Summary: The Council was at fault for the way it carried out an Occupational Therapist assessment of Ms X. This caused her injustice as Ms X cannot be sure her needs were properly considered and Ms X could have received an assessment under the Care Act 2014 sooner. To remedy the injustice caused, the Council agreed to apologise to Ms X, make a payment for the distress she experienced and carry out an new Occupational Therapist assessment.

The complaint

1. Ms X complains about the way the Council carried out an Occupational Therapy assessment of her needs and the time it has taken to assess her under the Care Act 2014.

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The Ombudsman’s role and powers

2. 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)
3. When considering complaints, if there is a conflict of evidence, 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.
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. As part of this investigation, I considered the information provided by Ms X and the Council. I discussed the complaint over the telephone with Ms X.

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What I found

Law and guidance

6. 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. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. 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.
7. Councils must carry out assessments over a suitable and reasonable timescale considering the urgency of needs and any variation in those needs. Councils should tell people when their assessment will take place and keep them informed throughout the assessment.
8. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs 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 council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

What happened

9. In June 2023, Ms X was admitted to hospital and had surgery on her back. Following her hospital discharge she was referred to the Occupational Therapy service at the Council for an assessment.
10. An Occupational Therapist attended Ms X’s property on 10 July 2023 to carry out an assessment. The report from this visit made no recommendations for Ms X to receive support with personal care.
11. Within a few hours of the Occupational Therapist’s visit, Ms X received an email from the Occupational Therapist saying her case was closed.
12. Over the next few days, correspondence between Ms X and the Occupational Therapist, showed Ms X raised concerns about the assessment. She said it was only for 15 minutes and that the Occupational Therapist had wrongly stated Ms X had asked for freshly cooked meals as support and had gotten her medical conditions wrong. The Occupational Therapist told Ms X she may have misinterpreted their discussion about freshly cooked meals. The Occupational Therapist also said they arrived for the assessment 10 minutes early and waited for Ms X to get herself ready. They said the assessment lasted much longer than 15 minutes as no Occupational Therapy assessment would last 15 minutes.
13. On 15 July 2023, Ms X made a formal complaint to the Council. Ms X said she thought the visit on 10 July 2023, was to carry out an assessment under the Care Act 2014. Ms X said the assessment only lasted for 15 minutes and then she received an email two hours later saying her case was closed. Ms X provided evidence from her ring doorbell which showed the Occupational Therapist arriving at 9:51am and leaving at 10:15am. Ms X said she was in considerable pain after having surgery and was struggling to look after her three children. Ms X said she found cooking difficult because of the pain she was in and wanted some support with basic tasks.
14. In mid-August 2023, the Council responded to Ms X’s complaint. The Council said that the issues she raised about the Occupational Therapist would be discussed with them during their supervision. The Council said it had referred Ms X for an assessment under the Care Act 2014. The Council explained she was on the waiting list for the Council to allocate her a social worker to carry out the assessment.
15. In mid-October 2023, Ms X said the Council carried out an assessment of her needs under the Care Act 2014 and established that she had eligible care needs. The Council offered to put in place enablement care for Ms X while it carried out the assessment, however Ms X declined this.
16. Ms X said the Council is now in the process of putting in place some care for her for support around the home and in the process of costing this.

Analysis

17. Ms X complains about the quality of the Occupational Therapist’s assessment. Ms X said the assessment was only 15 minutes long and not detailed enough to establish her needs. She also said the assessment report contained information which was incorrect and this showed the assessment was not carried out properly.
18. The Occupational Therapist said the assessment was much longer than 15 minutes. Ms X provided evidence from her ring doorbell which showed the Occupational Therapist arriving at 9:51am and leaving at 10:15am. Correspondence between Ms X and the Occupational Therapist showed that they both acknowledged the assessment did not start when the Occupational Therapist arrived as Ms X was expecting the assessment to start at 10am and was not ready. On balance I am satisfied that the assessment was only around 15 minutes in length as Ms X reported.
19. As the Occupational Therapist said in correspondence that no assessment could last 15 minutes, I am satisfied on balance that the assessment did not properly explore Ms X needs. This was fault.
20. As I have found fault, I need to consider what injustice this caused Ms X. Had the assessment been carried out properly, the Council may have established Ms X needed some support with personal care, particularly as the Council found Ms X has eligible care needs after carrying out a Care Act assessment. The fact that the assessment only lasted 15 minutes and Ms X received an email two hours later closing her case has caused her distress.
21. Ms X cannot be sure she is receiving the correct help around her property from an Occupational Therapist’s point of view. There could be further assistance and adaptations she needs in her property.
22. The Council would have likely referred Ms X for an assessment under the Care Act sooner if the Occupational Therapist had recommended Ms X needed some assistance with personal care. It took the Council around a month to refer Ms X for a Care Act assessment after the Occupational Therapist’s assessment, and only after she made a complaint. Had the Occupational Therapist’s assessment been carried out properly, the Council may have referred Ms X for a Care Act assessment earlier. I do not consider this has caused Ms X additional injustice as the Council offered to put in place some care while it carried out her assessment, however Ms X refused this.

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Recommended action

23. Within one month of my final decision the Council agreed to carry out the following:
• Apologise to Ms X for the way the Occupational Therapist assessment was carried out.
• Pay Ms X £150 to acknowledge the distress she experienced as a result of the way the Occupational Therapist assessment was carried out and to recognise the uncertainty she experienced from not knowing whether she could be entitled to any help and support from an occupational therapy point of view.
• Arrange with Ms X to carry out a new Occupational Therapy assessment, to establish whether Ms X needs any additional support.
• Consider whether it can do anything to put in place measures which record how long an Occupational Therapist’s assessment takes. So if there are any disputes, the Council has a record of how long an Occupational Therapist spent assessing someone.
24. The Council should provide us with evidence it has complied with the above actions.

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Final decision

25. I have completed my investigation and found the Council was at fault which caused injustice. The Council agreed to the above actions to remedy the injustice caused.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman