Kent County Council wrongly refused to pay for short-term residential care for an elderly woman, and delayed in providing services for a young disabled woman.

Local Government Ombudsman, Anne Seex, has issued two reports today (31 July 2012) criticising Kent County Council over adult social care complaints. One (ref 11 001 504) concerns payment for an elderly woman's short-term residential care, and the second (ref 10 012 742) concerns failure to provide services for a young woman with learning disabilities.

Report ref 11 001 504

In her report concerning the elderly woman's residential care payment, the Ombudsman says: “The Council’s internal guidance said that staff could only use the Council's own homes, or places it had 'pre-purchased', or community hospitals. The requirement to offer service users a genuine choice of placement when they are assessed as needing residential care is enshrined in law. The guidance did not adhere to these principles.”

The Ombudsman is pleased that the Council has agreed to fulfil her recommendations to remedy the injustice.

An elderly woman needed to go into a residential home for a short time when she was discharged from hospital. She needed to be in a home close to her daughter so she could visit. The daughter found a home from the Council's approved provider list but the Council refused to pay the fees.

The reason the Council refused to pay was that senior officers in adult social services had issued instructions about short-term residential care. The instructions were that staff could only use the Council's own homes, or places it had 'pre-purchased', or community hospitals.

The daughter paid for her mother to have a place for four weeks in a residential home not covered by the instructions. She complained to the Council about its decision not to pay for the place, but senior managers would not change it.

After four weeks, everyone involved agreed that the elderly woman should stay in the residential home permanently. The Council then agreed to pay the costs but still refused to pay for the first four weeks.

The Head of Policy & Service Standards in adult social services said he had not known about the instructions. The officers who issued the instructions said they were a response to a high level of vacancies in 'pre-purchased' places, a budget crisis, and pressure to free-up hospital beds.

The Ombudsman found the instructions from senior managers were contrary to the 1992 Choice of Accommodation Directions. The Directions say a person can choose a permanent or temporary residential care home (if certain conditions are met as they were in this case). She found maladministration by the Council for:

• refusing to fund the first four weeks of the place in the residential home
• issuing instructions to staff that were contrary to Government directions, and
• not realising that the instructions were wrong when the daughter complained, and not correcting them.

The Council has agreed to remedy the injustice by:

• apologising to the woman’s daughter
• refunding the cost of the first four weeks’ residential care (£1,560)
• withdrawing the incorrect instructions, and 
• identifying other people who may have been adversely affected by them.

Report ref 10 012 742

In her report concerning services for a young woman with learning disabilities, the Ombudsman says: “The Council’s failure to complete an assessment before the young woman was 18 caused her the injustice of losing services she was assessed as needing. The support plan that was eventually produced did not include services to meet these needs.” In addition, the Council’s poor communication led to uncertainty, confusion and frustration for the young woman and her family, and she was denied a direct payment and the choice to arrange her own respite care.

Miss B was a young woman with learning disabilities attending college. Her mother contacted the Council in good time to begin planning what services she would have once she was 18. A care manager should have been involved as soon as Miss B was 17½, but this did not happen until after she was 18. The care manager assessed Miss B’s needs as serious enough to be eligible for services, and to include opportunities to socialise during evenings and weekends. There was a delay in producing a support plan and, when it was eventually produced, it did not include all Miss B’s eligible needs.

Miss B’s mother was not offered a carer’s assessment, although she was providing a substantial amount of care for her daughter. The Council did not offer a service that could provide her with a break from her caring responsibilities until the Head of Service responded to her complaint. That service – respite care for Miss B only in one of the Council’s own residential homes – did not comply with the legal requirement to offer a direct payment. The internal Council guidance issued to care managers in July 2010 restricting respite care to the Council’s own residential care homes did not comply with the law.

The Ombudsman found maladministration by the Council in:

• not assessing Miss B until four months after she was 18
• not producing a support plan for another four months
• not including Miss B’s assessed needs that were eligible for services in that support plan
• poor and confusing communication with Miss B and her family
• not offering Miss B’s mother a carer’s assessment
• not offering Miss B direct payments so she could arrange her own care, and
• restricting respite care for Miss B to its own residential care homes.

The Council’s officers have agreed that it will remedy the injustice caused to Miss B and her family. It will pay the value of the services Miss B lost between becoming 18 and them eventually being provided and £250 to reflect her mother’s time and trouble in pursuing the complaint. It will also amend the form it uses for support plans and tell everyone entitled to respite care of their right to have direct payments.

In 2009 the previous Ombudsman issued a report finding maladministration by the Council in having a policy of restricting respite care for disabled children to its own residential homes. The Ombudsman said: “I am surprised and disappointed to find the maladministration recurring in services for adults with a learning disability. I appreciate the Council’s need to use its resources as effectively as possible but that cannot be at the expense of peoples’ right to the choice and flexibility that direct payments give.”

Article date: 31 July 2012