Decision Date: 21 March 2023
What happened
Ms X complained that the Council failed to provide her son, Mr Y, with suitable and sufficient respite care and failed to meet her needs as a carer.
Mr Y lived with his mother, Ms X. He has physical and learning disabilities and is a full-time wheelchair user. He received a direct payment from the Council for support from a personal assistant to meet his personal care needs and received funding for five days per week at two separate day services, one of which is a farm which also offers respite care. The direct payment is managed by Ms X.
In February 2022 Ms X informed a Social Worker from the Council that she was struggling with her caring role. The carer’s assessment that was carried out at this time identified that Ms X was eligible for carer’s support and the Social Worker agreed to explore respite services as an option. Mr Y was in agreement with this.
The Social Worker, along with the Council’s brokerage team, identified two care homes that could meet the needs of Mr Y. Ms X declined both of these services as one was too far away and the other had limited male staff and it had been noted that Mr Y preferred male staff for personal care. Ms X advised the Social Worker that her preference would be for Mr Y to have respite at the farm. The case notes recorded that the Social Worker contacted the farm but received no response. There was no record of the Social Worker pursuing this.
In May 2022 the farm emailed the Social Worker asking if they could provide respite for Mr Y and were asked for costs. At this time Mr Y also confirmed to the Social Worker that he wanted respite care.
Ms X contacted the Social Worker in early June and said that the need for respite was now becoming desperate. She advised that she felt Mr Y would only be content with respite at the farm. The Social Worker advised Ms X that the farm had not yet confirmed costs and given the intensity of the situation she would explore other options.
Ms X complained to the Council in July about the delay in organising respite services and a lack of support for her as a carer.
In August Mr X’s partner contacted the Social Worker requesting an update on respite for Mr Y. The Social Worker advised of a series of contacts between the Council and the farm and put forward a request for respite to the Council’s budget holder at the end of August. This was approved for two nights a month at the farm.
Ms X had a carer’s assessment in September which showed she was eligible for practical support to enable her to have a break from her caring role. A carer’s support plan was drawn up with a budget of one penny per week / fifty-two pence per year.
The Council responded to Ms X’s complaint in mid-September saying:
- Respite had been offered but declined as it was not at the farm;
- A direct payment had been agreed to fund respite
- A carer’s assessment had previously been offered, alongside a sitting service but this had been declined as Mr Y did not want different care workers
- There would be a review of her carer’s assessment.
Mr Y had his first respite stay at the farm at the end of September 2022 seven months after it was first requested.
What was found
The LGSCO highlighted that while the Council met its s10 duty under the Care Act and completed a carer’s assessment with Ms X, it should have also reviewed Mr Y’s care and support plan due to the risk that existing care arrangements may change should Ms X be unable to care for her son. There was no evidence that the Council did this, nor did it issue a carer’s support plan for Ms X.
The delay in arranging respite was found to be directly linked to the Council failing to adequately review Mr Y’s care own and support plan, and a lack of pro-activity on behalf of the Social Worker. The LGSCO stated that the Social Worker should have pursued the farm regarding respite arrangements and costs and the failure to do so meant that Mr Y and Ms X lost a number of months of respite breaks.
S26 of the Care Act 2014 states that a personal budget is the figure given to give a clear indication about the cost of care and support that will be met by the Council. A carer’s need for support can be met by providing care to the person they care for which would need to be recorded in the care and support plan if the person was in receipt of social services, as well as the carer’s support plan.
As the personal budget set for Ms X at one penny per week could not realistically meet any carer’s needs the LGSCO suggested it must have been an error in the paperwork and therefore fault. The carer’s support plan also did not specify how the Council would meet Ms X’s needs as a carer. This was also fault.
The Council had subsequently completed a second carer’s assessment and issued a carer’s support plan for Ms X which the LGSCO found to be a partial remedy. However, Mr Y’s care plan did not identify respite costs, and whilst funding is now in place, the process and paperwork is all at fault under s26 Care Act. The LGSCO found this to cause injustice to Ms X about lack of clarity causing confusion about agreed funding and/or services.
To remedy the injustice of avoidable confusion and a delay in respite services, the LGSCO recommended that the Council:
- pay Ms X and Mr Y £300 each to reflect the loss of respite,
- pay £300 each to Ms X and Mr Y to reflect the avoidable confusion and distress caused by the delay in completing a carer’s assessment for Ms X, the failure to give a personal budget and failure to review Mr Y’s care and support plan
- apologise to Ms X and Mr Y, and
- review Mr Y’s care and support plan and Ms X’s carer’s support plan to ensure that both parties’ personal budgets are accurate and current.
Points to note for councils, professionals, people using services and their carers, advocacy groups, members of the public
It should have been considered by the Social Worker that respite at the farm was both the choice of Ms X and Mr Y and that this would give the control that is referred to as a well-being factor in s1 of the Care Act, and therefore likely best value as well as best practice.
The council’s position was that it was not agreed that the other places explored were not ‘suitable’. The reality of ‘respite’, though, being that the person’s need AND the carer’s need is met, tends to mean that it just won’t happen unless it’s attractive to the person cared for, and the council’s stance ignored Ms X and Mr Y’s preferences. Respite is in fact a service for the cared for person in the vast majority of cases, as it is the response to the carer’s withdrawal from meeting the needs for that period.
We wonder whether the facility was registered to provide overnight stays. We know that there is often an issue about that for people who would otherwise be living at home; the question is are they just going on holiday, or are they to be provided with care together with accommodation elsewhere, or simply personal care, because they are not ‘living’ at the facility. If the accommodation is not being charged for, they can receive personal care through a direct payment through a direct arrangement with an employee, we think.
From the report it seems that the Farm option was just not adequately pursued. We understand that with the increasing pressures on adult social care it can be difficult for officers to be proactive, but this is no excuse. The Local Authority Social Services Act 1970 s6(6) states in relation to the duties of a director of social services [DASS] ‘’A local authority which have appointed, or concurred in the appointment of [a person under this section] shall secure the provision of adequate staff for assisting him in the exercise of his functions’’. In practice this means that social services functions should be given special protection and that a lack of staffing, and the subsequent pressures on caseloads, is not justification for inaction, and is a breach of the law.
It is also concerning that it took seven months for any support services to be put in place for Ms X in better managing her caring role. The s1 wellbeing duty applies to carers as well as the cared-for person and this fault as set out by the LGSCO not only flies in the face of this, but also the Council’s own Public Guidance which says:
‘’If you provide unpaid care for an adult family member or friend, you might need support to help you look after your own health and wellbeing. We can arrange for an assessment of your needs to help you continue in your role as carer, even if the person you care for does not receive care and support from Adult Social Care. If you are eligible for support following your carers assessment, a support plan will be developed with you to help with your needs.’’
The full Local Government Ombudsman report on the actions of Redcar & Cleveland Council Council can be found here: https://www.lgo.org.uk/decisions/adult-care-services/assessment-and-care-plan/22-010-645