Gateshead Metropolitan Borough Council (18 010 671)

Category : Housing > Allocations

Decision : Upheld

Decision date : 12 Mar 2020

The Ombudsman's final decision:

Summary: Mr B complains about the actions taken by the Council in respect of an application for medical priority to obtain more suitable housing in the Council’s area. We find the Council has not fully considered the extent of Mr B’s health needs and the support his carer provides. But we also find Mr B has not given full information to support this process. The Council has agreed to obtain further evidence and carry out another review of his medical needs.

The complaint

  1. Mr B complains that Gateshead Metropolitan Borough Council (the Council) in respect of his housing application:
    • failed to take all his circumstances into account and, without good reason, refused to award medical priority to his application; and
    • delayed in dealing with his review request and complaint;

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The Ombudsman’s role and powers

  1. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’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, section 34(3), as amended)
  2. 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)
  3. 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)

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How I considered this complaint

  1. I have considered the complaint and the documents provided by the complainant, made enquiries of the Council and considered the comments and documents the Council provided. I have written to Mr B and the Council with my draft decision and considered their comments.

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What I found

The Council’s Lettings Policy

  1. This policy says that if a person lives outside the borough they will be included on the housing register but they will only accrue “waiting time” in the General Needs Category. Any housing priority will not be recognised unless the person is able to provide proof of their “need” to move into the area and demonstrate why this “need” cannot be satisfied within their current location.
  2. In order to qualify for rehousing on medical grounds, a person’s current home must present a risk to their health and wellbeing and they must therefore be requesting a move to an alternative property that will eliminate or substantially minimise these risks.
  3. The Council’s policy has three levels of housing need:
    • Critical: - for people who need to be discharged from a hospital or care home and their life would be at risk if they were to return home.
    • Urgent: - for people who have a severe medical need and can no longer cope in their current home. They have an urgent need for support, cannot access basic facilities within the home and which cannot be provided in their current area or home and can be provided by a move to a different area.
    • Substantial: - for people who have a substantial medical need which could be eased or improved by re-housing but the severity is not enough to merit urgent need status. It would apply where they have some difficulty gaining access to basic facilities within their home, there is minimal support in their current area and a move to an alternative area or home would provide significant additional support from others that could not otherwise be provided.

What happened

  1. Mr B has a number of physical conditions which significantly affect his quality of life. Due to the chronic and ongoing nature of these conditions he also has depression. He lives alone in a two-bedroom adapted bungalow in a neighbouring borough to Gateshead. He is originally from Gateshead and his brother still lives there.
  2. His carer also lives in the Gateshead area. She visits him regularly to do shopping cleaning and housework for him. She helps with personal care tasks arising from one of his medical conditions. She does not drive and finds the bus journey difficult. It takes an hour and does not run in the evenings or at weekends. She has found it increasingly difficult to visit Mr B as regularly since her mother became ill.
  3. He has applied to join the housing register in his council area and has been awarded medical priority.
  4. In January 2018 he applied to the Council to join its housing register. He said he wished to move due to his health, welfare and to be nearer family and his hospital appointments. He also said his property was unsuitable for his needs, indicating he had some difficulty using the bathing facilities and steps to access the property.
  5. He also completed a medical priority application form, giving more details about his health conditions. He said his last hospital appointment had been in Newcastle in July 2017. He said he felt lonely, vulnerable and isolated in his current home because he didn’t see anyone. He struggled to climb stairs, use the toilet and complete personal care tasks and he needed help with shopping, housework and meal preparation. He had access to a car but wanted to move due to isolation to be nearer his carer and his family.
  6. The Council accepted Mr B onto the housing register but refused to award him any medical priority. The decision dated 12 February 2018 said he was suitably housed in a bungalow which met his medical needs and suggested his carer could move nearer to him.
  7. In late February 2018 Mr B requested a review of the decision. He said his property was not suitable as he needed a wet room, a lower toilet and no steps at the front door. He said he was isolated from his friends, family and carer and she was his lifeline, coming up three times during the week and staying overnight. But due to the buses she could not come at weekends and it was a three-hour round trip. As the weather had been bad she had only been able to come once that week and she was also looking after her mother which meant she could not move.
  8. As part of the review, in May 2018, Mr B’s GP sent a letter detailing his conditions and medication, (which included morphine tablets and other strong painkillers). He said the combined effect of Mr B’s illnesses caused many symptoms including pain, low mood, low motivation and lethargy. He said while the prognosis with one of his conditions was good, the other main physical condition was degenerative and likely to get worse. Furthermore, his depression was severe and enduring, likely to last for the rest of his life and causes him considerable disability.
  9. The Council sent its review decision to Mr B on 25 June 2018. It upheld the decision not to award him any medical priority. The letter mentioned he had depression but did not detail the severity or enduring nature of it. It did provide more detail about one of the physical conditions.
  10. It said it had contacted his carer who had confirmed she provides assistance with shopping, housework, preparing meals, managing affairs, travel to appointments and emotional support, six times a week and stayed three nights a week. She said she only provided personal care occasionally. The Council recognised that his carer was experiencing difficulties maintaining that level of support and a move closer to her would improve Mr B’s quality of life. But it said assistance with this was available from his own Council.
  11. The notes of the review process say that:

Mr B is not in receipt of any care or support specific to his medical conditions from his carer.

  1. It noted he had not contacted his own council for assistance with care or adaptations to his current home. It concluded by saying his needs could be met by his own Council and the desire to move to Gateshead was a preference not a need.
  2. Mr B contacted our office in October 2018 saying he had since been in touch with the Council about his review, but the decision remained the same. The Council said it had not received a complaint from Mr B so we returned the complaint to the Council asking it to investigate. The Council has provided a copy of a letter it sent to Mr B on 5 December 2018 asking him to submit his grounds for making a complaint. It says Mr B did not contact the Council again until June 2019 when he wrote asking to escalate his complaint.
  3. In August 2019 the Council replied saying the decision on his review remained the same.
  4. The Council has provided a copy of a second letter from his GP dated 7 August 2018, but date-stamped as received by the Council on 15 August 2019. This mentions his four main physical conditions and goes into significant detail about the very difficult side effects. It also states Mr B has chronic intractable depression due to the effects of his illnesses.
  5. Mr B contacted our office again and also escalated his complaint to stage three of the Council’s procedure. In September 2019 we agreed to investigate his complaint and I made enquiries.
  6. On 5 October 2019 the Council responded to his complaint. It said the Council had fully considered his circumstances and not awarded him medical priority because his current home was suitable for his medical needs. He had not established that he needed to move into the Gateshead area due to his medical conditions and that the support he needed could be provided by his home council. It said his current home did not pose a risk to his health or wellbeing, his current care arrangements met his needs and were sustainable in his current location and further assistance with his care was available in his current area.

Analysis

Medical priority

  1. The Council has fully considered Mr B’s medical needs arising from his physical health conditions. It reached the view his current accommodation meets those needs and Mr B can approach his housing provider for any necessary adaptations. It notes that Mr B’s carer does not provide personal care and Mr B is able to access basic facilities within his home and cope generally. So it has concluded that Mr B has not satisfied the requirements of the policy to show that he needs to move to Gateshead in respect of his physical needs. I cannot find fault with this part of the decision at the time it was made.

Initial view on mental health needs

  1. My initial view was that the Council had not properly considered Mr B’s medical needs arising from his mental health condition: his GP describes his depression as severe and enduring, likely to last for the rest of his life and causing him considerable disability. Mr B describes feeling isolated and cut off because of the location of his property and his carer providing a lifeline for him. The Council’s review notes mention depression only once and do not consider any needs arising from this condition. The Council concluded that Mr B does not receive any care or support specific to his medical conditions from his carer.
  2. I did not think the Council had provided any explanation as to why the considerable emotional support the carer provides has been discounted and whether the location of his property affects his mental health as he is isolated and cut off from his carer and family.
  3. The Council has disputed this conclusion. It said the first GP’s letter confirmed that Mr B was not on any medication for depression and did not raise any issues with the location of Mr B’s property/distance from his support network having an impact on his mental health. It pointed out the second GP letter, although dated 7 August 2018, it was not received by the Council until 15 August 2019 and so did not form part of the review. It said Mr B could use his car to visit his carer, and she managed to stay with him three nights a week, so he was not isolated.

Revised view on mental health needs

  1. I accept the Council did not have the second GP’s letter until after the second review was completed on 6 August 2019 and so the Council was not able to take this into account. So in the light of this, I have reconsidered my conclusions.
  2. I maintain my view that the Council has not adequately considered or explained:
    • why Mr B’s carer does not meet any care needs arising from his medical conditions, given that she provides essential support to mitigate the impact of chronic and debilitating depression. The Council has relied solely on the fact Mr B does not take medication for depression without asking the reasons for this;
    • whether the difficulties the carer experiences in getting to Mr B’s property via public transport, three times a week (due to additional caring responsibilities for her mother) to provide support, makes Mr B’s property unsuitable;
    • whether the Council’s view that Mr B can visit his carer by car is viable, given the detail provided by his GP (in the letter received in August 2019) of the impact of the side effects of his condition; and
    • whether the Council’s view that Mr B’s own Council can provide equivalent support is viable, given the combined impact of his mental and physical needs.
  3. Although Mr B has not shared this with the Council, he has provided significant information to me about the extent of his difficulties (and the personal care his carer provides), during the course of the investigation, which needs to be put to the Council for further consideration.

Delay

  1. The Council took nearly four months to complete the first review request. I accept it obtained further information from Mr B’s GP and his carer but I consider two months would have been a more reasonable timescale.
  2. In respect of the complaint process there appears to have been a breakdown in communication: we sent the complaint back to the Council in October 2018; it says it wrote to Mr B in December 2018 asking for more information about his complaint, but Mr B did not respond until June 2019. The Council then responded to the complaint at stage two of its process within two months and at stage three within a further two months. I understand Mr B feels there has been great delay in the process which has further aggrieved him, but I cannot find fault with the Council’s actions in this process: it has acted when contacted by Mr B.

Injustice

  1. Mr B does not fully understand why the support provided by his carer has been discounted as non-essential or why it is reasonable to ask him to substitute this support from a person he does not know, through his own council. This has caused him distress and frustration. However, this situation is partly due to Mr B not providing full information about the effect of his conditions and the care he receives in this regard.

Agreed action

  1. In an attempt to move forward I asked the Council (within two months of the final decision) to:
    • obtain further evidence from Mr B, his doctor and his carer about Mr B’s mental and physical health needs and the support he requires/receives from his carer; and,
    • carry out a further review of Mr B’s case.
  2. The Council has agreed to my recommendations.

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Final decision

  1. I consider this is a reasonable and fair way of resolving the complaint and I have completed my investigation on this basis.

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Investigator's decision on behalf of the Ombudsman

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