Decision Date: 27 June 2024
Summary
Miss X complained the Council did not correctly update a care plan for her son Mr Y or her carer’s support plan. Miss X claimed the Council used an unsuitable care agency for activities for her son, so that she got some well-overdue respite, without consulting her or Mr Y, and delayed completing a Financial Assessment.
The Council delayed the provision of respite care and failed to consult regarding the care provider.
The Council agreed to apologise to Miss X and pay her half the respite care costs, subtracting the client’s contribution, from 21 June 2023 to 5 February 2024.
What happened
December 2022 to February 2023
In December 2022, the LGSCO reached a final decision on Miss X’s previous complaint about care for Mr Y. The Council agreed to carry out a mental capacity assessment, review Mr Y’s care plan and his financial assessment, and pay Miss X £500 and apologise.
By the end of February 2023, the Council did everything it could to comply with the Ombudsman’s decision, which included—
- sending a DRE form to Miss X;
- completing a mental capacity assessment for Mr Y;
- considering its duty to provide transport for Mr Y;
- updating Mr Y’s care and support plan;
- providing a draft carer’s support plan for Miss X; and
- paying the backdated carer’s grants and £500 payment.
The Council was unable to update Mr Y’s financial assessment as Miss X had not returned the DRE form sent to her.
The Council also detailed it should provide regular ongoing respite for Ms X through Mr Y’s activities detailed in his care and support plan. The carer’s support plan detailed that Miss X would receive ongoing regular respite four days a week.
March 2023 to May 2023
Following contact from Miss X in March 2023, the Council reconsidered the support for Miss X as Mr Y’s carer, agreeing that she would benefit from 12 hours of respite care from Friday to Sunday.
Miss X said she did not want the respite care until the Council completed Mr Y’s financial assessment, but the Council said it could not do so until Miss X returned the DRE form.
June 2023 to 24 January 2024
In June 2023, the Council gave Miss X another copy of her carer’s support plan and reminded her to provide her comments. She said she was happy to provide care for Mr Y but needed a respite package in place. The Council issued her with an updated carer’s support plan on 21 June 2023 and arranged an interim respite care package with a provider, referred to as “Provider 1”.
Miss X returned the DRE form on 8 September 2023 and formally complained that the Council failed to provide her with information about care plan reviews and respite care. The Council responded on 18 September 2023 saying, among other things, that it set up a care agency to meet Miss X’s 12-hour respite care needs, but the client’s contribution was £65.27 a week.
Miss X responded on 3 October saying the Council failed to put the 12-hour respite care package into Mr Y’s care plan or her carer’s support plan. Miss X said that meant that the support costs or the charges could not be calculated.
She also said—
- the Council used Provider 1 in September 2023 without consulting her or Mr Y; and
- Provider 1 failed to show the expected level of professionalism and courtesy, causing the withdrawal of the 12-hour respite care package.
The Council responded on 24 October 2023, most notably saying it would waive any client contribution costs until Mr Y and Miss X confirmed how they wished the 12 hours of respite care to be provided.
On 22 November 2023, the Council provided the outcome of the DRE assessment, considering each DRE request in full. It said the allowable ones were within the £10 weekly disregard the Council automatically applied during a financial assessment.
On 24 January 2024, the Council updated Mr X’s care and support plan to include 12 hours of respite care through Provider 2 and for 36 hours of respite care x 3 per year through direct payments with Provider 2 starting February 2024.
What was found
December 2022 to February 2023
The LGSCO did not find any fault during this period as the Council acted in line with the regulations. Although it could not complete a financial assessment by February 2023, the LGSCO did not find fault as this was because Miss X did not return the DRE form the Council sent to her, although no examples of the Council’s reasoning were given.
March 2023 to May 2023
Again, the LGSCO did not find any fault. The Council correctly reassessed Miss X’s needs and offered support but had felt unable to implement it because Miss X had not returned the DRE form and had declined the start of the support because she wanted Mr Y’s financial assessment completed before she received 12 hours of respite care.
June 2023 to 24 January 2024
The LGSCO found no fault in relation to the DRE form and financial assessment. It was Miss X’s responsibility to return the DRE form to the Council, and the Council could not complete Mr Y’s financial assessment until Miss X acted. The Council followed the correct processes in carrying out the DRE assessment, addressing each request and considering each on their merits, and explaining why certain things were or were not DREs which they would disregard against income.
The LGSCO did, however, find fault regarding respite care commissioned from Provider 1. The Council took nearly seven weeks to implement an interim respite care package while it tried resolving the DRE and financial assessment issues. It also did not liaise with Miss X or Mr Y about the suitability of Provider 1 for Mr Y’s activities, in implementing the care package before this was due to start, meaning Miss X or Mr Y could also not provide any commentary. It was therefore the Council’s fault that the respite care foreseeably broke down.
Yet this fault was mitigated by the fact that the Council warned Miss X on 31 August 2023 about Provider 1; she did not voice any concerns.
The Council agreed to apologise to Miss X and pay her half the cost of the 12-hour respite care, subtracting the client contribution, from 21 June 2023 to 5 February 2024.
Points to note for councils, professionals, people using services and their carers, advocacy groups, members of the public
The report said this: ‘The Council’s failures caused Miss X to miss 12 hours of respite from 21 June 2023 until 5 February 2024. …Paying half the cost of the 12 hours of respite care, minus the client’s contribution, from 21 June 2023 to 5 February 2024, would enable Miss X to source some catch-up respite care for that which she has missed.’
It seems as if Mr Y had a care package of his own, into which the activities could go, and he could be charged for them. This was not a case of substitute care being provided directly to Mr Y through Miss X’s support plan. It is puzzling that the Ombudsman does not address the specific point that the respite hours did not appear in either the carer’s plan or the son’s plan. Since the respite was going to be achieved through activities, it seems obvious that it should have been updated in the revised care plan, under s27, especially as it gave rise to a further charge to the client.
Normally the finalisation of the means assessment would have nothing to do with the obligation to meet the needs, but there were very particular instructions from Miss X in this case.
Miss X obviously wanted to know what the impact of her having this ‘respite’ through activities for Mr Y would BE, on his charges; we think that the LGSCO could have made it clear to everyone else that the two would not normally be related.
We wondered whether the point of the linkage was that if the respite was being funded by direct payments, the means assessment would have had to have been finalised because the amount would have been paid net of the charge, but in fact direct payments were intended only for the 36 hrs x 3 times a year.
Most of the report relates to complaints where no fault was found, providing helpful glimpses of good practice by the Council in its implementation of respite care. How the Council erred, however, shows why delays and failures to consult or involve the client and carer can cause respite care to break down and thus cause carers, who can sometimes be responsible for providing invaluable amounts of support, to lose hours of much-needed respite.
As in Lambeth’s case, the effective delivery of a care and support plan for someone can often depend on the attractiveness of the respite activity to the person drawing on services, in their and the carer’s perception, making it especially important for Councils to implement systems that enable carers to take long enough breaks. The report demonstrates that a wait of nearly seven weeks to implement an interim respite care package while other issues are ongoing is not good enough. This is notwithstanding the fact that the issues were caused by a carer’s delay in returning a DRE form, which prevented the Council from completing someone else’s financial assessment.
The report also suggests that Councils will be held responsible for failures to meet a carer’s needs if their lack of consultation with the relevant persons causes respite care to foreseeably break down with a provider. Instead, Councils must consult with a carer and/or the person they are caring for, if appropriate, before the implementation of respite care involving a provider of activities for the adult being cared for. The principal reason for this is that this allows the carer and the person they care for to provide their input to personalise the respite care through a person-centred approach facilitated by the Council. Without this, the collapse of such a package becomes likely when the person it is designed for has had no say in curating it. Notable in this case however is the LGSCO’s attribution of fault to the Council instead of the care provider, especially in light of the unspecific allegations of unprofessionalism by the complainant. Even so, it was the Council’s failure to consult and involve that was most likely to be responsible for the breakdown of the respite care plan.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s London Borough of Lambeth (23 013 429) report.
If you are affected by the issues in this report, please consider asking a free, one-off question, anonymously, at a level of principle, here. Our experts’ response will give you an opinion which may then help you and the broader community when posted.
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