recommendations for improvements in procedures. In response to my recommendations the Council has that within three months of the decision on this complaint it will take the following action:
• review the process of carrying out parent carers assessments so they can be combined with a child in need assessment where the parent wishes;
• review the forms used and decide whether it needs to align them more to the section 17 requirements rather than using the headings from adult carers assessments; and
• explain the outcome of the review to the Ombudsman with reasons for its decisions.

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Final decision

57. I have found there was some fault in the parent carers assessment process, but the evidence does not support a finding that this affected the outcome for Mrs X. I am satisfied with the action the Council has agreed to take to review the assessment process and so I have completed my investigation.
58. 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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Investigator's decision on behalf of the Ombudsman