Summary: Housing and adult social care failed to work together to assess the needs of an elderly woman with health problems who was homeless. The departments failed to carry out appropriate housing and social care assessments within a reasonable timeframe or issue written decisions. This caused avoidable distress, time and trouble and a loss of reablement care. The Council will apologise, make symbolic payments, provide housing advice and introduce procedures for joint working between housing and adult social care.

The complaint

1. Ms X complained London Borough of Haringey (the Council) did not provide appropriate accommodation or care and support for her mother Ms Y.
2. Ms X said this caused avoidable distress and a debt because she had to secure care and housing for Ms Y herself which she cannot afford.

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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. 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)

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How I considered this complaint

5. I considered Ms X’s complaint to the Council, its responses and documents described in this statement. I discussed the complaint with Ms X
6. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance: homelessness

7. Someone is threatened with homelessness if, when asking for assistance from the Council on or after 3 April 2018 he or she is likely to become homeless within 56 days. (Housing Act 1996, section 175(4))
8. If a council has ‘reason to believe’ someone may be homeless or threatened with homelessness, it must take a homelessness application and make inquiries. The threshold for taking an application is low. The person does not have to complete a specific form or approach a particular council department. (Housing Act 1996, section 184 and Homelessness Code of Guidance paragraphs 6.2 and 18.5)
9. Councils must arrange interim (emergency) accommodation where there is reason to believe an applicant may be eligible, homeless and in priority need. This is a low threshold (Housing Act 1996, section 188)
10. Councils must take reasonable steps to help to secure suitable accommodation for any eligible homeless person. When a council decides this duty has come to an end, it must notify the applicant in writing (Housing Act 1996, section 189B)
11. If a council is satisfied an applicant is homeless, eligible for assistance, and has a priority need the council has a duty to secure that accommodation is available for their occupation. This is called ‘the main housing duty’ (Housing Act 1996, section 193)
12. Adults are only eligible for homelessness assistance if they are habitually resident in the UK. There is no definition in law of habitual residence. It means there must be some permanence. The Homelessness Code of Guidance says a period of between one and three months is likely to demonstrate habitual residence. (Homelessness Code of Guidance, Annex 1 paragraph 14)
13. After completing inquiries, the council must give the applicant a decision in writing. If it is an adverse decision, the letter must fully explain the reasons. All letters must include information about the right to request a review and the timescale for doing so. (Housing Act 1996, section 184, from 3 April 2018 Homelessness Code of Guidance 18.32 and 18.33)
14. Councils can suggest alternative solutions in cases of potential homelessness where these would be suitable and acceptable to the applicant. However, councils must not do this to avoid their legal duties, especially the duty to make inquiries into the applicant’s homelessness. The Ombudsman has criticised councils for ‘gatekeeping’ practices, for example, failing to take a homelessness application at the earliest opportunity. (Homelessness Code of Guidance for Local Authorities, paragraphs 2.3 and 6.4)

Relevant law and guidance: adult social care

15. A council must 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 outcomes they want to achieve. It must also involve the individual and where appropriate their carer or any other person they might want involved. (Care Act 2014, section 9)
16. An assessment should be carried out over an appropriate and reasonable timescale taking into account the urgency of needs. Councils should give the person an indicative timescale and keep them updated. (Care and Support Statutory Guidance 2014, Paragraph 6.24)
17. An adult’s needs meet the eligibility criteria if they arise from or are related to a physical or mental impairment or illness and as a result the adult cannot achieve two or more of the following outcomes and as a result there is or is likely to be a significant impact on well-being:
• Managing and maintaining nutrition
• Maintaining personal hygiene
• Managing toilet needs
• Being appropriately clothed
• Making use of the home safely
• Maintaining a habitable home environment
• Accessing work, training, education
• Making use of facilities or services in the community
• Carrying out caring responsibilities.

(Care and Support (Eligibility Criteria) Regulations 2014, Regulation 2)

18. If a council decides a person is eligible for care, it should prepare a care and support plan which specifies the needs identified in the assessment, says whether and to what extent the needs meet national eligibility criteria and specifies the needs the council is going to meet and how this will be done. The council should give a copy of the care and support plan to the person. (Care Act 2014, sections 24 and 25)
19. Intermediate care is a structured programme of care provided for a limited time (usually six weeks) to help a person maintain or regain the ability to live independently. Reablement is a type of intermediate care which has a focus on helping the person regain skills and reducing their needs through providing services in the home. (Care and Support Statutory Guidance Paragraphs 2.12 to 14)
20. Councils must make arrangements for ensuring internal co-operation between officers exercising social care functions and housing functions. There will be cases where a member of staff will need to explicitly ask for co-operation, for example by requesting specific action on an individual case. (Care Act 2014 section 6 and Care and Support Statutory Guidance, paragraphs 15.23 and 15.25)
21. The Council does not have any written procedures for social care and housing staff to ensure internal co-operation between staff dealing with customers who may be homeless and may also have social care needs. The Council told me ‘we have working relationships between housing and adult social care…. We will seek national best practice and procedures to strengthen this.’

What happened

22. Ms Y is elderly and has long-term health conditions. She has a British passport. Ms Y lived in another country and came to London in June 2022 after her husband died. Ms X told me her mother has memory loss and in June, she began to suspect Ms Y had dementia. Ms X said she could not continue to look after Ms Y and Ms Y wanted to be near family.
23. Ms X submitted an on-line homeless referral form on 17 June on Ms Y’s behalf. The form said the family was asking Ms Y to leave on 30 June and she requested sheltered housing.
24. On 21 June, a housing needs officer interviewed Ms X and Ms Y by phone. The note of the interview set out the Ms Y’s background and why she had come to the UK. The housing needs officer advised they would look into whether or Ms Y was habitually resident (see paragraph 12). The housing needs officer noted Ms X told him Ms Y could not live independently and she may need additional care.
25. On 21 June, the housing needs officer emailed Ms X asking for proof of identity, residence, income and medical needs for Ms Y. Ms X responded supplying documents and gave Ms Y’s GP’s name and address. Ms X chased the housing needs officer on 26 June saying the last day Ms Y could stay in her home was 30 June. Ms X went on to say she had made an appointment for Ms X to attend the Council’s offices on the 30th and her mother would need an immediate placement.
26. On 24 June, Ms X emailed the Council’s first response team (this is the initial contact team for referrals for adult social care). She explained Ms Y could not live with her because her property was not suitable due to steep stairs and the risk of falls. Ms X said she had not been able to go to work as she felt her mother could not be left safely on her own. She said Ms Y needed sheltered housing. Ms X went on to say she could only accommodate Ms Y for one more week. She said Ms Y was a British citizen with a British passport.
27. An officer from the first response team spoke to Ms X on 24 June. The note of the call said Ms X had applied for sheltered housing and did not need a care package. Ms X told me she never said Ms Y did not need care.
28. An internal email dated 30 June from a customer services officer to the housing needs officer and other council officers said Ms Y and her son had attended the Council’s offices that morning seeking assistance with health and housing issues. The email went on to say the housing needs officer was on leave and Ms X said she had given Ms Y notice to leave.
29. Another housing needs officer spoke to Ms X on 30 June. Ms X said she could not look after her mother and wanted her to leave and felt she needed care. The second housing needs officer mentioned Ms Y was not likely to be habitually resident in the UK. There was a further call between Ms X and the original housing officer on 1 July with the latter saying Ms Y needed to be habitually resident in the UK to be eligible for housing assistance from the Council.
30. Ms X spoke to a senior housing needs officer and emailed her further copies of the documents she had already provided. Ms X’s email said her mother could not manage the stairs safely and needed accommodation on the same level and care. There was no response from the senior housing needs officer, despite them saying they would progress the case.
31. On 1 July, Ms X spoke to an officer in the first response team. After the call, she emailed to say she was concerned about leaving her mother alone at home because she was at risk of falling on the stairs.
32. An occupational therapist spoke to Ms X on 4 July. Ms X said she had found a flat in extra care sheltered housing and the family could afford to pay for this for a month. Ms X asked if the Council would then take over funding.
33. On 5 July, Ms X emailed the housing needs officer. She said she had not heard anything from him despite emailing and leaving him messages.
34. Ms X also emailed the first response team on the same day to say Ms Y had memory loss, physical health problems and she would not be able to fund Ms Y’s housing or care long-term. Ms X said she could not cope with Ms Y and she was in urgent need of a social care assessment.
35. Ms X sent the housing needs officer a further email on 9 July. She reminded him he had promised to contact her after he had spoken to his senior. The housing needs officer emailed again to say Ms Y needed to meet the habitual residency test and Ms X said she had spoken to adult social care and had an appointment with them. There was no further contact from the housing needs officer despite a further chasing email from Ms X on 14 July. The housing needs officer noted Ms X ‘was aware we may be finding mother not eligible and will come back if she wants to pursue an application but is exploring an option she has found.’
36. There is no record of any further contact by the housing needs officer.
37. Ms X emailed the first response team on 9 July saying Ms Y would be leaving her property and Ms X would fund the sheltered flat for three months (including paying the weekly care and support charge). She said after three months, the Council would be responsible for her mother.
38. Ms X emailed the Council’s adult social care team on 21 July to inform them she had found a flat in extra care sheltered housing for Ms Y from the 25th and could only afford to pay for one month. Ms X asked the Council to assess Ms Y for a care package and advised Ms Y had suspected dementia, had just had a brain scan and was waiting for an appointment at the memory clinic.
39. On 25 July, Ms X complained to the Council. She said no-one had responded to her requests for a social care assessment and her mother had just had a diagnosis of dementia. The following day, a senior social worker emailed Ms Y apologising for the delay and saying Ms Y would be allocated a social worker as soon as possible.
40. On 28 July, a social worker completed a social care assessment for Ms Y. The outcome was Ms Y was eligible for social care.
41. The social worker completed a care and support plan on 3 August. This said Ms Y would receive reablement care for six weeks consisting of support with preparing morning and evening meals, prompting and assistance with personal care and prompting with medication. After six weeks of reablement, there would be a review.
42. The Council responded to Ms X’s complaint (see paragraph 39) on 9 August saying a social worker had now completed an assessment and would present this to the management panel. The response went on to say an occupational therapist would also assess Ms Y.
43. On 10 August, a manager spoke to the general manager of the sheltered housing scheme (this is not owned or run by the Council). The general manager advised clients could self-refer to the scheme if they could pay privately for care. However, if social services were referring, the client must need 10 hours care a week or more.
44. A social worker emailed Ms X on 12 August. The social worker said the outcome of the social care assessment was Ms Y’s needs could be in mainstream housing with reablement care and the social care team would not fund the care part of her extra care sheltered housing costs. The social worker said Ms X needed to contact housing.
45. Ms X replied on 28 August raising more than 20 points about her mother’s health, welfare and her concerns about this. She said she wanted to appeal the assessment and would support her mother in the appeal. Ms X also said she had contacted the housing department for housing for Ms Y, but they ignored her request for assistance and failed to contact her despite chasing.
46. The Council treated Ms X’s email as an escalation of her complaint. It responded saying an OT was writing to the housing association (which manages the extra care sheltered scheme) to ask it to install grab rails and a shower seat. The Council’s response went on to say:
• A social worker had attempted to arrange a face- to-face assessment, but Ms X had refused to participate in this.
• Ms Y’s current needs did not meet the threshold for care in extra care sheltered housing and she was not eligible for a placement in extra care sheltered housing.
47. Unhappy with the Council’s response, Ms X complained to us.
48. At the end of September, the social worker spoke to Ms X to arrange a reassessment of Ms Y. Ms X said the social worker should book the appointment with Ms Y directly and she did not want to get involved.
49. Following the complaint response summarised in paragraph 46, a social worker and an OT visited Ms Y at the end of October. The OT carried out an assessment for equipment and the social worker reviewed Ms X’s social care assessment. The social worker considered Ms Y would be able to live in general housing with a package of care. The social worker also noted social care had agreed a package of reablement care, but the family were paying for Ms Y’s care privately, so this was not needed.
50. Ms X told us Ms Y’s GP confirmed her diagnosis of dementia at the start of November and so a social prescriber at Ms Y’s GP practice telephoned the Council’s social care team to tell them. Ms X said the social care team told the social prescriber about the recent care review and this was the first she had heard of any council officers visiting her mother again. Ms X told us neither she nor Ms Y had received any feedback or copies of the assessment, review or any care and support plan.
51. Since contacting us, Ms X has made a further complaint to the Council about the social worker and OT’s visit. She asked for a fresh social care assessment by a different social worker. This was completed in January 2023. The outcome was Ms Y did not meet the national eligibility criteria for adult social care (see paragraph 17). The case notes said the social worker spoke with the general manager of sheltered housing who told her Ms X placed Ms Y before a social care assessment and this was therefore a private arrangement. Care staff confirmed Ms Y did not need any care and support other than with medication and she was independent in all other aspects of care.

Was there fault and did this cause injustice?

52. There was fault by the Council:
1. The housing needs team failed to take appropriate action to respond to Ms X’s request for housing for her mother who she could no longer accommodate from the end of June 2022. My view is the Council failed to act in line with the obligations in the Housing Act 1996 set out in paragraphs eight to 13. The housing needs team should have decided whether or not Ms Y was habitually resident in the UK and informed Ms X and Ms Y of its decision. It should have then gone on to decide if Ms Y was owed an interim accommodation duty. It should have completed inquiries to establish if Ms X was owed the main housing duty and given her a decision in writing.
2. Officers in housing and adult social care also failed to co-operate with each other effectively or at all in June and July 2022 which is a failure to act in line with Section 6 of the Care Act 2014. The adult social care team should not have told Ms X she needed to contact housing to seek accommodation for her mother; it should have made a direct referral to the housing options team. Equally, the housing needs officer should have liaised with adult social care to ensure an urgent care needs assessment was carried out. Instead, Ms X was pushed between the two departments, which were both unhelpful and failed to provide any practical advice or assistance. Ms X should not have needed to complain in order to get a social care assessment for her mother because the Council was required to complete one within a reasonable time frame in line with paragraph 6.24 of Care and Support Statutory Guidance. Given Ms Y’s likely homelessness at the end of June, the social care team did not act with appropriate urgency to complete the needs assessment.
3. There is evidence of gatekeeping by the Council (a reluctance to complete the relevant inquiries to enable a decision on the main housing duty) as well as poor communication with Ms X. Communication by the housing needs team was far below the standard we expect of councils and no decisions were made or issued in writing. Ms Y had to chase housing and social care officers repeatedly for responses which were not forthcoming. This would have been stressful for her and caused avoidable time and trouble including in complaining.
53. The outcome of the social care assessment at the end of July was Ms Y was eligible for care and support and her needs could be met by reablement care in the extra care sheltered housing scheme. The review after six weeks concluded Ms Y’s needs could be met with home care in general housing and she did not need a placement in extra care sheltered housing. Having identified during the review that Ms Y would need alternative housing as she did not need a placement in extra care sheltered housing, the social care team again failed to co-operate with housing to ensure Ms Y received support, advice or assistance on how to source alternative housing. This was a further failure to act in line with Section 6 of the Care Act 2014.
54. There was further fault in the failure to let Ms X or Ms Y have copies of the assessment, review or care and support plan.

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Agreed action

55. The aim of our recommendations is to try and put the person back into the position they would have been ‘but for’ the fault. This is not possible where there is insufficient evidence to conclude what would have happened if the council had acted correctly. In Ms Y’s case, the Council needed to decide in June 2022 whether or not she was habitually resident in the UK. I cannot say on a balance of probability what the decision would have been at the time. I can conclude is that a social care assessment within an appropriate timeframe, given the urgency, would have resulted in an offer reablement care before the end of June. So Ms Y would have been able to have reablement care which could have improved her independence and safety at Ms X’s home while longer-term arrangements for housing were resolved in a planned way with effective joint input from housing and social care.
56. On the basis that Ms Y lost the benefit of reablement care and Ms X suffered avoidable distress and time and trouble complaining, my recommendations are the Council should, within one month of my final decision:
• Apologise to Ms X and pay her £500
• Apologise to Ms Y and pay her £500
• Provide tailored written advice to Ms X and Ms Y about Ms Y’s housing options if the family are no longer able continue to afford to pay for private care in Ms Y’s current housing. (Such as private sector housing or sheltered and community good neighbours housing.)
57. Within three months, the Council should have in place written procedures for co-operation between housing and adult social care and provide me with copies of those procedures.
58. The Council has accepted all my recommendations. It should provide us with evidence it has complied with the above actions.

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Final decision

59. Housing and adult social care failed to work together to assess the needs of a an woman with health problems who was homeless. The departments failed to carry out appropriate housing and social care assessments within a reasonable timeframe or issue written decisions. This caused avoidable distress, time and trouble and a loss of reablement care. The Council will apologise, make symbolic payments, provide housing advice and introduce procedures for joint working between housing and adult social care.
60. I have completed the investigation.

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Investigator's decision on behalf of the Ombudsman