Decision Date: 29th August 2024
Summary
Mrs X is the mother and carer of Mr K. She complained that the Council failed to begin Mr K’s transition from children’s to adult social care services in a timely manner. As a result, Mr K was left without appropriate respite care and Mrs X did not receive adequate support regarding the use of direct payments. This caused Mrs X distress and frustration.
What happened
Mr K’s care plan included a place at a special school, personal assistant input, and overnight respite at a residential centre.
The Council did not reassess Mr K’s needs or begin a transition to adult services until July 2023, just six months before his 18th birthday. The Council should have begun this when Mr K was 13 or 14.
When the Council did visit Mr K, the assessment found that among other things, he would require continued support for personal care and independent living. It also highlighted his need for respite care and that his children’s respite would cease when he turned 18. The Council therefore consulted adult respite care providers. None of the six providers it contacted in the following months were able to adequately meet Mr K’s needs; therefore the Council extended his children’s respite care until February 2024, after his birthday.
Mrs X complained to the Council that they had not started planning early enough and a plan was still not in place for post-February 2024. The Council recognised this and apologised for its delay.
The Council met with Mrs X prior to February 2024 and explained its ongoing search for appropriate respite care. It stated that if no appropriate placement could be found it could either ‘pass the budget to a care provider’ or issue direct payments to Mrs X.
Mrs X asked the Council to escalate her complaint to stage two of its process as the apology had done nothing to remedy the situation. She also requested a carer’s assessment to discuss her support needs.
At the start of January Mrs X told the Council that her struggle to find overnight carers was preventing her from visiting her family. She asked the Council to pass the funding to a care provider to arrange (using an individual service fund approach, it is assumed). The Council consulted several providers and offered extra support where the provider queried their own ability to meet Mr K’s needs. The case notes showed the Council contacted them to discuss what support might make this possible, including providing a carer to go into the respite centre to give 1:1 care. The Council still could not find an appropriate provider.
The Council responded to Mrs X’s complaint agreeing to reapproach the providers but did not pay any compensation as Mrs X and Mr K had not been without the children’s respite service up to that point.
By mid-February, Mr K had been placed on a waiting list for suitable respite provision. Alternatives had been offered but were considered unsuitable by Mrs X due to the distance from Mr K’s school. The Council told Mrs X that the only other options were overnight carers in their own home or for carers to take Mr K to private holiday let accommodation.
Mrs X asked the Council to approve direct payments as Mr K was now without any respite provision. She expressly stated that this was not her preference, but felt she had been left with no choice. The direct payments covered 24 nights of respite. Mrs X asked the Council for help regarding the direct payments as she was unsure how to use them and queried whether they would cover the care needed.
The Council carried out a carer’s assessment with Mrs X in April, and it focused on the lack of respite care and agreed that both Mrs X and the Council would continue to look for alternatives. In May, the Council found a respite provider but again the distance meant Mrs X found it unsuitable. Additionally, weekend stays were unavailable.
What was found
The Council accepted that it began planning Mr K’s transition too late. The LGSCO recognised that whilst Mr K had services throughout that time, the Council’s ‘poor planning’ will have led to distress and uncertainty.
The LGSCO acknowledged the possibility that proper planning on behalf of the Council may not have resulted in appropriate respite care due to the unavailability of providers and their inability to meet Mr K’s needs, and called it ‘service failure’.
The LGSCO commented on the Council’s efforts to locate an appropriate provider, even offering additional support and looking outside their area.
The LGSCO found no fault regarding the calculation of direct payments. Whilst Mrs X says they were not sufficient, the Ombudsman was confident that the problem was the lack of carers available, not the payments being too low.
The LGSCO did find that the conduct of the Council constituted a service failure as none of their actions had resulted in respite care for Mr K.
Additionally, the Council failed to support Mrs X when she reported her difficulties in finding overnight carers. The LGSCO emphasised that the Council’s duty was not discharged by simply making direct payments and leaving Mrs X ‘unsupported trying to arrange care for her son’. This was fault.
Whilst the LGSCO was completing their review, Mrs X found a provider able to give respite in her home overnight and the Council has agreed to discuss the funding of this provider. Mrs X expressed concerns regarding the Council’s communication as it had previously been inadequate. The Council will contact Mrs X as part of the agreed remedy.
The LGSCO also found fault on behalf of the Council as they took too long to complete a carer’s assessment. Mrs X requested a reassessment in November 2023 as she disagreed with the findings of the previous assessment. This was scheduled for February 2024 but did not go ahead. Mrs X asked again to redo the assessment in March 2024, but this wasn’t completed until June 2024. The LGSCO said this caused Mrs X avoidable frustration.
The agreed remedy was as follows:
- The Council will apologise in writing to Mrs X.
- The Council will make a symbolic payment of £500 to reflect the distress their failures have caused.
- The Council should continue to aid Mrs X in finding respite care out of the home, decide whether it can fund the provider chosen by Mrs X, and advise her on how she can spend the one off payment.
Points to note for Councils, professionals, people using services and their carers, advocacy groups and members of the public.
The important legal point in this report is that it was characterised as service failure to meet the assessed needs. We keep a careful eye out for the Ombudsman’s reports metaphorically shrugging and saying, ‘Well, what else could you do?’
We were impressed with Hertfordshire’s case notes that showed the commissioners had not been cost capping or being inflexible about what they would have put in the care plan, had they only been able to find a provider who was willing, sooner. Neither of the providers who could meet the needs were suitable for Mr K during weekdays due to the travel involved.
Having avoided doing that metaphorical shrugging, though, the Ombudsman’s investigator also avoided the obvious answer to the absence of provision: if nobody wanted the role for the money being offered, then the money being offered was not able to be regarded as rationally sufficient to meet need! “Mrs X says this is not sufficient, but the Council has calculated the amount based on the assessment, and it seems to me that Mrs X has not been able to find carers, and there is no information to suggest that this is due to the direct payments being too low.”
The fact that this Council uses the model of allowing carers to take people with eligible needs to holiday let accommodation is interesting to us. We think that this is a good way of meeting needs lawfully because it is not the provision of care together with accommodation, and it is not the provision of personal care in a place where the person is living – but we hope that the council was wanting to use registered personal care providers if commissioning that care, all the same.
Overnight care in the man’s own home would have been just as good, but it does require a proper rate to be paid if it is the ONLY service that the PA is going to provide, and we suspect that Herts may have been trying to pay a sleeping night allowance because it could see no difference in principle between this sort of a service and one where the person is there on a more regular basis.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Hertfordshire County Council (23 017 457) report.
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