Summary: Mrs X complained the Council failed to properly assess her daughter, Miss Y’s care and support needs, or Mrs X’s needs as her carer and has not provided the necessary support or agreed respite. The Council’s failure to provide the agreed respite over a significant period is fault. This fault has caused Mrs X and Miss Y an injustice.

The complaint

1. The complainant, whom I shall refer to as Mrs X complained the Council failed to properly assess her daughter, Miss Y’s care and support needs, or Mrs X’s needs as her carer and has not provided the necessary support.
2. Mrs X also complains that despite assurances the Council is seeking suitable respite, she still does not receive the assessed 36 days a years respite from her caring role. Mrs X says she has not had a break from her caring role for three years and this is having a detrimental impact on her wellbeing.

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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 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)
4. 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)
5. 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)
6. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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What I have and have not investigated

7. Although Mrs X complains she has not had respite from her caring role since March 2020, my investigation will focus on matters since 2022. I do not consider it appropriate to exercise discretion to consider issues much outside the 12 month time frame. It was open to Mrs X to complain to the Ombudsman sooner.

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How I considered this complaint

8. As part of the investigation, I have:
• considered the complaint and the documents provided by Mrs X;
• made enquiries of the Council and considered the comments and documents the Council provided;
• discussed the issues with Mrs X;
• Mrs 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

Background

9. Mrs X lives with her daughter Miss Y and is her primary carer. Miss Y has a care and support plan which provides for Direct Payments to fund a personal assistant (PA) to support Miss Y in accessing the community; access to a day centre; and 36 days a year respite provision. The Council uses Centre 1 for respite services for people with Learning Disability and Autism.
10. This provision was interrupted by the COVID-19 pandemic and national lockdowns. Mrs X and Miss Y shielded for over a year.

The complaint

11. The Council reviewed Miss Y’s care and support plan in February 2022. The review notes Miss Y had returned to the day centre, two days a week but had been unable to access Centre 1. Centre 1 would not let Miss Y use its services as she had not received the COVID-19 vaccinations. Mrs X had been unable to find a PA due to the pandemic but had recently identified an agency and Miss Y now had a PA to support her in the community for eight hours a week.
12. Mrs X explained she may need use the respite provision to travel abroad to visit her family and wanted to ensure Miss Y would be looked after. The records note it would be healthy for Mrs X and Miss Y to have a break from one another and this would also help with Miss Y’s independence. Both Mrs X and Miss Y confirmed they would like to explore the shared lives scheme and supported living.
13. The next entry in the Council records is early April 2022 when Mrs X raised concerns that Miss Y could still not return to Centre 1 as she was not vaccinated. The Council contacted Centre 1 who confirmed Miss Y could access its services again, provided she tested before visiting. The notes say Centre 1 agreed to contact Mrs X to discuss dates for respite. Mrs X did not want Miss Y to return to Centre 1 given their disagreements over the COVID-19 vaccination.
14. In July 2022 the Council contacted an alternative respite centre to see whether they could offer respite services to allow Mrs X to visit her family. There is no record of a response or of any attempt to follow this up. In late November 2022 the Council told Mrs X it would follow up on the alternative respite placement in the new year and would also explore shared lives. There is no record of any action to follow up either the respite placement or the shared lives scheme in early 2023.
15. Mrs X made a formal complaint about the failure to provide respite in March 2023. An officer discussed Mrs X’s concerns with her in early April 2023 and then responded to her complaint. The officer noted there were attempts to assess Miss Y’s needs and provide a care and support plan, but that there were difficulties in providing the service. During the pandemic services had to act according to government guidance, which meant people had to be vaccinated to access them.
16. The officer noted Mrs X had felt bombarded and that discussions around vaccination had damaged her relationship with the social worker. This had meant the Council had not progressed with arranging the service they needed. The officer assured Mrs X the contact was well intended and apologised for any distress it caused.
17. In relation to respite care, the officer noted Mrs X did not now want Miss Y attend Centre 1 and confirmed it would try to arrange respite through shared lives or other options.
18. To resolve the issue the Council allocated Miss Y a new social worker who would complete a new assessment and care and support plan and seek suitable respite. The Council expect this to be completed by the end of April 2023.
19. As this did not happen, Mrs X contacted the Ombudsman in May 2023 and asked us to investigate her complaint. Since complaining to us the Council has now completed a new assessment. The assessment notes that Mrs X and Ms Y are happy with the provision at the day centre and both would like Miss Y to try other activities and sessions. Mrs X also reiterated she would like to support Miss Y in exploring the possibility of a supported living placement and for Miss Y to access a respite placement. There was also further discussion regarding exploring shared lives.
20. In response to my enquiries the Council says the case was allocated to a new social worker in April 2023 and they made contact with Mrs X in June 2023. It says the delay in contacting Mrs X was due to the new social worker needing to speak to the previous social worker and annual leave. The assessment was completed on 6 July 2023 and the outcome was for a new care and support plan to be completed and a referral for a new day opportunity and other social activities. Miss Y had not been accessing the community with her personal assistant due to an issue with her foot, this would be reinstated once Mrs X had an update from the hospital. The Council would also explore respite with the shared lives programme.

Analysis

21. It is clear from the documentation that Miss Y has not received her agreed respite support. This is in part due to the COVID-19 restrictions and the need to be vaccinated. However the documentation also shows that once restrictions were lifted, the Council has not been proactive in identifying or following up alternative respite provision. There have been delays and periods of inactivity.
22. There are multiple references in the Council’s records to exploring the shared lives scheme and supported living placements since February 2022, but there is no evidence this had been actioned or followed up. The Council identified a potential alternative respite provision in July 2022, but again there is no evidence this was followed up, despite an assurance it would be.
23. In response to Mrs X’s formal complaint the Council said it would complete a new assessment and care and support plan as well as seeking suitable respite within the month. Yet the assessment did not take place until July 2023, three months later. And the Council’s case notes do not suggest there has been any further action since then to arrange respite.
24. The failure to ensure Miss Y had access to suitable respite provision is fault. This fault has caused Mrs X and Miss Y an injustice. Mrs X should have respite from her caring role for 36 days each year. Not being able to access this respite has affected Mrs X’s health and wellbeing. It has also meant she has been unable to visit her elderly parents who have been unwell. Respite would also have enabled Miss Y to improve her independent living skills and given her the opportunity to try other activities.
25. In this instance I consider a symbolic financial remedy, in recognition of the impact the failings have had on Mrs X and Miss Y, would be appropriate

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Agreed action

26. The Council has agreed to:
• Apologise to Mrs X and Miss Y for the failure to provide respite care. In making this apology the Council should take account of our guidance on making an effective apology ;
• Make a payment of £1,000 to Mrs X to recognise the distress and harm caused as a result of the failure to provide respite;
• Make a payment of £1,000 to Miss Y in recognition of the distress and missed opportunity caused by the failure to provide respite care;
• Proactively seek and secure a respite placement for Miss Y. The Council should provide us with evidence of the steps it has taken to ensure a respite placement is available as soon as possible.
27. The Council should take this action within one month of the final decision on this complaint and should provide us with evidence it has complied with the above actions.

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Final decision

28. The Council’s failure to provide the agreed respite over a significant period is fault. This fault has caused Mrs X and Miss Y an injustice.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman