Summary: Miss X complained the Council did not accept medical evidence to increase her housing priority band. We have found fault in the length of time taken to complete medical assessments, but not the outcome of the assessments themselves. To remedy the injustice caused, the Council has agreed to apologise to Miss X for the uncertainty the delays would have caused and share Ombudsman guidance with relevant officers.

The complaint

1. Miss X complains the Council refused to accept relevant evidence which would have increased her housing priority band. Miss X also complains the Council placed her in a band which was not appropriate for someone with her health issues.
2. Miss X says she cannot get the housing she needs and this has affected her mental 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 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. (Local Government Act 1974, section 34(3), as amended)
5. 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)

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How I considered this complaint

6. I have considered all the information Miss X provided and discussed this complaint with her. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
7. Miss X and the Council had the opportunity to comment on my draft decision. I have taken any comments into consideration before reaching my final decision.

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What I found

Relevant law, guidance and policy

Housing allocations

8. Every local housing authority must publish an allocations scheme that sets out how it prioritises applicants, and its procedures for allocating housing. All allocations must be made in strict accordance with the published scheme. (Housing Act 1996, section 166A(1) & (14))
9. An allocations scheme must give reasonable preference to applicants in the following categories:

• people in insanitary, overcrowded or unsatisfactory housing; or
• people who need to move on medical or welfare grounds;
  (Housing Act 1996, section 166A(3))
   

10. Localism Act
    The Localism Act 2011 introduced new freedoms to allow councils to better manage their waiting list and to tailor their allocation priorities to meet local needs.

No fault

11. The Ombudsman may not find fault with a council’s assessment of a housing application or a housing applicant’s priority if it has carried this out in line with its published allocations scheme.
12. The Ombudsman recognises that the demand for social housing far outstrips the supply of properties in many areas. We may not find fault with a council for failing to re-house someone, if it has prioritised applicants and allocated properties according to its published lettings scheme policy.

The Council’s allocation policy

13. The Council has a housing allocation policy (the policy) which sets out how it prioritises applicants and its procedures for doing so. The policy has a banding scheme to categorise the needs of those applying.
14. Band C of the policy is for those who have a “reasonable preference” and have for example, some minor overcrowding in their current accommodation, or a significant medical or welfare need that has been agreed with the Local Authority.
15. Band D of the policy is (amongst others) for those who have a local connection but whose current accommodation meets their needs.
16. Amongst other things, the policy states that applicants may be asked to complete a medical assessment form or provide documentation from medical professionals. It also states that even if supporting documents say a move to alternative accommodation would be essential, it is for the Council to decide the appropriate level of priority in accordance with the allocation scheme.
17. The policy states that for cases where illness or disability is serious, the Council’s Independent Medical Adviser (IMA) will assess the case.
18. The policy has an appendix for people who need to move on medical or welfare grounds, this places applicants in either Band A (urgent medical or welfare need) or Band C (those who need to move on medical or welfare grounds) of the general allocation scheme.

What happened

19. Miss X lived with her partner Mr Y outside of the Council’s area but in the same county. Miss X says she has a degenerative condition which affects her mobility. She wished to move back to the Council’s area where she grew up, to be closer to her support network and for mental health reasons.
20. Late in April 2021, Miss X submitted an online housing application to the Council.
21. In mid-August 2021, the Council placed Miss X onto Band D of its housing allocation scheme after it had received evidence of her connection to the local area.
22. Late in September 2021, Miss X provided medical information to the Council with a view to increasing her priority banding.
23. In mid-January 2022, the Council’s independent medical adviser (IMA) assessed the information but this did not give Miss X any form of medical priority. At the same time, the request for an extra bedroom to accommodate Mr Y’s children was turned down.
24. In March 2022, Miss X provided more medical evidence to the Council. She sent in letters from her GP and a consultant specialist to outline the difficulties she faced.
25. Early in April 2022, Miss X complained to the Council. In her email, she said:
• she felt she had been treated unfairly and unequally;
• she needed an accessible home;
• she had provided enough information to the Council about her degenerative condition but this had not changed her banding; and
• she believed the Council and its IMA had not changed her banding due to her younger age rather than her level of disability.
26. In April 2022, the Council sent Miss X an annual review email, after which she advised the Council Mr Y’s teenage son had now moved in with them.
27. The Council responded to Miss X’s stage one complaint later in April 2022. The Council said:
• its IMA felt there was not enough evidence to support an increased priority banding or the request for an additional bedroom when her documentation was reviewed in January;
• it would review any other supporting medical evidence Miss X could send in (particularly any report from an Occupational Therapist (OT)) and advise of the outcome;
• it had not discriminated against Miss X because of her age but that there was a very high demand for social housing; and
• that if Miss X sent in proof of Mr Y’s son living with them, it would review her application accordingly.
28. Mr Y then complained to the Council on behalf of Miss X in mid-May 2022. He said:
• Miss X’s medical conditions had been misunderstood;
• she had provided as much evidence as she could including MRI results and statements from medical specialists;
• that as a couple they were being asked to bid on properties that were for people with no disabilities, who had no pets or children and who wanted to live alone;
• he wanted to know why another OT report would make a difference as they had sent one in already; and
• that moving closer to Miss X’s family would benefit her and her mental health as well as lessening the strain on Mr Y as her main carer.
29. The Council responded late in May 2022. In its letter, it said:
• it wanted to assure them that Miss X was not being discriminated against;
• it did not have an OT report on file only a letter confirming an appointment;
• the medical evidence submitted had led to being placed in Band D which reflected that Miss X was currently adequately housed;
• it had received further medical evidence in March, this had not yet been reviewed but the Council would be in touch after it had;
• any evidence of Mr Y’s son living with them would change their banding; and
• the Council could see no evidence of any wrongdoing in how Miss X’s application had been and was being processed.
30. The Council directed Miss X and Mr Y to the Ombudsman if they remained unhappy with the outcome of their complaints.
31. Further communication passed between Miss X and the Council in June 2022. She supplied evidence that Mr Y’s son was living with them. Miss X then submitted an OT housing needs report towards the end of June 2022.
32. By the end of the month, the Council had placed Miss X onto Band C to reflect minor overcrowding and had increased her housing need to two bedrooms.
33. At the beginning of August 2022, the Council’s IMA assessed Miss X’s medical information submitted in March and June. Her medical needs were classed as ‘medium medical’ which would also have given her a Band C priority.
34. The Council confirmed that since the band change in June 2022, Miss X had been able to bid on 25 flats and six bungalows.
35. Late in December 2022, the Council nominated Miss X to a local housing association for a two-bedroomed, ground floor flat close to her family and support network.
36. Miss X has since confirmed that her and Mr Y have now moved into a two-bedroomed, level access, ground floor flat with outdoor space. She also confirmed that some minor modifications are soon to be carried out to the property to enable her to use the shower more comfortably.

Analysis

37. The Ombudsman is not an appeal body. This means our role is not to consider whether a housing allocation decision has put the applicant in the correct banding or not. Rather, we consider whether the Council decided on the application properly, having regard for the key factors and policies which are relevant.
38. If we consider the Council followed processes correctly, we cannot question whether the decision was right or wrong, regardless of whether a complainant disagrees with it.

Medical information

39. Miss X complained that she initially sent medical information to the Council with a hope of increasing her housing priority banding but that the information was lost. As part of my enquiries, I asked the Council to comment on this. In response, the Council said it had only received information from Miss X in September of 2021 and the IMA assessed this in January 2022. The Council confirmed it had no evidence to say any medical information had been lost before that submitted in September 2021. Due to a lack of evidence either way, I am unable to determine if the Council acted with any fault in this matter.
40. Miss X also implied to the Council that her circumstances were exceptional and should be treated as such. As part of my enquiries, I asked the Council what consideration it had given to this. In response, the Council said that it had considered this and there was no evidence her circumstances were exceptional.
41. It also said that it had considered the OT report and that when doing so had decided none of the needs listed were exceptional either. It said that there are two-bedroomed bungalows and ground floor flats within the local housing stock and that many of these would either meet Miss X’s needs already or be suitable for adaptation.
42. The Council has provided a rationale for its assessment and was within its rights to decide there were no exceptional circumstances in this particular instance. The Council was not at fault.

The first medical assessment

43. I have viewed the medical paperwork assessed in January 2022 and the result from the IMA. The Council has also provided evidence to show it considered this and other relevant information before making the decision that Miss X would stay in Band D – which meant it considered she was adequately housed at that time.
44. Whilst Miss X was unhappy with this, the Ombudsman cannot question the decision of the IMA and Council because of this difference in opinion. I have viewed the policy. There is no evidence there was any fault in how the process was carried out. The Council was entitled to make the decision for Miss X to stay on Band D.
45. The IMA’s first assessment did, however, take a little over three and a half months to complete. The Ombudsman’s guidance on good administrative practice outlines the need for reasonable, timely decisions to be taken. The assessment delay was avoidable and is fault. It would have caused frustration and uncertainty to Miss X. The injustice is not significant enough to warrant further action other than the recommendation of an apology, which is made below.

The second medical assessment

46. The IMA did not assess the new medical information sent in March and June of 2022, until August 2022.
47. I have viewed the medical paperwork assessed in August 2022 and the result from the IMA. The Council has also provided evidence to show it considered this and other relevant information before prioritising Miss X as Band C for medical needs. There is no evidence there was any fault in how the process was carried out. The Council was entitled to make the decision to place Miss X on Band C.
48. As part of my enquiries, I asked the Council to explain the reason for the delay in assessing the medical paperwork. In response, it said that it receives a “very high volume of supporting medical information (which) inevitably has an impact on the time taken to carry out the assessments.”
49. The information sent in March was not assessed for nearly five months. Again, this delay was avoidable and is fault. It would have caused Miss X further frustration and uncertainty. I have made a recommendation below to remedy this injustice.
50. As the paperwork sent in March was considered together with the OT report sent in June, I cannot say if the earlier information on its own would have resulted in a band change for Miss X. On balance, I am satisfied that when March’s information was considered together with the OT report, it would have resulted in the change from Band D to Band C.
51. As it was, Miss X had already been moved to Band C with her priority backdated to when the Council received the evidence about Mr Y’s son moving in. Her medical needs were now noted as an addition to the banding.
52. I am pleased to note that Miss X has now been rehoused in her preferred location.

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Agreed action

53. The Council has agreed that within four weeks of the date of my final decision, it will:
• apologise to Miss X for the delays in completing the IMA assessments;
• share the Ombudsman’s guidance on good administrative practice with officers dealing with medical assessments; and
• propose time periods to help manage people’s expectations when submitting medical information for assessment.
54. The Council should provide us with evidence it has complied with the above actions.

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Final decision

55. I have now completed my investigation. I uphold this complaint with a finding of fault causing an injustice.

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Investigator's decision on behalf of the Ombudsman