Date of decision: 13 January 2026
Summary
The Council delayed assessing a woman with significant disabilities for property adaptations, resulting in her being forced to wash using only a sink. This caused prolonged indignity and hardship in her already challenging daily life.
What happened
A woman with significant disabilities was living in a property with a bath or shower that she could not use due to her condition, so, as a result, washed herself using only the sink. In March 2023, an occupational therapist (OT) made a referral to Tower Hamlets Council for her to be assessed for a wet room, but the Council failed to record or action this referral. Ms X heard nothing further until her GP contacted the Council on her behalf in January 2024, reiterating the need for a wet room assessment.
By late January 2024, the Council contacted Ms X, allocated her case to an officer in February 2024, and on 5 March 2024 carried out an initial assessment, deciding first to order bathing equipment for use in the existing bath. In early June 2024, the Council determined the equipment was ineffective, so the case officer requested a further assessment for major adaptations and arranged reablement support to assist Ms X with daily tasks, including washing.
In late July 2024, the Council informed Ms X she was on the waiting list for an OT to assess her for major adaptations.
In early September 2024, Ms X complained to the Council that it had lost her 2023 referral and failed to progress her wet room application.
In mid-September 2024, the Council responded, acknowledging receipt of the March 2023 OT referral with supporting evidence but no record on its adult social care system; it noted the initial trial of bathing equipment post-March 2024 assessment, apologised for the delay and upset from not processing the 2023 referral, reported recruiting a service improvements team manager to oversee referral processes, and stated Ms X would be allocated to an OT in early October 2024.
In October 2024, an OT assessed Ms X, and in November 2024 sent wet room proposals and specifications to the Council. By December 2024, the Council had sent the landlord a copy of the wet room proposals for Ms X’s property.
What was found
The Council was found at fault for not actioning the March 2023 OT referral despite there being evidence of receipt. This was fault by the Council.
Once Ms X was referred back to the Council by her GP in January 2024, it took the Council 6 months to decide she needed adaptations. If the Council had acted on Ms X’s referral in March 2023 it could have come to the same decision by September 2023. Therefore the Ombudsman considered there was a delay of 9 months in processing Ms X’s referral for adaptations. As a result, Ms X had to spend longer in a property where she was unable to wash properly.
Where someone has been deprived of adaptations which would have increased their independence and improved their daily life, the Ombudsman would usually recommend a remedy payment in the range of £150 to £350 per month. The Ombudsman considered this situation to be at the higher end of this payment range. The Ombudsman considered the extent of adaptations Ms X needed, the impact on her daily life which meant she could not wash properly, and that she did not have alternative support during this period of delay, as this was only in place from June 2024.
Ultimately, this breached efficient processing expected under the Housing Grants, Construction and Regeneration Act 1996 and March 2022 government guidance on Disabled Facilities Grants (DFG), particularly Stage 2 from first contact to assessment.
From January 2024 first contact, it took nearly a year to identify suitable works. This far exceeded the 65-day guidance for urgent complex cases, due to delays in the initial assessment (January to March 2024) and OT adaptation assessment (June to October 2024), amounting to further service failure.
The Council agreed to apologise to Ms X, pay £3,150 for the nine-month delay (£350 per calendar month, as per Ombudsman’s remedies guidance), and a further £500 for distress and inconvenience arising from processing delays. The Council was also to consider why there was such a long wait to process Ms X’s application and what actions it could take to reduce the wait for an OT assessment. It should report back to the Ombudsman with any changes to its procedures it intended to make.
Points to note for councils, professionals, people using services and their carers, advocacy groups and members of the public
The Ombudsman only investigated matters up until December 2024 which was when the Council sent Ms X’s landlord a copy of its proposals for a wet room in her property. We don’t know how long the rest of the process took because a complaint only looks backwards after a Council has been given a chance to respond to the complaint as originally made.
The Government issued non-statutory guidance about DFGs in March 2022. This identifies five key stages to delivering home adaptations. A council should decide a grant application as soon as reasonably practicable. Timescales are given for moving through the stages which depend on the urgency and complexity of the works required.
The Ombudsman’s analysis under housing grants law rightly identifies delays in DFG processing as fault, but could have considered how the nine-month failure to respond to the OT referral on bathing needs, forcing sink washing, created an appearance of care and support needs under community care law, triggering a mandatory timely needs assessment to evaluate impact on wellbeing, including personal dignity and suitability of living accommodation.
Public law principles of competent assessment were not considered, as the report does not provide information as to how the council evaluated total bathing needs or involved Ms X properly before trialling equipment in March 2024. The report sets out that in early June 2024, the Council put in place some reablement support for Ms X, but does not specify if this provision resulted from a Care Act compliant needs assessment. We think the provision of reablement support is strange in this context since this is normally only short term support, and a lawful assessment may well have concluded that Ms X needed longer term assistance, at least pending the adaptations.
It seems obvious to us that since an OT made the original referral in 2023, it was already clear that an adaptation was needed, which made the period of prevention and reduction measures otiose. That smacks of robotic pathway following, instead of attention to what had already happened, which was a referral lost for no apparent reason!
We note that this report is categorised on the LGSCO website under Adult Social Care rather than Housing, which is another puzzle – under the heading of Assessment and Care Plan…
Tower Hamlets has already been specifically criticised by the Ombudsman in the last year or so, for poor liaison between housing and social services departments, so failure to comment on progress in this regard is a weakness in the report, to our minds. Councils should promptly screen referrals for Care Act duties alongside DFG timelines, advise individuals of assessment rights during delays, and ensure interim prevention like reablement is not substituted unlawfully for full assessment or just ended after 6 weeks; people using services can request assessments explicitly, citing wellbeing risks from unmet needs. Of course it’s always possible that this disabled woman had capacity to refuse being formally assessed under the Care Act.
It would have been really simple for Tower Hamlets management to look up the Remedies Guidance and provide the woman with an offer of £300 pcm and avoid being taken to the LGSCO at all. One can only wonder why the complaints officer does not do that every time it is found that an apology is needed.
Please use the following link if you want to read the original Local Government and Social Care Ombudsman’s London Borough of Tower Hamlets (25 001 433) 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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