Date of decision: 13 March 2025
Summary
A mother complained about Dorset Council’s failure to communicate, act promptly, review needs, appoint an advocate, and complete a continuing healthcare (CHC) checklist for her disabled adult daughter, and multiple instances of fault were found.
What happened
Miss C, an adult with physical disabilities, mental health, and neurodevelopmental conditions, was assessed by Dorset Council in May 2023.
The assessment identified significant care needs. It noted that Miss C was non-weight bearing and spent most of her day in bed. She was unable to transfer from her bed to the wheelchair independently because of the layout of her flat.
The care plan was confusing as the narrative referred to Miss C receiving four visits a day, but the hours set out at the end of the plan did not accord with that picture and were as follows:
- One hour of support in the morning.
- Two 45-minute visits at lunchtime and late afternoon.
- Miss C received a further two 2-hour visits a week to support with paperwork, email, telephone calls and so on.
Miss C was admitted to hospital in June 2023, and on discharge at the end of July 2023, the hospital’s clinical co-ordinator made a request to increase the care package, unaware of the current package.
Her mother, Mrs B, repeatedly requested reviews, advocacy, and a CHC assessment, but the Council failed to act or respond over several weeks.
A care plan review took place in August 2023. It said Miss C was only able to walk a few metres. It also noted that she used a wheelchair outside of the property. The care plan was revised as follows, adding up to the same amount overall:
- One 30-minute visit each morning
- Two 1-hour visits at lunchtime and late afternoon.
- The further two 2-hour visits per week were unchanged
Subsequent requests for further assessment and support went unanswered.
The Council’s manager visited in September 2023, agreeing actions that were also not followed up.
Mrs B formally complained in November 2023, but the Council delayed its response until April 2024, by which time key actions—including appointing an advocate and supporting a housing application—were still outstanding.
Miss C’s social worker contacted the Council’s housing department in May 2024 and asked them what further evidence Miss C needed to provide to be considered for a higher priority band as Miss C’s current accommodation did not meet her needs. The response was that detriment to wellbeing evidence could be provided by her GP, OT, social worker, health visitor or any other independent source. The Council awarded Miss C ‘band B – high housing need’ on 21 August 2024.
The CHC checklist was still not completed by the time of the Ombudsman’s decision.
What was found
The Ombudsman found fault in the Council’s handling of communication, delays in reviewing needs, failure to appoint an advocate, and not completing the CHC checklist.
These failures breached statutory duties under the Care Act 2014, including the duty to review a care plan upon any reasonable request, to involve and appoint a Care Act advocate where substantial difficulty with engagement exists, and to act on requests for CHC checklisting and referral – there is a DUTY of referral under the Care Act Assessment regulations.
Once the social worker became involved in May 2023, the housing department agreed an increase in banding in August 2023. The Council’s delay in supporting Miss C’s housing application was found to have likely delayed Miss C’s move to more suitable accommodation, causing uncertainty and distress.
The Ombudsman ordered the Council to apologise, pay £250 for distress and uncertainty, and to complete the CHC checklist.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
The Care Act 2014 and Care and Support Statutory Guidance set out the following duties of the Council –
- Duty to assess any adult with an appearance of need for care and support, regardless of financial situation or perceived eligibility (Care Act 2014, s.9).
- Duty to review care and support plans at least annually, and upon reasonable request by the adult or their representative (Care Act 2014, s.27).
- Duty to involve the adult, any carer, and any person the adult requests, in assessment, care planning, and review processes (Care Act 2014, s.9, s.25, s.27; Guidance para 6.30).
- Duty to appoint an independent advocate where an adult has substantial difficulty in engaging with assessment or care planning and has no one appropriate to support their involvement (Care Act 2014, s.67)
- Duty to act on requests for NHS Continuing Healthcare (CHC) assessment, and to complete the CHC checklist promptly.
In this case, the failure to respond to requests for review and advocacy was a breach of statutory duty, not able lawfully to be excluded by resource constraints.
The Council’s failure to communicate and act promptly undermined the statutory requirement for timely and person-centred care planning and review.
Reviews must be substantive, not merely administrative, and must address changes in need, involving the person and their chosen supporters. The Council’s failure to act on clear evidence of changed needs and requests for review, and to provide accessible communication and advocacy, breached both statutory and public law duties, exposing the authority to legal challenge and compensation.
This case highlights the need for councils to ensure robust systems for timely reviews, communication, and advocacy appointments, especially for those with complex needs. Professionals should be alert to statutory triggers for advocacy and review, and act without delay.
The Ombudsman’s analysis in this case aligns with core Care Act duties.
But there was no explanation of the Ombudsman’s view that the CHC checklist issue was ‘outside the council’s control’ – which was notable, given that one can be done by either health or social services.
And we think it could have more strongly emphasised that failure to appoint an advocate when required renders assessments and plans unlawful and invalid if challenged, as established in community care law and the SG v Haringey 2015 case. The legal right to funded Care Act advocacy is triggered by substantial difficulty in engagement with the particular Care Act process and absence of an appropriate informal supporter or the person’s lack of consent to a willing one. Delays in appointing an advocate, where substantial difficulty is apparent, renders the assessment and planning processes non-compliant and potentially invalid.
It should also be observed that the delay in progressing agreed actions (housing support, the CHC checklist) exposed Miss C to ongoing unsuitable accommodation and uncertainty, contrary to the Care Act’s well-being principle, even though there was no Care Act duty to re-house her directly.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s Dorset Council (24 007 557) report.
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