London Borough of Tower Hamlets (22 008 300)

Category : Housing > Allocations

Decision : Upheld

Decision date : 08 May 2023

The Ombudsman's final decision:

Summary: there was no fault in the way an Occupational Therapist assessed Mrs X’s housing needs in April 2022 and made recommendations about a suitable type of property. However the Council’s failure to reply to an email from Mrs X’s son accepting an offer to arrange a new assessment was fault. The Council has agreed to apologise for this.

The complaint

  1. Mr W made this complaint on behalf of his mother, whom I shall call Mrs X, with her written consent.
  2. Mr W complained about the way a housing Occupational Therapist (OT1) assessed Mrs X’s housing needs in April 2022. In particular he considers she was biased and changed her initial assessment that Mrs X required ground floor accommodation.
  3. Mr W also says the Council falsely claimed in its final response to the complaint that he had refused its offer to arrange a second OT assessment. There was also a failure to communicate with him properly because the Council did not reply to his email accepting a second assessment.

Back to top

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 consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
     
  2. If we are satisfied with an organisation’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)

Back to top

How I considered this complaint

  1. I have spoken to Mr W, considered the Council’s response to my enquiries and read the relevant records, including the OT’s housing needs assessments.
  2. Mr W and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

Back to top

What I found

The Council’s housing allocations scheme

  1. The Council’s published scheme explains that some types of home are designated for specific groups of applicants because of their age, disability or other characteristics.
  2. The decision to award priority for a ground floor property on medical or disability related grounds is made by a Lettings Officer following a medical assessment and recommendation from a health advisor.
  3. Category A and B wheelchair accessible properties are allocated to applicants who need to use a wheelchair indoors as well as outside.
  4. Preference for ground floor flats is given to applicants who need a home with no internal stairs.
  5. Preference for a property with a garden may be given to:
    • Applicants with a disabled child under 18 who can benefit from a safe and supervised outdoor playing space; or
    • Adults who have:
      1. a severe cognitive impairment who are at risk of wandering and need constant supervision;
      2. a sensory impairment and/or a guide dog and who live alone or with other disabled adults;
      3. a limiting illness and who are caring for children;
      4. a severe, permanent and substantial disability or severe long-term illness.

Background

  1. Mrs X is a Council tenant. She has several medical conditions which affect her physical health and limit her mobility. She lives with her son, Mr W, in a four bedroom first floor maisonette. There is one step to the entrance of the block and no lift in the building. There are four flights of seven steps, with landings, and an external walkway to reach the front door of Mrs X’s home.
  2. Inside Mrs X’s home there are 13 steps between the floors. A stairlift and handrails have been installed. Mrs X sleeps on a bed in the living room and has an accessible toilet on the same floor. The adapted wet room is on the top floor.
  3. Mrs X only leaves the maisonette to attend appointments because she struggles to manage the steps down to the ground floor. She negotiates the steps slowly with support from a family member. Mrs X has an attendant propelled wheelchair to use outdoors. Mr W says his mother is a prisoner in her home and her health has deteriorated as a result.
  4. Since 2019 Mrs X has had the highest priority – Band 1 Group A - for rehousing under the Council’s housing allocations scheme. This priority was awarded because she is under-occupying her property (she has more bedrooms than she and her household need). Applicants awarded the highest medical priority for rehousing are in the same priority band and group.

The housing needs assessment

  1. Mr W complained to us about a housing needs assessment carried out in April 2022. Mr W was present for the assessment. He says the OT told them Mrs X needed ground floor accommodation but she later changed her recommendation.
  2. Mrs X’s housing needs had previously been assessed by another OT in October 2019. I shall refer to her as OT1. We are not investigating what happened in that assessment. But I have summarised the recommendations made by OT1 because they are relevant to the April 2022 assessment.
  3. In the 2019 assessment OT1 said the external stairs were a barrier to Mrs X getting access to the community. Mrs X had expressed a wish to move to a ground floor flat with a garden. Based on her observations and assessment, OT1 made the following recommendations in 2019:
    • Maximum floor level without a lift: ground floor;
    • Maximum floor level in building with a lift: any floor level;
    • Property with no internal stairs, or, if there are stairs, it must be suitable for a stair lift to be installed;
    • A Category C lifetime home;
    • OT viewing of property required.
  4. In February 2022 Mr W completed a medical self-assessment form on behalf of Mrs X. It asked for medical priority for rehousing to a ground floor property with a garden. It also said Mrs X needed a wheelchair accessible property.
  5. In April 2022 a locum OT, whom I shall call OT2, visited Mrs X to carry out a housing needs assessment. Mr W was present to advocate and interpret for his mother. OT2 recorded Mrs X’s medical conditions and observed her mobilising indoors using a walking frame and transferring on and off the stairlift. She noted Mrs X used an attendant propelled wheelchair outdoors.
  6. I have read OT2’s assessment report. She changed one of the property recommendations made by OT1 in October 2019. She observed that Mrs X depended on the stairlift to get up the internal stairs. She said it would impede Mrs X’s access within the property if she were to move to a property which did not already have a stairlift.
  7. In her report she noted that Mr W disagreed with the floor level recommendation in the 2019 housing needs assessment. He considered his mother could only manage in a ground floor property. But OT2 decided there was no medical reason why Mrs X could not access a property on any floor provided it had lift access. She noted Mrs X had to be accompanied when she went out in her wheelchair.
  8. The only difference between the October 2019 and April 2022 assessments relates to the need for a stairlift. OT2 decided that if Mrs X were to move to a property with internal stairs, a stairlift should already be in place. The floor level recommendations from the October 2019 report for a ground floor property (if there was no lift in the building) or a property on any floor (in a building with a lift) did not change.
  9. There is nothing in the April 2022 report to suggest that OT2 told Mr W or Mrs X during the assessment that she would recommend a ground floor property. Following the visit, OT2 discussed her findings and recommendations with a supervisor who approved them. The Council explained this is a standard procedure to ensure OTs are consistent and apply the relevant eligibility criteria.
  10. In April 2022 Mr W complained about the assessment. Specifically he said OT2 had said during the assessment that Mrs X was entitled to a ground floor property because she was incontinent. By then OT2 had left the Council at the end of her contract. Her supervisor spoke to Mr W in early May. Mr W also expressed concerns that OT2 had not observed his mother using her wheelchair when entering and leaving the building and had not asked about her mental health.
  11. Following her telephone conversation with Mr W, the supervisor sent him an email to explain that incontinence would not justify a health recommendation for a ground floor property. She also said the fact that Mrs X used a wheelchair outside was not, in itself, a sufficient reason to recommend a ground floor property. She said OT2 had observed Mrs X’s dependence on the stairlift to reach the upper floor of the maisonette. She had therefore recommended that any property with internal stairs should have a stairlift because it could take months for one to be installed. In view of Mr W’s dissatisfaction with the assessment, she offered to arrange a new assessment with an interpreter who speaks Mrs X’s language.
  12. The Council investigated Mr W’s complaint at both stages of its complaints procedure in April and May 2022. It did not uphold the complaint but repeated the offer to arrange a new assessment.
  13. Mr W did not reply immediately due to other demands on his time. On 1 July 2022 he sent an email to the supervisor saying his mother wished to accept the offer of a new assessment with an interpreter who speaks her language. The Council did not respond and Mr W did not contact them again to chase this up.
  14. The Council says the team does not recall receiving Mr W’s July email. It apologised that it was overlooked at the time.
  15. In late November 2022 we made enquiries to the Council and asked about the failure to reply to Mr W’s email. The Council then contacted Mr W and arranged an appointment for two OTs to review Mrs X’s housing needs on 26 January 2023. One of the OTs speaks Mrs X’s language and the other OT was her supervisor.
  1. Mr W was present at the January 2023 assessment. I have read the OT’s assessment report. She noted Mr W had challenged the recommendations made by OT2 in the April 2022 assessment. In particular, he disagreed with the recommendation for a property with no internal stairs and a property on any floor with lift access rather than ground floor only. He considered Mrs X was being by-passed for suitable homes due to the recommendation for no internal stairs.
  1. On the following day, Mr W sent an email saying he was satisfied with the new assessment and the way the two OTs had conducted it.
  1. The January 2023 assessment did not result in any changes to the floor level recommendations made in the October 2019 or April 2022 assessments. The report gave the following reasons:

Any floor lifted – Mrs [X] can be on any floor lifted, there is no medical reason as to why Mrs [X] cannot access a property on any floor with a lift as she is always accompanied when outdoors in her attendant propelled wheelchair.

No Internal stairs - Mrs [X] is heavily reliant on a stairlift to negotiate internal stairs therefore a property without a stair lift in situ will severely impede her accessibility within the property.

  1. On 15 February 2023 the Council wrote to Mrs X to confirm the outcome.

Analysis

  1. I found no fault in the way OT2 carried out the assessment of Mrs X’s housing needs in April 2022. I understand Mrs X and Mr W have a strong preference for a ground floor property. But OT2 had to consider if Mrs X met the relevant criteria for a ground floor only recommendation. Following her assessment, she decided Mrs X could manage on any floor level provided there was a lift in the building. She took into account that Mrs X was always accompanied when she went out. She also kept the October 2019 recommendation for a ground floor property if there was no lift in the building.
  2. Mr W recalls OT1 saying that Mrs X was eligible for a ground floor property because of her incontinence. He says she later changed her opinion. But there is nothing in her report to support that and, as OT1’s supervisor explained, incontinence is not a reason to recommend a ground floor property. A recommendation for a ground floor only property is based on the applicant’s accessibility and mobility needs not their continence needs.
  3. If there was no fault in the decision making, we cannot question the merits of the decision. We are not an appeal body and we cannot overturn the OT’s assessment. OT2 properly exercised her professional judgment based on her assessment of Mrs X’s needs. I also found nothing in her report to suggest she was biased and this influenced her decision-making.
  4. The Council’s failure to respond to Mr W’s July 2022 email was fault. The Council also wrongly stated in its final response to Mr W’s complaint that he had refused the offer of a new assessment. In fact he had not refused but had not taken up the offer by then. The Council should apologise to Mr W for this.
  5. The failure to respond to Mr W’s July email contributed to the delay in arranging the new assessment. However I must also consider Mr W’s actions. If he had followed up by sending a reminder to the OT supervisor, it seems likely this would have prompted her to arrange an earlier date for the new assessment.
  6. In the event the January 2023 assessment did not change the April 2022 recommendations about the appropriate floor level, or that a property with internal stairs should have a stairlift. As there was no change in the recommendations, Mrs X did not miss out on opportunities to bid and be considered for other types of property.
  7. Mrs X can bid for ground floor properties advertised on the choice-based lettings scheme. However, in line with its housing allocations policy, the Council will prioritise those applicants with an assessed health need for a ground floor only property.

Back to top

Agreed action

  1. Within one month of my final decision, a manager should make a written apology to Mr W for the failure to respond to his July 2022 email and for wrongly stating in its response to his complaint that he had rejected the offer of a new OT assessment for his mother.
  2. The Council should provide us with evidence it has complied with the above actions.

Back to top

Final decision

  1. I have completed the investigation and found fault in the way the Council communicated with Mr W. This caused Mr W frustration which can be remedied by an apology.

Back to top

Investigator's decision on behalf of the Ombudsman

Print this page

LGO logogram

Review your privacy settings

Required cookies

These cookies enable the website to function properly. You can only disable these by changing your browser preferences, but this will affect how the website performs.

View required cookies

Analytical cookies

Google Analytics cookies help us improve the performance of the website by understanding how visitors use the site.
We recommend you set these 'ON'.

View analytical cookies

In using Google Analytics, we do not collect or store personal information that could identify you (for example your name or address). We do not allow Google to use or share our analytics data. Google has developed a tool to help you opt out of Google Analytics cookies.

Privacy settings