Summary: Ms X complains the Council has failed to meet her grandmother’s needs properly since she left hospital in 2024. There is no evidence of fault by the Council.

The complaint

1. The complainant, Ms X, complains the Council has failed to meet her grandmother’s needs properly since she left hospital in 2024.

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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. 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)
4. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, sections 24A(1)(A) and 25(7), as amended)

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How I considered this complaint

5. I have:
• considered the complaint and the documents provided by Ms X;
• discussed the complaint with Ms X;
• considered the comments and documents the Council has provided in response to my enquiries;
• considered the Ombudsman’s guidance on remedies; and
• invited comments on a draft of this statement from Ms X and the Council, for me to consider before making my final decision.

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What I found

What happened

6. Ms X’s grandmother, Mrs Y, is very frail because of her age. She has poor mobility and cannot weight bear. Before going into hospital in January 2024, Mrs Y lived at home with a care package comprising four calls a day. Three of the calls needed a single care worker, but the bedtime call needed two care workers.
7. The Council assessed Mrs Y’s needs under the Care Act 2014 on 16 January, while she was in hospital but ready to go home. The assessment did not identify any issues with her mental capacity. It said she:
• had been living downstairs, with a hospital bed, and did not use the upper floor of her home;
• needed a hoist for all transfers, which an occupational therapist would have delivered, as her mobility had declined further;
• had previously declined a hoist at home but was now “more accepting of this idea” and recognised her mobility had declined.
8. Mrs Y’s family confirmed her care package was working well. The Council produced a care and support plan based on reinstating four calls a day, but with two care workers for each call:
• 1 hour each morning, 09.30 to 10.30
• 30 minutes each lunchtime, 13.30 to 14.00
• 30 minutes each teatime, 17.00 to 17.30
• 30 minutes each evening, 21.00 to 21.30
9. Mrs Y returned home on 23 January, after equipment (e.g. hoist) was delivered to her home on 22 January.
10. On 23 January Mrs Y’s family raised concerns about the new hoist. They said the care workers were struggling with it and Mrs Y would be left in her chair. The Council asked the agency which provides occupational therapy support to visit and assess the equipment. The care provider told the Council its care workers had reported no problems with the equipment.
11. An occupational therapist visited on 24 January. They noted Mrs Y did not like using a hoist. The occupational therapist ordered more equipment (a different hoist) and said Mrs Y should remain in bed until it arrived. Mrs Y’s family said they were not happy with the advice provided by the hospital occupational therapist, or with Mrs Y remaining in bed. The Council referred them to the hospital’s complaints process.
12. On 12 February the Council noted an occupational therapist had been visiting Mrs Y regularly to ensure she had the right equipment in place. Another hoist was in place and Mrs Y was living in a different room. It was now safe to hoist her again, but she was not to sit in her chair for more than six hours, until her sitting balance improved.
13. On 13 February the care provider told the Council Mrs Y did not have enough core strength to sit in her chair for long periods, so would remain in bed during the day. This also meant Mrs Y could no longer use a commode. She had also been slipping out of her chair.
14. Mrs Y went into hospital on 19 February after falling out of bed and burning her knee on a radiator. She returned home on 22 February. An occupational therapist arranged delivery of a floor bed to mitigate the risks from falling out of bed.
15. On 1 March the Council noted Mrs Y would have a seating assessment, to identify a suitable chair for her to sit in, when her occupational therapist returned from leave.
16. On 24 April the Council noted an occupational therapist would have bed rails fitted, to prevent Mrs Y from falling out of bed.
17. When the Council spoke to Ms X on 3 May, it advised her to contact the occupational therapist about Mrs Y’s equipment. Ms X asked to speak to Mrs Y’s assigned social worker. The Council told her Mrs Y did not have one, as social workers would end their involvement after completing their work.
18. Following the call, Ms X complained to the Council about:
• the support provided for Mrs Y
• difficulties contacting the social worker and occupational therapist
• the occupational therapy equipment, bed rails (which had been removed), hoist and commode
19. On 7 May Ms X asked for a fast-track assessment for NHS Continuing Healthcare. The Council told her it was not responsible for organising fast-track assessments.
20. On 22 May, the Council told Ms X Mrs Y had not qualified for NHS Continuing Healthcare.
21. On 23 May Mrs Y’s family told the Council she had not had a suitable chair to sit in since she left hospital. They said, after trying out several chairs, a suitable one had been identified two weeks ago and they were waiting for delivery.
22. When the Council replied to Ms X’s complaint later in May, it said:
• The decision to return home was discussed and agreed with Mrs Y and her family.
• Following concerns raised about her equipment by Mrs Y’s family on 23 January, the Council arranged for an occupational therapist to review it. It also contacted the care provider which confirmed its care workers had no issues with the equipment.
• Mrs Y’s care transferred from the short-term discharge to assess team to the long-term locality team on 1 March.
• It referred Mrs Y for an assessment for NHS Continuing Healthcare and provided Ms X with the contact details. NHS Continuing Healthcare arranged to assess Mrs Y in May.
• It was satisfied officers had been contactable, had given advice and had signposted to other services when necessary.
• It could not comment on equipment provided by another agency.

Is there evidence of fault by the Council which caused injustice?

23. There is nothing in the Care Act 2014 which requires everyone receiving services to have an allocated social worker. Many councils work by assigning social workers when a specific piece of work needs doing, such as assessing or reviewing someone’s needs. Between such activities, people can contact the duty team to discuss any issues. There is no fault in that.
24. The evidence does not support the claim that the Council has failed to meet Mrs Y’s needs. It has put support in place and increased her package of care so she can remain in her own home. That it has taken time to get some of the right equipment in place, does not reflect fault by the Council, but the complexities of Mrs Y’s circumstances and her increasing frailty.

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Final decision

25. I have completed my investigation on the basis there is no evidence of fault by the Council.

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Investigator's decision on behalf of the Ombudsman