Summary: Mrs X complained the Council delayed carrying out a review of her mother Mrs Y’s care needs and failed to investigate safeguarding concerns raised about a relative’s behaviour towards Mrs Y. The Council was at fault for the delay in carrying out the needs assessment and review and for failing to act in response to the safeguarding concerns raised. It has agreed to apologise to Mrs X and Mrs Y and makes payments to acknowledge the distress and frustration caused to them both and for the missed support for Mrs Y. It has also agreed to remind relevant officers to respond appropriately to safeguarding concerns and to keep suitable records of their decision making.

The complaint

1. Mrs X complained the Council delayed carrying out a review of her mother Mrs Y’s care needs, after family members informed the Council Mrs Y required more support and they were unable to assist. Mrs X says this meant Mrs Y did not receive all the care she required and caused Mrs X distress.
2. In addition, Mrs X complained the Council failed to undertake a safeguarding investigation when family members raised concerns about a relative’s behaviour towards Mrs Y. She says this left her mother at risk and caused her and her mother distress.

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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. When considering complaints, we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
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)

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How I considered this complaint

6. I have considered the information provided by Mrs X and have discussed the complaint with her. I have considered the Council’s response to my enquiries and the relevant law and guidance.
7. I gave Mrs X and the Council the opportunity to comment on a draft of this decision. I considered any comments I received in reaching the final decision.

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What I found

The relevant law and guidance

Assessment of needs

8. 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. Where the council identifies “eligible” care needs it will prepare a care and support plan that sets out how those needs will be met. The council can meet the person’s eligible needs by arranging for a care provider to provide care.
9. The Care and Support Statutory Guidance sets out an assessment should be carried out over an appropriate and reasonable timescale taking into account the urgency of needs and a consideration of any fluctuation in those needs. Local authorities should inform the individual of an indicative timescale over which their assessment will be conducted and keep the person informed throughout the assessment process.

Safeguarding

10. A council must make enquiries if it thinks a person may be at risk of abuse or neglect and has care and support needs which mean the person cannot protect themselves. An enquiry is the action taken by a council in response to a concern about abuse or neglect. An enquiry could range from a conversation with the person who is the subject of the concern, to a more formal multi-agency arrangement. A council must also decide whether it or another person or agency should take any action to protect the person from abuse. (section 42, Care Act 2014)

What happened

11. In June 2022 Mrs X asked the Council for support for Mrs Y. She said Mrs Y lived in her own home with another relative who did not provide her with any help. Mrs X said Mrs Y had medical conditions which meant she needed assistance with everyday activities like dressing, bathing and changing. The Council’s notes record an officer tried to call Mrs X twice in early August 2022 to discuss the referral but there was no answer and no facility to leave a message. The notes record an officer spoke to Mrs X in late August and she confirmed Mrs Y still did need support.
12. In September 2022 the Council allocated an officer, Officer A, to carry out a needs assessment. Officer A completed the needs assessment in mid October 2022 and arranged a care package of 17.5 hours per week for three visits a day to support Mrs Y with washing and dressing, personal care, medication and support with getting a meal. The care package started soon after. Mrs X contacted the Council as a care worker then turned up without any warning.
13. In December 2022, Officer A arranged a review meeting with Mrs X and Mrs Y for early January 2023. Officer A agreed to arrange an interpreter to support Mrs Y as English is not her first language and Mrs X could not attend due to a breakdown in the relationship between her and the other relative living with Mrs Y. At the time Mrs X also asked about chiropody and support with a medical condition. Officer A advised those issues were for the GP and not the Council.
14. The notes record Officer A attempted to call Mrs X on the day of the review to cancel as they had not managed to arrange an interpreter. Mrs X emailed officer A three days later to ask why they had not attended and what was happening. Officer A advised they could not attend due to short staffing in the office. They said they would rebook the review once they had secured an interpreter.
15. Mrs X complained to the Council in early February 2023. Her complaints included that: Officer A had still not arranged a review; some care workers could not speak the same language as Mrs Y; and Mrs Y needed more assistance as the relative living with her was not supporting her.
16. In mid February 2023 the Council’s notes record the care provider contacted it with a concern that Mrs Y had a swollen lip and there was tension between her and the relative she lived with. The Council’s notes record it received a safeguarding concern regarding the relative in early March 2023. It was passed to Officer A to raise. In late March 2023 the Council also received a police report related to potential financial abuse. The report noted there was no immediate threat as the relative living with Mrs Y had moved out earlier that month. The Council says at that time the police were unable to find evidence of financial mismanagement.
17. In late March 2023 Officer A spoke to the care provider. They noted the relative living with Mrs Y had moved out and that the care provider had no concerns regarding the support it provided to Mrs Y.
18. The Council responded to Mrs X’s complaint in late March 2023. It apologised that Officer A had not arranged the review and said this was due to staff sickness. It advised a senior practitioner would contact Mrs X to discuss the way forward regarding a review and to ensure an interpreter was available. It noted the care provider initially had difficulty finding care workers who spoke the same language as Mrs Y but said this issue had now been resolved.
19. In June 2023 Mrs X contacted the Council to request a review of Mrs Y’s care needs. She said she heard nothing further from Officer A and Mrs Y needed further support.
20. In early August 2023 Mrs X emailed the Council again chasing up the review as she had heard nothing further.
21. In late August 2023 a Council officer, Officer B contacted Mrs X to complete review of Mrs Y’s care needs. Mrs X agreed to attend to interpret and support Mrs Y. Officer B completed a home visit. At the meeting Mrs X discussed the pressure on her completing shopping, domestic tasks and arranging for Mrs Y to attend appointments. She also requested support to enable Mrs Y to take part in community activities. The review proposed an increase of 5 hours to the care package to support Mrs Y with shopping, community engagement and domestic tasks.
22. In response to my enquiries, the Council advised Mrs Y’s care package had increased from late October 2023 to include an additional five hours per week of support. It also said that it felt the proportionate response to the safeguarding concern was to provide case management to increase the support to the family as Mrs Y’s relative had left the property.

Findings

23. Mrs X first requested support for Mrs Y in late June 2022. The Council completed the assessment in mid-October 2022. The Care and Support Statutory Guidance sets out that an assessment should be completed over an appropriate and reasonable timescale. We would normally expect this to be in around six weeks. The delay in carrying out the assessment was fault. This caused uncertainty over whether Mrs Y should have received support sooner.
24. The Council agreed to review the care package in early January 2023. This did not happen and was fault. The Council then, in response to Mrs X’s complaint in March 2023, agreed an officer would contact her regarding the review. This did not happen and was further fault.
25. After Mrs X contacted the Council again, in early August 2023, the Council arranged to review Mrs Y’s care needs. The review in late August 2023 recommended an increase in support of five hours per week to assist Mrs Y with accessing the community, domestic tasks and shopping. This increase was not actioned until late October 2023. The delay in increasing Mrs Y’s support once the review was carried out was fault.
26. The care provider raised a concern with the Council in mid-February 2023. The Council also received a safeguarding concern in early March. I have seen no evidence the Council took any action in response to these concerns at the time.
27. The Council failed to properly investigate the concerns raised under the safeguarding procedures. This was fault. In response to my enquiries the Council said it felt the proportionate response was to provide case management to increase the support to the family given the relative had left the property. However, this is not reflected in the case records. In addition, the Council took no action to progress the review of Mrs Y’s care needs until late August 2023. Given the alleged perpetrator had left the property, Mrs Y was no longer at risk of harm. However, the Council’s failure to respond appropriately to the concerns raised caused Mrs X and Mrs Y frustration and uncertainty.
28. The delay in reviewing Mrs Y’s care needs caused uncertainty over whether she should have received an increase in support sooner. Had the Council properly responded to the safeguarding concerns in March 2023 I consider it is likely it would have looked to increase the support it provided to her at that time, given she was now living alone. Although Mrs X provided some support, on balance, I consider Mrs Y was without all the additional support she needed between March and October 2023.

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Agreed action

29. Within one month of the final decision the Council has agreed to:
1. Apologise to Mrs X and Mrs Y for the distress caused by its delays in carrying out and reviewing the needs assessment.
2. Pay Mrs Y £400 to acknowledge the support she missed out on due to the Council’s delays.
3. Pay Mrs Y £250 and Mrs X £250 to acknowledge the distress and frustration caused by the delays and failure to respond to the safeguarding concerns raised.
30. Within two months of the final decision, the Council has agreed to remind relevant staff of the need to respond appropriately to safeguarding concerns raised and to record their actions and decision making, including where the decision is that no further action is required at that time.
31. The Council should provide us with evidence it has complied with the above actions.

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Final decision

32. I have completed my investigation. There was evidence of fault causing injustice which the Council has agreed to remedy.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman