Decision Date: 26th August 2024
Summary
The LGSCO found fault in Bristol’s failure to complete a carer’s assessment as requested by Mr J. He was the informal carer of his mother, Mrs K, and suffered distress due to the uncertainty the Council’s delay created.
What happened
In April 2023, Mrs K was discharged from a nursing home and provided with a package of support.
The care package arranged by the Council involved care visits four times daily to aid with Mrs K’s personal care and medication among other things.
The Council was aware of the close relationship between Mrs K and her son, Mr J, the complainant and was in ongoing contact with him regarding his mother’s care. The Council’s care notes record Mr J’s repeated concerns that his mother’s care was ‘insufficient,’ and that as a result he played an increased role in supporting Mrs K. This included doing her shopping, cooking and cleaning.
In mid-July 2023, the Council was contacted by Mr J’s GP with concerns regarding his role as his mother’s carer and his inability to provide the care needed. This resulted in the Council providing Mrs K with a place at a day centre once a week.
In September 2023, Mr J once again expressed concerns about Mrs K’s care package. He additionally submitted to the council a form requesting a carer’s assessment. He stated that whilst the care agency aided Mrs K in washing, he carried out cooking, laundry and other daily activities acting as her ‘sole carer.’
Mrs K’s dependency on her son meant that he “recently stopped work due to an increased caring role.” Mr J said this negatively impacted his work and social life and his ability to maintain personal relationships.
The Council says this form was passed to their Integrated Carers’ Team and Mr J was placed on a waiting list for an assessment. It wasn’t until June 2024, over 9 months later, that an assessment was offered to him. At this point Mrs K had re-entered a nursing home and Mr J refused the assessment.
By December 2023, Mrs K’s and her husband’s needs had increased and the Council had arranged for Mrs K’s return to a care facility.
In the course of investigation, the Council admitted Mr J’s delay is ‘not atypical’ with over 250 people awaiting a carer’s assessment.
What was found
Mr J complained that the Council did not provide an ‘adequate care package’ for Mrs K at the outset.
The LGSCO found no fault regarding the Council’s original care assessment and subsequent care package provided post discharge. The package was successful in supporting Mrs K at key parts of the day and included a daily sitting service that was of help to both Mrs K and her husband.
In addition, no fault was found in the ongoing review and amendment of the care plan. The Council responded effectively to concerns regarding the administration of Mrs K’s medication and offered additional support in the form of a day centre place and subsequent move to a nursing home when Mrs K’s needs increased.
Whilst the LGSCO recognised Mr J’s concerns regarding the adequacy of care, it found that the lack of specificity in his reports meant the Council cannot have been expected to provide increased care beyond what was offered.
The LGSCO recognised Mr J’s need for a carer’s assessment; there was a disparity between the Council’s record of Mr J’s input and his declaration of his role in his assessment form.
Whilst no fault was found on behalf of the Council for not completing a carer’s assessment before it was requested by Mr J in September 2023, the LGSCO did find fault in the ‘disappointing’ delay Mr J faced once a request for an assessment had been submitted.
An injustice was caused by this fault – the distress Mr J suffered as a result of frustration and uncertainty created by the Council’s delay. However, the LGSCO believed Mr J has suffered no loss of service due to the increasing needs of his mother and found it impossible to say what support could have been offered to Mr J had the assessment been completed promptly.
The LGSCO recommended an apology be provided by the Council to Mr J to remedy the avoidable distress its actions have caused. The Council agreed to provide this within 20 working days.
Additionally, as a result of the investigation, the Council has implemented various tools in hopes to clear the backlog of people awaiting a carer’s assessment. These include a ‘prioritisation tool’ and an increase in recruitment. By March 2025 it aims to complete all carers’ assessments within 6 weeks.
Points to note for councils, professionals, people using services and their carers, advocacy groups, members of the public
If a person’s concerns are not explicit or coherent, a council can easily be persuaded not to bother to explore them, by the shortage of staff that all councils are struggling with. But it is not acceptable.
Carers’ assessments are as much of a duty as are needs assessments for people who present as directly in need. They cannot be withheld because there is insufficient staff. Section 6 of the Local Authority Social Services Act 1970 is still in force, and it requires that adult social services departments are always adequately staffed for the discharge of statutory functions. This is ignored, country wide, on the basis that the duty to assess has no time limit other than the normal public law requirement that any duty be discharge within a reasonable time.
Readers could infer from this report that carers’ assessments are the foundation of services for all carers, but in fact the absence of a willing or able carer would obviously mean that the individual in need of care would need MORE care. The Carer’s Assessment is for people who need support of some sort, in their own right, or funding by way of a carer’s direct payment.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Bristol City Council (23 014 040) report. The Link should be the manually typed name (Council or provider) and bracketed number of the report with the link to the original report page then added behind that text, with use of Insert and Link into the Word document, to make it live and therefore turn Blue.
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