Disabled woman had care package reduced by more than half following flawed assessment by Bolton council

The Local Government and Social Care Ombudsman has found Bolton Metropolitan Borough Council significantly reduced a disabled woman’s care package without properly assessing her needs.

The woman, who is registered blind and has numerous health conditions and disabilities, previously received a personal budget for 67 hours of care per week.

After a number of stays in hospital, when she was seriously ill, a fresh assessment of the woman’s care needs was carried out. But this took more than a year to complete, and was highly inaccurate – with basic errors about her religion and preferred language.

The woman’s package was reduced to 25 hours a week, causing her significant problems carrying out basic activities, including communication, taking medication and preparing food. She provided the Ombudsman with a list of 75 accidents she had over 12 months.

Because of her disabilities, the woman needed support to challenge the assessment. Her personal assistant had to spend many hours helping her do this because the council didn’t offer support.

The Ombudsman’s investigation found the council at fault for failing to assess the woman’s needs when she left hospital. And when the council did start the reassessment, it was with the intention of reducing her care hours. The assessment did not consider the woman’s fluctuating needs or the cumulative impact of her health conditions, despite clear evidence provided. It also took too long to produce the assessment.

The Ombudsman criticised the way the council handled the woman’s complaint, and its failure to make reasonable adjustments for her disabilities so she could make the complaint.

Michael King, Local Government and Social Care Ombudsman, said:

“While I appreciate the pressures councils are under, the amount of support and budget given to someone should not be based on financial matters, but on a person’s needs.

“In this case the council used a flawed assessment to reduce the woman’s support by more than 60%, causing her significant distress.

“I am concerned the council has used the same approach with other people in its area, so I welcome its commitment to review other cases to see if they comply with the Care Act.

“I also welcome the steps the council has already taken to remedy the complaint and improve its services for people in its area.”

The Local Government and Social Care Ombudsman’s role is to remedy injustice and share learning from investigations to help improve public, and adult social care, services. In this case the council has agreed to apologise to the woman, and pay her £3,800 to acknowledge the distress, time and trouble it caused when it failed to provide sufficient support and listen to what she said.

It has also agreed to pay the woman’s longstanding daytime personal assistant £500 in recognition of the unpaid, and on demand support she provided in the absence of other support.

In response to a draft report, the council reinstated the woman’s personal budget for 67 hours immediately, pending reassessment by an experienced social worker with knowledge and understanding of sight loss.

It will discuss with the woman, and ensure its records note, suitable reasonable adjustments for her.

The Ombudsman has the power to make recommendations to improve processes for the wider public. In this case the council has agreed to review the services of the agency which provided support with the direct payments.

It will also review cases over the past 12 months where people with complex needs have complained about reductions in budgets, to ensure the reviews were in line with Care Act. It will ensure all assessments, reviews and support plans are completed in line with the Care Act in future.

It will also review its complaints process and ensure its responses to complaints are effective.

Article date: 13 June 2019

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