Summary: We have not found fault with the way the Council assessed Mrs C’s needs for care and support and offered her different options to meet her needs and move from her current accommodation.

The complaint

1. Mr and Mrs D complain on behalf of their adult daughter, Mrs C. They say the Council has not done enough to assist Mrs C in moving out of the care home (the Home) where she is living and move into the community near to where Mr and Mrs D live.

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The Ombudsman’s role and powers

2. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
3. 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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What I have and have not investigated

4. I have considered the actions of BCP Council. Mrs C has made an application for housing in a neighbouring Council’s area (Council 2). I have not investigated the decisions or actions by Council 2 in terms of housing.

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How I considered this complaint

5. I have discussed the complaint with Mr and Mrs D and I have considered the information that they and the Council have sent and the relevant law, guidance and policies.

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What I found

Law, guidance and policies

6. The Care Act 2014, the Care and Support Statutory Guidance 2014 set out the Council’s duties towards adults who require care and support. The Council also has its own policies.
7. The Council has a duty to assess adults who have a need for care and support. If the needs assessment identifies eligible needs, the Council will provide a support plan which outlines what services are required to meet the needs.
8. The threshold for eligibility is based on identifying how a person’s needs affect their ability to achieve relevant outcomes, and how this impacts on their wellbeing. Council must consider whether:
• The adult’s needs arise from a physical or mental impairment or illness.
• As a result of the adult’s needs the adult is unable to achieve 2 or more of the specified outcomes.
• As a consequence of being unable to achieve these outcomes there is a significant impact on the adult’s wellbeing.

Outcomes

9. The outcomes are:
• Managing and maintaining nutrition
• Maintaining personal hygiene
• Managing toilet needs
• Being appropriately clothed
• Being able to make use of the home safely
• Maintaining a habitable home environment
• Developing and maintaining family or other personal relationships
• Accessing and engaging in work, training, education or
• Making use of necessary facilities or services in the local community
• Carrying out caring responsibilities for a child.

What happened

10. Mrs C is an adult woman who has a syndrome similar to dementia which is linked to alcohol misuse. Mrs C has significant short term memory loss. Mrs C does not have the mental capacity to manage her finances so Mr and Mrs D, who hold a Lasting Power of Attorney for property and finance for Mrs C, manage her finances and give her a small allowance.
11. Mr and Mrs D also hold a Lasting Power of Attorney for health and welfare for Mrs C, but Mrs C has the mental capacity to make decisions about her care and where she wants to live, so Mrs C makes those decisions.
12. Mrs C and her husband moved to the BCP area in August 2020. She received support from her husband and a Council funded package of care of 8 hours support a day. The marriage broke down and the package of care was increased. In the following months, Mrs C was admitted to hospital and then went to live back in the community where her alcohol misuse increased. Mrs C received a notice to quit her tenancy in February 2022. She moved into the Home in March 2022.
13. The Home specialised in providing care and support to adults over 18 who had a variety of complex needs and neurological conditions including dementia. While Mrs C lived at the Home, her alcohol misuse stopped around August 2022.

Assessment and care plan - September 2022

14. The Council assessed Mrs C’s needs for a care and support in September 2022.
15. The social worker said Mrs C had eligible needs in the following areas:
• managing and maintaining nutrition
• maintaining personal hygiene
• maintaining a habitable home environment
• being able to make use of the home safely
• developing and maintaining family or other personal relationship
• accessing engaging in work, training, education or volunteering
• making use of necessary facilities or services in the local community including public transport and recreational facilities or services
16. The social worker said Mrs C was receiving 24-hour support at the Home, but Mrs C said she wanted to move out of the Home.
17. The social worker said there were concerns about Mrs C living in the community, related to the support she needed in day to day living because of her dementia/memory loss but also related to the risk of a relapse into alcohol misuse. Mrs C was also a vulnerable adult at risk of abuse in the community so a risk assessment would have to be carried out for a move into the community. The social worker agreed to make an application for extra care housing. (Extra care housing, generally speaking, allows people who have social care needs to live in their own home but with care staff available 24 hours.)

Mrs C’s application for housing

18. Mrs C’s social worker progressed Mrs C’s application for extra care housing in the BCP area with BCP’s housing department.
19. Mrs C and her parents felt that Mrs C could live in general needs housing. Mrs C wanted to live near Mr and Mrs D as she was familiar with the area and as Mr and Mrs D would be able to provide additional support. However, Mr and Mrs D lived in Council 2, not in BCP, so Mrs C made an application for council housing to Council 2.
20. The Council’s social worker discussed Mrs C’s housing situation with Council 2’s housing officer in February 2023. Council 2’s housing officer explained that there was no extra care housing in the exact area where Mr and Mrs D lived. The social worker said she was applying for extra care housing for Mrs C in BCP but Mrs C would need to make her own application for general needs housing in Council 2.
21. Mrs C’s social worker contacted Council 2’s housing officer in April 2023. She said BCP Council supported Mrs C’s application for housing and wanted to know if there was anything further BCP Council could do to assist.
22. Council 2’s officer replied in May 2023 and said that, if Mrs C was successful in obtaining social housing in Council 2, then BCP Council would need to confirm that it was willing to put in an appropriate care package before Mrs C would be offered a tenancy. So any information to support Mrs C’s application would be helpful.
23. Mrs C’s social worker sent Mrs C’s Care Act assessment to Council 2.
24. Mrs C was allocated a low priority banding for housing in Council 2 in June 2023 with an effective date of February 2022.

Review of assessment and care plan – August 2023

25. The social worker reviewed Mrs C’s assessment and care plan in August 2023. Mrs C had been alcohol free for a year.
26. Mrs C told the social worker she still wanted to move out of the Home and live independently near Mr and Mrs D in Council 2. The social worker said BCP Council was supporting her in this aim and it would put provide her with an updated care plan once Council 2 offered her accommodation.

Further developments

27. Mrs C’s social worker emailed Council 2’s housing officer in August 2023 and asked whether there was anything further that BCP Council could do to support Mrs C in obtaining priority in her housing application.
28. Mrs C’s social worker spoke to Council 2’s housing officer in September 2023. The social worker said she had updated Mrs C’s assessment and asked if there was any further information she needed to add that would assist Council’s 2 housing department in reviewing its decision about the priority banding. The housing officer said that the assessment would not change Council’s 2 decision.

The complaint

29. Mr and Mrs D complained to their MP in July 2023 and the complaint was sent to the Council in October 2023. Mr and Mrs D said:
• Mrs C had been living at the Home for 18 months, but she did not need to live in the Home and she could live independently close to them.
• The Council had refused to carry out a reassessment of Mrs C which would help her in her application for housing in Council 2.
• The situation was making Mrs C ‘miserable’ and they felt she had been forgotten.
30. The Council responded in November 2023 and said:
• The Council did not refuse to reassess Mrs C but had explained that it was unlikely that this would affect the priority banding in Council 2. Mrs C had been reassessed in August 2023 but this did not affect her priority banding in Council 2.
• The Council and the family agreed that Mrs C was ready to live in a more independent setting. But Mrs C only wanted to move to the area where Mr and Mrs D lived and the availability of housing was limited so this would increase the waiting time.
• If Mrs C would agree to broaden the area she would agree to move to, then she would be able to move out quicker. BCP Council had a good choice of extra care housing which Mrs C could move to.

BCP Council’s offers

31. I asked BCP Council whether it had considered offering extra care housing for Mrs C in Council 2’s area, not just BCP’s area. The Council said there was no extra care housing in the exact area where Mrs C’s parents lived. The closest extra care housing developments in Council 2’s area were 10, 24 and 25 miles from the area where Mr and Mrs D lived.
32. The Council said it had offered extra care housing in its own area (BCP) which was only 6.7 miles from where Mr and Mrs D lived, but the family had declined this offer. The Council said it could offer 7 further extra care housing developments in an another area which was a little further away but these had also all been declined by the family.
33. The Council said that residential care (a care home) with easier access into town had also been offered but that had been declined as the client group was people over 65 and Mrs C was younger.
34. The Council said it had also considered sheltered housing (sheltered housing has lower support than supported/extra care housing), but there was little availability of sheltered housing for people under 55 in the area where Mr and Mrs D lived. Mrs C had bid for sheltered housing in Council 2 but it was unlikely that her bid would be successful.
35. The Council said it held a multi-disciplinary meeting with Mrs C’s GP in April 2024 to see if Mrs C could be given medical priority to improve her banding and this was currently being followed up.

Analysis

36. I appreciate how difficult the current situation is for Mrs C and her parents. Mrs C does not want to live in the Home and says she no longer needs that level of support. I fully understand the distress this is causing her, but I can only investigate whether there is any fault in the Council’s actions.
37. The Council has carried out an assessment of Mrs C’s needs in line with the Care Act. It has considered Mrs C’s needs and outcomes and has made decisions based on the assessment. It has provided her with a care plan to meet her needs. I find no fault in that respect.
38. It appears to me that the Council, Mrs C, Mr and Mrs D all agree that, ideally, Mrs C is now ready to move out of the Home where she is currently living. A residential environment may have been helpful in the beginning but Mrs C has now been alcohol free for two years and wants to move to more independent living.
39. The Council’s position is that Mrs C needs extra care housing to meet her needs as it would give her the care and support that she needed but also the independence of her own flat that she wanted. It would also lower the risk of harm and abuse in the community which she may face as a vulnerable adult.
40. I note that the Council has made a number of offers of alternatives to Mrs C which would meet her needs. The Council has offered extra care housing which is 6.7 miles from the area where Mr and Mrs D live and it has offered extra care housing in other areas, at different distances from Mr and Mrs D, but these offers have all been declined.
41. The Council has also offered Mrs C a residential placement in the area where Mr and Mrs D live which has been declined.
42. I appreciate that Mr and Mrs ideally would like extra care housing in the area where Mr and Mrs D live, but unfortunately there is no extra care housing in that area so a compromise has to be reached. Therefore overall I cannot say there is fault in the offers made by BCP Council.
43. Mrs C has made an application to Council 2 for general needs housing, but this has not been successful due to the low priority banding that she has been awarded.
44. I note that BCP Council has liaised with Council 2 and has supported Mrs C’s housing application. Mrs C’s social worker has chased Council 2 and has provided it with the evidence it asked for to support Mrs C’s housing application. So I find no fault in that respect.
45. However, ultimately BCP Council does not have the power to make a housing allocation decision in Council 2. Only Council 2 can make that decision. If Mrs C disagrees with the housing banding that she has been allocated by Council 2, then she could ask for a review of the decision from Council 2.

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The final decision

46. I have completed my investigation and have not found fault by the Council.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman