Decision Date: 29th September 2024
Summary
Mr X cared for wife Mrs X and requested both a care needs assessment for her and a carer’s assessment for himself. He complained that the way the Council proposed to assess their needs was inappropriate and as a result no care and needs assessment had been completed for Mrs X and they did not receive the care and support they needed.
What happened
Mr X asked the Council for assistance in caring for his wife, Mrs X, who had several serious health conditions, prior to 2023. However, the Council stated that Mr X declined access to undertake assessments at those times, stating that Mrs X could not participate in any in person, telephone or online assessments, due to her condition.
Mr X believed the care he provided was impacting his own wellbeing and was worried about his ability to continue in his caring role.
In late 2023 Mr X contacted the Council again requesting an assessment of his wife’s care needs and a carer’s assessment for himself.
Mr X wanted the Council to complete Mrs X’s assessment through him. However, the Council made it clear that they would need to meet with or speak to Mrs X to complete their assessment. Mr X maintained that this was impossible.
The Council proposed alternative ways in which it could assess Mrs X’s needs. These included a supported self-assessment which would minimise any contact it needs to have with Mrs X, telephone or virtual meetings, arranging an assessment to coincide with Mrs X’s other healthcare appointments or even including Mr X and health professionals known to Mrs X to fully identify her needs.
Additionally, the Council took steps to confirm Mrs X’s mental capacity by contacting health professionals who knew her. It was told that Mrs X had capacity, and some obvious anxiety and difficulty engaging with other professionals but that it was manageable, when assisted by Mr X.
The Council met with Mr X to carry out a carer’s assessment a week after he requested one in October 2023. The Council found that Mr X was eligible for some support which could be met through respite care, sit in services and small direct payments.
Mr X declined the respite care and sit-in services. He disagreed with the Council’s assessment and the level of payment it suggested. The Council then considered this and made some adjustments to its assessment. It did not accept that Mr X spent as many hours caring for Mrs X as he said he did.
Mr X and the Council exchanged many emails in late 2023 and Mr X reiterated his disagreement over the assessment. He stated he did not want in-home carers or other sit in type services. Mr X could not specify what type of support he had in mind when the Council asked him.
In early 2024 Mr X sent the Council documents so that they could set up his direct payments which were backdated to October 2023. When Mr X told the Council he believed his care to be ‘worth more’ than the direct payments provided, the Council referred him to the Department for Work and Pensions because it was not its role to provide him with an income.
What was found
The LGSCO recognised that, by law, the Council must include the person being assessed within their assessment. It was satisfied that the Council had been flexible in proposing ways of assessing Mrs X’s needs.
The LGSCO also recognised that the Council gave Mr X clear reasons why it needed to be in contact with Mrs X, for example, to plan for times when Mr X may be unable to care for her.
The LSGCO found no fault in how the Council managed the situation; it showed evidence of flexibility and an understanding of the distress that contact with social workers may cause.
Regarding Mr X’s carer’s assessment, the LGSCO was satisfied that the Council responded appropriately and promptly to Mr X’s request and the concerns he raised.
However, the LGSCO did consider the Council’s lack of explanation to be fault. The Council’s failure to explain why it considered Mr X to provide fewer hours of care than he stated was found to be unsatisfactory.
The agreed action was as follows: the Council would review Mr X’s support plan including the number of support hours he provides, and backdate any increase in payment it considers appropriate.
Points to note for Councils, professionals, people using services and their carers, advocacy groups and members of the public
The man in this report seems to have been torn between the need for support in caring for his wife and the need to be paid for it, and the Council would have had to have explained that there is a general prohibition on Council money being used for this purpose unless it was necessary.
That does not mean that public law principles can be ignored, however, with regard to taking a view about how much input the man was providing; he might have thought that being there was the equivalent to a paid service, but he was not saying that he could not be there or was not willing to be there. In that situation, no council would be offering a skilled care rate, in our view. But it needed to engage and make its position clear.
The Ombudsman’s investigator set out the rules for proceeding with an assessment in the face of real difficulties:
The Care and Support Statutory Guidance (“the guidance”) says councils should carry out needs assessments in an appropriate and proportionate way.
If someone is thought to lack the capacity to consent to or ask for an assessment, or is considered to be at risk of abuse or neglect, a Council should still carry out an assessment and should involve any person it considers to be interested in their welfare.
Assessments should be flexible and can carried out in different ways, including:
- a face-to-face assessment between the person and an assessor;
- a supported self-assessment, which should use similar assessment materials as used in other forms of needs assessments, but where the person completes the assessment themselves and the local authority assures itself that it is an accurate reflection of the person’s needs (for example, by consulting with other relevant professionals and people who know the person with their consent);
- an online or phone assessment, which can be a proportionate way of carrying out assessments;
- a joint assessment, where relevant agencies work together to avoid the person undergoing multiple assessments;
- a combined assessment, where an adult’s assessment is combined with a carer’s assessment so that interrelated needs are properly captured and the process is as efficient as possible.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s London Borough of Hillingdon (23 016 163) 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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