Summary: Ms X complained the Council rejected her application for a place on the housing register on medical grounds. She said her accommodation negatively affects her health. The Council is at fault for not properly considering and engaging with medical evidence. Ms X also complained her flat is overcrowded, there is no evidence the Council is at fault.

The complaint

1. Ms X complained the Council rejected her application for a place on the housing register on medical grounds. She also said her flat is overcrowded, damp and a long way from the nearest bus stop. Ms X said her accommodation negatively affects her health. Ms X is also the carer for her disabled mother. She would like the Council to rehouse her in a two bedroom property and reconsider her priority according to her medical conditions.

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What I have and have not investigated

2. I have not investigated Ms X’s complaint about damp in her property. This falls outside the jurisdiction of the Local Government and Social Care Ombudsman.

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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 an injustice, 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 following:
• The complaint and the documents provided by the complainant.
• Documents provided by the Council and its comments in response to my enquiries.
• The Housing Act 1996.
6. Ms X 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 legislation

The published scheme

7. Every local housing authority must publish an allocations scheme that sets out how it prioritises applicants, and its procedures for allocating housing. All allocations must be made in strict accordance with the published scheme. (Housing Act 1996, section 166A(1) & (14)).

Reasonable preference

8. An allocations scheme must give reasonable preference to applicants in the following categories:
• homeless people;
• people in insanitary, overcrowded or unsatisfactory housing;
• people who need to move on medical or welfare grounds;
• people who need to move to avoid hardship to themselves or others;
  (Housing Act 1996, section 166A(3))

Decisions and review rights

9. Councils must notify applicants in writing of the following decisions and give reasons:
• that the applicant is not eligible for an allocation;
• that the applicant is not a qualifying person;
• a decision not to award the applicant reasonable preference because of their unacceptable behaviour.
10. The Council must also notify the applicant of the right to request a review of these decisions. (Housing Act 1996, section 166A(9)).
11. Housing applicants can ask the council to review a wide range of decisions about their applications, including decisions about their housing priority.

Review procedures

12. Statutory guidance on the allocation of accommodation says:
• review procedures should be clear and fair with timescales for each stage of the process
• there should be a timescale for requesting a review, 21 days is suggested as reasonable;
• the review should be carried out by an officer senior to the original decision maker, or by a panel not including the original decision maker
• reviews should normally be completed within a set deadline, eight weeks is suggested as reasonable.

No fault

13. The Ombudsman may not find fault with a council’s assessment of a housing application or a housing applicant’s priority if it has carried this out in line with its published allocations scheme. The Ombudsman recognises that the demand for social housing far outstrips the supply of properties in many areas. He may not find fault with a council for failing to re-house someone, if it has prioritised applicants and allocated properties according to its published lettings scheme policy.

The Council’s policies and procedures

14. The Council’s policy refers to the Housing Act 1996 section 166A as amended and states the housing authority is to give reasonable preference to people who need to move on medical or welfare grounds.

Choice based lettings

15. Properties are let through the Home Connections Choice Based Lettings scheme. Eligible individuals on the scheme bid on available properties, the Council offers the bidder with the highest priority the property, providing it is suitable.
16. The scheme gives points following an assessment of the applicants needs. Applicants with the same number of points will be re-housed in date order.

Medical priority

17. Where suitable, a medical advisor will provide an assessment for applicants to advise the Council if the priority group is met. As part of the assessment for medical priority consideration will be given to the suitability of the current property and any adaptions that have been carried out. If the housing needs are met or could be met by making adaptions, medical priority may not be awarded.
18. Re-housing on medical, welfare and disability grounds normally arises when:
• The housing situation seriously adversely affects health; and
• The property cannot reasonably be adapted to meet needs and thereby causes the need to move.
19. The situation usually arises when:
• There is a housing factor which directly adversely affects a medical condition.
• Adverse housing factors have a serious effect on the ability to cope on the quality of life.
• On occasions, an additional bedroom or extra space may be needed on health grounds.
20. The policy states a wide variety of circumstances can occur which cause a need to move on medical or welfare ground. Each case is considered on individual severity and merit. It gives examples of housing factors which may seriously, adversely affect medical conditions, welfare or disability. These include the following:
• Dampness, caused by irreparable structural defect causing severe chest conditions requiring hospitalisation.
• Overcrowding, which increases the risk of infection in some susceptible individuals and therefore seriously affect their health, for example individuals undergoing chemotherapy, Acquired Immune Deficiency Syndrome (AIDS).
• Unsuitable for mobility impairment, where individuals have problems walking and climbing stairs making it difficult to reach or move within accommodation. Various medical conditions can cause reduced mobility, but only severe cases are likely to be awarded priority for re-housing, for example lower limb amputation, registered blind.
• Effect on psychiatric conditions

Request for review

21. An applicant can ask for a review. Where it is reasonable practicable, a review will be carried out within eight weeks by a senior officer who did not make the initial decision.

Overcrowding

22. Priority for overcrowding is determined by the number of bedrooms a household is lacking. Applicants are given points to reflect the level of overcrowding. Applicants who are statutorily overcrowded will qualify for the highest priority.
23. The policy awards 100 points for overcrowding of a family lacking one bedroom. It awards a further 50 points for resident applicants. Ten points are deducted for an all-adult household.

What happened

24. I have summarised below the key events; this is not intended to be a detailed account.
25. Ms X lives in a one bedroomed flat with her adult son. She said the flat is overcrowded. Ms X complained her flat has a leak and is damp. The kitchen is mouldy. She said the kitchen opens on to the lounge so cooking smells go into the living area.
26. Ms X has been diagnosed with a number of conditions which cause pain and tiredness. She also has asthma and allergies. Ms X has prescription medication to treat the conditions.
27. Ms X struggles to walk and receives Personal Independence Payment (PIP) for mobility. She says she cannot climb one flight of stairs and the flat is too far from public transport.
28. A letter dated 2021 from a specialist doctor within the NHS explains Ms X gets pain in her foot. On examining Ms X, the doctor notes ‘even light touch caused her a significant amount of pain’. It states Ms X had previously had physiotherapy and injections but not noticed any improvement.

Application for medical priority

29. Ms X applied for medical priority in 2002, 2004, 2014, 2017, 2020 and again in 2022. The Council considered her recent application for medical priority at the beginning of February 2022. An Officer at the Council wrote to Ms X and said the Council acknowledges her medical condition, but states there is no medical evidence the property impacts on her medical conditions. The Council did not support a medical priority and recommended her property was suitable.
30. Ms X asked for a review of the decision. The Council accepted Ms X’s request.
31. A Senior Council Officer, not involved in the original decision reviewed the matter and sent a decision letter to Ms X in April. The letter says the Officer considered the information on Ms X’s file, lists her medical conditions and the medication she takes. The letter refers to the allocation scheme noted above which states it must consider if ‘the housing situation seriously adversely affects health’. It concludes saying there is no evidence to suggest Ms X’s conditions are not being managed with treatment and says whilst it ‘…acknowledges that your conditions do cause you some discomfort, I am not satisfied that your home adversely impacts on your health.’
32. The letter acknowledges Ms X is a carer for her mother and that Ms X says her flat is too far from the nearest bus stop. It refers to Google maps and states her property is a seven minute walk to the bus stop where she can take a bus to visit her mother. The letter says the total journey takes 24 minutes. In response to my enquiries, the Council said there are three bus stops near Ms X’s property, within a four and seven minute walk. It also says ‘…the proximity to bus stops and underground stations are not factors that the council considers when assessing application for housing…’.
33. In Ms X’s application form she said ‘…the nearest bus stop which requires me to walk for 25 minutes and stop many times to get rest due to my swollen and numbness in my feet and chronic pain in lower back and hips…’
34. The review letter concludes the Officer will not be overturning the original decision and will not support medical priority.

Overcrowding

35. The Council said it accepted Ms X’s transfer application for a two-bedroomed property in December 2003.
36. The Council awarded 140 overcrowding points to Ms X, in line with its housing scheme. She has 100 points for lacking one bedroom and 50 residents points. The Council deducted 10 points as the household is all adult.
37. Ms X is on the Council’s housing register for a transfer to a two bedroom property. There are several households before Ms X on the transfer list as they either have more points or have the same number of points but applied earlier.

Analysis

Application for medical transfer

38. The decision letter dated February 2022 for Ms X’s application for a transfer on medical grounds is sparce. It states Ms X does not meet the requirements for transfer on medical grounds. It does not give any detail, it does not state the medical conditions Ms X suffers from or how Ms X’s property might affect these, it does not refer to or engage with any medical evidence. This is fault.
39. A Senior Officer at the Council that had not previously been involved with the matter reviewed the decision, as required by the policy. The Council are not at fault here.
40. The Council’s policy says it should consider the review within eight weeks where reasonably practicable. The Council responded slightly over the eight-week target. While this is not best practice, I do not consider it significant enough to be fault. Neither did it have an impact on any alleged injustice suffered by Ms X.
41. The review letter states the Council considered Ms X’s information on file. It does not refer to any specific documents it reviewed or highlighted medical evidence in support of its decision. The contents of the letter is at odds with the doctors letter from 2021 which refers to Ms X suffering a ‘significant amount of pain’; the Councils letter describes Ms X suffering ‘some discomfort.' The doctors letter refers to treatment which ‘has not improved her symptoms’ whereas the Councils review says ‘There is no evidence to suggest that your medication has not aided your conditions.’ The Councils decision letter does not properly engage with the medical evidence and its findings appear contradictory to the doctor’s letter. I am not satisfied the Council has properly considered all the evidence to make a robust decision. This is fault.
42. The review letter and the Councils response to my enquiries shows the Council considered Ms X’s location and how far she is from the nearest bus stops using Google Maps. It does not recognise that Ms X might walk slower than the average person as calculated by Google, and that she might be in pain whilst walking. Ms X’s application form states it takes her 25 minutes to walk to the nearest bus stop as she takes breaks due to numbness and chronic pain. The Council failed to consider the information provided in Ms X’s application and consider the case on its own merits, and instead applied an average measure.
43. In its response to my enquiries, the Council said it does not consider closeness to bus stops or underground stations when assessing applications, it is not within its scheme. The Council has however considered this in its review of Ms X’s application and it formed part of its decision letter. As this has been a factor in its decision making, the Council should apply a subjective measure rather than relying on an average taken from Google maps. If the Council are going to consider journey times, it should have calculated how long the journey would take Ms X and how this might affect her. It has not done so. This is fault.

Overcrowding

44. The Council has calculated the number of points for overcrowding in line with its allocations scheme. The Council are not at fault.

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Agreed action

45. Within two months of my final decision, the Council should reconsider the medical evidence and review Ms X’s application for medical transfer. The Council must give clear reasons for its decision and show it has considered the evidence.

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Final decision

46. I have completed my investigation. The Council are at fault for not properly considering the medical evidence and not giving clear reasons for its decision.

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Investigator's decision on behalf of the Ombudsman