Failings or delays in Assessments, Reassessments & Reviews

This section of complaints covers a wide range of issues.

Reports highlight that people with complex needs are often discharged from hospital without assessment by social services, and that this is rarely from choice.

There are major problems with transition – a transition assessment is required to be undertaken as part of one of the statutory reviews of the EHC plan (Department of Health Statutory Guidance 16.11), unless there’s a very good reason why not.

People’s and Carers’ assessments are a statutory duty under the Care Act – triggered only by the appearance of needs for something in the nature of being looked after.

The LGO highlights that it is not only the law but good practice to involve the person and their family in the assessment process The LGO is more likely to find fault if the Council has not even attempted to involve or inform the person.

With regard to revisions to plans, and especially where support is being reduced or removed or suspended, the LGO considers whether the Council properly assessed a person, in terms of what the impact would be of a reduced package.

A person should be reassessed/reviewed every year (6 months if on direct payments, because the financial probity issue is greater, there). The LGO affords Councils some leeway, but generally states that over a year is an unreasonably long time between reviews, and may be considered as fault. The LGO considers the facts of the case and whether the delay was ‘reasonable and acceptable’. Failure properly to assess a person has an impact, in that people may be left with insufficient support, for an indefensible amount of time, and their informal carers unreasonably put upon.

Section 27 of the Care Act makes review, and revision, where it is considered necessary, a statutorily underpinned process, with definite steps and due process rights attached to it. It provides for review from time to time, or as per a schedule, or on the basis of any reasonable request by or on behalf of a service user. A change in circumstances is the trigger to an unscheduled review, and to a proportionate re-assessment if a review has revealed changes perceived to affect the plan. When a Council identifies a change in someone’s needs, it should be able to articulate on the basis of identified material what it thinks the change is.

Assessments are not assessments for services, but in terms of deficits, they are a good point to be considering the actual amount of support needed, ie how many hours of support, where and for what type. The LGO will only find fault, however, if the Council actually fails to meet the person’s needs.

Name of Council	Subject Matter	Title of Report	Number
Warwickshire	Capacity Assessment	Warwickshire Council at fault regarding mental capacity assessments and failure to provide an advocate	18 017 301
Sefton	Capacity Assessmnet	Sefton Council at fault for failing to carry out a mental capacity assessment	19 005 279
Worcestershire	Capacity Assessment	Worcestershire Council at fault for delay in providing care and accommodation, for failure to assess capacity to make decisions, for failure regarding consideration of the need for advocacy, and failure to assess a carer	18 007 624
Surrey County et al	Capacity Assessment	Council AND NHS at fault for failing to update care plans in readiness for transition, and follow up safeguarding concerns	18 016 501
Calderdale	Capacity Assessment/Needs Assessment	Calderdale Metropolitan Borough Council at fault for delays, and for failing to carry out relevant assessments at the point of hospital discharge	19 000 907
Royal Borough of Greenwich	Failures Relating to Assessments	Royal Borough of Greenwich at fault for delays in assessment and making unsubstantiated accusations	19 010 775
Staffordshire	DoLS Requests	Staffordshire County Council found at fault for decision to use its own policy to avoid carrying out requested DoL Safeguards assessments	18 004 809
Hestoncourt Ltd	Equipment	Hestoncourt Limited at fault for providing inadequate care, and referred to the CQC for potentially falsifying records	19 001 354
Lancashire	Equipment	Lancashire County Council at fault for failing to ensure the right provision was in place at a care home, resulting in an unwanted move	19 005 812
Lincolnshire	Needs Assessment	Lincolnshire County Council, Lincolnshire Partnership NHS Foundation Trust and Lincolnshire East CCG found jointly at fault for failing to work together properly with regard to s117 aftercare	18 012 682
Sefton	Needs Assessment	Sefton Council at fault for failing to engage an appropriately qualified deafblind assessor	19 017 266
Suffolk	Needs Assessment	Suffolk County Council at fault for carrying out flawed assessments and care plans and preventing a chosen representative from providing support during reviews	17 018 391
Staffordshire	Needs Assessment	Staffordshire County Council at fault for delay in reassessment and not meeting an assessed eligible need	19 011 306
Windsor and Maidenhead	Needs Assessment	Royal Borough of Windsor and Maidenhead at fault for failing to properly consider the risks when separating a married couple of 59 years, failing to provide adequate care and failing to provide appropriate complaint responses	18 015 872
North Yorkshire	Needs Assessment	North Yorkshire County Council at fault for failing to properly consider the need for maintaining a habitable home and being properly dressed	19 013 234
Hertfordshire	Needs Assessment	Hertfordshire County Council found at fault for delegating responsibilities to Foundation Trust and ultimately for allowing it to fail to ensure sufficient assessment and discharge planning	17 013 594
Croydon	Needs Assessment	London Borough of Croydon Council at fault for severe delays and unexplained systemic failures in transitioning to adult services, carers’ assessments and direct payments for the package	18 015 014
Essex County	Needs Assessment	Essex County Council and Clinical Commissioning Group at fault for the way they assessed care needs and entitlement to Continuing Healthcare funding, Ombudsman finds	17 015 113
Norfolk County	Needs Assessment	Norfolk County Council at fault for failing to produce a clear care plan and incorrect advice on direct payments and Disability Related Expenditure	18 012 426
Lambeth	Needs Assessment	Lambeth Council and the CCG at fault for delays in needs assessments and handling of a restitution claim	17 005 393
Milton Keynes	Needs Assessment	Milton Keynes Council at fault for needs assessment flawed by a ‘last resort’ policy, for leaving a paid personal assistant working without pay – and for providing a care package clearly insufficient to meet needs	18 003 035
South Tyneside	Needs Assessment	South Tyneside Metropolitan Borough Council at fault for failing to follow assessment guidelines in regards to deafblind clients, failing to backdate direct payments, and failing to investigate restriction of contact imposed by its commissioned care provider	15 016 702
Buckinghamshire	Needs Assessment	Buckinghamshire County Council at fault for failing to commence section 42 safeguarding enquiries and for failing to provide a needs assessment	19 000 746
Norfolk County	Needs Assessment	Norfolk County Council at fault for failing to complete a follow-up of a newly reduced support plan	18 019 204
Norfolk County	Needs Assessment	Norfolk County Council found at fault for failing to meet assessed eligible needs with a care plan that allowed for a refusal of a carer (both paid and unpaid) to do any more – and now making restitution for that wrongdoing	19 002 258
Somerset	Needs Assessment	Somerset Council at fault for excessive delay, inadequate assessments, poor policy management and failure to address an increase in needs, properly	16 016 775
Bracknell Forest	Needs Assessment	Bracknell Forest Council at fault for improper assessments and for failing to inform family of its social care rights	18 013 073
Bradford Metropolitan District	Needs Assessment	City of Bradford Metropolitan District Council at fault for serious delays in decision-making and failing to communicate properly	19 000 350
Brighton & Hove	Needs Assessment	Brighton & Hove Council NOT at fault with regard to its approach to a finding of non-eligibility	19 002 889
Buckinghamshire County	Needs Assessment	Buckinghamshire County Council at fault for failing to safeguard and properly assess a person	18 005 323
Croydon	Needs Assessment	Croydon Council at fault for serious delay in completing care assessment	18 016 105
Kirklees Metropolitan	Needs Assessment	Kirklees Metropolitan Council at fault for failing to assess needs properly	18 011 052
Lewisham	Needs Assessment	Lewisham Council at fault for delay in carrying out a care needs assessment; failure to consider the significance of an ASD assessment and failure to retain an Advocate	18 001 147
Bromley	Needs Assessment	London Borough of Bromley at fault for failing properly to consider a request for extra support	18 016 782
Hammersmith and Fulham	Sensory Assessment	London Borough of Hammersmith and Fulham found at fault for delays in completing a sensory assessment and in implementing reablement support	18 019 465
Hammersmith and Fulham	Needs Assessment	London Borough of Hammersmith & Fulham at fault for delays in reviewing care and the carer’s and client’s packages	18 019 910
Waltham Forest	Needs Assessment	Waltham Forest Council found at fault by ombudsman after delaying a Carer’s Assessment for two years from the date requested and even then failing to provide the outcome of the assessment to the carer	18 006 436
Kirklees Metropolitan	Revision to Care Plan without Review	Kirklees Metropolitan Borough Council at fault for withdrawing vital services and failing to recognise its responsibility to respond to a subsequent crisis.	19 009 200
Kirklees Metropolitan	Revision to Care Plan without Review	Kirklees Council at fault for removing respite care and setting arbitrary limit to funding	19 008 980
Kent County	Revision to Care Plan without Review	Kent County Council at fault for incorrectly backdating payments	18 002 469
Kent County	Failure to review, provision of poor advice	Kent County Council at fault for failure to review and re-assess – and for misleading advice, at the start of the pandemic – to direct payment managers/holders	20 012 990
Gloucestershire County	Needs Assessment	Gloucestershire County Council at fault for acting contrary to expert medical advice, failing to meet needs and failing to undertake carers’ assessments	19 014 556
Lincolnshire	Care Plan Fault	Lincolnshire County Council reduces a care package on the basis that the staff and carer’s evaluation of the young woman’s abilities was very different – without any fault in approach – but WAS found at fault for failure in putting part of the continuing reduced care package in place	21 014 797
Merton	Care Plan Fault	Merton found at fault for not reviewing a care plan, not justifying its rationale for offering less than was regarded as needed, and not monitoring direct payments	21 010 255
Wirral	Care Plan Fault	Wirral Council at fault for failing to complete a timely assessment of care needs, when a person arrived from another council’s area, resulting in a direct loss and breach of the Continuity provisions in ss37-38 of the Care Act	22 005 781
Bournemouth, Christchurch and Poole	Care Plan Fault	Bournemouth, Christchurch and Poole Council at fault for failing to cover or have suitable arrangements to cover unexpected leave.	21 017 826
Birmingham	Delays, Needs Assessment	Birmingham Council was found at fault for historical injustice, delays in assessment for transition to adult care services and numerous failures to reassess and provide carers’ assessments	19 012 575
York	Delays	York Council at fault for delays in reviewing a care package after Covid-19, poor record keeping about transport provision, and failing to offer a carer’s assessment	22 000 366
Rutland	Care Plan Fault	Rutland County Council failed to properly consider personal budget needs.	22 000 033
Warwickshire	Care Plan Fault	Warwickshire County Council unjustly fails to provide reasoning for ‘disregard decision’	21 007 248
Redbridge	Care Plan Fault	London Borough of Redbridge is found to be at fault for unjustified delays in reviewing care packages	21 003 768
Bournemouth, Christchurch and Poole Council	Needs Assessment	Bournemouth, Christchurch and Poole Council fails to conduct a financial assessment of a joint account	21 012 463
Kent	Delays, Needs Assessment	Kent County Council at fault for delay in Assessment	21 018 229
Leeds	financial assessments, mental capacity, deputyship	Leeds found not at fault for insisting that only a legally authorised person may complete financial assessment for an incapacitated adult	22 006 315
Lancashire	Care Plan Fault	Council found to be at fault for inadequate care plan, inadequate financial assessment and failure to assess mental capacity or to refer for advocacy	21 015 121
Northumberland	Safeguarding	Northumberland County Council at fault for causing considerable distress but not as having contributed to the death of a man subject to flawed safeguarding	22 002 090
North Lincolnshire	Delays, Needs Assessment	North Lincolnshire Council at fault for delays in completing a Care Act assessment, when LGSCO found no more than 4 months would have been reasonable and which resulted in an unnecessarily extended stay in a care home	19 008 400
Lancashire, East Lancashire NHS Trust and Victoria Care Home	Delays, Needs Assessment	Failings found with Lancashire Council, East Lancashire NHS Trust and Victoria Care Home around a mishandled hospital discharge, ignoring the family in care planning, overlooking the need for an appropriate interpreter for assessments and then inadequate continence care, poor record keeping and poor communication by the Care Home	21 018 340
Newham	Care Plan Fault	London Borough of Newham at fault for failing to provide a personal budget, failing to explain its reasons for rejecting a placement it had identified, and failing to consider a family’s opinion as to why other placement suggestions were not suitable	20 001 102
Cambridgeshire	Care Plan Fault	Cambridgeshire at fault for a 20-month, ongoing delay in providing a needs assessment, and for failing to implement agreed complaint remedies	21 017 827
Shropshire	Care Plan Fault	Shropshire Council at fault for failing to involve LPA Holder in care planning	22 002 667
Windsor and Maidenhead	Care Plan Fault	Royal Borough of Windsor and Maidenhead at fault for how it handled care assessment	22 010 740
North Yorkshire	Care Plan Fault	North Yorkshire Council at fault for failing to review mental capacity assessment	20 006 413
Staffordshire	Care Plan Fault	Staffordshire at fault for delayed assessment after a move to the area, failing to conduct a carer’s assessment, provide agreed services and support with managing a DP	22 002 399
Islington	Care Plan Fault	Wide-ranging service failure including with regard to the s5 commissioning for sufficiency and diversity duties – at the London Borough of Islington	22 003 113
Essex	Needs Assessment	Essex County Council fail to follow statutory guidance in assessing and setting up care and support	22 010 085
Wigan	S117	Wigan Metropolitan Borough Council and Greater Manchester Mental Health Trust fail to implement Section 117 aftercare thinking or services	22 007 491
Nottinghamshire	Care Plan Fault	Nottinghamshire County Council at fault for failing properly to consider best interests as part of a statutory decision-making function	22 003 087
Portsmouth	Care Plan Fault	Portsmouth City Council at fault for failing to address potential wishes o needs for family involvement in processes	22 007 125
Leicester	Needs Assessment	Leicester City Council confused by ordinary residence rules, resulting in failure to complete a carer’s assessment	21 010 191
Lancashire	Care Plan Fault	Lancashire County Council at fault for failing to secure the planned respite care and over communications about potential supported living settings	22 010 039
Southwark	Care Plan Fault	Southwark fails to apply the principles of the Mental Capacity Act properly	22 011 943
Staffordshire	Care Plan Fault	Staffordshire County Council fail properly to advise direct payment recipients of their rights	22 005 255
Hackney	Care Plan Fault	London Borough of Hackney at fault for failing to provide an enhanced care package after a person’s discharge from hospital	20 007 613
Bracknell	Care Plan Fault	Bracknell Forest Council failed to follow basic MCA processes when making a best interests decision	22 007 716
Bromley	Care Plan Fault	London Borough of Bromley failed to follow up on care home concerns resulting in degrading treatment for a resident	22 001 040