Council reduces woman’s needs without assessment, ombudsman finds

A council has agreed to review its care needs assessment and support planning processes after it confused three stages of a woman’s assessment.

According to the Local Government and Social Care Ombudsman, Kingston upon Hull council did not “properly assess” the eligible needs of Mrs X; an elderly woman who had poor vision and cared for her husband.

It also reduced some needs without assessing if she was capable of doing domestic tasks, such as cooking and cleaning.

Initial assessment

In March 2016, the council assessed Mrs X’s care needs and said she had eligible needs concerning personal care. The council agreed that she needed a 30-minute shower call twice a week.

Mrs X said she required assistance with household cleaning and shopping as well, with the council advising her that she could employ a cleaner privately.

During the same visit, the council cancelled Mrs X’s domestic support she received for four hours per week, deciding she “would only be given money to cover assessed needs”.

It also noted she was paying privately for help with ironing and gave her a list of private care providers who could help with cleaning and shopping.

First complaint

Nine months later, Mr Y, Mrs X’s husband, complained to the council on behalf of his wife, prompting a fresh assessment of Mrs X’s needs.

Kingston upon Hull council carried out a carer’s assessment on this occasion as Mrs X now supported her husband, who had his own health needs.

Mrs X told the council that her caring responsibilities were “mentally and physically exhausting”, adding she felt “trapped” and was at “breaking point”.

In April 2017, the council reassessed Mrs X’s needs. She told assessors that she could manage some needs like preparing ready-meals, maintaining the home and shopping. However, she said that these took her a long time to complete compared to an average person.

Once again, Mrs X said she was caring for her husband, who she suspected of having dementia, and wanted a break.

During the assessment, Mrs X requested that her cleaning and shopping support was reinstated. But the council said she would have to arrange this privately because it was a non-care related need and sent her a list of providers.

She also made the council aware that she had cancelled the shower calls and was managing these needs herself. The local authority noted this was because of concerns about service costs.

Significant impact on well being

In May 2017, Mr Y again complained to the council on his wife’s behalf. He said it should have assessed Mrs X’s overall care needs because his wife could not achieve Care Act outcomes due to her disability.

My Y added that the council had confused the needs assessment with the care and support plan and pointed out that Mrs X’s sight continued to worsen. This had a “significant impact” on her wellbeing, he claimed.

The council responded, saying that Mrs X was managing her personal care and had cancelled the shower calls. It said she had asked for support for her husband, who had been assessed separately.

It said that Mrs X was able to prepare ready-meals in the microwave and did not need support with this.

Kingston upon Hull council added that cleaning and shopping duties were a non-care related support and would charge Mrs X the full cost.

Failed assessment

The ombudsman found that Kingston upon Hull council was at fault as it confused three stages of Mrs X’s assessment.

It concluded that the council did not properly assess Mrs X’s eligible needs. Instead, it said that the local authority had decided Mrs X was meeting some of her needs and removed these from the care and support plan without deciding if these were eligible needs.

According to the ombudsman, the council should not have assumed that shopping and cleaning were always non-care related support needs as they are covered by the Care Act outcomes.

It also stated that, if Mrs X was struggling to meet those outcomes and it was negatively affecting her wellbeing, these would have been eligible needs.

Kingston upon Hull council was found to be at fault because it failed to show whether it had decided Mrs X needs for support with shopping and cleaning were eligible needs.

It failed to evidence if it was cheaper for her to pay for this privately rather than access services through the Council.

Resolutions

Kingston upon Hull council has apologised to Mrs X and has commenced a re-assessment of her needs under the Care Act.

The council has agreed to review its process for assessing needs and care and support planning. It plans to ensure that staff follow a three-stage-process to identify all needs, eligibility and consider what support is needed.

Training for all staff involved in Care Act assessments will be offered in light of this case to ensure that processes are understood and followed.