Summary: We will not investigate Miss X’s complaint about her care by Royal Borough of Greenwich and Oxleas NHS Foundation Trust. The Council and Trust have accepted errors and taken steps to put things right. Further investigation by the Ombudsmen is unlikely to achieve more.

The complaint

1. Miss X complains about her care and support from Royal Borough of Greenwich (the Council) and Oxleas NHS Foundation Trust (the Trust) when she moved back to Greenwich.
2. Miss X complains about delays completing her needs assessment and failure to provide interim care or direct payments. She says this led to a gap in her care. Miss X also complains about the actions of a social worker, including the refusal to make changes to her draft care plan.
3. Miss X is unhappy with the way her complaint was handled, the way a meeting was carried out and the inappropriate involvement of specific managers.
4. As a result, Miss X says she was left without care or direct payments for months, which significantly impacted on her mental health, finances and wellbeing.
5. Miss X would like the organisations to formally acknowledge failure to meet duties under the Care Act 2014 and to put appropriate support in place to meet her needs. She is also seeking systemic improvements and additional financial redress to reflect the impact on her.

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The Ombudsmen’s role and powers

6. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
7. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’.
8. 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. If there was no fault in how the organisation made its decision, we cannot question the outcome.
9. We may decide not to start or continue with an investigation if we believe:
• it is unlikely we could add to any previous investigation by the bodies, or
• we cannot achieve the outcome someone wants

(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

10. I considered evidence provided by Miss X, the Council and the Trust as well as relevant law, policy and guidance.
11. Miss X had an opportunity to comment on my draft decision. I did not receive any comments.

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What I found

What happened

12. Miss X has complex mental health needs. She lived in Greenwich then moved to another area when she was placed in temporary accommodation in 2024.
13. The Care Act 2014 (the Act) requires councils to carry out an assessment for any adult with an appearance of need for care and support. In November 2024, Miss X’s local council assessed her needs and put a care plan in place. She was entitled to direct payments funding seven hours of support a week. Direct payments are monetary payments made to individuals which enable people to arrange their own care and support to meet those needs.
14. In late April 2025, Miss X moved back to Greenwich. Miss X promptly contacted the Council about her care.
15. The Council employs social workers who are based in the Oxleas Community Mental Health Team (CMHT). These social workers are responsible for carrying out needs assessments for people with mental health needs.
16. The Council received a copy of Miss X’s needs assessment from the other council and referred the matter to the CMHT, as the direct payments related to mental health.
17. On 19 June 2025, the CMHT started to assess Miss X’s needs.
18. Miss X complained to the Council about delay assessing her needs and failure to provide interim support or direct payments. In October 2025, the Council issued its final complaint response, upholding Miss X’s complaint. The Council accepted there were delays completing her needs assessment and a lack of interim care or direct payments. The Council apologised to Miss X and said lessons had been learned. The Council offered Miss X £1332 for missed direct payments and a total of £1500 for distress, risk of harm and inconvenience.
19. Miss X also complained to the Trust about delays with her assessment and the actions of the social worker who completed the assessment. The Trust issued several complaint responses. The Trust acknowledged there had been a gap with Miss X’s care and interim care should have been provided. The Trust also accepted there had been a delay completing Miss X’s needs assessment and she had not been kept updated. The Trust also accepted problems with the way amendments to the draft care plan had been handled. The Trust apologised and said staff training would take place.
20. The Trust arranged for another needs assessment to be carried out by a new social worker. The Trust also met with Miss X to discuss her concerns. Following this, it offered her £500 in recognition of the delayed needs assessment.
21. In October 2025, Miss X complained to the Trust about the way her second needs assessment had been carried out. Miss X felt the social worker had been dismissive of her needs and she was unhappy with the social worker’s behaviour. She also complained that the social worker’s managers had been involved with her previous complaint. Miss X said she was uncomfortable with the way a meeting had been conducted and raised concerns of ethnic bias.
22. The Trust replied that staff recollection of the meeting was different to Miss X’s account. The Trust said certain comments had been intended empathetically and for information but apologised if Miss X had perceived them as judgmental or discriminatory. The Trust accepted the involvement of certain staff may have undermined Miss X’s trust in the assessment process. The Trust offered an independent assessment with an assessor unconnected to previous complaints to help rebuild trust, and it outlined several systemic changes to improve communication and record keeping.
23. During my consideration of the complaint, Miss X told me she had agreed that a further full re-assessment was not required, she was in discussion with the independent social worker to make the necessary amendments, and her care plan was due to be finalised soon.

Analysis

24. There are indications of fault in the organisations’ handling of Miss X’s needs assessments and the lack of interim care or direct payments. The Council and Trust have already accepted a range of failings. I have considered the outcomes sought by Miss X and the actions already taken by the organisations to see whether the Ombudsmen could add anything further by investigating.
25. Miss X says she would like her care plan finalised and adequate care put in place. We cannot decide what level of care is appropriate for any individual. This is a matter of professional judgement and a decision that the relevant organisations must make. As the CMHT has not completed the needs assessment yet, we cannot take a view on whether there has been any fault in the process, and we cannot influence an ongoing assessment.
26. Once the assessment process is complete, Miss X would need to raise a formal complaint with the organisations if she is unhappy with the assessment process and/or outcome. Miss X could then return to us if she remains unhappy after the local complaints process has finished. We could then consider whether there was any fault in the way the assessment process was carried out. However, as above, we cannot recommend what care Miss X should receive.
27. Miss X is seeking formal acknowledgement of breach of duties under the Act. The organisations’ complaint responses already formally acknowledge and apologise for failure to meet statutory duties in relation to Miss X’s care. We cannot add to this.
28. Miss X would like systemic improvements to prevent these mistakes happening again. The Trust’s complaint responses outline several improvements taken because of Miss X’s experience. These include speaking directly with staff, issuing staff reminders and actions to improve record keeping and communication with service users. The Trust has provided us with evidence that these steps have been completed or are in the process of being implemented.
29. Finally, Miss X is seeking further financial redress as she does not feel the amount offered by the organisations adequately reflects the impact on her. Miss X has received over £1300 from the Council for actual financial loss, in relation to missed direct payments. She had also received a total of £2000 from the Council and Trust in recognition of the impact of the errors on her personal wellbeing. This amount is in line with the Ombudsmen’s guidance on remedies and we would be unlikely to recommend more.
30. I have carefully considered the actions already completed by the organisations in response to Miss X’s complaint and I am satisfied that they have taken reasonable steps to put things right. I recognise Miss X remains dissatisfied, but further investigation by us is unlikely to achieve more.

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Decision

31. There is no basis for the Ombudsmen to investigate this complaint. The Trust and Council have already accepted fault and taken steps to address this. Further investigation by the Ombudsmen is unlikely to add to the actions already completed by the organisations.

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Investigator's decision on behalf of the Ombudsman