Summary: A man complained that a social worker fabricated an assessment, which made it harder for him to get the right support. The Ombudsmen have decided not to investigate the complaint because it is unlikely they would find evidence of fault causing injustice.

The complaint

1. A man I will call Mr D, represented by his grandmother who I call Ms P, complained that a social worker I will call Officer B fabricated an assessment in November 2016 to secure his diagnosis as learning disabilities. Mr D said this “laid down a narrative for all other services to follow” and made it harder for him to access services. He said he wanted improvements to be made so that this did not happen again, and for the fabricated report to be removed from his records.

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The Ombudsmen’s role and powers

2. The Ombudsmen investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, the Ombudsmen consider whether it has caused injustice or hardship (Health Service Commissioners Act 1993, section 3(1) and Local Government Act 1974, sections 26(1) and 26A(1), as amended).
3. The Ombudsmen have the power to jointly consider complaints about health and social care. Since April 2015, these complaints have been considered by a single team acting on behalf of both Ombudsmen. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA)
4. The Ombudsmen may investigate complaints made on behalf of someone else if they have given their consent. The Ombudsmen may also investigate a complaint on behalf of someone who cannot authorise someone to act for them, if the Ombudsmen consider them to be a suitable representative. (Health Service Commissioners Act 1993, section 9(3) and Local Government Act 1974, section 26A(1) and 26A(2), as amended)
5. The Ombudsmen cannot question whether an organisation’s decision is right or wrong simply because the complainant disagrees with it. Nor can they decide what level of care, or what type of care, is appropriate and adequate for an individual. This is a matter of professional of judgement and a decision that the relevant responsible body has to make. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended, and Health Service Commissioners Act 1993, sections 3(4)- 3(7))
6. The Ombudsmen provide a free service, but must use public money carefully. They may decide not to start or continue with an investigation if they believe:

• it is unlikely they would find fault, or
• the fault has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify their involvement, or
• it is unlikely they could add to any previous investigation by the bodies, or
• they cannot achieve the outcome someone wants, or
• there is another body better placed to consider this complaint, or
• it would be reasonable for the person to ask for a review or appeal.

(Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

7. I considered information provided by Ms P and Mr D in writing, and information provided by Ms P by phone.
8. I shared a draft of this decision with Ms P and considered her comments.

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What I found

9. In 2016, Mr D had an assessment by an educational psychologist who wrote a report dated 6 October 2016. This said Mr D has “mild to moderate learning difficulties” and mental health needs, and was vulnerable due to the combination of these.
10. As Mr D became ineligible for help from Child and Adolescent Mental Health Services (CAMHS), he was referred to the Community Mental Health Team (CMHT). He, Ms P and Ms P’s partner met with Officer B from the CMHT on 18 November 2016.
11. Ms P provided a copy of the CMHT’s records relating to this appointment. Officer B recorded that she met with them at 10:30 in the morning. Ms P said Officer B’s note of the appointment was made at 10:30am, before the appointment took place. However, the electronic record shows that Officer B made notes about the appointment at 17:43 but recorded that the appointment took place at 10:30.
12. Officer B’s records say Mr D was already allocated a social worker from the learning disability team, having previously had a social worker from the leaving care team. The learning disability team confirmed that Mr D met their criteria. Officer B reviewed records relating to Mr D, which included documentation by a CAMHS psychiatrist that Mr D had borderline learning difficulties, mental health needs, and had been assessed for autism by a social work team. Officer B noted that the social work team reported that there was no evidence that Mr D had autism, but Ms P and her partner believed he had autism.
13. Officer B concluded that the “learning disability service is the most appropriate agency to meet [Mr P’s] needs”.
14. Officer B recorded that she went to Mr D’s home at 15:00 on 18 November to meet with Mr D and the other social workers involved. Officer B told him he had been discharged from mental health services and the social worker from the learning disability team would be his social worker.
15. Ms P and Mr D told us that in early 2017 they asked Mr D’s GP for an autism assessment. The GP said he had already had one. They advised the GP that Mr D had seen Officer B for a mental health assessment, not an autism assessment. After this, they made an information request for Officer B’s assessment report.
16. Mr D and Ms P complained to the CMHT in June 2017 that they had recently received a copy of Officer B’s report and realised it was fabricated. They said after a very short appointment Officer B met him at home and interviewed him along with other professionals, which made him feel anxious and vulnerable. Further correspondence between Ms P, Mr D and the CMHT shows that they disagreed about the time of the appointment and about what happened at the meeting in the afternoon.
17. Ms P and Mr D told us in September 2017 that Officer B’s report sabotaged Mr D’s referral for a full autism assessment, and he had been on a waiting list for this for 10 months. In early November 2017 Mr D had a full autism assessment and was diagnosed with autism.

Analysis

18. When deciding whether to investigate a complaint, we must consider whether it is likely that we would find that there was fault causing a significant injustice.
19. In this case, the records of the appointment complained about show that Officer B did not assess Mr D for autism or learning disabilities. Learning difficulties had already been identified. The assessment was of whether Mr D should be supported by the CMHT. Officer B was entitled to decide that the learning disability team were better placed to support Mr D. This is a matter of professional judgement.
20. I have not seen any reason to believe that the dispute over the time the appointment took place has a bearing on Mr D’s subsequent access to services. Further, this part of the complaint involves conflicting accounts of events and it is unlikely that an investigation would resolve this to Mr D and Ms P’s satisfaction.
21. I have not seen any reason why Officer B’s assessment should have made it harder for Mr D to get a full autism assessment. If Ms P and Mr D found it difficult to persuade the GP to refer Mr D for this, they could have raised this with the GP practice.
22. I consider that we should not investigate this complaint because it is unlikely we would find evidence of fault causing a significant injustice.

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Decision

23. The Ombudsmen will not investigate this complaint.

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Investigator's decision on behalf of the Ombudsman