Summary: Mr X complained the Council did not follow the correct process when it rejected a medical assessment application he submitted on his and his son Y’s behalf requesting priority status on its lettings scheme. He also complained the Council significantly delayed responding to his application. He said this situation has negatively affected his and Y’s health. There was fault in the way the Council initially made its decision to refuse Mr X’s application. Mr X did not suffer a significant injustice because it later assessed Mr X’s medical application correctly and it did not award him priority. There was fault when the Council significantly delayed responding to Mr X’s application. The Council has agreed to apologise to Mr X and pay him £100 to acknowledge the time and trouble he was put to. It should remind its staff of the importance of keeping to required timescales.

The complaint

1. Mr X complained the Council did not properly consider the information he provided in support of his application for priority status on the Council’s lettings scheme. He also complained the Council failed to acknowledge or respond to his application in a timely manner.
2. He said this matter has put him to time and trouble making the applications and negatively impacted his son Y’s health.

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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 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)
4. 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)
5. 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

6. I contacted Mr X and discussed his view of the complaint.
7. I made enquiries of the Council and considered the information it provided, this included Mr X’s medical file, Mr X’s housing application, complaint form and correspondence shared between the Council and Mr X.
8. I have written to the Council and Mr X with the details of the draft decision and have given them both the opportunity to comment. I gave both the opportunity to comment before I wrote the final decision.

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What I found

The Council’s allocations policy

9. The Council’s policy is to offer the majority of applicants a choice of accommodation by way of a choice based lettings scheme.
10. Every local housing authority must publish an allocation scheme setting out how it prioritises applications and how it allocates housing.
11. In line with the Housing Act 1996, section 166A (3) an allocations scheme must give reasonable preference to applicants in the following categories:
• homeless people;
• people in insanitary, overcrowded or unsatisfactory housing;
• people who need to move on medical or welfare grounds;
• people who need to move to avoid hardship to themselves or others.

Medical assessment

12. Every medical application is assessed by the Council. The Council may ask for the opinion of a medical advisor. The Council does not assess the severity of the applicant’s condition but tries to establish their difficulty in coping with their existing housing.
13. If necessary, the Council will ask for a medical report from an independent medical adviser. The adviser bases their assessment on the medical condition, the effect the property has on that condition and how moving to an alternative property could help. The adviser does not carry out individual medical examinations, their opinions are based on:
• the information given by the applicant on the medical assessment form;
• any medical evidence;
• any medical assessment referral form; and
• copies of any previous medical applications and opinions.
   
14. After the advisor provides his/her opinion on the medical assessment form, the Council’s housing register officer carries out an assessment and writes to the applicant with their decision within 28 days of receiving the request.
15. If additional information is submitted after an assessment, the Council will carry out a new assessment based on the information available at that time. If necessary, the Council will obtain a further opinion from a medical advisor. The Council should notify the applicant of its decision within 8 weeks of receiving the request.

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What happened

16. Mr X has various health issues and his young son Y is autistic.
17. On 2 January 2020, Mr X sent the Council a medical assessment form on behalf of himself and Y asking to be given priority housing status on its choice based lettings scheme. Mr X said Y’s development was being negatively affected by the lack of space. He said he could not ventilate the property because Y did not understand the dangers of opening windows. Mr X also raised concerns about the structural integrity of the building and the lifts.
18. The Council’s housing officer responded to Mr X’s application on 29 January 2020. The officer said that as Mr X’s difficulties were caused by overcrowding, he would need to fill out a separate assessment.
19. Mr X was unhappy with the Council’s response and submitted further information regarding his and Y’s medical needs on 16 March 2020. The Council sought medical advice but did not make Mr X aware of this or keep him updated on the progress of his application.
20. On 1 October 2020, the Council forwarded an email from its medical advisor stating the property was suitable for Mr X based on his health needs and he did not qualify for priority status. The Council said it originally meant to send this information to Mr X in April 2020.
21. On 7 October 2020, the Council’s housing officer wrote to Mr X and stated, “As per our policy, we will only award reasonable preference where an applicant’s current accommodation is unsuitable and it exacerbates the poor health of the applicant.”
22. The officer acknowledged Mr X and Y’s health issues but did not award him priority status on medical grounds stating, “I am satisfied that the current accommodation, although possibly unsuitable, does not exacerbate the poor health of the applicant.” The Council concluded the letter advising Mr X of his right to review the decision.
23. Mr X complained again to the Council. He asked the Council to clarify whether it had sought advice from a medical professional. He also reiterated his unhappiness with how long it had taken the Council to respond to his application.
24. On 3 December 2020, the Council wrote to Mr X and confirmed it had sought advice from a medical professional who agreed he did not meet the criteria for priority status. The Council again acknowledged that the property was not ideal but advised Mr X to request to have the lift fixed and shields installed which would allow him to ventilate the property without unlocking the windows. The Council upheld its decision not to award Mr X priority status and told Mr X he did not have a further right of review.
25. Mr X brought his complaint to the Ombudsman. In response to our enquiries, the Council confirmed the reasoning the housing officer gave Mr X for rejecting his initial application was incorrect. The Council said Mr X had not been disadvantaged by this because it would not have awarded him priority status on medical grounds if it had assessed the application correctly.

Findings

26. Mr X remains unhappy the Council did not approve his application for housing priority status on medical grounds. It is not the Ombudsman’s role to decide whether the Council should have approved Mr X’s application; it is our role to decide whether the Council made the decision properly. The Council is required to assess each medical assessment on its own merit and seek medical advice if necessary. The Council has acknowledged it gave Mr X incorrect information when it rejected his application the first time. This is fault. The Council went on to assess the application correctly and did not grant Mr X priority status. I therefore cannot see that Mr X has suffered an injustice because of this fault.
27. After Mr X applied to the Council for a second time, the Council considered the information Mr X provided and asked for advice from a medical advisor. The medical advisor and the Council then wrote to Mr X declining his application and explaining their reasons for doing so. The Council made Mr X aware of his right to review the decision and again sought medical advice when he provided additional information. The Council decided the additional information did not qualify Mr X for priority status and explained its decision. This is in line with the Council’s process. There is no evidence of fault in the way the Council made its decision on this occasion.
28. Mr X has complained about the length of time it took the Council to respond to his application. The Council is required to respond to applicants within 28 days of receiving the application. Mr X submitted his application in March 2020 and did not hear from the Council until October 2020 when he chased for a response. This is fault. Mr X was put to unnecessary time and trouble contacting the Council for an update and the Council should address this.

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Agreed action

29. Within one month of the date of the final decision, the Council has agreed to send Mr X an apology and pay him £100 to acknowledge the time and trouble caused by the significant delay in responding to his application.
30. Within three months of the date of the final decision, the Council should provide evidence showing it has reminded its staff of the importance of adhering to timescales when responding to medical assessment applications.

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Final decision

31. There was evidence of fault by the Council causing an injustice and I have made recommendations to address this, which the Council has agreed to. I have completed the investigation.

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Investigator's decision on behalf of the Ombudsman