London Borough of Hillingdon (22 003 847)

Decision : Upheld

Decision date : 31 Jan 2023

The complaint
The Ombudsman’s role and powers
How I considered this complaint
What I found
Agreed action
Final decision

The Ombudsman's final decision:

Summary: the Council was at fault in the way it managed Mr W’s needs as a vulnerable homeless man with unmet social care needs. This caused injustice because it prolonged his stay in emergency hostel accommodation and delayed the provision of practical support to meet his care needs. The Council has accepted my findings and agreed to provide a suitable remedy.

The complaint

Ms X made this complaint on behalf of her brother, Mr W. Ms X is a suitable person to make the complaint for Mr W because he is vulnerable and cannot complaint to us.
Ms X complains that the Council:

allocated Mr W temporary accommodation in March 2020 without first completing a mental capacity assessment to decide if he could make a homelessness application and manage in general needs housing;
did not properly consider whether Mr W needs supported accommodation, rather than general needs housing, and take account of the views expressed by his GP, consultant neurologist and Ms X;
delayed putting in place a care package to support Mr W while he remains in hostel accommodation.

Mr W did not move into the temporary accommodation allocated in March 2020 until January 2023. This was due to delay in completing necessary works and installing an over bath shower to meet needs arising from his disability. The Council has written off the rent and Council Tax due since March 2020 but Mr W paid standing charges for utilities at a flat he was not able to occupy.

The Ombudsman’s role and powers

We cannot investigate late complaints unless we decide there are good reasons to do so. A complaint is late 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)
Ms X complained to us in June 2022. We exercised discretion to investigate events from March 2020 when Mr W made a homelessness application to the Council. In making that decision, we took into account that Mr W is vulnerable because of a disability which caused significant cognitive impairments. Ms X and her sister continued to engage with Council officers to raise concerns that Mr W’s housing and social care needs were not being met throughout this period. There was also a continuing injustice to Mr W while he remained in the hostel. For these reasons, we decided there were good reasons to make an exception to the 12 month time limit.
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)
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)

How I considered this complaint

I have spoken to Ms X and considered all the information she provided.
I considered the Council’s response to my enquiries and the relevant housing and adult social care records.
Ms X and the Council had an opportunity to comment on my draft decision. I considered their comments before making the final decision.

What I found

Background

Mr W has an acquired brain injury which left him with profound physical, mental and cognitive disabilities. This affects his behaviour and his ability to manage daily activities. His GP says Mr W finds it difficult to process information and communicate effectively. He has short and long term memory loss and a short attention and concentration span. He has depression, anxiety and panic attacks and is prone to aggressive outbursts. He also has uncontrolled epileptic seizures and impaired sight. Mr W is vulnerable to financial abuse and exploitation from others.
Mr W became homeless when he had to leave his parents’ home in late 2019. I have investigated the key events since March 2020 when an officer in the Council’s homelessness prevention team first interviewed Mr W and assessed his housing needs. In this statement, I have not given a detailed account of everything that has happened since then. Instead I have focused on the main events relevant to this complaint and the Council’s housing and social care duties.

Mr W’s capacity to make a homelessness application and manage a tenancy

An officer in the homeless prevention team interviewed Mr W at the Council’s offices in early March 2020. Mr W’s sister was present.
At the time, Mr W did not have a Court appointed deputy and no one had lasting power of attorney to manage his health and welfare or property and finances. A deputy was not appointed by the Court of Protection until April 2021.
In January 2020 Mr W signed a statement giving consent for the Council to speak to one of his sisters about his housing and social care needs.
The officer also had access to Mr W’s care needs assessment which a social worker had completed in late December 2019 and reviewed in early February 2020. It said the Council had not started a mental capacity assessment. It recorded that Mr W was often forgetful and could not manage day to day paperwork. It said he needed support with a number of physical tasks and/or required significant support to avoid low mood, loneliness or risk of harm. It said he could be left alone for extended periods, and did not need night-time support, but needed support to stay safe.
I asked the Council if the housing officer had considered whether Mr W had capacity to make a homelessness application. It said the officer had taken into account information in the Adult Social Care needs assessment. Although he was aware that Mr W was vulnerable, he knew Mr W was being supported by a social worker and his sisters.
In late April 2020 a social worker met Mr W and completed two mental capacity assessments. One was to decide whether Mr W had capacity to manage a tenancy. The other was to decide if he had capacity to manage his finances.
I have seen the social worker’s records of both assessments. The social worker asked Mr W a series of questions to assess his capacity in each area. He concluded that Mr W lacked capacity to manage his finances and was at risk of financial abuse and exploitation. This prompted the Council to make an application to the Court of Protection for a deputy to manage Mr W’s finances. The social worker concluded Mr W did have capacity to manage a tenancy.

Mr W’s homelessness application and his delayed move to temporary accommodation

The officer completed a resettlement form with Mr W to record his housing needs. It referred to Mr W’s brain injury and disabilities. Sections on the form which give details of care needs and supporting agencies were left blank. The form noted Mr W needed a one bedroom property close to local shops, medical facilities and transport. It did not identify his need for a shower.
The Council accepted the relief duty on 2 March 2020 and booked Mr W a room in a hostel on the same day. This was arranged as interim accommodation.
The Council says the officer prepared a Personalised Housing Plan for Mr W on the same date. It is not clear from the Council’s records whether this was sent to Mr W. The officer involved no longer works for the Council.
On 16 March 2020 the Council asked Mr W to sign an agreement for a self-contained one bedroom ground floor flat. Ms X says the flat had no gas supply. She has provided photographs taken at the time. There were no floor coverings in the flat and several walls had bare plaster and needed redecoration. Mr W spent one night there and then returned to the hostel because there was no gas supply for the central heating boiler.
In late April 2020 the Council ended the relief duty and accepted it owed Mr W the main housing duty as an eligible homeless person in priority need. It sent him a letter to notify him of this decision. Ms X says Mr W did not show her this letter and so she was not aware he had the right to request a review of the suitability of his accommodation.
The Council’s Voids team later inspected the temporary accommodation and considered it met the Council’s minimal lettable standard. The Council says the gas company is responsible for the gas supply and installing a gas meter and this was not part of the checks carried out in the voids inspection. The incoming tenant must sort this out with the gas company. Ms X says it took time to resolve this because Mr W could not make the arrangements himself, the utility companies would not deal with her and there was no Court appointed deputy in place until April 2021. A gas meter has since been fitted and the boiler was recommissioned in 2022.
Mr W has epileptic seizures so it is not safe for him to use a bath. Ms X first contacted Mr W’s social worker in September 2021 to say Mr W needed to have a shower head installed. She raised the request again in March 2022. The Resettlement team advised her to contact the Social Care team.
In mid-April 2022 an Occupational Therapist assessed Mr W and recommended an over bath shower was installed because Mr W did not want a level access shower. This request was sent to the Adaptations Team in late April 2022. Work to install the shower did not begin until mid-October 2022.
The Council says it took six months to start the adaptations work because the team had to check if it was feasible to carry out the work and then get quotations and funding approval. It says it discussed with Ms X the option of Mr W surrendering the property but they chose not to do that. Ms X says she had already spent a lot of time liaising with the gas company to get the supply connected and liaising with the Council about the works. She did not want Mr W to surrender the tenancy having invested so much time to get the property ready.
The Council confirmed it has written off all the rent, water charges, Council Tax and service charges that were due from the time Mr W signed the temporary accommodation agreement in March 2020.
Ms X told me Mr W’s deputy has paid standing charges for utilities even though Mr W has not been able to occupy the flat since it was allocated in March 2020.
Mr W finally moved to the temporary accommodation in early January 2023.

Mr W’s need for supported accommodation

Ms X believes Mr W is at risk of exploitation if he lives alone in general needs housing. She is worried he may become a victim of “cuckooing”. This term is used to describe a situation where someone takes over a vulnerable person’s home for criminal activities or to financially abuse them. Mr W has been a victim of financial abuse in the past and the police and the Council’s safeguarding adults team carried out an investigation. She thinks Mr W would be much safer and at less risk of abuse in supported accommodation.
The Council says supported living accommodation is designed for adults who need 24/7 care which cannot be managed with home care support, telecare support or support from voluntary sector agencies or informal carers.
Mr W’s care needs assessments did not identify a need for a supported living placement.
Mr W’s GP stated in January 2020 that Mr W required supported accommodation in the long term. It said he had poor self-care skills and was at risk of exploitation.
In April 2021 Mr W’s consultant wrote to express strong concerns about Mr W’s ability to live independently. He said Mr W could not live by himself, was a danger to himself and would need regular checks even in supported accommodation.
The Supported Living Panel considered Mr W’s case on two occasions in April and May 2021. It decided Mr W did not meet the criteria for supported accommodation. Instead it considered he could be suitably supported in general needs accommodation with a care package, Telecare and a key safe. The social worker said the Panel would review its decision if his circumstances changed or the situation became urgent.
The Council has explained that Mr W did not meet the criteria for supported accommodation because he did not have autism or a learning disability. And Mr W is not old enough (65 or older) to meet the criteria for extra care supported housing.
Mr W’s consultant wrote another letter in April 2022. He said in strong terms that Mr W would be at risk of harm or injury if he lived unsupervised in general needs housing. He focused on the risks to his health if he had unwitnessed seizures and failed to take his medication. He was firmly of the opinion that Mr W should be in some form of supported living placement.
I have seen no evidence that the Council reviewed Mr W’s case to take account of the views Mr W’s consultant expressed in April 2022. It may not have changed the Panel’s decision that Mr W did not meet the eligibility criteria for supported accommodation because the information in the April 2022 was similar to the contents of his April 2021 letter. But it was fault not to consider and respond to this evidence.

Delay in providing the care package

In February 2021 the social worker completed a Care Act needs assessment which found Mr W was eligible for social care support because he had the following needs:

Support to maintain a clean and habitable home environment;
Managing and maintaining nutrition;
Maintaining personal hygiene
Making use of the home safely

It also noted that he had to be prompted to take medication.

A weekly indicative budget was included to provide the required support. A further needs assessment was completed in August 2021. Around this time Mr W had been nominated for a tenancy of a Housing Association property and was expected to move to this accommodation. However this planned move did not happen because the Housing Association decided Mr W did not meet their criteria.
In mid-August 2021 Ms X contacted Mr W’s social worker. She said the Brokerage team had found a care agency which could deliver the agreed care package from 17 August. The social worker told her the care package had been put on hold until Mr W moved to the self-contained temporary accommodation.
In late October and early November 2021 Ms X contacted Mr W’s social worker again to chase this up. She said Mr W needed help to clean his room in the hostel.
The Council says it tried to arrange to blitz clean Mr W’s room at the hostel but it was not possible to gain access. Mr W was either not in, had switched off his phone or was sleeping in late. A blitz clean was completed in 2022.
The Council says a planned daily care call could not be put in place because Mr W would not engage with officers at the time.
In late November 2021 Ms X sent an email to Mr W’s social worker. She said Mr W needed the care package to start immediately. She said the hostel manager had told her most vulnerable residents had a care package and she did not understand why Mr W did not have one. Ms X said Mr W’s room had not been cleaned since he moved to the hostel in March 2020 and it was extremely unhygienic. The hostel did not provide a room cleaning service and Mr W was not capable of cleaning it himself.
A care package was eventually put in place for Mr W at the hostel from late June 2022. This consisted of a daily care call for 30 minutes from one carer to help Mr W shower, or wash and dress, and to prompt him to prepare a meal and drink and take his medication.
The carers are expected to observe and record Mr W’s abilities to be independent and safe within his own home and feed back to Adult Social Care if his needs are not being adequately met through the current care package.

My analysis

The evidence shows Mr W is a very vulnerable man who needs social care support. My overall finding is that he did not receive adequate support from housing and adult social care services while he was homeless and at risk.

Mental capacity to make homelessness application and manage a tenancy

There were clearly some doubts about Mr W’s capacity so it would have been good practice for the Council to have completed and recorded a mental capacity assessment to satisfy itself Mr W could make a homelessness application and manage a tenancy before it asked him to sign the temporary accommodation on 16 March 2020.
However the mental capacity assessment completed in late April 2020 found Mr W did have capacity to manage a tenancy. For this reason, I do not consider the delay in completing this assessment affected the outcome. Mr W would still have been placed in temporary accommodation if this assessment had been completed sooner.
I recognise Ms X has continuing concerns about Mr W’s ability to manage a tenancy. However I cannot question the merits of the social worker’s decision in April 2020. He made the decision following a meeting with Mr W in which he asked several questions to assess his ability to understand and retain information about his responsibilities as a tenant. I find no fault in the way that decision was made.

Delayed move to temporary accommodation

Mr W was allocated the temporary accommodation in March 2020. However he remained in the B&B hostel for 34 months before he moved into the flat in January 2023.
The following factors, which were outside the Council’s control, contributed to this delay:

the property was allocated just before the first COVID-19 lockdown which delayed the void inspection and repairs to the property;
it took time to make arrangements with the utility companies to supply and connect gas and electricity in the flat.

However the Council should have done more to assist Mr W with the move and to expedite essential adaptations to provide an over bath shower. Mr W could not move into the property until these works were completed. Due to this fault, Mr W had to stay for much longer than he should have done in a small room in the hostel. I have made recommendations for a remedy below.

Need for supported accommodation

Mr W does not meet the criteria for supported accommodation for adults with autism or learning disabilities. He is not old enough to be considered for extra care supported housing schemes.
We cannot criticise the merits of a decision which has been properly made. The Supported Living Panel considered Mr W’s needs in April and May 2021 and decided he could be supported in general needs housing with a care package. If that arrangement proves not to work, Mr W’s social worker will then have to consider other options.