Decision Date: 23rd November 2020
Miss X and Miss Z complained on behalf of their mother, Mrs Y, for whom they both held Lasting Power of Attorney for health and welfare.
Mrs Y had a Care Act assessment in March 2019 which identified that she should be referred for a pendant alarm, a bathing assessment and a further assessment to determine her night-time needs. At the time she was living in her own home.
In May 2019, Mrs Y told the Council that she wanted to move closer to her daughter Miss Z who lived in Stockport. Mrs Y was assessed as having capacity to decide where she lived.
The Council told the LGO that it was agreed that Miss Z would explore options for Mrs Y as she was looking to move into ‘new housing’ rather than residential care.
On the 1st July the Council put in place night time care for Mrs Y. A week later she fell at home and was admitted to hospital. The CCG arranged for Mrs Y to receive rehabilitation at a residential nursing home (Care Home A) on discharge.
Miss X told the Council on 21st August 2019 August that the family wanted Mrs Y to move to Stockport as soon as possible. At the time, Mrs Y was living in care home A.
On the 30th August, the Council undertook a further reassessment and concluded that Mrs Y no longer had capacity to decide where she lived. Miss Z agreed to transfer Mrs Y to a short term reablement service (Care Home B). This also took place on the 30th August.
Mrs Y was reassessed on arrival, which concluded that Mrs Y required a nursing placement.
In the end, Mrs Y returned to Care Home A on the basis that it could meet her nursing needs.
As both Mrs Y’s daughters still wanted her to move to Stockport, she was added to the Integrated Community Service (ICS) Team waiting list for an allocated social worker at the end of September.
Through October and November 2019, the family continued to chase the Council for a social worker to be allocated. They explained that Mrs Y’s health was deteriorating and provided evidence to show this. She now required psychological/cognitive care in addition to her physical care needs.
On 20 November Miss X complained to the Council about the lack of support for Mrs Y. She asked for a social worker to “get the move sorted quickly and efficiently as a matter of urgency”.
The next day a social worker undertook a care needs assessment of Mrs Y.
On 8 January 2020 the social worker contacted Miss X and requested an update on their home preferences for Mrs Y and her move to Stockport.
Miss X responded two months later and said that they were happy with the care Mrs Y was receiving at Care Home A, and that moving her now would be detrimental to her health and wellbeing.
On 6 March the Council responded to Miss X’s complaint.
- It acknowledged that Mrs Y did not have a consistent social worker whilst she was under the care of the ICS team
- It also acknowledged that the family had requested a social worker in October 2020 and accepted that there had been a delay in allocating the case.
- It apologised for the faults identified and for the delay in responding to the complaint.
Miss X remained unhappy and complained to the Ombudsman in March 2020 that the delay by the Council meant that her mother was now not well enough to move.
Sadly, Mrs Y passed away in August 2020 and was not living near to her daughters.
What was found
The LGO first established that the Council appropriately undertook all needs and mental capacity assessments in line with guidance.
However, the Council was at fault for the delay in allocating a social worker when Mrs Y returned to Care Home A at the end of September 2019. The family repeatedly requested a social worker to facilitate a move for Mrs Y, the Council was aware that her health was deteriorating, and Mrs Y herself wanted to move closer to her daughters. The delay caused the family uncertainty. The Council’s explanation that the case was not considered a priority at the time because Mrs Y was safe and in a care home.
The LGO also said the Council was at fault for the delay it took in responding to Miss X’s complaint.
The LGO recommended the Council apologise to the family, make a payment of £100 for the uncertainty and distress caused by the delay in allocating a social worker and a further £100 for the delay in responding to the complaint.
Points to note for councils, professionals, people using services and their carers, advocacy organisations
Whilst the LGO found that the council did act appropriately by its actions, the real fault here was regarded as the delay in allocating a worker to progress Mrs Y’s desire to move to Stockport.
We would have to point out that one shouldn’t even NEED a social worker in order to make that move however – anyone competent could have followed through on the decision to place Mrs Y out of area.
We would also point out that the report leaves it wholly unclear as to why the council would have been involved in this lady’s move to Stockport at all. If someone wants to move or IS moved to housing under their own steam or via the efforts of a benignly intentioned relative, the person loses their ordinary residence connection with the old area – UNLESS the person is going to go into a form of accommodation such as housing that counts as specified accommodation (such as sheltered or very sheltered tenancy). But even if that had been clearly the intention from the report, there is no discussion as to how Shropshire would have organised the allocation of a tenancy to a person from Shropshire, in Stockport!
Once she deteriorated of course, she would have needed a care home, and that WOULD have been specified accommodation so Shropshire would have remained liable.
It is easy to see that the initial request may not have ‘seemed’ urgent to the Council, but neither could the Council look into the future and establish how Mrs Y’s needs would change in the coming months.
The Care Act 2014 could have enabled this Council to act sooner. It was first told of the desire to move to Stockport a couple of months after its initial assessment of her care needs. This was at a time when Mrs Y had capacity to tell the Council what she wanted to happen. 6 weeks later in July, the change in needs occurred.
Section 19(3) says this:
A local authority may meet an adult’s needs for care and support which appear to it to be urgent (regardless of whether the adult is ordinarily resident in its area) without having yet—
(a) carried out a needs assessment or a financial assessment, or
(b) made a determination under section 13(1).
On this basis, the Council could have chosen to meet Mrs Y’s needs in May. Its assertion in August that a reassessment needed to happen before decisions could be made failed to recognise that the Council had the power under s.19 to meet Mrs Y’s needs and then follow up with the reassessment later.
It correctly followed procedures in terms of the process a Council uses to determine where a person will live and whether nursing care is a requirement etc, but in fact it had a power that could have been helpful in enabling this lady to move closer to her family.
The Council deemed that because Mrs Y was safely living in a suitable care home, she was not a priority for allocating a social worker. This clearly did not allow for the possibility that her needs had changed, or that she had expressed a desire to move that the Council had not responded to some months earlier. It’s not a legitimate basis for allocating people to services or to staff resources, and hasn’t been legitimate since the Sefton case in the late 1990s.
The legislation does not specify timescales for meeting needs because councils have competing demands and pressures. It also does not dictate to councils how they must prioritise their workloads.
On the other hand, public law principles decree that any duty must be discharged within a reasonable time in light of the circumstances, and there is also a little known section in force from an Act brought into force as long ago as 1970 that says that councils must furnish Directors of Social Services with sufficient staff for the discharge of their function. It is an urban myth that councils can just freeze vacant posts – social services have been made a priority BY PARLIAMENT.
When running any kind of a waiting list and hoping to get away with it, what any council needs is a manager with enough sense to run a system for ‘keeping in touch’ with those who are waiting for assessments and care planning and for using information as to changes in the person’s needs – because rational defensible delay is all about lawfully relevant considerations, not factors that are NOT lawfully relevant.
If you want help, please consider seeking advice from CASCAIDr via our referral form on the top bar menu of the site.
The full Local Government Ombudsman report of Shropshire Council’s actions can be found here