Decision Date: 2 September 2024
Summary
Ms Y, mother and informal carer of Mr X, suffered detriment to her physical and mental health after Newham delayed in assessing the long term social care needs of Mr X and her needs as a carer.
There was an additional delay in its agreement to provide the required funding for a day centre placement which directly contributed to Ms X’s inability to receive respite care during her recovery from earlier cancer treatment.
What happened
Mr Y is a young adult who has an autism diagnosis. His mother, Ms X, is his informal carer and he lives with his her and the family.
In October 2022, Ms X requested that Mr Y receive support so that she would be able to have time away from her chosen responsibilities surrounding his care. Due to a series of delays in conducting and reviewing assessments for Mr Y’s social care needs and Ms X’s carer’s needs, as well as providing funding for Mr Y’s day centre placement, Ms X’s request for respite care did not materialise.
The Council conducted a Care Act assessment regarding Mr Y in February 2023. According to the findings of the February 2023 report, Mr Y was eligible to receive care and the combined carer’s assessment stated that Ms X had recently finished cancer treatment and required support to allow for her recovery.
According to Section 10 of the Care Act, a carer’s assessment must include, amongst other things, “an assessment of – whether the carer is able… to provide care for the adult needing care, whether the carer is willing… [to provide care]… [and]… to what extent the provision of support could contribute to the achievement of [outcomes the carer wishes to achieve in day-to-day life].”
Additionally, regardless of Ms X’s reduced care capabilities, the report also found that Mr Y would be best supported in residential care for the longer term, and the social worker checked ‘no’ for the box for a Shared Lives arrangement. Ms X’s preference for a particular care home for Mr Y’s future placement was also noted.
When the LGSCO investigated this case in 2024, it requested all Care Act assessments regarding Mr Y. However, the Council omitted this February assessment, merely giving a ‘reassessment’ from 2024. Ms X was the one who provided the February 2023 assessment. The Council’s reasoning was such that the February 2023 document was simply a draft and that it did not keep draft assessments.
In May 2023, the same social worker who filled out the assessment paperwork also completed a “Short-term service request form” stating that:
- “Several months” had passed since Ms X had requested respite.
- Mr Y had been assessed by a day centre and was waiting for funds.
- It had been suggested that Mr Y spend three days per week at a council day centre.
- The social worker and the manager had spoken about the funding request and would “send a short-term intervention for approval.”
On the paperwork, the manager had written: “I agree to authorise this short-term service request…. funding agreement will need to be agreed and authorised by Newham’s case discussion and funding panel or alternatively through Head of Service. Head of Service is aware that Ms X has been waiting for her son to receive support for a number of months however and Mr Y is in need of an outlet from home in order that his mother is able to continue caring for him informally herself.”
In January 2024, the Council received a complaint from Ms X regarding matters she had previously discussed with the LGSCO amongst other things.
An advocate met with Mr Y in January and February to ascertain what he believed was necessary for his care. He was happy to move out and in line with Ms X’s preference, he also preferred the residential placement.
Mr Y was re-assessed again in February 2024 by a different social worker. The outcomes were similar in that he remained eligible to receive support and Ms X too, was now eligible for carers’ support. The recommendation was that provision be made through a Shared Lives scheme. Ms X stated that she had not even seen this assessment.
In February 2024, the Council responded to Ms X’s complaint, writing:
- A manager (the one writing the response in question) “authorised a short-term service request in May 2023, agreeing a proposal for Mr Y to attend a day centre should be discussed and funding pursued.”
- Funding had not been supplied for Mr Y to attend the day centre.
- Records indicated Ms X had communicated with Mr Y’s social worker between May and December 2023 regarding long-term care and accommodation; however, no conclusion had been reached about procuring the funds for his placement in the day centre.
- Based on Mr Y’s discussion with the second social worker, he had been recommended a Shared Lives placement (rather than residential care).
To Ms X’s dissatisfaction, the manager did not uphold her complaint. Consequently, she complained to the LGSCO in April 2024.
In May 2024, the Council finally approved the funding required for Mr Y to attend the day centre for three days [presumably per week but the report doesn’t say].
The Council told the LGSCO that a new care and support plan dated 2024 stated Ms X’s health conditions inhibited her from meeting the needs of Mr Y. The plan noted that carer’s breaks were to be included in the plan itself, whilst she was able to provide support by shopping and doing meal preparation. According to this plan, the Council was funding Mr Y’s attendance at the day centre three days a week. However, the suggestion for long-term accommodation still remained a Shared Lives scheme.
Ms X stated that she had not ever seen the February 2024 assessment or this brand new care and support plan.
What was found
Note that the LGSCO will not consider ‘late complaints’ regarding council conduct without an appropriate reason. Late complaints are classified as those that have occurred more than 12 months prior. Even though her complaint was not made until April 2024, Ms X’s cancer diagnosis and treatment was sufficient reasoning, hence, the LGSCO investigated from October 2022.
The LGSCO found multiple faults with Newham in its failure to meet the social care needs of Mr Y and the carer needs of Ms X, as it did not do so in an efficient manner:
- It took five months for the Council to complete a draft assessment (October 2022 to February 2023) which was unreasonable in relation to Ms X’s condition and recuperation needs;
- Even though Mr X and Ms Y were eligible for their respective support budgets, the Council did not take action after the draft assessment had been completed. The 18 month delay between the draft assessment and the care and support plan from June 2024 is fault and a breach of Sections 24 and 25 Care Act 2014 which require the Council to meet eligible unmet needs through the creation of a support plan (including for the carer) and funding in accordance with the plan;
- Although it had been raised by the manager in May 2023, a decision to approve funding for the day centre was not approved for a year, in May 2024, by which time Ms X already had complained to the LGSCO.
- There is fault in the contradictory nature of the draft assessment of February 2023 which recommended a residential placement and a day centre placement for Mr Y, whilst the February 2024 placement suggested a Shared Lives placement and a day centre. No clear rationale was provided for this deviation despite the fact there had been no change in Mr Y’s actual needs.
- The fact that Ms X and Mr Y did not receive copies of the care and support plan nor the later assessment was also fault.
As a result, Ms X faced the injustice that she was not able to receive the respite care she was legally entitled to, which caused additional physical and emotional distress whilst she was already burdened with recovering from her cancer treatment.
There was also injustice experienced by Mr Y in his inability to attend the day centre even though he was eligible (the Council is required to meet his eligible needs). Consequently, he was deprived of social opportunities and experiences which he could have gained skills from.
Newham was required to provide evidence it had complied with these recommendations:
- A manager with no previous involvement should review Mr Y’s social care assessment. This manager should be able to authorise decisions regarding funding, whether that be for a residential placement, Shared Lives placement, or an alternative placement that is suitable for Mr Y. This manager should inform both Mr Y and Ms X of the outcome.
- This same manager should review Mr Y’s care and support plan. If necessary, revisions should be made so that necessary funds are available to meet Mr Y’s needs.
- Newham Council should ensure Mr Y is able to attend his day centre placement (including provisions that enable travel support).
- Compensation of £1000 should be paid to Ms X to acknowledge physical and emotional distress caused by inability to receive respite care.
- Compensation of £2000 should be paid to Mr Y to acknowledge skills and socialisation he was hindered from receiving resulting from the lost opportunity for attending the day centre placement.
- An apology for the injustice caused.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
This would have made a good judicial review had Ms X felt up to it, possibly acting for Mr Y as litigation friend: the grounds would have been
- unconscionable delay in completing a s9 and s10 assessment,
- unconscionable delay in following through after that assessment to turn the identified needs into proper response plans, whether combined or separate;
- breach of the Care Act in failure to deliver the funding to follow on from the service recommendation as soon as feasibly checked and authorised by a senior line manager.
It is interesting to note that Councils even have funding panels, given that there is no discretion not to meet the needs on account of the cost. But it is because there is, in most cases, a range of ways in which the needs can be defensibly regarded as able to be met adequately and appropriately, and the Panel is there to make that decision.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s London Borough of Newham (24 000 025) 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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