Summary: Ms X complains the Council did not meet Mrs Y care and support needs. She says this impacted Mrs Y’s wellbeing. We find the Council at fault which caused Mrs Y injustice. The Council has agreed to apologise to Mrs Y, issue her reviewed care and support plan and take service improvement action.

The complaint

1. Ms X complains about the Council’s handling of Mrs Y’s care and support needs. Specifically, she complains the Council:
1. Did not allocate Mrs Y a social worker for three years;
2. Did not meet Mrs Y’s needs for three years; and
3. Handled her complaint poorly.
2. Ms X says this caused Mrs Y to have unsuitable care which impacted her wellbeing.

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The Ombudsman’s role and powers

3. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)
4. 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)
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)
6. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
7. 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)

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What I have and have not investigated

8. Ms X says matters have been going on since 2021. Ms X complained to us in April 2024. As I have said above, we cannot investigate late complaints unless there are good reasons for us to do so.
9. In this case, I have decided there are no good reasons to exercise our discretion and look back further than April 2023. This is because Ms X knew about the matter and could have complained. I have therefore only considered the Council's actions from April 2023 onwards because this is 12 months before Ms X brought her complaint to us.

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How I considered this complaint

10. I considered the information and documents provided by Ms X and the Council. Ms X and the Council have had an opportunity to comment on a draft of this decision. I have considered all comments received before making this final decision.
11. I also considered the relevant statutory guidance, as set out below.

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What I found

What should have happened

Delay in allocating social worker (part a of the complaint)

12. The Care Act 2014 give local authorities a duty to provide information and advice. The duty to provide information and advice underpins any contact or intervention that the local authority has with the individual. Local authorities need to provide comprehensive information and advice about care and support services in their local area. This is to help people to understand how care and support services work locally, the care and funding options available, and how people can access care and support services.
13. The Act clearly sets out that they must provide information on:

• what types of care and support are available – e.g. specialised dementia care, befriending services, reablement, personal assistance, residential care etc
• the range of care and support services available to local people, i.e. what local providers offer certain types of services
• what process local people need to use to get care and support that is available
• where local people can find independent financial advice about care and support and help them to access it
• how people can raise concerns about the safety or wellbeing of someone who has care and support needs

14. All information and advice must be provided in formats that help people to understand, regardless of their needs. This may include a range of different types of information, and include working with partners to provide information on different services together.
15. The Council’s website advises that if the individuals needs or finances change, they should get in touch with their social worker and let them know. If they do not have a social worker or do not know their contact details, then the person can contact the Council instead. The Council will then arrange for their social worker or another member of their team to call you back.

Care and support needs (part b of the complaint)

16. 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.
17. 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.

Complaints procedure (part c of the complaint)

18. Councils should have clear procedures to deal with social care complaints. Regulations and guidance say they should investigate and resolve complaints quickly and efficiently. A single stage procedure should be enough. The council should include in its complaint response:

• how it considered the complaint;
• the conclusions reached about the complaint, including any required remedy; and
• whether it is satisfied all necessary action has been or will be taken by the organisations involved; and
• details of the complainant’s right to complain to the Local Government and Social Care Ombudsman.
  (Local Authority Social Services and National Health Service Complaints (England) Regulations 2009)

19. The Council’s website states it will acknowledge stage one complaints about adult social care within three working days. It says it will speak to the complainant and agree a timescale. It says it will agree a timescale for complaints escalated to stage two and update the complainant throughout the investigation.

What happened

20. Mrs Y has care and support needs. She has a care and support package including care workers visiting her home several times a day.
21. Prior to April 2023, Mrs Y moved to another area and the Council changed her social work team. The new team did not allocate Mrs Y a social worker.
22. In May 2023, Ms X contacted the Council and requested an updated care plan for Mrs Y.
23. In July, a social worker visited Mrs Y at home with Ms X, and a representative from Mrs Y’s care worker provider.
24. Between July 2023 and February 2024, Ms X was in contact with the duty social workers about Mrs Y’s increased needs.
25. In February 2024, Ms X made a formal complaint about the lack of allocated social worker and lack of care and support plan reviews for Mrs Y.
26. In March, the Council apologised to Ms X for the service it provided to Mrs Y. It accepted Mrs Y’s main contact for social work support was the duty line. It agreed with Ms X the best action would be to allocate a social worker to complete a review of Mrs Y’s needs.
27. Ms X escalated her complaint to stage two.
28. In April, in response to Ms X’s complaint, the Council agreed Mrs Y had not received consistent social work support which it accepted was inappropriate. It told Ms X this was because of unfilled vacancies in the social work team Mrs Y was allocated to. It told Ms X it had allocated a new social worker to Mrs Y’s case who would review her care needs.
29. In late April, the new allocated social worker visited Mrs Y and Ms X to introduce themselves.
30. A meeting to formally review Mrs Y’s care and support plan was set for mid-May.
31. To date, the Council has not yet issued a reviewed care and support plan for Mrs Y.

Analysis

Lack of allocated social worker (part a of the complaint)

32. The Care Act 2014 sets out the legal responsibilities of the Council. There is no legal requirement for Councils to allocate social workers to individuals in its adult social care service. The Council’s website also provides advice in the event someone’s needs have changed, and they do not have an allocated social worker. The Council met its duty to provide information and advice to Mrs Y and therefore I do not find fault with the Council’s decision-making not to allocate Mrs Y a named social worker.

Care and support needs (part b of the complaint)

33. The Council says its social worker completed a review of Mrs Y’s needs during their visit in July 2023. The Council’s records do not evidence this. The Council last reviewed Mrs Y’s care and support plan prior to April 2023. The statutory guidance says councils should review care and support plans at least every 12 months. Furthermore, Ms X requested a review of Mrs Y’s care plan in May 2023. The Council is yet to issue a review of Mrs Y’s care and support plan. The Council has not met its statutory duty to review Mrs Y’s care plan every 12 months or consider Ms X’s request to review the care plan. This is fault.
34. The Council says the reasons for its continued delay issuing a reviewed care and support plan are the review meetings were repeatedly rearranged by Ms X and there was long term staff sickness. I am satisfied Ms X contributed to the delay in the Council completing the review process. For this reason, I consider any injustice to Ms X to be limited.
35. A review meeting has now been completed; however, the Council has not yet issued a reviewed care and support plan. It says this is because Ms X disagrees with the contents of the plan. The statutory guidance says reviews must include the person’s carer. Ideally, the Council will issue a plan which is agreed by the Council and the person and their carer. However, to avoid delay and meet its statutory duty the Council should have issued the plan and addressed Ms X’s concerns through its appeal process.
36. Ms X made a separate complaint about the contents of the proposed reviewed care and support plan. She says her new complaint is about reduced hours of care in Mrs Y’s reviewed care and support plan. Therefore, the delay in the Council completing its review has caused Mrs Y to access more hours of care than she would have done if the Council completed its review on time. For this reason, I consider the injustice to Mrs Y to be limited.
37. Ms X contacted the duty social work team several times between May 2023 and April 2024. The nature of the contacts were requests for the Council to meet Mrs Y’s increased needs. The documents I have seen show the duty social work team responded to Ms X promptly and addressed each concern she outlined, with the exception of not following up on her request for a review of Mrs Y’s care and support plan in May 2023.

Complaints procedures (part c of the complaint)

38. The Council acknowledged both Ms X’s stage one and stage two complaints within three working days. This is in line with its website and is not fault.
39. In both its stage one and stage two complaint acknowledgements it told Ms X it aimed to respond within 20 working days and would update her if it needed longer to complete its investigation. It took 25 working days to respond to her stage one complaint and had contacted her during its investigation with an update and apologised for its delay. It responded to her stage two complaint within the agreed timescale. Although the stage 1 response was slightly beyond the published timescale, I do not consider the delay is significant enough to make a finding of fault. I find no fault with the Council’s handling of Ms X’s complaint at the second stage of the process.

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Agreed action

40. Within four weeks of my final decision, the Council has agreed to:
1. issue the reviewed care and support plan without further delay.
2. provide a written apology to Mrs Y for the delay issuing her care and support plan.
3. remind its staff about the importance of considering reasonable requests for care and support plan reviews from any person acting on behalf of an adult, in accordance with statutory guidance.
41. The Council should provide us with evidence it has complied with the above actions.

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Final decision

42. I have completed my investigation. I find the Council at fault and this caused injustice. The Council has agreed to issue the reviewed care and support plan, apologise to Mrs Y and take service improvement action.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman