Decision Date: 10 May 2023
What happened
Ms X complained on behalf of her daughter, Miss Y, that the Council failed to carry out a proper Occupational Therapy (OT) assessment and failed to take into account her views, as her daughter’s carer.
Ms Y lives with her mother and as a result of her disabilities, is non-verbal and relies on her mother to advocate and care for her. In 2019, Ms X applied to the Council for a Disabled Facilities Grant (DFG) for housing adaptations for Miss Y, including to the upstairs and downstairs bathrooms. This was granted and work began.
In early 2020, Ms X asked for the work to stop as she did not believe it to be in line with the specifications set out by the OT assessment. She also felt that she was being ‘pressured into accepting the works’ even though she did not believe they met Miss Y’s needs. The Council commissioned a further OT assessment in March 2020, which resulted in some amendments to the recommended adaptations, including to the bath and toilets.
The works were not restarted, as Ms X was dissatisfied and felt that they did not meet the OT’s specifications. She complained to her Councillor in late 2020, The Council replied to the Councillor’s contact but Ms X remained dissatisfied, and contacted her Councillor again in 2021.
In April 2022, an OT, a surveyor, and the building contractor visited Ms X’s home to discuss the adaptations, which were then restarted. The following month, Ms X asked the contractor to stop work and again contacted the Council stating that she did not believe that the specifications of the OT assessment were being met, and that the basins and toilets were not suitable for Miss Y’s needs. The Council replied saying that the OT had confirmed that the toilets and basins were suitable, and it requested that the contractor return to complete the works.
Ms X contacted the Council again the following month maintaining her stance that the basins and toilets were not suitable and provided the Council with information regarding the type of sink she considered would meet Miss Y’s needs. She said she felt she was not being listened to, as Miss Y’s carer, and requested to meet with a manager prior to the adaptations recommencing. The Council replied to Ms X five days later saying again that the OT had confirmed that the adaptations were appropriate to meet Miss Y’s needs and therefore it could not fulfil Ms X’s requests [the report does not state whether this included meeting with a manager].
Ms X formally complained to the Council on 20 May 2022. She said the adaptations did not meet the specifications recommended by the OT in March 2020, and reiterated that she did not feel listened to by the adaptations team. The Council provided its stage one response on 13 June 2022 [16 working days later, within the Council’s 20 working day time frame for complaint responses]. The Council acknowledged that there had been issues with the adaptations in the bathroom, but that these had been addressed via a further OT assessment [we presume they meant the April visit to be the second assessment] to ensure that all Miss Y’s needs were captured. It further stated that the OT, surveyor and contractor had made some amendments to the adaptations during their visit, and following this, the Council was satisfied that the adaptations were suitable for Miss Y.
Ms X escalated her complaint to stage two on 25 June 2022. She said that the toilet was not suitable and that the OT had not assessed Miss Y’s ability to access it. She further complained that her knowledge and experience regarding Miss Y’s needs were not valued or considered during the assessment and adaptation works. The Council responded four days later acknowledging that Ms X felt that it had not valued her views, but reiterated that the works were confirmed by two OTs as meeting Miss Y’s needs.
Ms X remained dissatisfied with the Council’s response and escalated her complaint to the Ombudsman.
Following contacting the Ombudsman, Ms X contacted her MP in late 2022 to get assistance in requesting the Council carry out a further OT assessment. This happened in February 2023, at which time the OT recommended adaptations to both toilets to meet Miss Y’s needs.
What was found
In its enquiries, the LGSCO found no evidence of an OT assessment completed in April 2022, nor how it demonstrated how the adaptations were suitable to Miss Y’s needs, nor how it had sought Ms X’s views to represent Miss Y during the assessment process. As Ms X had asserted that no OT assessment was undertaken in April 2022, and the LGSCO found no evidence of one, it found the Council’s stage two complaint response that the adaptations were considered suitable based on two OT’s assessments to be flawed. This was fault.
The LGSCO found further fault in the Council’s consideration of Ms X’s knowledge and expertise of what was suitable for Miss Y. The April 2022 records do not show that Ms X’s views were considered, indeed there was no reference to her views anywhere in the casenotes at that time.
Acknowledging that the Council did commission another OT assessment in February 2023, the LGSCO highlighted the significant delay in doing so, and the subsequent delay in providing adequate adaptations. The result of this was that Miss Y had the continued use of an inadequate bathroom, which was detrimental to her, and Ms X as her carer.
The LGSCO recommended that the Council:
- apologise to Ms X and Miss Y for the faults identified;
- pay Ms X £150 in recognition of the stress caused by the matter; and
- pay Miss Y £1,350 (£150 a month for the nine months delay).
Points to note for councils, professionals, people using services and their carers, advocacy groups, members of the public
There have been several studies over the years which highlight that parents of disabled people feel that their knowledge is not valued, and that the clinical expertise of professionals is held in higher regard. S.9(5) of the Care Act 2014 states:
‘’A local authority, in carrying out a needs assessment, must involve—
- the adult,
- any carer that the adult has, and
- any person whom the adult asks the authority to involve or, where the adult lacks capacity to ask the authority to do that, any person who appears to the authority to be interested in the adult’s welfare.’’
It seems that in this case the Council felt it ‘knew best’, not only ignoring Ms X’s views, but seemingly not seeking to include Miss Y in the process in any alternative way e.g., via an independent advocate. It is disappointing that the Ombudsman didn’t draw more out of this glaring omission.
Personalisation has gone from being a ‘buzz-word’, to an expectation, with the Care Act highlighting the importance of promoting a person’s wellbeing through a number of ways including ‘’suitability of living accommodation’’ [s1(2)(h)]. Yet, despite this, and the accompanying rhetoric that comes from councils and statutory services, Miss Y and Ms X’s experience is not uncommon.
The full Local Government Ombudsman report on the actions of London Borough of Hillingdon (22 011 685) Council can be found here: 22 011 685 – Local Government and Social Care Ombudsman