Council breached Care Act in delaying assessment, not issuing plan and charging for intermediate care

    Ombudsman says council’s failings caused woman with multiple needs avoidable distress and inconvenience

    Image of filing cabinet with 'investigations' label
    Credit: tashatuvango / Adobe Stock

    A local authority breached the Care Act 2014 when it failed to assess a woman’s needs for several weeks, produce a care plan when she was deemed eligible or provide her with free intermediate care, an investigation has found.

    In a report, the Local Government and Social Care Ombudsman said Durham council’s failings caused the woman, who has mental and physical health problems, “avoidable distress and inconvenience”.

    Durham has accepted the ombudsman’s judgment and agreed to the report’s recommendations to apologise to Mrs X, pay her £300 and review council care planning procedure.

    Delayed assessment

    Mrs X contacted the council on 28 June 2019, describing her medical conditions and explaining she couldn’t sleep, didn’t like to go out and struggled to get dressed, use her wet room, or do housework. The council sent Mrs X information about care providers, cleaning services and a befriending service.

    On 17 July, she contacted the council again and said her doctor told her to contact the council’s social care team about her mental and physical health problems and how this impacted her ability to manage her home. She was told to ask her doctor to make a referral to mental health services.

    The council received a referral letter from Mrs X’s doctor on 30 July, describing the impact of her health conditions and said she needed a support worker. The council said it was unable to help and that Mrs X would have to fund her own care.

    Finally on 9 August, following a joint request from Mrs X’s local MP and doctor, the council referred Mrs X’s case to a social worker to arrange an assessment.

    The assessment, on 28 August, found Mrs X had eligible needs for care and support arising from her physical condition as well as depression and anxiety. With reference to the outcomes set out in the eligibility criteria regulations under the Care Act, it found she was unable to:

    • Manage and maintain her nutrition.
    • Maintain her personal hygiene.
    • Make use of the home safely.
    • Maintain a habitable home environment.
    • Access facilities in the community.

    Mrs X’s social worker discussed a care package with her and Mrs X agreed to have a financial assessment to see how much she would have to pay toward her care. She did not want to start any care until she knew the results of her financial assessment.

    On 19 September, the council wrote to Mrs X and said she would have to pay £112.75 a week towards the cost of her care, a contribution that upset her. Her social worker agreed to send a funding request to the NHS, who then made a referral to the council for intermediate care (IC) on 18 October.

    The NHS assessed Mrs X as struggling to wash, dress, and prepare meals and proposed a care package of 30 minutes’ personal care in the morning twice a week, an extra 15 minutes twice a week for showering, and 40 minutes’ care for evenings meals, washing dishes, and to supervise and encourage mobility. The package was intended to last six weeks.

    On 12 November, Mrs X spoke with the council and said she wanted to cancel her intermediate care (IC) package, which she had been unhappy with, to which the council agreed. The council then sent Mrs X an invoice for the IC care package.

    Multiple failings

    The ombudsman found that Mrs X clearly expressed a need for support when she first contacted the council in June 2019 and this was repeated by her doctor, meaning the council’s first contact service should have referred for an assessment under section 9 of the Care Act “The council has a duty to assess someone who appears to have care and support needs, it did not refer Mrs X for an assessment until it received a request from her doctor and MP.

    “While the council did carry out a needs assessment, there was a delay of about six weeks, Mrs X was put to unnecessary time and trouble contacting her GP, her MP, and making a complaint before she got an assessment,” the watchdog said. “That caused added avoidable distress and inconvenience to what was already a distressing situation for Mrs X.”

    When the council finally carried out Mrs X’s assessment and identified eligible need for care and support, it did not produce a care plan which was a fault, the ombudsman found, as this is required by section 24 of the Care Act.

    Under the Care and Support (Charging and Assessment of Resources) Regulations 2014, intermediate care must be provided free for six weeks, meaning the council was wrong to send Mrs X an invoice for her IC package. While the council waived the fee, this did not take away the distress Mrs X suffered, the watchdog said.

    The council accepted it wrongly charged Mrs X for her IC after an administrative error when the care provider was changed. It has cancelled the charges. It also accepted the identified failings on the delay in assessing Mrs X and not producing a care plan when required.

    Recommendations accepted

    Lee Alexander, Durham County Council’s head of adult care, said the council received the ombudsman’s decision and acted swiftly in ensuring all the actions were implemented.

    “We carried out a thorough review of our care planning procedure and have shared the results of this with all staff. All employees who work in the social care direct service have also been reminded of our duty to offer an assessment where there is an appearance of need.

    “We have since updated the ombudsman on the steps taken and been informed it is satisfied and considers the matter complete.”

    4 Responses to Council breached Care Act in delaying assessment, not issuing plan and charging for intermediate care

    1. Karen Dube December 18, 2020 at 12:00 pm #

      Quality services are costly. Risk assesments and communication is crucial. Neglect of comprehensive Care Plans can lead to catastrophic suffering for those whose lives are entrusted to protect them get it wrong
      It is sad for children and indeed their parents when professionals formalise legitimise and normalise what amounts to torture for those less able to speak for themselves.
      It will be useful if relevant people are identified included in consultations concerning family lives. If decisions are based on assumptions, limited or restricted information results in irreprable damage to the families affected
      Who has the ultimate responsibility for ensuring the safety of those in need is safe? Who monitors the welfare of the cared for in the system? With whom is the information shared ?
      When we ask What happened? What went wrong? How can this be addressed and corrected? Who can in the Children’s Services answer these questions.

      It is sad to see families suffering. How can Communities contribute to make a difference especially during this Festive season

    2. Gerald December 18, 2020 at 5:30 pm #

      Dear Karen
      Have you heard off “Safeguarding” this is a separate Department in County Councils who have been given the duty to deal with matters of this nature. They are supposed to be autonomous and can be called upon to ensure the wellbeing of any member of the Public, I suggest that anyone who is concerned should be advised to contact them to report any issue whatsoever.

    3. Joy McCalla December 21, 2020 at 6:38 am #

      I agree the council failed to carry out their statutory duties within suitable time and this lady had to involve her doctor and mp before appropriate action taken. This at times seems to happen due to the increasing demand on social services, reduce staffing and the ungoing pressure on social workers.

      • Alex December 21, 2020 at 11:45 am #

        And it sometimes happens because not all social workers are conscientious or competent. For once let’s accept responsibility and not revert to “lack of resources” as the get out. Unless we are honest, bad practice will continue to harm.