The Ombudsman's final decision
Summary: Mr and Mrs X complained the Council left them without the social care support they needed. There was no fault in the Council’s actions.
The complaint
Mr and Mrs X complained that the Council: promised to provide a wet room and a personal assistant (PA), music and art therapy and care calls for showers; failed to provide reasonable adjustments; and did not respond to their complaint.
Mr and Mrs X say they are in crisis and not receiving any support. They say this has affected their mental and physical health.
The Ombudsman’s role and powers
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) 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 spoke to Mrs X and gave her the opportunity to discuss her complaint with me.
I made enquiries of the Council and considered the information it provided.
I wrote to Mr and Mrs X and the Council with my draft decision and will consider their comments before I make my final decision.
What I found
Law and guidance A council has a duty to arrange care and support for those with eligible needs, and a power to meet both eligible and non-eligible needs in settings other than care homes. A council has discretion to charge for non-residential care following a person’s needs assessment. Where it decides to charge a council must follow the Care and Support (Charging and Assessment of Resources) Regulations 2014 and have regard to the Care Act statutory guidance. (Care Act 2014, section 14 and 17) Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan.
There are three main ways a personal budget can be administered: as a managed account held by the council; as a managed account held by a third party; or as a direct payment. (Care and Support Statutory Guidance 2014) Under section 117 of the Mental Health Act 1983, councils and the NHS have a joint duty to provide after-care services to people who have been detained in hospital for treatment under certain sections of the 1983 Act. These services are free and are not means tested.
Under the Housing Grants, Construction and Regeneration Act 1996, councils have a statutory duty to give grant aid to disabled people for certain adaptations. These are called Disabled Facilities Grants (DFGs). DFGs for adults are means tested.
What happened In August 2020, Mrs X contacted the Council to say she was struggling with personal care and needed a wetroom. She said Mr X was unable to help her because of his own health needs.
A Council officer called Mrs X and explained she may be eligible for help, but the Council would need to carry out a financial assessment. The officer also explained Mr X could have a carer’s assessment.
Mrs X said both she and Mr X refused to have a financial assessment.
The officer referred Mrs X to the occupational therapist (OT) to determine whether she required adaptations to her bathroom which could be provided under the disabled facilities grant (DFG) scheme. It was noted, however, that agreement from Mr and Mrs X to a financial assessment would be needed before going any further. This was because without an assessment, any DFG application could not proceed.
On 8 October, Mr X emailed the Council and said he was very stressed and depressed and was struggling to cope.
A Council officer met with Mr and Mrs X the following day. The officer said the DFG team was planning to install a wetroom, but it was likely Mrs X would have to contribute financially because she was a home owner. The officer suggested that in the meantime, a care worker could visit to support Mrs X to take a shower. It was explained that again it was likely that Mrs X would have to financially contribute to the cost of this.
The officer also said a social worker would call round with forms for Mr X to complete which would enable him to receive a carer’s personal budget. This would be provided with no financial contribution or assessment needed.
The social worker phoned Mrs X on 19 October to discuss when to start the shower calls but Mrs X said she did not want strangers coming into her house and terminated the call.
During this period, Mrs X regularly began to send the Council multiple emails expressing her belief that much of the information it, and other public bodies, had about her was false.
In November, the OT visited Mr and Mrs X. Mr X declined to complete the carer’s forms to access a personal budget. This is because he wanted certain information to be amended on historical health and Council records before he would complete them. Mrs X said she would not have a financial assessment which meant the DFG could not go ahead. Shortly afterwards, Mrs X blocked the email address of the Council officer she had been dealing with.
In March 2021, a meeting was held with Mrs X’s consultant psychiatrist, a member of the community mental health team and Mr and Mrs X’s social worker. The consultant psychiatrist spoke of Mrs X accessing singing lessons and hydrotherapy in the past which had proved beneficial. The social worker stated funding for these may be available under section 117 of the Mental Health Act but this would have to be agreed with the NHS. It was also thought the NHS might fund a leisure pass to the swimming pool.
The Council telephoned Mrs X to see if she would agree to a social care assessment but she declined.
At the end of April, because of various actions by Mrs X, she was banned from a choir and lessons she attended.
At the beginning of May, Mrs X contacted the Council and asked for support for Mr X. Another social worker took over and she and a colleague visited at the end of May. The case notes record Mr X needed personal care and support with making meals, but he would not accept this. Mr X said he needed help with domestic chores and the social worker advised him to complete the carer’s form so a personal budget could be allocated.
A second meeting was arranged for the beginning of June, but Mrs X cancelled it. The social worker asked her to provide alternative dates so the meeting could be rearranged.
Mrs X continued to send the Council large volumes of emails although she did not respond with alternative dates for a meeting. The social worker sent her another email stating if she did not respond with dates within three weeks, she would close the case.
On 5 July, the social worker emailed Mrs X to say she was closing her case. She provided details of who to contact at the Council if she decided she wished to have an assessment in the future.
Mrs X complained to the Council on 12 July about the lack of care for her and Mr X. The Council responded three days later to say that it had tried to set up meetings to assess them both, but these had been cancelled. It provided Mrs X with details of who to call if they wished to continue with the assessments.
In mid-July, the Council received a referral from Mrs X’s new GP’s surgery. The Council responded and said it would post Mrs X the assessment forms because it had tried to set up meetings before and Mrs X had not cooperated. It posted these at the beginning of August.
Later in August Mr X returned his carer’s assessment forms.
Mrs X emailed the Council and a date for her and Mr X’s assessments was set up for early September. By this stage it had been established any social care received by Mrs X would be free to her under s117 of the Mental Health Act.
The notes from the meeting record Mrs X wanted a personal budget so she could find her own cleaner, care worker and PA. She also said she would use the money to pay for drinks, food and taxis when she was out. The social worker explained that a personal budget was not to pay for things like this and that Mrs X could either be given a prepayment card, which could only be used for the care specified in her care plan, or the Council could set up a third party bank account. The notes record the social worker explained the role Mrs X would have to take on as an employer if she decided to employ her own PA. The social worker said Mrs X’s case would have to go to a panel for approval.
The following day, the social worker emailed Mrs X further information about prepayment cards and asked if she preferred a card or a third party bank account.
The social worker spoke to Mrs X on 8 September on the phone because Mrs X was unhappy with the two options and wished to receive cash into her own bank account. The social worker explained these were the only options available and requested she inform the Council which she preferred by 14 September otherwise the case would be closed.
Mrs X sent a number of emails to the social worker stating she had been misinformed about personal budgets and she wished to be paid directly into her own bank account.
On 20 September the social worker emailed Mrs X and said the Council was willing to consider another option. This would be to make cash payments into a separate bank account in Mrs X’s name purely for paying care workers. Cash withdrawals would not be allowed and the account would be closely monitored for three months to ensure it was being used correctly. The social worker asked Mrs X to contact her to discuss the information the Council would need to progress her case.
Mrs X sent the social worker a considerable number of emails over the next few days but did not respond to the issues around this new option. On 3 October, the Council wrote to her and said it had closed her case. It explained what she needed to do and who to contact if she wished to pursue a personal budget.
In February 2022, Mrs X complained to the Ombudsman.
The Council also received an email on behalf of Mrs X from her MP. It continued to receive large volumes of emails from Mrs X and began to consider a plan to manage the emails. It also emailed Mrs X in April 2022 to remind her that if her or Mr X’s circumstances had changed and they wanted to explore the support previously offered, to contact Adult Social Care.
My findings
The case notes record the Council acted promptly to requests by Mrs X, and referrals from other agencies, to begin the assessment process to determine whether she had care needs and qualified for a DFG. However, Mrs X either cancelled the appointments or declined to provide the necessary financial information. On each occasion, the Council acted appropriately by asking her to provide new dates to meet and then giving warning the case would be closed if she did not respond. Each time their case was closed, Mr and Mrs X were provided with the information they needed if they wished to engage with the Council. There was no fault in the Council’s actions.
Mrs X said the Council failed to make reasonable adjustments in how it communicated with her. There is no record that at any time Mrs X requested reasonable adjustments were made. There is also no evidence Mrs X struggled with any method of communication used by the Council. She was proficient in the use of email and the telephone. The Council responded using the same methods and also made in person visits. There was no fault in the Council’s actions.
Final decision
The Council was not at fault. I have completed my investigation.
Investigator's decision on behalf of the Ombudsman