The Local Government and Social Care Ombudsman has stated that councils must meet all the assessed eligible care needs of service users after investigating Northamptonshire County Council’s treatment of a profoundly deaf man.
In February 2016 Northamptonshire assessed the man – who also has anxiety, severe sleep apnoea and other mental health needs – as needing both day- and night-time support. But his care package only offered a personal assistant from 10pm to 8am.
The council also advised the man that if he wanted day time support it would reduce his night-time care. The man and his parents subsequently spent more than £17,000 on day time care.
Eligible care
Northamptonshire council told the ombudsman it did not recognise day- and night-time sleep monitoring due to sleep apnoea as an eligible care need, but had allowed the man to spend his personal budget on night-time support because he agreed it would enable him to meet his day time needs. The man denies agreeing this.
The ombudsman’s report on the case concluded that the council was a fault. It found that the council had “clearly reached and documented a decision that Mr X had eligible needs in both the daytime and at night” in his care and support plan.
“While the council sought to meet Mr X’s ‘priority’ need, service users should not be asked to choose which needs the council should meet,” said the report. “The council has a duty to meet all eligible needs.”
The ombudsman said the council should pay £1,100 compensation to the man and his family as well as reimburse the £17,444 they spent on private day care.
It also said the council should fund night and day care for the man until an independent reassessment or change in needs occurs. The council should also ensure its social workers are trained in assessing people who are deaf and have other complex needs.
Acceptance of fault
“People should not be put in the position of having to pick and choose which areas of their life are supported and which neglected,” said ombudsman Michael King.
“When an assessment is done and essential care needs are identified, it’s not an option to prioritise the support and discard any that do not suit the council.”
In April 2017 Northamptonshire council initially accepted it was at fault but disputed the amount to be reimbursed.
But it then withdrew its acceptance of fault in August 2017 on the grounds that it does not accept the care and support plan for the man identified day- and night-time eligible care needs.
Matter of urgency
Instead the council offered the man a £250 goodwill payment on the basis that he may not have fully understood the situation.
King said: “I am particularly disappointed Northamptonshire council has reneged on its acceptance of fault, and left the family without support for so much longer than if they had put in place earlier the remedy I recommended.
“I now call on it to consider my report as a matter of urgency and put in place all the care this man and his family need.”
Evidence of expenditure
A spokesman for Northamptonshire County Council said: “In the interests of balancing the provision of quality services against ensuring taxpayers’ money is spent correctly, we are challenging a number of aspects of the ombudsman’s recommendations.
“This includes issues around the private care purchased by the service user, which was an informal care arrangement and for which he has been unable to adequately evidence this expenditure.
“That said, we are committed to working with the service user and his family to ensure that an up-to-date assessment of his needs can take place and that these assessed needs are met in accordance with our eligibility criteria for services.”
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Just one of the worrying and depressing things about this case is perhaps hidden in the last sentence – “ ..assessed needs are in accordance with OUR eligibility criteria for services “.
I thought eligibility criteria were to a national standard – called the Care Act!!!
Surprise surprise and I bet any reassessment will find that he suddenly does not need the services identified in the first assessment. Yet again, a council finding any way possible to avoid having to provide proper support and pay for the care needs and no doubt will drag this vulnerable service user up to the high court to avoid paying.
this way of conducting assessments is endemic amongst Councils and Health Trusts all over the UK. They are quick to direct complainants into their internal complaints service knowing that it will take months before they finally conclude in their own favour [very few cases of complaint are ever resolved in favour of the service user as an internal process can never be impartial] and then the Ombudsman will take mnay more months, and the Council like this one can choose to ignore his ruling if he does not agree with them! this is a ntaional scandal and Council social workers should never collude with it, which sadly a lot of them are bullied into doing by their employers, the very Councils which investigate their own complaints! I am both a senior social worker and carer for a service user and I stand up in favour of the client where I think it is merited regardless of how unpopular I may be witht the employer!..our primary duty is to our vulnerable clients not our paymasters
Wouldn’t overnight monitoring for sleep apnoea be a health need? The PA was there primarily to monitor breathing overnight I assume which isn’t ‘secondary or ancillary’ to social care. The local authority shouldn’t have been providing it all?
A rather confusing judgement. The idea of personal budgets, I thought, was to give exactly this type of choice. A similar example would be using a personal budget for respite, to give the main care can have a break so they can provide the care the rest of time.
This judgement would appear to indicate that if someone spends a personal budget on something the Social Worker thinks they don’t need, then Social Services have to provider a second budge to provide the care they do need.
Although this looks like a victory for the client, it may actually end up reducing choice for future clients.
You hit the nail on the head – the idea of a personal budget was to enable clients to be “creative” in how they met their needs. This judgement can only encourage social workers and local authorities to require customers to purchase services that explicitly meet the assessed eligible needs. A hollow victory.
I know this going to be hugely unpopular but I agree with the council. Under personalisation he was assessed and given a budget which he could then decide how to spend. He chose to spend it on overnight support every night. In my experience no one gets a 7 overnight support unless they are chc funded. If this is upheld the flood gates will open. Social care is already under enormous budget pressures and people have to prioritise and make choices. I mean who would have agreed at a funding panel for 7 overnight care for sleep apnoea? Assistive technology? ChC? Sounds he chose to spend the money on this and then challenged it when there was none left for the day support.