Summary: Mrs Z on behalf of her parents, complained the Council lost documents relating to a care assessment, delayed implementing a suitable care and failed to complete a carer’s assessment. Mrs Z says as a result she had to pay privately for carers to meet her parents’ needs. The Council failed to upload notes of a review meeting, failed to complete a carer’s assessment and delayed responding to a request from Mrs Z to discuss matters. A suitable remedy is proposed.

The complaint

1. Mrs Z, on behalf of her parents Mr and Mrs X, complains the Council lost documents relating to a care assessment and delayed implementing a suitable care package as well as failing to complete a carer’s assessment.
2. Mrs Z says her parents missed out on appropriate care meaning she had to pay privately for carers.

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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. 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 the investigation, I have:
• considered the complaint and the documents provided by the complainant;
• made enquiries of the Council and considered the comments and documents the Council provided;
• discussed the issues with the complainant;
• sent my draft decision to both the Council and the complainant and taken account of their comments in reaching my final decision.

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What I found

Care Plan

6. 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.

Reviews

7. Section 27 of the Care Act 2014 says councils should keep care and support plans under review. Government Care and Support Statutory Guidance says councils should review plans at least every 12 months. Councils should consider a light touch review six to eight weeks after agreeing and signing off the plan and personal budget. They should carry out reviews as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. Councils must also conduct a review if an adult or a person acting on the adult’s behalf makes a reasonable request for one.

Carer’s Assessment

8. Where somebody provides or intends to provide care for another adult and it appears the carer may have any needs for support, the council must carry out a carer’s assessment. A carer’s assessment must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
9. As part of the carer’s assessment, the council must consider the carer’s potential future needs for support. It must also consider whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)

Direct payments

10. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly.

Key facts

11. This section sets out the key events in this case and is not intended to be a detailed chronology.
12. Mrs and Mrs X lived together in ground floor accommodation. Both have a diagnosis of dementia and they require support to meet their daily care needs due to the decline in cognition. A package of care was in place to provide support to both Mr and Mrs X.
13. In November 2023 a review meeting took place to consider the level of care and support provided to Mr and Mrs X. The social worker for Mr and Mrs X attended the review meeting but failed to input any notes of this meeting onto the case record system.
14. Mrs Z says the day after the review meeting, she emailed the social worker explaining it had been difficult to talk openly in front of her parents about the situation. She asked if she could speak with the social worker to explain her parents’ situation and needs further. The Council received the email but did not take any action in response. It was not until January 2024 that a discussion took place.
15. In February, before any increase in care for Mr and Mrs X could be actioned, Mrs X was admitted to hospital. Mrs Z and her sister contacted the social worker by email several times about their mother’s care needs. However, the social worker was absent from work and so was unable to respond. The Council acknowledges an out of office message was not set up and so Mrs Z was not aware of the social worker’s absence. Before her discharge from hospital, a review of Mrs X’s care needs took place to identify the support she would need to return home.
16. Mrs Z notified the Council she had been privately funding a carer and wanted the Council to provide this extra care particularly to help Mrs X access the community. The Council said this had not been raised during the review before the hospital discharge. It said a new social worker had been allocated and she would arrange a review of the package of care and the extra costs associated with community access. It said it would also complete the carers assessment outstanding from November 2023.
17. Mrs Z made a formal complaint to the Council in March 2024. The Council responded on 1 May upholding some of the issues raised. It said it was unable to reimburse privately funded care costs or provide any compensation as funding had not been agreed before Mrs X went into hospital.
18. A further review of Mrs X’s needs was carried out in July 2024. Mrs X’s health had significantly deteriorated and she required assistance with all personal care needs during the day and night. This resulted in Mr and Mrs X moving into a residential care home in September. It is my understanding the family is raising a separate complaint about this.

Analysis

19. A review of Mr and Mrs X’s care needs was carried out in November 2023. However, the social worker dealing with the case failed to upload any notes of the discussion or what was found. The Council says the notes are no longer available. It is noted the social worker was absent from work for a period of time however, this was several months after the November review meeting.
20. The Council has a policy which states “it is a fundamental requirement that notes relating to an individual, their carer or family must be recorded on the same day as the event, contact or information arises.” The failure to record the notes of the review meeting is fault.
21. There are some notes which give basic details about what was discussed. The Council appears to suggest that nothing arose which required it to take further action or to increase the amount of care provided to Mr and Mrs X. While it is not possible to know exactly what was discussed, the short notes that are available indicate discussions included Mrs X wanting to attend an art class instead of the day centre, Mr X needing a break from his caring role and moving to direct payments to give the family flexibility around the care. There is nothing to suggest action was taken following the review meeting in respect of any of these issues. This is fault.
22. The day after the review meeting, Mrs Z emailed the social worker saying she wanted to discuss matters further. She explained it had not been possible to properly raise and explain issues in the presence of her parents. The social worker failed to respond to this message. Contact was not made with Mrs Z until January after the family made further approaches to the Council. This failure to respond to the message is fault. As a result, Mrs Z lost the opportunity to properly explain her parents’ needs and to request further support.
23. While the Council did take some action in early 2024, not all issues were pursued before Mrs X was admitted to hospital which changed priorities. An assessment was completed to enable Mrs X’s discharge from hospital as well as further assessment in July 2024. By this time, Mrs X’s needs had change significantly and so it is not possible to use these later assessments as an indication of what would have happened if the Council had acted promptly in November 2023. The failure to take prompt action caused frustration and uncertainty.
24. Mrs Z and her sister employed carers privately to provide the care Mr and Mrs X needed because the Council failed to act. As part of her formal complaint, Mrs Z asked the Council to reimburse these costs and pay compensation. The Council has considered the invoices provided by Mrs Z seeking reimbursement. It originally refused to make a payment saying the invoices did not specify the nature of the care provided and some included unrelated expenses such as dental treatment. However, it now accepts that some of the invoices relate to additional support to get Mrs X to health-related appointments and so has offered to pay £500.

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Agreed action

25. To remedy the injustice caused as a result of the fault identified above the Council will, within one month of my final decision, take the following action:
• Apologise to Mrs Z and Mr and Mrs X;
• Make a symbolic payment of £500 to recognise the distress, frustration and uncertainty caused. This is in addition to the payment offered by the Council to reimburse the additional carers costs; and
• Issue a reminder to all staff about the Council’s recording policy and the need to respond to emails in a timely manner.
26. The Council should provide us with evidence it has complied with the above actions.

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Final decision

27. I have completed my investigation with a finding of fault for the reasons explained in this statement. The Council has agreed to implement the actions I have recommended. These appropriately remedy any injustice caused by fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman