Summary: Mr X complained about the Council’s assessment of, and review of its decision about, his medical priority on the housing register. We have found fault by the Council, causing injustice, in failing to properly review its decision about Mr X’s priority band. The Council has agreed to remedy this injustice by apologising to Mr X, making a payment to reflect his upset and uncertainty and carrying out a fresh review.

The complaint

1. The complainant, Mr X, complains about the Council’s assessment and review of his priority on its his housing register.
2. Mr X says it failed to properly take into account the medical evidence and advice provided about the impact of his current accommodation on his health and his urgent need to move to a suitable property. He wants the Council to move him into a high priority band.

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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.
4. 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)
5. 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)
6. 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

7. I spoke to Mr X, made enquiries of the Council and read the information Mr X and the Council provided about the complaint.
8. I invited Mr X and the Council to comment on a draft version of this decision. I considered their responses before making my final decision.

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What I found

What should have happened

The Council’s allocations policy

9. Every local housing authority must publish an allocations scheme that sets out who can apply to join its register for social housing, how it prioritises applications for, and allocates, social housing. All allocations must be made in strict accordance with the published scheme. (Housing Act 1996, section 166A(1) & (14))

The Council’s current published policy

10. The Council’s policy sets out the priority bands, and the categories and criteria for each band, in its published policy. These bands are:
1. Band A: urgent priority. This includes a category for urgent medical need where the applicant is at significant risk of:

• physical injury by remaining in their current home and is requesting a move to more suitable type of accommodation; or
• a severe breakdown in their mental health by remaining in their current home.
2. Band B: high priority. This includes categories for:
• medical need: where applicants have a serious medical condition that is made worse by the style or functionality of their current home. There must be a causal link between the property type and the deterioration or discomfort arising from the medical problem. Priority is not awarded for medical conditions alone. And applicants must show a move to the property type requested will help halt the deterioration in the condition and/or make the applicant more comfortable; and
• care need: for those who need to move closer to family, friends or relatives to receive physical or emotional support or care because of a medical condition. To qualify for this, if already resident in the Council’s area, the applicant must be living more than 3 miles from those who will be providing the care. There must be evidence this support cannot be provided in the current location.
3. Band C: medium priority. There is no medical need category in this band
4. Band D: low priority. There is no medical need category in this band
5. Band E: no priority. This includes existing secure social housing tenants with no other housing need.

11. The policy also sets out the criteria for bedroom numbers and says:

• This is dependent on the size of the household. Each adult over 21 is awarded one bedroom;
• where there is a demonstrated need for an additional room for a carer or medical equipment, as evidenced by medical information, an additional bedroom can be allocated; and
• as the Council has limited availability of general needs 1-bedroom flats, single persons and couples assessed as eligible for 1 bedroom will be allowed to bid on both 1 and 2 bedroom general needs flats, maisonettes and bungalows, subject to an affordability assessment.

Decisions and review rights

12. Housing applicants can ask the council to review a wide range of decisions about their applications, including decisions about their housing priority.
13. 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; and
• reviews should normally be completed within a set deadline - 8 weeks is suggested as reasonable.

Our role

14. The Ombudsman recognises that the demand for social housing far outstrips the supply of properties in many areas. 
15. We 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.

What happened

16. I have set out a summary of the key events below. It is not meant to show everything that happened. It is based on my review of all the evidence provided about this complaint.

October 2023: Mr X’s application to join the Council’s housing register

17. Mr X is an existing social housing tenant and lives in a one-bedroomed, self-contained property. He has a serious, long-term medical condition which causes seizures.
18. In October Mr X applied to join the Council’s housing register. He told it he had a medical need to move because:

• the seizures, caused by his medical condition, had become more frequent and he struggled to go out alone;
• his current home was unsuitable because it was too far from the family members providing his support and care; and
• he needed a second bedroom. Because of his medical condition, a family member needed to stay overnight to monitor his condition.

19. Mr X provided medical evidence in support of his application. This confirmed his medical condition and seizures and said:

• Mr X needed the support of family members who were his carers, particularly following seizures; and
• he wanted to move closer to them as he felt he now required more support because of his medical conditions.

20. The Council assessed Mr X’s application. It decided he should be placed in Band E and allowed to bid for 0-1 bedroom properties. It told him about his right to request a review of its decision.

November 2023: Surveyor’s visit

21. A Council surveyor visited Mr X’s property and advised the following work was needed:

• kitchen fan should be changed;
• sealing for rear timber door to stop draughts;
• location and repair of any leak causing water to get under the kitchen lino; and
• insulation above rear porch, if possible from roof.

January 2024: Mr X’s further contact with the Council

22. An advice organisation representing Mr X contacted the Council about his housing application. It told the Council Mr X understood it had said he could not be rehoused in the same area as family members providing his care.
23. In its response, the Council said priority is awarded for those applicants whose care providers live more than 3 miles away. Mr X already lived within 3 miles of the family members providing his care.

Mr X’s bedroom entitlement

24. In March 2024, the Council amended Mr X’s bedroom entitlement on his housing application to allow him to bid for 1 or 2 bedroom properties.

March 2024: Mr X’s request for a review of the priority band decision

25. Mr X, through a representative, asked the Council to review its decision to place him in Band E. They said Mr X needed to move away from the busy road outside his current home, because this was dangerous for him, and needed an extra room for his carer. They provided further medical evidence which they said confirmed Mr X’s need to move because of his medical condition.
26. I understand, that in addition to the medical information sent with Mr X’s application in October 2023, Mr X submitted the following additional medical evidence for the review:
1. a letter from a medical professional treating Mr X dated November 2023. This:

• said it was in support of Mr X’s application to move home;
• referred to Mr X’s frequent seizures. It said these were dangerous as they happened without any warning. Because of the busy road outside his house, Mr X didn’t go out because of the risk of a seizure on or near the road, which could be life-threatening; and
• referred to damp and mould at his current property which affected his health. It was a trigger for, and exacerbated, his seizure control.
2. a letter from a medical professional treating Mr X dated February 2024 about the impact of the seizures on Mr X. This:
• referred to a recent incident when Mr X suffered a seizure while putting bins outside his house and was at risk of walking into the busy road. It said Mr X needed to be accompanied by someone to maintain his safety; and
• asked the Council to prioritise Mr X for a move to a new property.

27. The Council acknowledged Mr X’s review request and asked him to provide any further information he wanted it to consider, by 22 April.

April 2024: Council’s review of its decision to place Mr X in Band E

28. The Council completed its review. In their letter of 30 April to Mr X notifying him of the outcome, the reviewing officer confirmed they had:
1. considered the:

• correspondence, on Mr X’s behalf, about the review request;
• medical evidence;
• information on how the housing officer decided to place Mr X in Band E; and
• Council policy, appropriate legislation and codes of guidance; and
2. noted the review request said he needed to move away from the busy road because it was dangerous due to his seizures; and
3. concluded the decision to place him in Band E, on the basis he was a secure Council tenant with no need to move, was correct.

29. In explaining the reasons for their decision, the reviewing officer said they:

• understood he had already been awarded an extra room to facilitate overnight stays by a carer;
• were satisfied Mr X had a serious medical condition, but not that there was a causal link between the property and an impact on his health;
• accepted, regarding the incident of Mr X having a seizure while putting bins out, there was a risk if this were to happen again, because of the busy road;
• understood Mr X was supervised by others when leaving his home because of safety concerns when near the road. The risk posed by him putting out the bins could be minimised by a carer carrying out this task or by using the Council’s assisted bin collection service.

My view – was there fault by the Council causing injustice?

30. The Ombudsman is not an appeal body. This means we do not take a second look at a decision to decide if it was wrong. Instead, we look at the processes an organisation followed to make its decision. If we consider an organisation did not follow its process correctly, we may recommend it make a fresh decision.
31. I have considered whether there was fault by the Council in the way it followed its process for the review of its decision about Mr X’s priority band.
32. The Council carried out the review within the appropriate timescales, after giving Mr X the opportunity to submit any further information. It was completed by a manager senior to the officer who made the original assessment.
33. But, in my view the Council failed to properly review its original decision because it failed to properly consider:
1. Mr X’s medical need for carers to stay with him overnight to monitor his condition and the impact on his health and safety of living in his one-bedroom accommodation. I have not seen any evidence the Council:

• accepted Mr X is entitled to a second bedroom for his carer. My understanding is he is only able to bid for a 2-bedroom property under the Council’s current policy allowing those eligible for 1 bedroom to bid for 2 bedroom properties; or
• considered whether Mr X’s need to move to a property with a second bedroom is a medical need for which priority should be awarded, and, if so, the urgency of this need.
2. the impact on Mr X of living next to a busy road. My understanding is the reference to Mr X having a seizure while putting the bins out, was an example of the ongoing risk to him because of the location of his current accommodation whenever he leaves his home, and not just when putting out the bins. The Council referred in its review decision to Mr X always being accompanied outside his home, but it hasn’t explained how it reached this conclusion.
3. the impact on Mr X of any damp and mould in his current accommodation. I note the surveyor’s report. But as the issue of damp and mould and its impact on Mr X was specifically raised in the medical evidence in support of his review request, my view is it should have been considered as part of the review process. I haven’t seen any evidence to show that it was.

34. In my view, by failing to consider the issues set out in paragraph 32, the Council failed to properly consider whether Mr X has a medical need to move, and if so, the appropriate priority band.
35. My finding is the Council failed to properly review its assessment that Mr X had no medical need to move, and that this failure was fault.

Impact of this fault

36. I consider the review outcome was flawed because of these failures. We cannot be sure the Council properly considered and applied the current allocations policy and all the relevant evidence before making its decision.
37. This has also caused Mr X upset and uncertainty about the review process and outcome.

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Agreed action

38. Within four weeks of our final decision, the Council has agreed to:
1. apologise to Mr X for its failure to follow its process correctly when it reviewed its decision about his priority. This apology should be in line with our guidance on Making an effective apology; and
2. pay Mr X £250 to reflect the avoidable upset and uncertainty caused by its failure. This is a symbolic amount based on our guidance on remedies
3. arrange for another senior officer to carry out a fresh review of its decision about Mr X’s medical priority:

• the officer should give Mr X the opportunity to submit any further evidence for this review; and
• if the new review should result in the award of a higher priority band, the Council should backdate the effective priority date appropriately, taking into account the relevance of any new information submitted.

39. The Council should provide us with evidence it has complied with the above actions.

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Final decision

40. I have completed my investigation and found fault by the Council causing injustice. The Council has agreed to carry out the above action as a suitable way to remedy this injustice.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman