Decision Date: 9th March 2023
Mr X is autistic. In April 2022, his social worker from the Council’s neighbourhood team completed a needs assessment. Mr X claimed he was not aware of this [the report gives no clue as to how that could have come about] and was not given a copy. The assessment noted the following about Mr X:
- He was socially isolated and unable to access the community independently.
- He had a history of self-harm and self-neglect.
- He required support accessing the community, developing or maintaining relationships, support with accessing money and shopping and reminders regarding personal hygiene.
His social worker recommended that Mr X attend day services two days a week to reduce isolation, access the local community and make positive new relationships. They took Mr X to view the day service and arranged a trial visit for early May. After the trial day, noting that Mr X had a positive day, the social worker agreed to explore arranging a taxi service to support Mr X’s attendance. The social worker contacted Mr X in early May to discuss transport arrangements. They noted that Mr X was undecided as to whether he wanted to attend and was unhappy at the assessed cost for his contribution to his care. Given that this assessed contribution was higher than one day’s cost at the day centre, Mr X wanted to attend twice a week [the report makes it impossible to say why one day was being considered by anyone to be enough but had it been one day, he could not have been charged any more than the cost of the service in any circumstances].
Two days later, Mr X was admitted to hospital after threatening self-harm. After his discharge, the social worker spoke to Mr X on the phone and agreed to visit him later that week. They also followed up on a referral made to the NHS for counselling for Mr X in February 2022. A few days later, Mr X’s mother called the Council to speak with the supervisor of Mr X’s social worker, wanting to cancel the day trips to the centre due to Mr X being unfit to attend. The supervisor then called Mr X, advising him that his GP may be able to refer him to counselling and agreeing to establish what days he could attend the service and whether a car scheme could support his attendance. Mr X’s mother then informed the supervisor that he did not want to attend the day service or use the car scheme.
In mid-May 2022, the NHS emailed Mr X’s social worker to confirm that funding would be in place for counselling. The supervisor spoke with the social worker and advised them to close Mr X’s case following contact with him and his mother.
In mid-June, Mr X’s advocate spoke to the supervisor, who informed them that his case was closed since he did not want to pursue day care.
Around the same time, Mr X’s advocate made a referral [it is not clear for what] on behalf of Mr X.
in late July 2022, Mr X contacted the Council to say he was unhappy to find out that his case had been closed and that he was not getting a new social worker as he previously requested.
A day later, his mother told the Council that she was not told about his case being closed and thought he would be contacted about getting a new social worker.
Mr X then complained to the Council. The Council’s response was as follows:
- Mr X’s social worker had regular contact with him, made a request for counselling and secured funding for this and for two days at a day service.
- The supervisor should have contacted Mr X to establish what he wanted to do rather than close his case following a discussion with his mother. It apologised. It said it would advise neighbourhood teams of the importance of communication prior to closing a case and the importance of sending a formal closure letter.
- Mr X’s case was now with the Council’s autism team.
Following this, a social worker from the autism team was allocated to Mr X. They met Mr X in August 2022 and completed a needs re-assessment. They then met again to discuss the possibility of support. Mr X was noted as being happy to consider receiving some support and consider counselling again.
Mr X contacted the Council in mid-October with concerns about his housing benefit being stopped as he had been staying with his mother. He was unhappy to find out that the social worker from the autism team had left, and later threatened to self-harm. He was then visited by a social worker, his benefit was reinstated in early November 2022, and a needs assessment and care plan was completed.
In February 2023, the Council confirmed that it identified a support provider for three four-hour sessions of support per week [the LGSCO report does not tell us what these were].
What was found
The LGSCO found no fault in Mr X’s social worker assessing his needs and seeking to provide support through a day service to meet them. However, in closing Mr X’s case without speaking to him directly, there was fault in the Council doing so. Also, in closing his case, after he was reluctant to use the day service or the car scheme, the Council failed to consider whether any other support may have been appropriate to address Mr X’s identified care needs (nb in November 2022, he had both a needs assessment and a care plan completed).
The LGSCO concluded that had the Council not closed Mr X’s case in June 2022, it is likely that he would have had access to some support at least three months earlier. The LGSCO could not conclude what would have happened and whether Mr X would have accepted the support had the Council identified a provider sooner. The Council’s failure to advise Mr X about counselling after the NHS confirmed funding was in place, and what he needed to do to proceed was fault. It was a missed opportunity for Mr X to pursue counselling.
In light of the Council’s submission of evidence to the LGSCO showing that it sent a reminder to staff of the need to confirm in writing to service users when it decides to close a case, the LGSCO found it appropriate to make no further recommendation.
Points to note for councils, professionals, people using services and their carers, advocacy groups, members of the public
It is strange that the LGSCO did not look into the needs assessment dated April 2022, considering that Mr X contended that it was done without his awareness and a copy of it was not provided to him!
Section 12(3) of the Act states that:
“The local authority must give a written record of a needs assessment to—
(a) the adult to whom the assessment relates,
(b) any carer that the adult has, if the adult asks the authority to do so, and
(c) any other person to whom the adult asks the authority to give a copy.”
When it comes to a Council keeping its cases open or closed, the report highlights the importance of maintaining direct communication with referrers. A Council should not close someone’s case without first consulting with them directly if possible. A Council can be found at fault if it closes someone’s case only after consulting with their parent, such as in this report, instead of also consulting with the relevant person being cared for. Closing someone’s case without properly consulting with them may also represent a Council’s failure to consider whether any other support may have been appropriate to address their identified care needs.
In relation to counselling, the LGSCO could have regarded counselling as a local authority obligation which the Council seems to have overlooked having power to provide. Under section 8 of the Act, counselling and other types of social work may be provided to meet needs under sections 18 to 20.
We find it interesting that the Council in its original response to the complaint thought that the “importance of sending a formal closure letter” was the issue at hand, rather than the fact they had just arbitrarily decided to close the case regardless of whether Mr X was eligible for support! Moreover, although the LGSCO did find fault with the Council for closing the case, it also seemed rather focussed on the absence of a closure letter: “The Council has provided me with evidence to show that following Mr X’s complaint it sent a reminder to staff of the need to confirm in writing to service users when it had decided to close their case. This was appropriate to prevent future injustice to others and so no further recommendation is required in this area.” We would suggest that the Council’s failure to send a closure letter was not the main cause of the injustice here!
The LGSCO indicates that Councils must be cautious about individuals being left without any support in place in cases where a social worker assesses them, only subsequently to leave the service. This can delay someone’s access to support by several months (in this case, it was at least three months). The fact that Mr X is autistic could also have perhaps been given greater consideration in terms of how he was affected, given that the effect that sudden surprises regarding support arrangements can have on autistic people is well-documented (and should certainly have been known by the ‘autism team’!)
The fact that Stockport has a dedicated autism team is encouraging, but the fact that Mr X was only allocated to that team after a complaint was made is disappointing, we feel. The Guidance makes clear that at first contact: “6.27 Staff who are involved in this first contact must have the appropriate training and should have the benefit of access to professional support from social workers, occupational therapists and other relevant experts as appropriate, to support the identification of any underlying conditions or to ensure that complex needs are identified early and that people are signposted appropriately.” A referral to the autism team to carry out the initial assessment at first contact would probably have made much more sense.
It is also not clear why Mr X said that “because his assessed contribution was higher than a day’s cost at the day centre, he was requesting to attend twice a week”. We would have liked to have seen this probed further, since the Council cannot legally charge someone more than the cost of the service (plus a small admin fee, if they are exceptionally a ‘full cost payer’).
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The full Local Government Ombudsman report on the actions of Stockport Metropolitan Borough Council can be found here: https://www.lgo.org.uk/decisions/adult-care-services/other/22-009-307