The Ombudsman's final decision
Summary: We will not investigate this complaint about direct payments. There is not enough evidence of fault in how the Council decided to assess Mrs Y’s needs to justify investigating. The Council has apologised for asking Mrs X and Mrs Y to gather quotes for support, and sent a reminder to its staff about correct processes. This is sufficient to recognise the inconvenience that caused.
The complaint
Mrs X complains on behalf of her wife, Mrs Y, about her direct payments. The Council did not provide clarity about how they could use direct payments, asked them to seek several quotes for different support, then said no to all their suggestions. It refused to assess Mrs Y via video call to account for her particular vulnerability to COVID-19. This caused Mrs X and Mrs Y significant stress and they have gone to unnecessary time and trouble. They want assurances they will not lose support, and clearer information on how they can use direct payments.
The Ombudsman’s role and powers
The Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or may decide not to continue with an investigation if we decide: there is not enough evidence of fault to justify investigating, or further investigation would not lead to a different outcome, or we cannot achieve the outcome someone wants.
(Local Government Act 1974, section 24A(6)) 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)
How I considered this complaint
I considered information provided by the complainant and the Council.
I considered the Ombudsman’s Assessment Code.
My assessment
Mrs Y’s last social care assessment was carried out in 2018. In late 2021 the Council began arrangements to reassess Mrs Y. In the meantime, while they discussed arrangements for this, Mrs X and Mrs Y asked the Council to clarify what support they could purchase using Mrs Y’s direct payments.
The Council asked Mrs X to gather quotes for things they would like to purchase with direct payments, to see if their requests could meet Mrs Y’s needs. On receiving quotes from Mrs X, the Council said the things she had suggested would not meet Mrs Y’s eligible needs. For example, she had included damp management works for the property. Mrs X says gathering the quotes caused her significant inconvenience and she remained uncertain about what would be appropriate.
The Council accepted when considering Mrs X’s complaint that it should not have asked her to gather quotes. It apologised and sent out a staff reminder about the correct process to follow. It has since clarified to Mrs X that while direct payments are considered on a case-by-case basis and it could not provide a finite list, they are for services, equipment or activities to meet assessed social care needs.
Mrs Y’s previous assessment and support plan should state her eligible needs. The Council also provides information on its website about what direct payments can be used for, giving examples and explaining people must “only spend [their] direct payments on things that [their] assessment shows that [they] need and that are reflected in [their] support plan”.
(Direct Payments – frequently asked questions – How can I use the money I receive from direct payments?)
The Council’s apology and staff reminder is therefore sufficient in the circumstances, to recognise the impact of its error in asking Mrs X to obtain quotes that were found to be unacceptable.
The Council wished to visit Mrs X and Mrs Y in their home to reassess their needs and offered to use personal protective equipment and take a lateral flow test beforehand. However, Mrs X and Mrs Y explained they were particularly vulnerable to COVID-19. The Council later accepted this in January 2022 and agreed to assess them via video call. It explained, however, it might find it could not complete a proportionate assessment this way, and that it may later decide its occupational therapist would need to visit the home.
There is insufficient evidence of fault in how the Council considered its decision. It is entitled, where it believes it cannot otherwise carry out a proportionate assessment, to decide it needs to carry out a home visit. In this case, it considered Mrs X and Mrs Y’s concerns and agreed to do what it could via video call. We cannot require the Council to provide assurances that it will not want to visit Mrs X and Mrs Y at home, because it may decide this is necessary in future to be able to properly assess their needs. It is entitled to come to such a decision if it properly considers their circumstances and any alternative options.
Final decision
We will not investigate Mrs X’s complaint because there is not enough evidence of fault in its decision around how to assess Mrs Y’s needs, and it has already provided an appropriate remedy for its error in asking Mrs X to seek quotes.
Investigator's decision on behalf of the Ombudsman