Summary: The Ombudsman found fault on Mrs T’s complaint about the Council failing to properly assesses her housing transfer application. It failed to properly consider whether she was housebound under its policy and nor did it give reasons for decisions. The agreed action remedies the avoidable injustice caused. The Ombudsman found no fault on her complaint about it failing to tell her of a suitable property. The landlord had a restriction about pets and Mrs T stated on her application she would not make alternative arrangements for her dog.

The complaint

1. Mrs T complains the Council failed to:
1. correctly assess her application for rehousing; and
2. tell her about a suitable property she was top of the waiting list for because it decided she was not prepared to make alternative arrangements for rehousing her dog.
2. As a result, as she lives in first floor accommodation, she cannot leave or access it independently which means she remains housebound, and she lost the opportunity to accept a suitable property.

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What I have investigated

3. I have not investigated any complaint Mrs T may have against the Council before November 2017. The paragraph at the end of this statement explains why.

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The Ombudsman’s role and powers

4. 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)
5. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
6. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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Council housing allocation policy (February 2015)

7. Under this policy, which was in force up to March 2019, applicants who need to move on care or support grounds will need to demonstrate they are required to give or receive constant care and attention to/from a close relative, as evidence by a professional’s report (for example, GP, occupational therapist, or social worker). (paragraph 3.6.1)
8. Its housing register consists of 4 Bands reflecting reasonable preference categories and local priorities. Applicants are placed in a Band according to their circumstances and the position in that Band, except for Band A, depends on the date of the application. When a household’s circumstances change, and the applicant is placed in a new Band or bedroom category, the application date is the date the Council was told of the change by the applicant. (paragraph 4)
9. The 4 Bands are:

• Band A: this is for those with an urgent or overriding need for re-housing. It includes those needing to move on hardship grounds as well as when emergency and temporary accommodation is not an appropriate response to that need. It includes those with Medical Priority 1, for example;
• Band B: this is for homeless households;
• Band C: this is for those in unsatisfactory housing conditions. It consists of 2 levels of priority. Priority level C, for those whose housing need arises from a single factor, and C+ where there are several factors. These factors include: lack of bedrooms; lacking a kitchen; Medical Priority 2 cases; and, ‘social and welfare’ needs (includes those showing they need to give or receive constant care and attention to/from a close relative); and
• Band D: this is for those threatened with homelessness or living in insecure accommodation. (paragraph 4)

10. Medical priority is limited to 2 groups (paragraph 5):

• Priority 1: those with an urgent medical need for alternative accommodation. This includes: a household where a member has a serious, possibly life-threatening illness or disability and whose housing circumstances are affecting their health very severely; or, a person discharged from hospital and it is likely they are to be deemed a priority non-intentionally homeless person if not rehoused; or, a household in which one of its members is housebound due to the design of, or access to, the building and where alternative housing will resolve the situation; and, social housing will demonstrably contribute to alleviating the impact of the medical condition; and
• Priority 2: a household where one or more members has an illness or disability and they require social housing to address their medical condition. For example, those who need an adapted or accessible property or need stability due to social disability or a mental health problem. It also includes: those where social housing will demonstrably contribute to alleviating the impact of the medical condition; or, a child with a serious medical condition and in the view of the medical adviser, there is a need for settled accommodation.

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The London Accessible Housing Register: good practice guide

11. This register (the LAHR register) was developed as an addition to London wide choice based letting schemes. It is not a stand-alone register of accessible housing and those who need it. It is a framework for collecting information on property access details and using this to assign a category to a property. The categories are based on national design guidance. The property categories can be used in all choice based letting scheme adverts to give applicants information about accessibility features of a property.
12. The categories are: A (wheelchair accessible throughout); B (wheelchair accessible essential rooms); C (Lifetime homes which provide level approach/entrance/doorways); D (easy access which provide level approach to the entrance, wider doors and more space than in general needs); E (Step-free which are general needs housing but have a level approach/entrance and level access throughout); and F (general needs: does not meet any of the other criteria).

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How I considered this complaint

13. I considered all the information Mrs T provided, including the notes I made of our telephone conversations, and the Council’s response to my enquiries, a copy of which I sent her. I sent a copy of my draft decision to Mrs T and the Council. I considered their responses.

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What I found

14. Mrs T has various health problems including lower back pain, a problem with her foot and hands, anxiety, and depression. These problems impact on her mobility. She and her family live in a first-floor maisonette (the flat) which has no lift. They have lived there since 2015.
15. To access her home, she needs to get up 3 flights of stairs. She cannot use the stairs without her family helping her use a stair climber. To get around inside the flat, she uses a walking stick and mobility trolley. Mrs T wants to move to a more suitable property that meets her needs. She believes the Council placed her in the wrong banding and she is now at risk in the flat where she feels isolated as she can only leave and enter with help.

Complaint a): correctly assess her banding

16. Mrs T believes the Council failed to place her in the correct banding. She was in Band C with Medical Priority 2 with a priority date in December 2016. The Council assessed her as needing a ground floor 3-bedroom property with level access.
17. Mrs T completed the following medical assessment forms:

• July 2018: With it, she sent a GP’s report. This stated: she was ‘almost wheelchair bound and can manage with 2 crutches just in the house only’; when a neighbour’s fire broke out a few months before, she was trapped in her own property as she could not get down the stairs; there is no lift to her flat; and, her partner has to lift and carry her down the external flights of stairs. She also sent a letter from her psychologist referring to her anxiety. On the form, Mrs T declared she had a problem using the external stairs and was housebound.

Mrs T’s evidence before the Council also included the occupational therapy report done in 2016. This said Mrs T could mobilise indoors with support but severe pain in her spine caused difficulty managing stairs, so she uses a stair lift. It also said Mrs T could not negotiate the external stairs and was housebound, ‘unless there is hospital transport to assist her on the stairs’.

The medical advisor assessed her as Medical Priority 2, needing a ground floor property, or one served by a lift. There was nothing entered in the comments section of the form the medical advisor signed when reaching this decision.

• September: The Physical and Social Disability Housing Panel (the Panel) reviewed her case. While it increased her priority for wheelchair accessible housing, it did not change her banding or priority under its housing allocation policy. The Council did not provide evidence the Panel considered, its decision, or reasons for the decision.
• January 2019: She again declared she was housebound, unable to use the external stairs, and her GP had to do home visits as a result. The Council’s records state the occupational therapist met Mrs T and, ‘feels [Mrs T] would be housebound in an emergency if alone in the property’. The therapist’s report noted Mrs T’s, ‘inability to safely manage the steps/stairs due to severe pain’. It also said she was, ‘housebound’. She could not accompany her daughter to appointments because of the external stairs. It noted she had a stair climber but, if her husband was not there to help, she will be housebound.

Two days later, the Council wrote to Mrs T after its medical advisor reassessed her. The Council decided she was Medical Priority 2 and in Band C, but category E for the LAHR. The medical advisor noted his advice from July 2018 remained his view. On the form, the advisor noted her stated medical conditions would not usually necessitate long-term wheelchair use and 2 of her conditions were potentially treatable. The ability to exit the accommodation in an emergency was not a medical matter and she may wish to contact the local safety departments to get a personal evacuation plan.

The letter the Council sent Mrs T advising her of the decision said the medical advisor was of the view she should still be awarded Medical Priority 2.

• March: She completed 2 medical assessment forms, again declaring she was housebound and unable to use the external stairs. She again said the GP had to do home visits.
• April: Her GP wrote to the Council again referring to the flights of steep stairs which meant she must use the stair climber. A separate letter set out the pain she suffered during a recent hospital visit caused by the ambulance crew using it.
• July: The Council asked its medical advisor to review her medical information. This was because if she was housebound, it would show Medical Priority 1 and a Band A placement; and
• September: The Council awarded her Medical Priority 1 and placed her in Band A with a priority date of 2 September. It assessed her as needing any property with ground floor level access or one with internal stairs where a stairlift can be fitted. It reached this decision after she sent her patient medical access record and an occupational therapy report dated July 2019.
• November: Mrs T confirmed she was prepared to rehouse her dog if needed.

18. The Council explained the assessment officer assesses housing applications. When they do so, officers look at it as a whole in accordance with the allocation policy to decide banding. The officer then applies the medical advisor’s recommendation. The assessment officer refers cases to a more senior officer if they think there is an inconsistency between the medical information and the medical recommendation.
19. The Council notes the medical advisor considered medical information and the occupational therapy reports. The case was also considered by the Panel. The medical advisor decided her medical conditions would not usually produce the level of disability she reported. Assessment officers did not consider there were enough grounds to reach a different conclusion.
20. The Council confirmed it has not given officers a definition of what amounts to being ‘housebound’. A case is referred to the Panel where an applicant claims they are housebound. Her landlord prepared a ‘personal evacuation plan’. In response to my draft decision, Mrs T confirmed she never received it.

Analysis

21. I consider there is fault on this complaint. In reaching this conclusion, I took the following into account:
1. The starting point is the situations, or criteria, set out in the Council’s allocation policy under the heading ‘Medical Assessments’. This explains Medical Priority 1 is for those with an ‘urgent medical need’ for alternative accommodation. Urgent medical need is not defined. The section goes on to explain Medical Priority 1 arises in 3 situations which are alternatives, with a requirement applying to all of them.
2. The first situation refers to those who have serious, possibly life-threatening illness or disability whose housing are affecting their health ‘very seriously’. This does not apply to Mrs T.
3. The second situation is for those discharged from hospital who are likely to be deemed priority, non-intentionally homeless. This does not apply to Mrs T.
4. The third situation is relevant to Mrs T’s assessment. This is for a household in which one member is housebound due to the design of, or access to, the building and where alternative housing will resolve that situation. It makes no reference to any medical condition. The inference, therefore, is that those falling within this situation have Medical Priority 1 because they have an urgent medical need.
5. This third situation consists of 3 separate considerations. The first is whether the applicant is ‘housebound’. The Council has no guidance to officers or medical advisors about what housebound is or how to assess it.
6. From July 2018, Mrs T consistently alerted the Council to being housebound. Mrs T’s GP at the time said she was almost wheelchair bound, could only use crutches in the flat, her partner had to carry her down the stairs, and she was trapped when a neighbouring flat caught fire.
7. While the Council said issues of whether a person is housebound or not are considered by the Panel, which looked at Mrs T’s case in September, I have seen none of the evidence it had before it, nor any notes recording its decision, or how it reached it.
8. The medical assessment form completed by the medical advisor gives no reasoning for the decision to not change her banding. Nor have I seen evidence of the assessment officer’s decision and what was taken into account when reaching it. This is fault.
9. In January 2019, she again declared she was housebound, could not use the external stairs and her GP had to do home visits for appointments. The Council’s records show the occupational therapist confirmed she would be housebound in an emergency if alone. The obvious inference from that statement was Mrs T was housebound, emergency or no emergency, when alone in the flat. This is logical as the stair climber would only be used with her family’s assistance. When she was alone, she could not use it.
10. The same month, the medical advisor decided not to change her priority or banding. He noted her medical conditions did not necessitate long term wheelchair use, 2 of her conditions were treatable, and said her ability to exit was not due to medical matters. She needed to get help to get a personal evacuation plan.
11. The letter to Mrs T about this decision told her what the decision was but failed to explain the reasoning behind it. Nor is there any evidence of the assessment officer considering the apparent conflict between the medical advisor’s decision and what the medical evidence, particularly that from the occupational therapist, said. This failure is fault.
12. I am satisfied there was a failure to properly consider Mrs T under the first consideration under this situation. There is no evidence the Council addressed the question of whether she was housebound. The evidence does not show how the Council considered this issue and what weight it gave to her evidence about being housebound.
13. The second consideration under this situation requires the Council to look at whether there is a link between being housebound and the design of, or access to, the building. Again, there is no evidence showing how this was considered or what was taken into account. This is fault. The medical advisor stated problems accessing the flat were not medical ones. This second consideration did not ask whether problems of design or access were linked to medical reasons, but that being housebound, for whatever reason, was linked to the design or access. As noted, the Council failed to consider the first consideration properly.
14. Mrs T argued she was housebound because of the design of the building. It had no lift but several flights of stairs she had to negotiate to access her flat. She had to use a stair lift but only when family helped her.
15. The third consideration of this situation is to look at whether, ‘alternative housing will resolve that situation’. There was no evidence this was considered.
16. The final requirement applies to all three situations. It was to consider whether, ‘social housing will demonstrably contribute to alleviating the impact of the medical condition’. I have seen no evidence to show the Council considered whether this applied to Mrs T. As the third consideration makes no reference to any medical condition, it is difficult to know what medical condition is meant here.
22. The Council sent me 3 pieces of evidence it received which it considered when awarding her Medical Priority 1 with Band A in September 2019. I have seen this evidence which includes an occupational therapy report. This noted:

• her carers refused to use the stair climber externally because of the potential for her to fall. Mrs T was dropped on several occasions. She is restricted to when she can leave the property as this relies on the presence of her family. This causes problems for her when needing to attend hospital and psychological appointments;
• she was housebound;
• the property was unsuitable for her needs and she was at risk there as there was no emergency evacuation plan. The stair climber cannot be used in an emergency as it relies on her family’s presence and presents a hazard on the stairs;
• she spends periods of time alone and cannot independently leave her home. This is restricting all aspects of her life;
• she has multiple medical conditions; and
• she needs urgent re-housing. She met the criteria for Medical Priority 1 as she is housebound due to the design of, or access to the building and where alternative housing will resolve that situation and the criteria that social housing will make their condition more manageable or enhance their general wellbeing.

23. The important statement made in this report was about her medical conditions which were listed towards the front of it. The report listed 4 conditions that were not mentioned in previous medical assessment forms or applications. The evidence does not show Mrs T told the Council earlier than 2019 about these 4 medical conditions. This was, therefore, new information before the Council when it decided to grant her Medical Priority 1.
24. On balance, I found fault in the way the Council assessed Mrs T’s application for re-housing for the reasons set out above. I am satisfied this caused her avoidable injustice. This included, not receiving the higher Medical Priority award earlier had she been given Medical Priority 1 in July 2018, the lost opportunity of being considered for suitable properties sooner with the higher priority, and her frustration at not having her evidence properly considered.

Complaint b): failure to inform of suitable property

25. Mrs T is unhappy the Council failed to tell her of a property she could have been allocated at the end of 2018. This was because she had said on her application form, she would not rehouse her dog if new accommodation had a no pet policy.
26. The Council explained it did not offer the property because it was pet free. On her housing application, Mrs T stated she had a dog and would not make alternative arrangements for it. An applicant is not contacted about a property where they have a pet and the landlord has a no pet policy. If Mrs T changed her mind about planning for her dog, she needed to tell the Council. Mrs T only told the Council about her change of mind a week after it offered the property to another applicant. This was towards the end of November 2018, following contact by a housing officer who wanted to discuss her pet ownership which prevented the Council considering her for some properties.

Analysis

27. I found no fault on this complaint. Mrs T’s housing application sent in 2016 states she has a dog. On the application, she responded ‘No’ when asked whether she would make alternative arrangements for her pet as some properties do not allow dogs/pets. When it decided her application, the Council sent her a letter. This explained the availability of the type of accommodation she needed was ‘very limited’ and urged flexibility both in terms of area and accommodation type. Mrs T replied to my draft decision saying she never received it. The letter ended by saying it would ask her each year if she was still looking for housing and to check all her details were correct.
28. In 2017 and 2018, the Council wrote to Mrs T asking her to renew her application and to tell it of any changes. The letters asked her to check all details were up to date. Mrs T did not amend the statement about making alternative arrangements. Again, Mrs T denied receiving them. As she made no amendments, the Council was entitled to rely on the information she gave on the application form. There was no fault by the Council when it did not offer her this property.

Agreed action

29. I considered our guidance on remedies.
30. I also note the Council, in response to my draft decision, acted on my recommendation to:

• Check whether any suitable properties became available from July 2018 had she been awarded Medical Priority 1/Band A from that date and assess whether she would have successfully bid for them. For every month Mrs T had to remain in unsuitable accommodation after a successful bid, the Council will pay her £350 a month. Any successful bid she might have made before 28 November 2018 will be ignored. This is because this was the date she told the Council she would make alternative arrangements for her dog.

31. The Council carried out these checks and confirmed Mrs T had not missed out on suitable properties since July 2018. As a result of her new banding, she accepted a suitable property and her new tenancy started in October 2019.
32. The Council will, within 4 weeks of the final decision on this complaint, carry out the following:
1. Send Mrs T a written apology for: failing to show it properly considered her medical assessment forms in line with its housing allocation policy; failing to explain in its letter the reasons for the decision not to award her increased Medical Priority/Banding; and for failing to show what the Panel considered and decided.
2. Review whether it needs to issue guidance about what amounts to being housebound to officers and medical advisors.
3. Remind officers and medical advisors of the need, when considering whether this housebound criterion applies, to take account of all the elements set out in it and address them in the decision record.
4. Remind assessment officers to set out proper reasons in letters notifying applicants of the decision after considering the medical advisor’s recommendations. In addition, to remind officers of the need to consider contradictions between evidence submitted and the medical advisors’ recommendations.
5. Make a payment to Mrs T of £250 for the avoidable distress caused which includes the stress, inconvenience, and frustration she experienced as a result of the fault identified.

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Final decision

33. The Ombudsman found fault on Mrs T’s complaint a) against the Council. The agreed action remedies the avoidable injustice caused. There was no fault on complaint b).

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Parts of the complaint I did not investigate

34. I have not considered any complaint Mrs T may have about the Council before November 2017. Any complaint before this date is late because she first contacted the Ombudsman about her complaint in November 2018.

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Investigator's decision on behalf of the Ombudsman