The Ombudsman's final decision
Summary: Miss Y complained on behalf of her mother, Mrs X. She said the Council failed to effectively communicate with its contractor to provide her mother with a high back chair to meet her needs. Miss Y said that this resulted in Mrs X using an unsafe chair for longer than necessary. The Council was not at fault in how it communicated with its contractor, but it was at fault for not acting on Mrs Y’s request to help remove some of her possessions to create space for a gantry hoist.
The complaint
Miss Y complains on behalf of her mother, Mrs X, that the Council failed to: communicate effectively with its contractor over providing a chair for her mother, Mrs X; and the Council did not properly consider her Disabled Facilities Grant (DFG) application in January 2019.
As a result, Miss Y says Mrs X was forced to use an unsafe high back chair which does not meet her needs.
What I have investigated I have investigated Miss Y’s complaint about the effectiveness of the Council’s communication with its contractor. The reasons for not investigating Miss Y’s complaint about the Council’s consideration of her DFG application are explained in the final paragraph of this decision.
The Ombudsman’s role and powers
We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse effect on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We may decide not to start an investigation if the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended) We may investigate matters coming to our attention during an investigation, if we consider that a member of the public who has not complained may have suffered an injustice as a result. (Local Government Act 1974, section 26D and 34E, as amended) 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)
How I considered this complaint
We have spoken to Miss Y, made enquiries of the Council and read the information Miss Y and the Council have provided about the complaint.
Miss Y and the Council have had an opportunity to comment on my draft decision. I considered their comments before making a final decision.
What I found
In July 2017 an Occupational Therapist (OT) assessed Mrs X and noted that since 2005 she used a rise and recline chair. The assessment also noted that Miss Y asked for a high back chair for her mother. However, in the professional judgment of the OT, Mrs X and her carers were not safe during transfers and Mrs X should be cared for in bed. The OT suggested the family should move their dining table to create space for a gantry hoist. Gantry hoists are floor-standing frames which can be used with a mains powered hoist unit or a battery powered portable hoist unit. They are usually stood over a bed and they are useful for those who are confined to bed for long periods. The OT noted the Council should review Mrs X’s sitting arrangements once there are “suitable hoisting arrangements” in place.
In January 2018 the Council wrote to Mrs X and told her that their property was not suitable for adaptations funded by a DFG. In the same letter the Council mentioned that removal of some of the furniture would allow it to install a gantry hoist.
We asked the Council if it had reviewed Mrs X sitting arrangement since 2017, but it said it had not. It explained that the family were asked to create space for a gantry hoist and they did not do this, so the Council did not carry out another reassessment.
In May 2018 the Council’s contractor said that Mrs X’s chair was beyond repair, and a new rise and recline chair was necessary. The Council approved the order and the contractor replaced Mrs X’s rise and recline chair.
In 2019 the Council visited Mrs X to assess her living environment and its suitability for DFG adaptations. The Council said that it discussed the difficulties of installing any equipment because of the lack of space, and said that the family wanted the DFG adaptations to remedy this.
In April 2020 Mrs X’s solicitor confirmed to the Council that she was not opposed to putting some furniture in storage so that adaptations can be made.
In response the Council said that it was willing to assist with clearing the living spaces to allow it to deliver the full package of care. We have seen no evidence to suggest that any action was taken following this declaration.
In July 2020 the Council’s contractor asked it to raise a new order for a high back chair for Mrs X. It said that after visiting her, she had a high back chair which was not part of standard stock, and the contractor could not repair it. The contractor asked the Council to replace Mrs X’s high back chair. It also said that if there were any problems, the Council should contact Miss Y and speak to her about it.
On the same day, the Council checked Mrs X’s records to make sure it was providing her with a chair that met her needs. After reviewing her case notes, the Council found no evidence it ever provided Mrs X with a high back chair. It said the latest OT assessment recommended that Mrs X use a rise and recline chair. This was not accurate, because the OT assessment of 2017 recommended Mrs X should be cared for in bed and the Council should review her seating arrangements once she had a hoist in place.
The Council visited Mrs X to carry out a holistic assessment of her needs in July 2020, but the assessment did not take place. The Council told us that the assessment would have considered Mrs X sitting arrangements, but Mrs X did not allow the social worker and the OT to enter her property. Mrs X told the Council the reason she did not want the OT to come in was because she felt they had preconceived opinions about her family. She felt they would not be able to objectively consider her needs. The Council’s records indicate that Mrs X would have allowed the social worker into her property.
In August 2020 the Council asked its contractor to order and replace Mrs X’s rise and recline chair.
The following day Miss Y called the Council and said the Council ordered the wrong chair. The officer who took the call referred her to the assigned case worker.
Two days later Miss Y complained to the Council. She said the Council delayed replacing Mrs X’s high back chair.
The Council did not uphold Miss Y’s complaint. It said that it could not replace a high back chair, as it was not the chair the Council supplied her with. It also said that it would only provide and order a chair for Mrs X that was in line with her latest OT assessment. The Council offered to organise a new OT assessment if Miss Y felt that Mrs X’s need had changed.
In September 2020 the contractor told the Council the order raised in August 2020 was for the wrong item. The Council replied on the same day and explained that it could only replace the rise and recline chair that Mrs X’s OT assessment identified as needed. The Council also told the contractor that Miss Y made a formal complaint and the Council’s complaints department was going to reply to her.
Miss Y was not satisfied with the response to her complaint and in late September 2020 she asked the Council to escalate her complaint. She asked why the Council did not contact her after the Council’s contractor made a request to replace Mrs X’s high back chair. She further complained the Council was deliberately not passing information to its contractor about which high back chair her mother needed. She asked the Council to either replace the chair or carry out an emergency OT assessment for her mother.
The Council replied to Miss Y in November 2020. It accepted that it should have contacted Miss Y before if ordered the rise and recline chair for her mother. However, the Council noted that even if it did speak to Miss Y, it would not have changed the order as an OT recommended the rise and recline chair. Nonetheless, the Council apologised for the lack of contact before making an order for Mrs X’s chair. The Council noted it was supposed to carry out another care needs assessment for Mrs X in July 2020, however the Council said this did not happen as Miss Y objected to another assessment.
In response to our enquiries the Council told us that it missed Mrs Y’s request for an OT assessment, and it apologised for this oversight. It said that the adult social care services had arranged a visit to Mrs X in July 2020, but she declined this assessment on the day of the visit.
Analysis An OT’s job role is to help people of all ages overcome the effects of disability caused by illness, ageing or accident so that they can carry out everyday tasks or occupations. An OT will consider all the person's needs - physical, psychological, social and environmental. On behalf of the Council an OT may assess someone’s home environment to recommend aids and adaptations to help them remain living at home. That is what happened in Mrs X’s case in 2017.
The latest OT assessment, carried out in 2017, recommended bed care to meet Mrs X’s needs, until a gantry hoist was fitted. Once this was done, the OT recommended the Council should reassess Mrs X’s seating arrangement.
The Council said that it has not reassessed Mrs X’s seating arrangements since 2017 because the family did not create the space necessary for the fitting of the gantry hoist. The Council provided us with evidence showing that following the 2017 OT assessment it asked the family to create space for the installation of the gantry hoist. Miss Y has told us the family removed some furniture from the room but would not remove a dining table. The Council recognised Mrs X’s had eligible needs but it could not force her to create the necessary space in her living environment to allow the delivery of the full care package.
The Council offered the family help with clearing a space in April 2020 and Miss Y accepted. There is no evidence the Council then arranged to do this. We consider the Council’s failure to organise the support for Mrs X to clear space in her home for the gantry hoist in 2020 to be fault. As a result, the Council allowed this matter to drift, expecting Mrs X to be cared for in bed for longer than it was necessary. We consider the Council missed the opportunity to progress the case when it did not follow up with the family after the request for help in April 2020.
We cannot say, even on balance of probabilities, what the outcome of a reassessment of Mrs X’s seating needs would have been had the Council acted on its offer from April 2020. This is because the Council has not carried out a reassessment at the time of writing my decision, and I have no indication of the approach it would have taken to how it would meet Mrs X’s needs. However, I can say the delay following April 2020 in the assistance of clearing out space and reassessment has caused Mrs X and Miss Y avoidable uncertainty about whether Mrs X may have received a new high back chair as a result of the reassessment.
In July 2020 the Council planned a “holistic” care needs assessment for Mrs X. Mrs X’s social worker, an interpreter and an OT attended her property to carry out the assessment, however the Council said Mrs X would not allow the OT to enter her property. The following day the Council emailed Mrs X’s solicitor and said that she had refused the Care Act 2014 assessment when she did not allow the OT access to her property. We consider this to be fault. The Care Act assessment does not require the presence of the OT. The Council has a strong argument for why an OT’s presence would be helpful and why it is supported by the Care and Support Statutory Guidance (CSSG). However, the OT’s presence was not necessary to carry out the Care Act 2014 assessment of needs. We consider the Council knew it needed to assess Mrs X’s care and support needs and should have proceeded without the presence of the OT. The Council’s decision not to carry out an assessment without an OT caused further injustice to Mrs X. Her Care Act assessment was delayed, and the Council refused to rearrange it until she agreed to let the OT come as well. I cannot say what the outcome of the assessment would have been, had the Council acted without fault, but I consider this compounds Mrs X’s and Miss Y’s uncertainty about what would happen next.
In the meantime, the Council ordered a replacement chair for the one recommended by an OT in the past. The Council told Miss Y that the latest (2017) OT assessment recommended the use of the rise and recline chair, which is not accurate. We consider this to be fault. This fault has further contributed to Mrs X’s and Miss Y’s uncertainty as she chased the Council, and expected it to provide the chair she believed met Mrs X’s needs.
There is no evidence of the Council delaying or mishandling communications with its contractors with regards to the chair Mrs X asked for.
In September 2020 Miss Y requested a reassessment of her mother’s OT needs. The Council accepted that it missed this request at the time. We consider this to be fault. The Council apologised for this oversight. Additionally, the Council said that its earlier offer to reassess Mrs X in July 2020 mitigates this fault. We do not accept this as Miss Y made her request two months after the previously scheduled visit in July 2020 and the Council should have considered the request afresh.
Agreed action
Within one month from my final decision the Council will: pay Mrs X £150 to recognise the uncertainty due to the lack of support in removing her possessions after April 2020; pay Miss Y £150 to recognise the uncertainty due to the lack of support in removing her possessions after April 2020; pay Miss Y £100 to recognise the avoidable time and trouble she was put to in having to bring her complaint to the Ombudsman to have her concerns considered; and offer Mrs X a Care Act 2014 assessment including an OT assessment, which can be carried out with the input of an independent OT. This should include the reassessment of Mrs X’s seating needs and whether she still requires a gantry hoist.
If the above reassessment of Mrs X’s seating needs suggests Mrs X still requires to clear space for the Council to install a gantry hoist, the Council will check with Mrs X and Miss Y within a month of the Care Act 2014 assessment if they still require help from the Council to action the removal of some of their possessions to enable the installation.
Final decision
The Council was not at fault for how it communicated with its contractor about Mrs X’s rise and recliner chair. However, the Council was at fault for not acting on Mrs Y’s request for help removing some of her possessions to create space for a gantry hoist and not continuing with a Care Act 2014 assessment after Mrs X would not allow the OT to enter her property.
Parts of the complaint that I did not investigate I did not investigate Miss Y’s complaint about the Council’s consideration of her DFG application. This is because the Ombudsman has considered these matters as a separate complaint. For this reason I have decided to use my general discretion not to investigate this part of Miss Y’s complaint.
Investigator’s decision on behalf of the Ombudsman
Investigator's decision on behalf of the Ombudsman