London Borough of Hillingdon at fault for failing to install property adaptations in a timely manner, resulting in a person being place?d at an increased risk of harm

Decision Date: 7th April 2021

What Happened

Ms C complained on her own behalf. Ms C lived in a first-floor housing association flat. She was registered blind, had a bad back and arthritis in her foot.

In June 2019, an Occupational Therapy assessment from the Council concluded that Ms C would need the following adaptations to her property:

  • An Intercom system, which the council was later informed (in December) was needed before the date of her operation on 8 January 2020
  • Mixed lever taps
  • A shower chair with arms and legs
  • Pull-out drop-down kitchen cupboard inserts
  • Raised toilet.

 The Council stated that the Occupational Therapist (OT) marked the assessment as “Category 2: STANDARD Client meets eligibility criteria, works to be progressed in chronological order.”

The Council told the LGO that the adaptations team has a target of 12 months for completing non-urgent works. The LGO stated in the report however, that the Council’s Service Level Agreement with its supplier appeared to state that works should be done within 15-16 weeks.

In August 2019 the Council asked the Housing Association for permission to carry out the adaptations, which it received three weeks later. The Council told Ms C that it was obtaining quotes for the works in September 2019. The Council received a quote for the bathroom works in mid-October 2019.

On 25 October 2019, the Council changed the priority of the work to “Urgent: Client in imminent danger or unable to remain in home.” The Council had apparently changed Ms C’s priority after consultation with the OT and a duty Occupational Therapist Prescribing Supervisor. However, there was no record of these discussions, therefore the LGO could find no clear reasoning as to why the case priority changed to urgent, or why it had not been classed as urgent in the first place.

It took three months after getting permission from the Housing Association to receive a quote in November 2019 for installing the automated door entry.

Ms C told the adaptations team on 17th December 2019 that she had a medical operation planned for the 8th January 2020, after which she would only be able to let people into her property and receive food and other deliveries via the intercom.

The Council attempted to fast track the intercom aspect of the adaptations. However, it took until the 18th February 2020 before the work was completed. The Council suggested a key safe as an interim solution, but Ms C declined, as she did not feel it would be safe.

As it happened, Ms C’s operation was postponed twice, therefore the intercom work was completed before she underwent surgery.

In early March 2020, Ms C complained to the Council about the delay of the intercom work and other adaptations which had still not taken place.

The Council told Ms C in mid-April that it was still waiting for aspects of the works to be financially approved, and still needed to obtain some quotes. The Council also stated that progress was now being delayed by Covid-19. The council told Ms C that the other adaptations would be carried out in November 2020.

Financial approval was formally submitted on the 5th August 2020. The grant was approved on the 1st September.

However, no further progress was made, as on the 6th August a meeting took place with an OT, which concluded that Ms C should move to a more suitable property. The OT’s view was that even with a star lift installed (which was not on her current list of adaptations), the property still posed a risk to her.

Ms C’s complaint about installing adaptations to her property, asserted that she was put at an increased risk due to the delay. Ms C highlighted these risks in her complaint:

  • Shower chair:
    • Ms C said her old shower chair, which was fixed to the wall, was falling to bits and she had fallen over in the shower because it was inappropriate.
    • The Council said that the OT observed in August 2019 that Ms C could safely transfer off the shower chair. The OT also inspected the chair and concluded that, while it was stiff and did not fold away easily, there were no signs it was unsafe.
    • Ms C said her old chair fell off the wall in March 2020 so had to ask a builder to put some sealant on it. The builder said this was a quick fix and not a sustainable solution. She said she reported this to the Council’s Adaptations Team, but they did not respond.
    • The Council told the LGO there was no evidence she or her advocate raised this with the Council. It said if Ms C had said she was at (imminent) risk the Council would have immediately looked into this.
  • Pull-out drop-down kitchen cupboard inserts:
    • Ms C had to use a step ladder to get into her cupboards due to the height which was dangerous due to her blindness, bad back and arthritis in her foot. Therefore, she stated that the Council continued to put her at risk of injury.
    • The Council stated that the OT had recommended a pull-down and pull-out be installed in her upper and lower cupboards due to Ms C’s sight impairment. It was only in August 2020 that Ms C stated she was ‘climbing’ to use the cupboards.
  • ●       Raised toilet with handrails:
    • o   Ms C said the Council put her at continued risk of falling and injuring herself by not providing this. She said she had a near miss falling off the toilet due to it not being raised or having a handrail.
    • The Council said the OT did not observe the need for a handrail to accompany the raised toilet, nor had Ms C raised this with the adaptations team.
  • Mixed lever taps:
    • Ms C stated that the mixed lever taps in the bedroom and the bathroom should have been installed urgently.
    • She said that was put at risk because the hot water tap ran very hot and she had to test the temperature by blindly putting her hand in it.
    • The Council said that Ms C did not highlight this issue with the OT or Adaptations team at any time therefore no urgency was noted.

The LGO found that this was not factually correct as evidence from the OT assessment report from August 2019 stated that Ms C reported that she has burnt herself trying to figure out which tap was for hot or cold.

The adaptations were never made in the end, as Ms C decided to find a more suitable property. The LGO asked the Council whether an OT had visited Ms C to determine any remaining risks and how they could be managed until Ms C moved house. The Council stated it had not done this but would do so immediately.

The Council also told the LGO that on average, it took 232 working days for adaptations to be made, but could not shed light on what differences there were between urgent and non-urgent cases.

What was found

The LGO stated that the Council “failed to have a clear system in place for prioritising cases”; it also failed to have “clear and separate time targets in place for urgent and non-urgent cases.” This was fault.

The LGO highlighted that the Council’s inability to at least differentiate between urgent and non-urgent cases and how long they took to complete hindered the Council’s ability effectively to monitor its performance and communicate with its clients about the priorities used and target completion dates. This was fault.

Furthermore, there was a delay in determining Ms C’s case as urgent. This was fault. The Council also failed to record its decision as to why the case’s priority was changed to urgent.

The LGO considered that although Ms C only told the Council about her hospital operation three weeks in advance, there was an unreasonable delay in installing the intercom system. It should have been installed within 55 days, but instead was installed six months after her assessment. This was fault.

The Council told Ms C that her adaptations would be completed by 20th November 2020. The LGO highlighted that if they had gone ahead, it would have taken one year and five months to complete the adaptations. This was an unreasonable delay and more than thirteen months longer than the time it should take according to the guidance. The LGO stated that all adaptations should have been completed by December 2019.

The Council also failed to assess Ms C in August 2020 to determine how her unmet needs and potential risks could be managed until she moved to another property. This was fault.

The LGO considered that there were some risks posed to Ms C regarding the taps and access to the high kitchen cupboards; however, she only alerted the Council to these risks in August 2020. There was no evidence Ms C came to any actual harm during the delays. But the LGO recognised that the delays and any “perceived avoidable risk, no matter how small” would have caused Ms C at least some level of distress.

The LGO recommended that the Council:

  • Apologise for not installing the adaptations within a reasonable time scale.
  • Pay Ms C £1,500.
  • Remind the OT service of the importance to discuss and clearly record how any needs and risks will be managed in the interim.
  • Review its policy, the system and the resources it has in place for ensuring necessary adaptations are delivered in a timely manner. This should include:
    • Agreeing separate time targets for non-urgent and urgent cases, that are in line with government guidance.
    • Ensuring clients are told in writing what priority their case is, explaining why it has been assigned that priority and what the Council’s official target is for starting / completing the works.

Points to note for councils, professionals, people who use services and their carers, advocacy providers and members of the public

Ms C was assessed as being eligible for a Disabled Facilities Grant. She experienced unreasonable delay from the Council. The Council did not have systems in place to manage priorities and timescales.

Guidance about these is set out in “Home adaptations for disabled people: a detailed guide to related legislation, guidance and good practice”. The guidance is non-statutory, and sets out how local authorities should prioritise cases and the timeframes of work being carried out in urgent and non-urgent cases. The timeframes of 55 days for an urgent case and 150 for non-urgent are significantly less than the length of time Ms C waited.

The guidance also says that the individual should be informed of the local authority’s system of prioritising cases and what priority, and therefore timescale, their case has been given. The guidance states that a person’s case should be considered urgent if they ‘cannot access essential facilities within the home’. 

In this case a system of prioritising was not in place and this led to delay and to needs not being met. Although the guidance is non-statutory, the LGSCO took the view that not having a process in place, similar to the guidance, was fault. This points to Councils needing to make defensible decisions about whether to follow or non-statutory guidance or not. Where that guidance is likely to lead a Council away from legal error, we suggest that it is worth following. Where guidance is informed and authoritative, it would possibly be foolhardy to ignore it.

In any case, in addition to the guidance setting out appropriate timeframes, local authorities need to take into account the public law principle concerning delay – if a statutory duty is not carried out in a reasonable timeframe it can be considered unconscionable and be challenged in the Administrative Court or raised as a complaint to the LGO. As in this case – the LGO is able to recommend a compensatory amount as recognition for the distress caused by the delay.

Finally, the LGO was concerned that the Council failed to (re)assess Ms C in August 2020 to determine how her unmet needs and potential risks could be managed until she moved to another property. We sometimes see a local authority breathe a sigh of relief when a long-term solution to meeting needs is found, and run the risk of overlooking the short-term needs that remain until that is put in place. The LGSCO wants to see Councils making a record of how needs and risks will be managed during a gap in provision. The implication is that, if something goes wrong, it will be hard for the Council to show it acted without fault.

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 London Borough of Hillingdon’s actions can be found here

https://www.lgo.org.uk/decisions/adult-care-services/disabled-facilities-grants/20-001-187

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