Summary: Mr D complained about the way the Council dealt with his adult social care support and his complaint about a social worker. We found a delay in assessing Mr D’s care and support needs and replying to his complaints. The Council has agreed to apologise and pay Mr D £150 to remedy the distress this caused.

The complaint

1. Mr D complains about his adult social care support. In particular about the way:
• his care and support needs were assessed in 2023, including delay;
• his concerns about the social worker were dealt with; and
• his case was referred to other teams or services.
2. This has caused him distress and meant he has not received any care and support.

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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 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)
5. 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)
6. The law says we cannot normally investigate a complaint unless we are satisfied the organisation knows about the complaint and has had an opportunity to investigate and reply. (Local Government Act 1974, section 26(5), section 34(B)6)
7. 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

8. I spoke to Mr D about his complaint and considered the Council’s response to my enquiries.
9. I discussed my findings with Mr D on the phone and sent him an audio version of my draft decision statement and this final decision statement. Mr D 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

Care and support

10. The Care Act 2014 requires local authorities to carry out an assessment for any adult with an appearance of need for care and support. The assessment determines what the person's needs are and whether the person has any needs which are eligible for support from the council.
11. Where councils have determined that a person has any eligible needs, they must meet those needs. The person's needs and how they will be met must be set out in a care and support plan.
12. Councils must arrange an independent advocate to facilitate the involvement of a person in their care and support assessment, if the person would have substantial difficulty in being fully involved and there is no appropriate individual available to support and represent the person’s wishes.

Safeguarding

13. 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. A council must also decide whether it or another person or agency should take any action to protect the person from abuse. (Care Act 2014, section 42)

Complaint procedure

14. Councils should have clear procedures for dealing with social care complaints. Regulations and guidance say they should investigate a complaint in a way which will resolve it speedily and efficiently. A single stage procedure should be enough. (Local Authority Social Services and National Health Service Complaints (England) Regulations 2009)

What happened

15. I have summarised the key events in relation to adult social care that I have investigated from January to July 2023. This is not meant to detail everything that happened. Mr D has also made complaints about other council services which have been dealt with in a separate case.
16. Mr D told us he has autism, anxiety, a panic disorder, and has had a stroke. He has neurological problems which cause difficulties processing written information.

Care and support assessment March 2023

17. On 5 January 2023, the Council asked a social worker to assess Mr D’s care and support needs. Mr D’s advocate emailed the Council on 7 February chasing the assessment.
18. The social worker emailed Mr D on 6 March to arrange the assessment. She then left him a voicemail message on 8 March. The assessment took place on 9 March. It was done virtually, rather than face-to-face and Mr D’s advocate was also involved.
19. I have seen the care and support assessment that the social worker wrote afterwards. This says that Mr D had been in contact previously with the NHS learning disability team. He needed help with a housing problem, support to access the community and possibly help with cooking. It was also noted that he had a utilities debt due to his need for extra heating.
20. The assessment found that Mr D was not eligible for social care support from the Council. But referrals would be made to a service which could help him with his housing matter, including whether there were any suitable benefits or grants from the Department of Work and Pensions. There would also be a referral to a community enablement service which could support Mr D with social opportunities, cooking and budgeting.
21. An advanced practitioner called Mr D on 13 April to discuss the outcome of the assessment and the support that was available. Mr D was unhappy with the assessment and considered the practitioner was not listening to him. He therefore asked to speak to the team leader. He did not want the written assessment to be sent to him.

Mr D’s complaints

22. Mr D complained on 17 April about the delay in having an assessment and about the social worker who carried it out. He said he had heard nothing from the Council or social worker until the day before the assessment, which had caused him to feel panicked.
23. Mr D said the social worker did not listen to him, had jumped to conclusions and was inflexible. She had been unable to explain her role and communicate clearly. He said the relationship with the social worker was not working.
24. The team leader called Mr D on 21 April. She said she would investigate the complaint. The Council has accepted there was then a delay in replying.
25. Mr D called the Council on 22 May in relation to his housing matter. The Council’s records say that Mr D reported he had made a suicide attempt. The Council contacted NHS mental health services and Mr D’s GP. It also raised a safeguarding alert.
26. Mr D made a further complaint on 23 May that the team leader had not yet responded to his complaint about the social worker. He also said the social worker had bypassed him and gone to his GP and advocate. His GP wrote to the Council that Mr D was not suicidal but there appeared to be a dysfunctional relationship and communication difficulties between Mr D and the adult social care team. Mr D had therefore requested a new social worker.
27. The community enablement service called Mr D on 31 May. He was confused about who they were and why they were calling. He said he did not require their service. Mr D chased the Council for a response to his complaint as he was waiting for the team leader to call him.
28. An adult social care manager called Mr D on 5 June 2023 to discuss his second complaint. Mr D wanted to speak to the team leader’s manager.
29. On 7 June 2023, Mr D again spoke to the social care manager about his complaints. He said the team leader had been dismissive and had not responded to him, so he needed to speak to her manager. Mr D said he needed support to process written information so emails should not be sent. The Council agreed to change Mr D’s social worker.
30. On 21 June 2023, the Council called Mr D to read out its formal response to his complaints. In relation to his first complaint about the social worker, it asked when the manager could call him. In relation to the second complaint about the team leader it said the Adult Social Care Service Manager would call him.
31. The Service Manager called Mr D on 27 June to discuss his complaint about the team leader. Mr D said he no longer wanted to communicate with the team leader.
32. The case record says the Service Manager said he would transfer Mr D’s case to NHS mental health services. I have seen evidence that a referral was made on 3 July 2023. In response to my enquiries, the Council said there would usually have been a multi-disciplinary meeting prior to a referral, but there was not one in this instance.
33. An adult social care manager called Mr D on 4 July. Mr D said he did not require mental health services and wanted a long-term planning social worker.
34. The Council sent its written response to Mr D’s complaint about the social worker on 5 July 2023. It said the social worker had now been changed and the team leader would not contact Mr D.
35. The Council spoke to the NHS mental health service on 5 January 2024. The mental health team said appointments had been offered to Mr D but he had declined them. Mr D came to the Ombudsman. He said the Council had told him that the problems with the social worker had been caused by his communication difficulties, but there had been a further assessment which did not involve an advocate.

My findings

Care and support assessment March 2023

36. It is not the Ombudsman's role to decide what, if any, care and support a person needs. That is the council's role. The Ombudsman's role is to consider if the council has followed the correct process for establishing a person's needs and if it acted correctly when this process was complete. In doing so we look at what information the council considered, and if it took account of the service user’s wishes. If a council considers all this information properly the Ombudsman cannot find a council at fault just because a service user disagrees with its decision, or outcome of an assessment.
37. Mr D complained about a delay in the care and support assessment. I have not seen when it was requested, but the case records show the request was forwarded to the adult social care team on 5 January 2023. It was allocated to a social worker who carried out the assessment on 9 March 2023. So there was a wait of about ten weeks.
38. The Government guidance does not set timescales for when assessments should happen. We expect councils should complete assessments in a timescale that is proportionate to the complexity of the issues, and normally within six weeks. So I find there was a delay of about a month in assessing Mr D. This caused him distress.
39. I have reviewed the care and support assessment carried out in March 2023. The assessment describes Mr D’s needs but concludes that he does not meet the criteria to be eligible for care and support from the Council. The social worker spoke to Mr D and to his advocate. I have seen no fault in the way the assessment was carried out. I therefore cannot criticise the Council’s decision that Mr D was not eligible for support.
40. I understand that Mr D was concerned about the social worker’s attitude, but I can make no finding on this as there is no recording of the meeting. In addition, it would be for Social Work England to consider complaints about the professional practice of a social worker.
41. The assessment document was not sent to Mr D but there was a conversation with him about its findings, so I do not find fault. However, I note that Mr D was not expecting the call from the enablement service and did not want their support. So it is unclear if the referral to that service was properly explained to him during the assessment or subsequent phone call.

Mr D’s complaints

42. Mr D complained about the social worker on 17 April 2023. The team leader called him to discuss this four days later but there was then a delay in replying to him, causing him to make a further complaint.
43. I have seen that the Council spoke to Mr D about his complaints on 7 June and 27 June. It tried to accommodate Mr D’s needs by reading out its complaint response to him and discussing his concerns on the phone. It changed the social worker on 27 June. But it did not issue its formal response until 5 July. This delay is fault, which caused Mr D distress.

Referral to NHS mental health services

44. Mr D complained that the Council referred him to NHS mental health services, but he also said the NHS had found no referral had been received. I cannot investigate the NHS Trust.
45. The Council’s case records show that it emailed the NHS Trust on 3 July 2023 to refer Mr D to the mental health team, although it had already contacted that team in May 2023 following reports that he was suicidal.
46. This referral followed a conversation the Service Manager had had with Mr D on 27 June. The record of that call says the Manager told Mr D he would be referring him to mental health services. It is not my role to determine if it was appropriate to refer Mr D to mental health services, or whether he needed a long-term planning social worker. The Council says there would usually have been a multi-disciplinary team meeting but I do not find fault in the way the referral was made.
47. I have not seen evidence of any response from the mental health team but in January 2024, it told the Council it had tried to make appointments with Mr D in August 2023, but he had declined these.
48. Mr D complained that the social worker had tried to section him in May 2023. I have seen no evidence of any attempts to section Mr D. However, there was a safeguarding alert raised after the Council received reports that Mr D was suicidal. The social worker contacted his GP and the mental health team. The Council decided not to carry out a safeguarding investigation. The Council has a legal duty to raise a safeguarding alert if it considers a person is at risk of harm, so I do not find fault with the Council’s actions.

Was there fault causing injustice?

49. I have found a delay of about a month in assessing Mr D’s care and support needs. This was exacerbated as the social worker did not contact him until the day before the assessment. I find this delay and lack of contact caused Mr D distress and anxiety.
50. I have found some delay in responding to Mr D’s complaints. This also caused distress.
51. When we have evidence of fault causing injustice, we will seek a remedy for that injustice which aims to put the complainant back in the position they would have been in if nothing had gone wrong. When this is not possible, we will normally consider asking for a moderate, symbolic payment to acknowledge the avoidable distress caused. But our remedies are not intended to be punitive and we do not award compensation in the way that a court might.

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Agreed action

52. Within a month of my final decision, the Council has agreed to apologise to Mr D and pay him £150 to remedy the injustice caused as described above.
53. The Council should provide us with evidence it has complied with the above actions.

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Final decision

54. There was fault by the Council. The actions the Council has agreed to take remedy the injustice caused. I have completed my investigation.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman