Council’s failure to support autistic man and mother led to ‘stress, anxiety and breakdown in family life’

A London borough has been told to pay out £1,000 apiece to an autistic man and his mother, who cared for him, after it failed to properly support them causing “stress, anxiety and a breakdown in family life”.

An investigation by the Local Government and Social Care Ombudsman found Croydon council at fault for not assessing ‘Mr D’ or his mother ‘Ms C’, and failing to provide Mr D with a support plan, personal budget or advocate.

Mr D had been moved into a flat of his own by the council after Ms C became unable to cope with him living with her. But it did not put in place adequate measures or assess her needs as a carer, leaving Mr D anxious and as a result bombarding his mother with threats and contacting her up to 80 times a day.

The ombudsman said Croydon should arrange for a reassessment of Mr D by someone trained and experienced in assessing and supporting people with autism and mental health problems.

It also told the borough to review its autism services, especially around whether staff are adequately trained, and establish a process of liaison with mental health services and autism specialists.

No fresh assessment or care and support plan

Ms C complained to the council in early June 2020, around 15 months after it had assessed Mr D and found him eligible for community-based support and in need of alternative housing, after he had been living with his mother.

In addition to being autistic Mr D has mental health problems, and can become verbally aggressive when anxious or frustrated.

The ombudsman’s investigation found no record of the new assessment by the council, which said it had in fact simply used a comprehensive assessment carried out in 2017 as the basis of a new one to avoid causing distress to Mr D.

In October 2019 the council told Mr D and Ms C that it had found him eligible for three two-hour support sessions a week, but provided no care and support plan setting out Mr D’s needs, desired outcomes or what measures it was putting in place.

The lack of a plan meant that when Mr D moved into a hostel the following month due to Ms C no longer being able to cope, support workers had no information as to what they could offer him.

Later, in spring 2020 after Mr D had moved into his own place, Ms C raised concerns that a support agency subsequently put in place “was not motivational or doing activities Mr D wanted”.

Threats to hurt mother

Support services were then suspended because of the national lockdown, but Mr D – who was struggling in his new flat because of neighbour nuisance and other difficulties – refused to re-engage once restrictions eased. After Mr D’s social worker arranged for support staff to visit him, “Ms C contacted the social worker saying that Mr D had threatened to hurt her if the support workers visited the property again,” the ombudsman’s report said.

Following Ms C’s complaint to Croydon about both the support workers and social worker, the council made a series of unsuccessful efforts to move things forward by contacting her and Mr D and trying to set up meetings with them.

In September 2020 the community learning disability team became involved and made a referral to the mental health team, as well as developing a health action plan. The mental health team rejected Mr D’s referral because he did not meet their criteria.

In her contact with the ombudsman Ms C said Croydon had ignored the fact that she has a medical condition affecting her ability to communicate, failing to put in place reasonable adjustments to meet her needs. She said the council had failed to properly support her son, leading to a family breakdown as Mr D’s behaviour towards her deteriorated because of his agitation.

“Ms C says the council failed to protect her as a carer and a person with needs,” the ombudsman’s report said. “In response to a draft of this report Ms C says the council’s actions have also affected her wider family including her older son who has had to provide her with support.”

‘Crisis point with no alternative options readily available’

The ombudsman concluded that Croydon, in failing to carry out a new assessment of Mr D, had offered no evidence that it investigated ways in which it could carry one out that would mitigate the levels of stress caused to him.

“In [failing to properly assess Mr D’s needs Croydon] failed to have regard for his Article 8 rights – in particular how his behaviour was affecting his relationship with Ms C and it potentially being a contributory factor in him leaving home as he did,” the watchdog’s report said.

“These rights would also have been identified had the council completed a carer’s assessment and support plan,” it added, noting that the failure to do so had “profound” consequences for Ms C. “Had the council completed these actions it may well have provided services which would have prevented Mr D reaching crisis point and leaving home.”

Despite seeking advice from a psychologist around communicating with Mr D, the council did not consider what adjustments support workers should make when engaging with him, the ombudsman found.

“The lack of reasonable adjustments is not in line with the Equality Act 2010, nor is it in the spirit of the Autism Act 2009,” the report said. “This says staff should be trained so they have sufficient skills to support people with autism and stresses the need for properly completed assessments.”

Croydon failed to consider Mr D’s needs around support to obtain skills for independent living, leading to anxiety on his part around accessing medication and healthcare, and handling bills – and shifting the burden of support onto his mother.

“The council failed to record preventive measures or a contingency plan of what would happen if Ms C could not cope and the situation became untenable,” the ombudsman’s report said. “This resulted in Ms C and Mr D reaching a crisis point with no alternative options readily available.”

‘Wide range of plans to improve care and support’

Michael King, the local government and social care ombudsman, said the case “highlights how crucial it is for staff to have appropriate training so they have the skills and knowledge to support people with autism”.

“The council failed to identify the man’s individual support needs and include him in designing his own support plan,” King added. “This left the man frustrated and anxious, and his mother bearing the consequences.”

A Croydon council spokesperson said the authority was sorry for not providing Mr D and his mother with the right support, adding that it had apologised to them for the distress caused.

“We are developing new training to ensure all adult social care staff are equipped with the skills and knowledge to properly support people with autism and their carers, working closely with specialist autism and mental health professionals in our community,” the spokesperson added. “In our autism strategy, developed with residents across Croydon, we have set out a wide range of plans to improve the care and support we offer people with autism and their families.”