Summary: Mrs X complained the Council reduced the support provided to her son, Mr Y, on his care plan without involving him in 2019. There was fault in how the Council reduced Mr Y’s care and support without notice and delays in arranging his direct payments in late 2020. It agreed to apologise to Mr Y and Mrs X, and pay them both financial remedies. It also agreed to review the training it provides to social workers about direct payments.

The complaint

1. Mrs X complained the Council reduced the support provided to her son, Mr Y, on his care plan without involving him in 2019. Mrs X said the actions of the Council led to Mr Y’s anxiety becoming worse and him being at risk without the 24-hour support he needs.
2. She wanted the Council to provide Mr Y with support which will meet his individual needs, apologise for reducing his support and pay a financial remedy to recognise the effects the lack of support had had on both her and Mr Y. She also wanted the Council to review the support provided to others at the complex where Mr Y lives.

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The Ombudsman’s role and powers

3. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
5. We may investigate complaints made on behalf of someone else if they have given their consent. (Local Government Act 1974, section 26A(1), as amended)
6. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
7. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)
8. 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)

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How I considered this complaint

9. I considered:
• the information Mrs X provided and discussed the complaint with her;
• the Council’s comments on the complaint and the supporting information it provided; and
• relevant law and guidance.
10. Mrs X and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

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What I found

Community care assessments and care plans

11. Sections 9 and 10 of the Care Act 2014 require local authorities to carry out an assessment for any adult with an appearance of need for care and support. 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.
12. Councils must provide a care and support plan where they decide someone needs care or support. The care and support plan should consider what the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the local authority must involve any carer the adult has.
13. The Care and Support Statutory Guidance (CSSG) says, when considering how to meet someone’s needs councils must consider the person’s views and wishes, along with the views of other adults involved in their care. Councils can also take into account a ‘reasonable consideration’ of its own finances and best value.
14. Section 27 of the Care Act says councils should review care and support plans at least every 12 months, or when someone with a care and support plan asks for one.

Direct payments

15. Direct payments are monetary payments made to individuals who ask for one to meet some or all their eligible care and support needs. They provide independence, choice and control by enabling people to arrange their own care and support to meet their eligible needs. Councils have a key role in ensuring that people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the councils should support them to use and manage the payment properly.

What happened

16. Mrs X’s son, Mr Y, has a diagnosis of autism and associated difficulties. He moved into supported housing in mid-2018 with a package of support arranged by the Council and has lived there since.
17. When he first moved into supported housing, Mr Y’s care plan said he needed a total of 34.5 hours support each week, a mixture of 1:1 and shared support (‘direct support’). His plan also included a contribution towards support workers sleeping on site in case of emergencies. Until early 2021, this support was provided by the supported housing provider Mr Y rented his home from.

Council audit of supported housing provider

18. In December 2019, the Council’s ‘Targeted Intervention’ team found the supported housing provider was not delivering all the support it was paid to deliver to Mr Y and the other residents.
19. After the provider told the Council it could not deliver all the hours it was supposed to, the Council negotiated with the provider to agree the hours it could staff. For Mr Y, the Council suggested reducing his direct support to 26 hours a week. However, the provider asked to reduce this further to 16 hours a week.
20. The Council agreed with the supported housing provider for it to deliver 16 hours a week direct support to Mr Y from March 2020. However, it did this without involving Mr Y, Mrs X or the Council’s autism or regular adult social care teams and it did not issue a new care plan with the reduced hours.
21. In June 2020, Mrs X found out about the reductions in Mr Y’s support after the supported housing provider wrote to him and the other residents. Mrs X complained to the Council in July 2020.

2020 review of Mr Y’s care and support

22. In response to Mrs X’s complaint, the Council reviewed Mr Y’s care and support, including a full reassessment of his needs at Mrs X’s request. A manager from the Council’s autism social care team carried out the review between July and December 2020. They involved both Mr Y and Mrs X in the review and incorporated the findings from an October 2020 independent report Mrs X asked to include.
23. The independent report recommended Mr Y should have around 24 hours a week support split between:
• prompts and encouragement in small sessions during the day to support him to live independently; and
• support accessing the community and activities outside Mr Y’s home.
24. The Council produced a new care and support plan in December 2020 which said Mr Y would receive two types of support:
• tenancy and accommodation support; and
• a direct payment for a personal assistant to help Mr Y access the community.
25. The new plan did not include any provision for night-time support although this was still available at the time from the supported housing provider. It also did not specify how many hours of support Mr Y should receive. Instead, it noted that these would be confirmed by the Council’s social care panel.
26. After Mr Y signed the plan, the Council’s adult social care panel approved a total of 22 hours a week support:
• 17 hours for tenancy and accommodation support provided by the supported housing provider; and
• 5 hours a week as a direct payment for Mr Y to employ a personal assistant to help him access community activities.

Withdrawal of supported housing provider

27. In January 2021, the supported housing provider gave the Council one month notice that it would be withdrawing support services from residents.
28. Around this time, Mr Y had a seizure and was diagnosed with epilepsy. The author of the independent report then recommended Mr Y had 24-hour access to support staff he was familiar with. It suggested that there were technological options to help Mr Y summon help if he had further seizures.
29. The Council commissioned two new providers, one to provide the direct (1:1 and shared) support, and a second to provide daytime and night-time remote ‘background’ support to residents. The background support was provided via telephone and tablet devices which could summon support workers at short notice.
30. The Council agreed to Mrs X’s request to transfer all of Mr Y’s direct support hours to direct payments, so she could arrange support for Mr Y herself.
31. The Council reviewed Mr Y’s support in February 2021. The updated plan included:
• a direct payment for 22 hours of support from personal assistants arranged by Mrs X; and
• a contribution to the background support commissioned by the Council.
32. Mrs X told the Council the background support was not suitable for Mr Y. She said he could, and would, not use the tablet provided and would, instead, contact Mrs X if anything happened. Mrs X wanted the Council to arrange for staff who previously worked for the supported housing provider to stay on-site and provide background support for residents, including Mr Y.
33. The Council told Mrs X this was not possible, as the provider would not allow it to use the on-site staff flat. Instead, it suggested that Mr Y’s personal assistants tried to help him become familiar with the background support staff. Mrs X says they tried to do this, but it did not work. The Council also suggested that if his current accommodation did not meet his needs, Mr Y could consider moving to shared housing with on-site support. However, Mrs X said this would not be suitable for Mr Y because of his other needs.
34. In June 2021, the Council carried out a risk assessment with Mr Y and Mrs X. Based on this assessment, the Council decided Mr Y would be unlikely to use any background or night-time support, even if staff were familiar to him. Instead, he would likely contact Mrs X. Mrs X says the Council did not get a correct picture of Mr Y’s views during that assessment or ask her whether she was able and willing to continue to support Mr Y.

Direct payments

35. The Council first agreed to make direct payments to Mr Y in December 2020. However, the first request Mr Y’s social worker made to the Council’s direct payment team did not contain all the required information.
36. Mrs X contacted the social worker but did not get a response. She also contacted the direct payment team for updates several times.
37. In February 2021, the direct payment team tried to clarify how Mrs X wanted to manage the direct payments; whether she wanted to employ assistants directly, or have the Council manage this.
38. Mr Y started receiving direct payments at the end of February 2021, and all 22 hours were transferred to direct payments from mid-March 2021. In September 2021, the Council also transferred Mr Y’s contribution to the background support to direct payments.

My findings

39. The law says we cannot investigate late complaints unless we decide there are good reasons. If someone is not aware of something a council has done until a later time, their complaint is not late if they complaint to us within 12 months of first becoming aware. The evidence suggests Mr Y and Mrs X were only aware of the changes to his care and support plan in June 2020. Mrs Y complained to the Council soon after this and complained to the Ombudsman in April 2021. Therefore, I am satisfied Mrs X’s complaint is not late and I have considered events from December 2019.

First changes to Mr Y’s care and support plan

40. In its responses to Mrs X’s complaint, the Council accepted it should have involved Mr Y and Mrs X in the 2019 review of his support. It apologised to Mr Y and Mrs X, then reviewed his needs and support in late 2020.
41. The evidence shows the targeted intervention audit was, effectively, a review of Mr Y’s care and support. However, that review was not person-centred, did not involve Mr Y or Mrs X and did not consider Mr Y’s individual needs. Instead of ensuring Mr Y’s needs were met and any shortfall in support was met from other sources, the Council asked the provider to decide how much support it could deliver. This was fault which meant Mr Y received less support than his support plan said he needed.
42. The evidence also shows the supported housing provider had not been providing all the support in Mr Y’s plan for some time before the December 2019 audit. There is no evidence the Council reviewed Mr Y’s care and support plan between July 2018 and March 2020. This was also fault. Had the Council reviewed Mr Y’s plan, it may have realised he was not getting all the support in his plan sooner than it did.
43. I cannot say how much support Mr Y needed between moving into supported housing and December 2020. His support plan on moving into supported housing said his support might decrease over time, and the Council decided in December 2020 that Mr Y needed a total of 22 hours of support. However, from the evidence available there was a missed opportunity to ensure Mr Y was getting all the support he needed and uncertainty about how much support this was.
44. Although the Council has apologised and later reassessed Mr Y’s needs, I am not satisfied this fully remedied the injustice to Mr Y. The Council should pay Mr Y £200 to recognise the missed opportunity and uncertainty around his support following the December 2019 audit.
45. I am also satisfied the changes made to Mr Y’s support plan caused Mrs X avoidable distress and worry about his welfare. Considering Mr Y’s reliance on Mrs X, and that this was the first time he had lived away from home, I am not satisfied the Council’s apology to Mrs X is an adequate remedy. The Council should pay Mrs X £200 to recognise the avoidable distress it caused her.
46. We considered the Council’s ‘targeted intervention’ approach in an earlier complaint (20005238). In that complaint the Council agreed to review the care and support provided to any people subjected to the audits. The Council has confirmed it has completed these reviews for others living in the same supported housing as Mr Y.

July 2020 review of Mr Y’s support

47. The Council’s records and needs assessment show the Council properly reassessed Mr Y’s needs in late 2020. It involved Mr Y, Mrs X and the support provider at the time. It also considered the independent report Mrs X arranged and the support it suggested was in line with that report. I am satisfied there was no fault in how the Council reviewed Mr Y’s needs and support in 2020.
48. The evidence shows the Council took a structured approach to calculating the support Mr Y needed and this was based on the needs assessment and the views of Mr Y, Mrs X and the support provider at the time. I am satisfied there was no fault in how the Council decided how much support Mr Y needed and I cannot question the Council’s professional judgement where it reached a decision without fault.
49. However, the Council got Mr Y to sign his support plan before it decided how much support he needed. There is also no evidence the Council shared its calculation with Mr Y or Mrs X, despite Mrs X raising concerns that the hours were not enough to meet Mr Y’s needs. Getting Mr Y to sign the plan before it was finalised was fault, although there is no evidence Mr Y missed out on any support because of this.

Background support

50. Mr Y had access to on-site background support until the supported housing provider withdrew its services in February 2021.
51. Following the notice of withdrawal, the Council arranged replacement direct and background support for residents. Given the short period of time available, I am satisfied the Council appropriately arranged replacement support for residents.
52. The Council considered Mrs X’s concerns about Mr Y being able to access the remote background support. It explained why it could not arrange for existing staff to provide this support. It also decided Mr Y did not need 24-hour 1:1 support and to impose this would both not be in his interests.
53. I appreciate Mrs X disagrees with the risk assessment the Council completed for Mr Y and its decision about how to provide background support. However, the evidence shows the Council took Mrs X’s views, Mr Y’s needs, the practicalities and possible costs into account when deciding what background support to provide and how to provide it. It supported efforts to help Mr Y become familiar with the remote support staff and suggested exploring alternative accommodation if he and Mrs X felt his current accommodation was not suitable.
54. For these reasons, I am satisfied there was no fault in how the Council arranged background support following the supported housing provider’s withdrawal. I cannot question the professional judgement of the Council where it has made a decision without fault.

Direct payments

55. The evidence shows there were delays in arranging direct payments for Mr Y. This was due to both confusion about how Mrs X wanted to manage the payments and through mistakes made by social workers, who were not aware of the Council’s procedures for direct payments.
56. Many of these delays were avoidable and were therefore fault. The delays caused frustration to Mrs X over a period of several months at a time of significant uncertainty about the support arrangements for Mr Y. It also meant that Mr Y went without some support with accessing the community. Although this was a small number of hours at the time, the delay lasted for several months.
57. The Council should apologise to both Mr Y and Mrs X for these delays, pay Mrs X £150 for the avoidable distress and frustration, and pay Mr Y £150 to recognise the effects of the support he missed due to the delays.

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Agreed action

58. Within one month of my final decision, the Council will:
• apologise to Mr Y and Mrs X for the delays in setting up Mr Y’s direct payments;
• pay Mr Y £350 for the uncertainty following the December 2019 changes to his support plan and delays in direct payments for support accessing the community; and
• pay Mrs X £350 for the avoidable distress and frustration caused by the December 2019 changes to Mr Y’s support plan and delays in arranging direct payments.
59. Within three months of my final decision, the Council will review the training it provides social workers about the Council’s direct payments procedures. It will ensure social workers know how to make the correct requests for direct payments.
60. I have not made any recommendations about others subjected to targeted intervention audits, as the Council agreed to review this in an earlier complaint (20005238).

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Final decision

61. I have completed my investigation. There was fault in how the Council reduced Mr Y’s care and support without notice in December 2019 and delays in arranging his direct payments in late 2020. It should apologise to Mr Y and Mrs X, and pay them both financial remedies. It should also review the training it provides to social workers about direct payments.

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Investigator's decision on behalf of the Ombudsman