Decision Date: 17 May 2023
What happened
Mr X complained that the Council failed to find him eligible for care and support under the Care Act 2014, that its assessment was flawed and that it failed to communicate with him.
Mr X lives alone with a diagnosis of anxiety, depression and personality disorder. He reported to the Ombudsman that he has difficulties with reading and writing, and his memory. He approached the Council’s adult care department for support with budgeting, as he had some large debts, and with housing repairs and a contribution to these costs.
In March 2022, a Social Worker from the Council was supporting Mr X with contacting his energy company. He was also receiving some support from a community organisation which was offering grants toward fuel bills and was arranging maintenance of his boiler and heating system.
Mr X had a meeting at the Council offices in early August 2022. The primary purpose of this meeting was to introduce him to his new Social Worker before they started the Care Act assessment. At this meeting it was recorded that Mr X was agitated and behaved in a way that caused the Council’s officers to feel intimidated and threatened, and the meeting ended. Following this, the Council completed a risk assessment, the outcome of which was that it would not hold further face-to-face meetings with Mr X, and a meeting was held on 26 August via Microsoft Teams to complete the Care Act assessment. Mr X joined via conference call .
The notes of this meeting highlight that Mr X gave an account of his needs, what he struggled with, and the support he was hoping to receive from the Council. He identified issues about his property which were causing him some stress, including repairs to his central heating system. Mr X was informed that the Council would not pay for these repairs and he decided to leave the meeting early. The notes also showed that during the meeting, the Social Worker considered the ten specified outcomes [under s2(2) Care and Support (Eligibility Criteria) Regulations 2015 which are:
- Managing and maintaining nutrition;
- Maintaining personal hygiene;
- Managing toilet needs;
- Being appropriately clothed;
- Being able to make use of the home safely;
- Maintaining a habitable home environment;
- Developing and maintaining family or other personal relationships;
- Accessing and engaging in work, training, or education;
- Making use of necessary facilities or services in the local community;
- Carrying out caring responsibilities for a child.
The Social Worker concluded from her assessment that Mr X was not prevented from achieving any of the specified outcomes due to a physical or mental illness or disability and therefore was not eligible for support under the Care Act 2014.
It was planned that the Social Worker would inform Mr X of the outcome of the assessment but the Council advised the LGSCO that she was unable to contact him, and he was informed by the advocate on 5 September. Following this, Mr X rang the Council and an officer explained the criteria to him, and why it was determined that he did not have eligible needs.
On 12 October Mr X contacted the Council’s complaints team saying that he felt his assessment had been rushed, and that it had been held virtually. He also complained that he had not received the outcome of the assessment (he may have meant in writing), despite being told someone would discuss this with him and despite the fact that there had been a call on 5 September.
Although Mr X was not eligible for services under the Care Act 2014, the records show that Council officers were liaising with his GP surgery regarding mental health support, and had referred him to community agencies for debt advice.
The Council responded formally to Mr X’s complaint on 4 November 2022 saying it did not uphold his complaint about the way the Care Act assessment was completed, nor the eligibility outcome.
What was found
The LGSCO found no evidence of fault with the way the assessment was completed. It had referred Mr X to an advocate to support him to express his views and wishes in the assessment, because of a previously upheld complaint, and the LGSCO found that he had been given time to express his views during the assessment on 26 August, and these were recorded in the notes.
The LGSCO considered that it was appropriate that the assessment was undertaken via telephone, and the Care and Support Statutory Guidance says that a council can do this when a person is already known to the service and does not have complex needs. It also found that it was appropriate to hold this assessment virtually given the potential risks to staff which were identified on 2 August. [No mention of whether it was a reasonable adjustment was made but it was implied that the LGSCO thought it was].
Whilst Mr X disagreed with the outcome of the assessment, the LGSCO found no fault in the way it was conducted. It is not within the Ombudsman’s powers to comment on the merits of a decision, only whether there was fault in the process. It found no fault in the Council’s conclusion that Mr X did not meet the eligibility criteria for care and support.
Points to note for councils, professionals, people using services and their carers, advocacy groups, members of the public
Clearly this man is someone who is struggling with daily living and with a set of expectations about the scope of adult social care.
S1(1) Care Act 2014 provides the ‘’general duty of a local authority, in exercising a function under this Part in the case of an individual, is to promote that individual’s wellbeing’’ and the Act gives clear guidance on the individual’s journey from referral to care and support planning, including the assessment and eligibility determination.
These are factors which must be woven in to the process rather than a set of outcomes to be delivered on, and a council can take a view, as long as it is defensible that that which is otherwise available to the person is able to meet their needs, even if their needs ARE found eligible, if it’s an area where there are community based support services to signpost people to. Whether they have to be contracted for depends on mental capacity and the person’s assets, because social care service delivery involves a subsidy against the real world cost of the provision.
The Care Act includes a provision set out in s4(1) ‘’A local authority must establish and maintain a service for providing people in its area with information and advice relating to care and support for adults and support for carers’’ which promotes a strengths based approach, enabling people to do what they can for themselves, with support only where required.
In times where councils are struggling for staff and resource, and may be tightening engagements to apply only where eligible needs are identified, the Council ensured it met its s4 duties in supporting Mr X to receive support from appropriate agencies and promoting community solutions, whilst retaining an active involvement in multidisciplinary support for Mr X. This shouldn’t be something to be celebrated, as it should be the norm by now, but in reality it isn’t, and so we say well done Northumberland! The report contained further detail about Mr X’s own conduct and demeanour and the LGSCO has the right to factor mitigating factors in to its consideration. The council made a great deal of effort to stick with this man throughout his Care Act journey albeit it was ultimately unproductive for him.
The full Local Government Ombudsman report on the actions of Northumberland County Council can be found here: 22 006 026 – Local Government and Social Care Ombudsman