Summary: Mr and Mrs X complain about delay by the Council in carrying out an assessment for the transition of Mr Y from children to adult care services. The Council is at fault as it delayed in carrying out a transition assessment for Mr Y and wrongly stopped his direct payments. The Council also failed to identify it had responded to Mr and Mrs X’s complaint when they chased for a response. The faults caused distress, uncertainty and avoidable time and trouble to Mr and Mrs X. The fault also caused injustice to Mr Y as he missed the benefit of increased support. The Council has agreed to remedy this injustice by apologising and making a symbolic payment of £1000 to Mr and Mrs X and a symbolic payment of £1000 to Mr Y.

The complaint

1. Mr and Mrs X complain that the Council delayed in carrying out transition planning for their son, Mr Y, for his move from children services to adult care services. Mr and Mrs X also complain the Council stopped Mr Y’s direct payments when he turned 18 despite the delay in assessing Mr Y for adult social care. As result, the Council has not provided adequate care and support for Mr Y which has placed a significant burden on Mr and Mrs X and caused significant distress to them.

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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. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
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)
5. Under our information sharing agreement, we will share this decision with the Office for Standards in Education, Children’s Services and Skills (Ofsted).

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How I considered this complaint

6. I have:

• Considered the complaint and the information provided by Mr and Mrs X;
• Discussed the issues with Mr and Mrs X;
• Made enquiries of the Council and considered the information provided;
• Invited Mr and Mrs X and the Council to comment on the draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance

7. When a child reaches 18 years of age, they are legally an adult and responsibility for meeting their needs moves from the council’s children services to its adult services. The legal basis for assessing their needs changes from the Children Act 1989 to the Care Act 2014. However, councils can decide to treat a children’s assessment as an adult assessment and can also carry out joint assessments.
8. Statutory guidance says transition assessments should begin when the council can be reasonably confident about what the young person’s needs for care and support will look like when they turn 18. However, for a young person with an Education Health and Care (EHC) plan, the process should begin in year 9 (age 13 to 14). The purpose of the assessment is to provide the young person and their family with information so they know what to expect in future and can prepare for adulthood. (Care and Support Statutory Guidance, paragraphs 16.7 and 16.11 and Special Educational Needs and Disability Code of Practice, paragraphs 8.57 and 8.59)
9. Transition assessments should be carried out in a reasonable timescale. (Care and Support Stautory Guidance, paragraph 16.32)
10. If transition assessment and planning is carried out as it should be there should be no gaps in the provision of care and support. However, if adult care and support is not in place when the young person turns 18, the council must continue providing the services under children’s legislation until it is in place or until it decides the young person does not have “eligible needs”.

What happened

11. The following is a summary of the key facts relevant to my consideration of the complaint. It does not include everything that has happened.
12. Mr Y has a severe learning disability, a number of health conditions and requires significant care which is provided by Mr and Mrs X. The Council provided direct payments for short breaks for Mr Y. As the Council provided services for Mr Y as a child and young person, it was required to assess Mr Y to determine if he required care and support after he reached 18 years old.
13. The Council has said a special educational needs panel referred Mr Y to the transitions team approximately eight months after he turned 16. The Council did not carry out a transition assessment at this time. There is no record to show the Council made a decision on when would be the right time to carry out a transition assessment for Mr Y.
14. In November 2022, the Council sent an email to Mrs X asking her to complete a form by the next day. This was to enable an officer to present Mr Y’s case at a panel to ensure he received the correct support after his 18th birthday. Mrs X told the Council she did not have time to complete the form and referred it to Mr Y’s EHC plan which she said contained the relevant information.
15. The Council has said Mr Y’s case was referred to a panel in December 2022 who referred Mr Y for a transition assessment.
16. The day before Mr Y’s 18th birthday, the Council stopped Mr Y’s direct payments. In response to my enquiries, the Council said children’s payments automatically stop when they reach 18. I understand the Council reinstated the payments a short time later.
17. The Council started Mr Y’s assessment approximately three months after his 18th birthday. The Council also carried out a continuing health care (CHC) checklist to decide if Mr Y should be referred to the Integrated Care Board (ICB) for a full assessment to determine if he was eligible for CHC funded care.
18. The assessment did not proceed for six months as Mr Y’s social worker was absent and the Council could not reallocate it to another social worker to complete. The Council completed the assessment in late November 2023.
19. The ICB decided Mr Y was eligible for CHC funding from November 2023 so it is now responsible for his care and support. The ICB has not yet finalised Mr Y's care package but it has issued a proposed support plan for discussion with Mr and Mrs X.
20. In response to my enquiries, the Council said that historically there had been delays in referring service uses for transition assessments. However, it has carried out a lot of work in its children’s and adult care services to improve the transition process so delays are minimal.

Complaint

21. In July 2023, Mr and Mrs X made a complaint to the Council about the delay in competing Mr Y’s transition assessment. The Council responded to Mr and Mrs X at stage one of the complaints procedure. The Council said it had not been able to progress Mr Y’s assessment due to the absence of the social worker. Due to pressures within the service it was not possible to allocate another social worker. The Council confirmed that Mr Y’s direct payments would continue in the meantime.
22. The Council has provided evidence to show it sent the response to Mr and Mrs X by email. I understand Mr and Mrs X did not receive the response. Mr and Mrs X have provided evidence to show they chased the Council for a response on two occasions. The Council told them it was chasing the service for a response.

Analysis

Transition assessment

23. The care and support statutory guidance provides that councils should carry out a transition assessment at the right time for the young person. This should also be at a time when the Council can be reasonably confident about what their needs will look like when they turn 18. So, there was no obligation for the Council to carry out Mr Y’s transition assessment when he turned 16. But the Council should have made an active decision about when an assessment would be of significant benefit to Mr Y. The Council has not provided any evidence to show the Council made a decision on when it should carry out an assessment for Mr Y. It has not explained why waiting until November 2022 was the right time to carry out an assessment for Mr Y. So, I cannot be satisfied, on balance, that it gave appropriate consideration to when it should carry out the assessment. This delayed carrying out the assessment. This is fault. Furthermore, Mr Y has an EHC Plan so it is not clear why the transition assessment was not integrated as part of his annual reviews.
24. The Council sent an email to Mrs X asking her to complete a form for Mr Y’s referral for the transition assessment in November 2022. The Council considers Mrs X did not engage. Mrs X indicated she could not complete the form within the extremely short timescale. On balance, I do not consider this is evidence to show Mrs X did not engage or that she contributed to the delay in referring Mr Y for a transition assessment.
25. The Council did not start the transition assessment until May 2023 which was after Mr Y had turned 18. I consider this is delay and is fault. The Council then delayed by six months in competing the assessment. I am mindful that the Council has said the delay was due to the social worker’s absence and it had no capacity to reallocate Mr Y’s case. But the care and support statutory guidance provides councils should carry out transition assessments within a reasonable timescale. I therefore consider the delay of six months in competing the assessment is excessive and is fault.
26. I cannot know, on balance, exactly what support Mr Y would have received if the Council had not delayed in carrying out his transition assessment. His needs may have changed during the period of delay. But the proposed support plan produced by the ICB shows the level of support suggested for Mr Y is higher than provided by children’s services. Even if changes are made to the final support plan, it is more likely than not that the level of support will be significantly more than Mr Y received as an under 18 year old. This shows Mr Y and Mr and Mrs X would have received considerably more support between the date of Mr Y’s 18th birthday and November 2023 if the Council had not delayed in carrying out the transition assessment. This will have caused significant distress to Mr and Mrs X. The delay also meant Mr Y missed the benefit of additional support for this period.
27. Mr and Mrs X consider the delay in carrying out and completing the transition assessment meant that they had significantly more appointments for Mr Y over a shorter period of time. Mr and Mrs X may have always had to attend a significant number of appointments for the transition assessment process. But, on balance, I consider the appointments would have been over a longer period of time if the Council had not delayed. So, the delay made the process more difficult and stressful for Mr and Mrs X to manage.
28. The Council is at fault for stopping Mr Y’s direct payments just before his 18th birthday. In response to my enquiries, the Council has said children’s services payments will automatically stop on the young person’s 18th birthday. Councils should not allow a gap in provision between children’s and adult care services. The Council had not carried out the transition assessment before Mr Y turned 18 so it should not have stopped the payment. I understand the Council reinstated the payment within a few days but the stoppage will have caused distress to Mr and Mrs X.
29. The Council has said it has improved its management of the transition process so late referrals are minimal. But the Council should share the learning from this complaint with relevant officers. This is to confirm they are aware of the Council’s duty to carry out the transition assessment when it is of significant benefit to the service user and that assessment should be completed within a reasonable timescale.

Complaint

30. The Council has provided evidence to show it responded to Mr and Mrs X’s complaint at stage one of the complaints procedure. But the evidence shows the response was not sent to the correct email address as there is a letter missing from the address. So, Mr and Mrs X did not receive the response. This is fault.
31. The Council was also unaware that it had sent the stage one response to Mr and Mrs X as it told them that it was chasing the service for the response. Had the Council realised it had sent the response then it could have resent the response to the correct email address. This suggests the Council’s system for monitoring complaint responses is inadequate.

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Agreed action

32. That the Council will:
1. Send a written apology to Mr and Mrs X for the distress, uncertainty and avoidable time and trouble caused by the Council’s delay in carrying out a transition assessment for Mr Y, wrongly stopping Mr Y’s direct payments, failing to send its stage one response to the correct address and failing to identify that it had responded to their complaint. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings.
2. Make a symbolic payment of £1000 to acknowledge the distress, uncertainty and time and trouble caused to Mr and Mrs X.
3. Make a symbolic payment of £1000 for Mr Y to acknowledge that he missed the benefit of increased support between the date of his 18th birthday and November 2023. This payment should be used to provide additional support for Mr Y in agreement with Mr and Mrs X.
4. By training or other means, share the learning from this complaint with relevant officers. This is to ensure they are aware of the Council’s duty to carry out the transition assessment when it is of significant benefit to the service user, to carry out the assessment within a reasonable timescale and to consider co-ordinating the transition assessment with an EHC plan annual review where applicable.
5. Review its procedures for stopping children’s services direct payments when the service user turns 18 to ensure checks are made to prevent direct payments being ended if an adult care package is not yet in place. This is to prevent a gap in provision between children’s and adult care services.
6. Review its complaint handling procedures to track when complaint responses are sent to the complainant. This is to ensure officers are aware a response has been issued.
33. The Council should take the action at a) to c) within one month and the action at d), e) and f) within two months of my final decision. The Council should provide us with evidence it has complied with the above actions.

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Final decision

34. I have completed my investigation and uphold Mr and Mrs X’s complaint. There was fault causing injustice to Mr and Mrs X and Mr Y which the Council has agreed to remedy.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman