Summary: Mr X complained the Council wrongly decided he and his family were not eligible for medical priority and emergency status on the housing register. He said this caused his family to be in overcrowded accommodation which impacts on his family’s health and development. While we do not find the Council at fault for its decisions, we find fault for a delay completing an assessment. This caused injustice. The Council has agreed to apologise and make a payment to Mr X to remedy the injustice caused.

The complaint

1. Mr X complains the Council wrongly decided he and his family were not eligible for medical priority and emergency status on the housing register. He says this means his family has been overcrowded which impacts on his wife and children’s health and development.

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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. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), 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)
5. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
6. 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

7. Mr X complained about housing register applications going back to 2021. Mr X complained to us in April 2023. As I have said above, we cannot investigate late complaints unless there are good reasons for us to do so.
8. In this case, I have decided there are no good reasons to exercise our discretion and look back further than April 2022. I have therefore only considered the Council's actions from April 2022 onwards because this is 12 months before Mr X brought his complaint to us.

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How I considered this complaint

9. I considered the information and documents provided by Mr X and discussed the complaint with him. I considered the Council’s comments and supporting documents it provided. Mr X and the Council had an opportunity to comment on a draft of this decision. I have considered all comments received before making this final decision.
10. I also considered the relevant statutory guidance, as set out below. I have also considered the Ombudsman’s published guidance on remedies.

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What I found

What should have happened

Medical Priority

11. The regulations governing housing allocations in England are set out in the Housing Act 1996. The law says 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. 
12. The Housing Act 1996 says 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))

13. The Council’s allocations scheme details the different priority banding and how it makes its decisions on priority.
14. It says officers in the Lettings Team make decisions on medical applications. It says the officers may ask qualified health advisors to recommend who should be given additional priority on health and medical grounds.
15. It says the priority medical award is normally recommended if the applicant, someone on the application, or someone the applicant provides care to has a severe long-term limiting illness, or permanent and substantial disability. It says their health or quality of life must be severely affected by their current home.

Emergency Status

16. The Council’s allocations scheme says Band 1 Group A is the highest priority banding available. Applicants with additional emergency status are given priority over other applicants in the same band. The priority of the applicants in Band 1 Group A without emergency status is done in order of their preference date.
17. The scheme details emergency status is the highest priority award. It will normally be considered where the criteria for a priority medical award is met and one or more of the following conditions also applies:
• someone is in hospital/residential care and cannot return home because it is not suitable;
• there is a risk to life;
• there are very exceptional circumstances.

What happened

18. In August 2022, Mr X made a housing application for priority banding on medical grounds.
19. In September, the Council rejected Mr X’s application.
20. In October, Mr X appealed the Council’s decision not to award his family priority banding on medical grounds. The Council rejected Mr X’s appeal.
21. In April 2023, Mr X made a new housing application for priority banding on medical grounds. The Council told Mr X it needed an Occupational Therapy (OT) assessment.
22. In October, an OT assessed Mr X’s family. The OT assessment said Mr X and his family met the criteria for very exceptional circumstances.
23. In November, the Council awarded Mr X priority banding on medical grounds. It decided not to award Mr X emergency status. The Council backdated this new status to March 2023.

Analysis

Medical Priority

24. The Council says Mr X’s application in August 2022 only included evidence it had already considered in his previous applications. Mr X agrees the information he submitted in his August 2022 application was additional information about his child’s medical condition which the Council already knew about.
25. The Council says the additional evidence Mr X submitted with his October 2022 appeal only confirmed information it already knew. It decided a new assessment was not justified.
26. Mr X submitted new information in his April 2023 application. The Council decided Mr X’s family needed an Occupational Therapy assessment on the basis of the new information. After the Council had assessed the new information, it made a different decision. This was appropriate.
27. The Ombudsman may not find fault with a council’s assessment of a housing application if it has carried this out in line with its published allocations scheme. On the information seen, there is no evidence of fault in how the Council assessed Mr X’s application for medical priority. This is because the Council properly considered the information it had available at the time it made its decisions.

Emergency Status

28. The Council considered the OT assessment and decided not to award Mr X’s family emergency status.
29. It decided Mr X’s application and circumstances were similar to many other applicants and were therefore not very exceptional.
30. The documents I have seen show the Council considered all available information about Mr X’s circumstances and made its decision in line with its policy. There is no evidence of fault with how the Council made its decision and therefore we cannot question the outcome.

Occupational Therapy Assessment Delay

31. While I find no fault with how the Council decided Mr X’s applications, there was a period of six months between the Council deciding Mr X’s family needed an OT assessment to completing the assessment. This is fault.
32. The Council says its criteria for an OT assessment changed which led to an increase in requests for assessment. It says high demand caused the delay in Mr X’s family having their assessment.
33. There is no statutory time scale for processing housing applications. However, we expect applications for priority awards to be processed without undue delay. A six month delay is fault. This caused injustice because Mr X experienced uncertainty.

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Agreed action

34. Within four weeks of this decision the Council has agreed to make a payment to Mr X of £150 to recognise the avoidable distress and uncertainty caused by its six month delay completing the Occupational Therapy assessment. This amount is in line with our published guidance on remedies and I find it to be an appropriate and proportionate amount given the factors in this case.
35. Within four weeks of this decision, the Council has also agreed to apologise in writing to Mr X for the avoidable distress and uncertainty caused by its delay in completing the OT assessment.
36. 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.
37. The Council should provide us with evidence it has complied with the above actions.

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Final decision

38. I have completed my investigation. I find the Council at fault and this caused injustice. The Council has agreed to apologise and make a payment to Mr X to reflect the injustice caused.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman