The Ombudsman's final decision
Summary: Mrs X complained about her adult son, Mr Y’s, care plan, which she said was not fit for purpose. There was no fault in the Council’s decision-making.
The complaint
Mrs X complained about her adult son, Mr Y’s, care plan, which she said was not fit for purpose.
Mrs X said the Council incorrectly recommended supported accommodation in Mr Y’s care plan, which he does not want. She said the Council failed to consider Mr Y’s wishes and refused to review the plan. This was unhelpful for Mr Y’s social housing application and caused distress.
Mrs X also complained the Council planned to meet Mr Y’s needs using support workers to help him complete jobs like housework and cleaning. She said this would not work for Mr Y, as it will make him angry and aggressive. Mr Y wants a direct payment so he can employ someone to do these jobs for him. This decision also caused distress.
The Ombudsman’s role and powers
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 significant injustice, or that could cause injustice to others in the future 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
As part of the investigation, I considered the complaint and the information Mrs X provided.
I made written enquiries of the Council and considered its response along with relevant law and guidance.
Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.
What I found
Assessment Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
Where a council determines a person has eligible needs it must meet those needs. Councils must produce a care and support plan setting out how any eligible needs will be met.
Care and support statutory guidance Councils may meet eligible needs by arranging for someone other than itself to provide a service, by directly providing a service, or by making direct payments.
Councils may meet need through types of care and support which are available universally, including those which are not directly provided by the council. For example, councils may put someone in touch with local community groups or voluntary organisations.
If a council is meeting someone’s needs, it must provide them with a personal budget.
What happened I have summarised below some key events leading to Mrs X’s complaint. This is not intended to be a detailed account of what took place.
Mr Y has autism, but he does not like to use this label and does not feel he needs support from any autism specific services. Prior to this complaint, Mr Y lived with Mrs X. Mrs X helped Mr Y with daily activities, such as medication, preparing meals, cleaning, and transport to appointments or social activities.
Mr Y wanted his independence and his own home. Mrs X therefore approached the Council’s adult social care (ASC) team on Mr Y’s behalf, asking for an assessment of his needs to support a housing application.
A social worker met Mr Y in October 2023 to discuss his needs and complete an assessment. The social worker’s record of the discussion states Mr Y struggled living with Mrs X and wanted to leave. He wanted to be independent, and to have support with things Mrs X would struggle to do. He wanted this support to come from someone who was not linked to a specialist service. He said he did not want to live in supported accommodation. However, he did agree to explore this option and agreed for the social worker to make a referral.
The social worker considered Mr Y would be at significant risk of unintentional self-neglect and social isolation if he went into accommodation without support. However, they felt with a careful transition and support Mr X would gain independence and adapt to manage his own home.
The social worker identified the following eligible needs under the Care Act: Managing and maintaining nutrition.
Maintaining a habitable home.
Developing how to manage home safely.
Accessing and engaging in work, training, and employment.
Accessing the community and making use of the necessary facilities.
Mrs X wanted to continue supporting Mr Y to meet these needs. This included support with medical appointments and shopping. However, she could not support him with managing a habitable home, due to her own health issues.
Mr Y considered support twice a week would help him manage his home and build skills. He was aware Mrs X could not help with this, so he wanted support from adult social care or supported accommodation to do this.
The social worker made a referral to supported accommodation. This housing comes with an allocated support worker and is therefore not a costed support service.
Mrs X contacted the Council’s ASC team at the end of October 2023. She said the Council’s housing service was assessing Mr Y for a Council flat. She asked for a direct payment so Mr Y could employ a personal assistant to help with appointments, shopping, and housework. She also asked for an appeal or review of the current assessment.
The Council said it assessed Mr Y’s contribution to the costs of any care and support it arranged at £27 per week. So, if he wanted to employ a personal assistant for cleaning he can do so privately, as the Council would class him as self-funding.
Mrs X said Mr Y needs more than two hours’ support each week, costing more than £27, so he would not be self-funding. She said Mr Y needed a support package for independent living in a Council home, and supported accommodation would be detrimental to him if it was multiple occupancy.
The Council confirmed supported accommodation is not multiple occupancy and Mr Y would receive floating support for 4-6 hours a week from his own support worker. The Council said if Mr Y is awarded a Council house it will look at what support it can provide at that stage. This would be aimed at promoting Mr Y’s independence. It said there was no dispute around Mr Y’s needs, so it did not know what Mrs X wanted to appeal.
Mrs X contacted the Council’s ASC team in December 2023. She said the Council’s housing service offered Mr Y a Council home and he will need help. She said having someone trying to help Mr Y tidy will aggravate him and he does not want this. She asked for a direct payment so Mr Y can employ someone to clean for a few hours a week and possibly take him shopping.
An officer telephoned Mrs X. They said ASC can provide support to promote Mr Y’s independence to complete these tasks himself, involving a support worker. Mrs X did not agree. She wanted Mr Y to have a direct payment to employ a personal assistant to do the tasks for him. The officer said the Council’s aim was to support Mr Y to do things independently. It was not the case that Mr Y cannot have a direct payment, but a support worker was the first step. If it was unsuccessful, the Council would then look at other support.
My investigation Mrs X told me Mr Y informed the Council several times he did not want supported accommodation. The Council then recommended supported accommodation anyway. This made Mr Y angry and caused them both distress.
Mrs X confirmed Mr Y has now moved into his new home and she is trying to support him. However, she has her own health issues, and does not think she can help Mr Y as much as she would like anymore. She said the Council’s support plan will not work. She fears Mr Y will be left without help because he will not let support workers in.
The Council told me if it can meet someone’s needs in an alternative way, such as a non-costed service, then it would not produce a personal budget. It is not opposed to a direct payment, but it considers it can meet Mr Y’s needs using a non-costed service.
The support the Council offered Mr Y is a free service from a third sector organisation. It is based on Mr Y’s desired outcomes and includes supported housing with a dedicated service to help people live independently.
The Council said Mr Y asked for support to enable him to become independent, and to learn to do things for himself. He did not ask for someone to do things for him. The Council also said there was no evidence of aggressive behaviour from Mr Y towards any professionals.
The Council said it did not refuse to do a review. There was no support in place as Mr Y had not moved into his new home.
Analysis Mrs X complained Mr Y’s care plan incorrectly recommends supported accommodation and failed to consider his wishes. I found the Council did involve Mr Y in the care planning process and properly considered his views and wishes, which are recorded. Despite Mr Y initially expressing reluctance for supported accommodation, his assessment states he did agree to the Council making a referral on his behalf.
Mr Y’s recorded wish was to learn the skills to live independently. The Council considered supported accommodation, with help from a support worker, was a suitable way to achieve this. I have not seen evidence of fault in that consideration.
The Council’s housing department later offered Mr Y social housing, so the care plan did not negatively impact him in this regard.
Mrs X also complained about the fact Mr Y’s care plan recommends meeting his needs with a support worker, who would help him complete tasks. The Council identified an eligible need in terms of Mr Y maintaining the home. It must take Mr Y’s views into account, which I consider it did, but the Council can decide how best to meet that need, and whether this requires a paid service.
It has not yet been possible to say whether a support worker will meet Mr Y’s needs, as no support has started. However, the Council’s aim, in line with Mr Y’s wishes, was to promote his independence. The Council considers this will be achieved better with support rather than with someone doing tasks for him. I do not consider there was fault in that decision.
The Council assessed Mr Y as having other eligible care needs besides maintaining his home. During Mr Y’s assessment, Mrs X said she wanted to continue supporting him to meet those other needs. That included helping him with appointments and shopping. At that time, it was only housework and cleaning Mrs X said she could not help with. The support the Council recommended for Mr Y took into account the support Mrs X said she would provide.
However, Mrs X later said Mr Y needed a personal assistant to help with appointments and take him shopping. If the situation has changed from the time of Mr Y’s assessment, and if Mrs X can no longer provide the same level of support, the Council may need to re-assess Mr Y.
Mrs X said the Council refused to review Mr Y’s care plan. I did not see evidence the Council refused to do a review. Rather, it said it found Mr Y had eligible needs, so it did not understand what Mrs X wanted a review of. It also said the support it recommended had not started, because Mr Y was still living with Mrs X. It said it would consider Mr Y’s support again once he moved into his new home.
Mr Y is now living in his new home. The Council therefore agreed to consider what support would be best suited to meeting Mr Y’s needs in his new home environment.
I appreciate Mrs X wants Mr Y to have a direct payment, but I have not seen evidence of significant fault by the Council. If the Council was providing a paid support service for Mr Y, and refused to consider a direct payment, that would be different. However, the Council is not proposing a paid service, and at this stage it is not providing Mr Y with any support.
The Council said Mr Y’s assessed financial contribution towards the cost of any care package would mean he is better off hiring a cleaner or personal assistant himself. The specific cost details can be reconsidered once the Council has determined what support it may offer Mr Y in his new home.
Final decision
I completed my investigation. I did not find fault in the Council’s decision-making.
Investigator’s decision on behalf of the Ombudsman
Investigator's decision on behalf of the Ombudsman