The social care watchdog is increasingly finding fault with council decision making in relation to social care assessments and care planning.
The Local Government and Social Care Ombudsman (LGSCO) upheld 80% of complaints it investigated relating to assessment and care planning in 2023-24, up from 67% in 2022-23 and 64% in 2021-22, according to its annual review of adult care complaints.
The ombudsman’s role
The ombudsman investigates complaints against local authorities and adult social care providers that cannot be resolved by the organisation. It then makes judgments about whether the council or provider is at fault – including in relation to compliance with the law, statutory guidance or procedures – and whether this has led to injustice to individuals.
While the watchdog investigated fewer assessment and care planning complaints in 2023-24 (240) than in 2022-23 (268) and 2021-22 (255), it upheld more cases (193) than in the two preceding years (180 and 163).
Council assessment and care planning failings
Complaints upheld included cases of councils delaying assessments, not making reasonable adjustments during the assessment process, not meeting a person’s eligible needs when they were required to do so, not reviewing care and support plans in a suitably timely fashion and drawing up plans that were insufficiently detailed or specific.
The ombudsman also received significantly more complaints about assessment and care planning in 2023-24 (695) than in 2022-23 (494) and 2021-22 (499).
However, of the 631 cases it decided, it determined that a third were not within its remit and closed 28% of the rest.
Ombudsman ‘unable to draw conclusions’ from complaint trends
Despite the sharp rise in the uphold rate for assessment and care planning cases, the LGSCO said that changes in its approach meant that it could not draw conclusions from the change.
“We have changed some of our internal processes over the last couple of years, prioritising investigation of those cases which have a wider public interest, which has an impact on the data,” said a spokesperson.
“Because of all this, when we look at the data, we would not be confident to draw any particular conclusions on any trends or patterns.
“We have seen a jump in the uphold rate for assessment and care planning, but we cannot be clear on the reason for this at this stage and without a longer term trend.”
Overall findings
Overall, the ombudsman investigated fewer adult social care complaints against councils and providers in 2023-24 (926) than in 2022-23 (1,078), but upheld a greater proportion – 80%, up from 75%.
The LGSCO also upheld an increased percentage, and number, of complaints it investigated regarding charging for care, with 82% (176) of decisions going against councils in 2023-24, up from 79% (151) the year before.
In relation to safeguarding, the uphold rate increased slightly, from 62% to 63%, year on year, but the number of cases investigated fell, from 54 to 34.
Councils and providers urged to improve communication
In her foreword to the annual complaints review, ombudsman Amerdeep Somal said: “Our casework highlights a range of concerns, specifically delays in the assessment of people’s needs, processes that fail to put the individual at the centre, care that fits with the system’s offer rather than the person’s needs and preferences, and poor communication with people who use services and their families, where information is unclear or too complicated.”
She added: “I urge all councils and care providers to focus on clear and timely communication. With effective communication channels, people feel well-informed and involved, and concerns are less likely to turn into complaints.”
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As a social worker who gets repeatedly asked to revise and resubmit assessment and care plans my only astonishment is that only 80% were upheld. Just last Friday I was told once more to “refine” my submission. The language around trying to justify refusing care or reducing care is horrendous, hypocrisy about “personalisation” is spirit crushing. Sadly that isn’t just my personal experience. Management group think on this is toxic and their behaviour is bullying and far from caring. Bank tellers the lot of them.
Every example Tom gives is my own experience too. In my bit of Yorkshire, can’t be too specific for fear of management bullying, we have grand statements and endless emails lauding the ‘service’ and how it’s people focused “always”. But it’s not and we are not. If you manage a service on self congratulation it’s just vacuous bilge isn’t it.
“Bank tellers the lot of them”. That’s it really.
Scrutinised all of the time , just let do or jobs as social workers instead of interfering .
Introduction of new social worker assessment system, seem focuse on ensuring all questions are ask to ensure the care act is met,in a one size fits all approach. It fails to consider the diversity of people and need.one section ask why some is ,or not working or training or volunteering ,or seeking education, not one statement say I an 93,and retired. This reflects the need work till you drop.Needs based assessment are great, but seems justify why we are not going to provide service
Councils move further and further away from timely, person centred work everyday.
Told to be person centred and then have our autonomy taken away by brokerage processes, budget panels, unqualified staff working from ticklists, and set categories and commissioning rules we can’t step out of.
Im waiting for the day it’s 1 social worker per team, checking the bare legality of decisions, and everyone else in the team is admin staff churning out phone assessments.
As long as we SAY we work in a strengths based way when asked, it’s fine.
We had a similar discussion with our new head of service when she came to us with her “listening hat” on. Colleague mentioned AI and how it was likely to erode skilled interactions and probable reduction in qualified social workers. The response? You can’t run away from technology, AI is just a refining tool to make ‘our’ work more efficient and less costly. Technology probably will result in hard discussions about team sizes but we mustn’t forget that ‘our’ work is always client focussed, if AI improves their experiences than we have to be professional about our focus. Can’t be clearer than that
As a manager, it saddens me greatly to hear social workers talk like this in these comments. While I can see where they are coming from, there is a lack of understanding of what the council function is and how it operates. No-one got into care to be bank tellers. Including managers. It’s a struggle to push back and ask a worker to revisit their professional recommendations, but all to often there is no clear rationale provided, and the proposed service is disproportionate to the persons actual need. Often the social workers can’t even link the service proposed to the need, just quoting what a provider says is needed, completely undervaluing their professional judgment. Who is really in it for the money, the manager gatekeeping scarce resources or the care provider making profit. My advice to you all would be to get a better understanding of commissioning and council functions and champion better training and government funding.
If I agreed all packages put before, the council would have been bankrupt 5 years ago. There would be no money to pay for staff which would leave more people at risk.
Try and reflect on what it is to be a manager. Just because you wouldn’t want to do it, doesn’t mean than no-one needs to. It’s a very lonely place in management.
Defensive, straw clutching, justifying rationing, just doing my job as the council requires management is the reason why social workers say the things we do. Sanctions by the Ombudsman are a piffle is it? Those pesky incompetent social workers will be missed by managers once AI replaces them. Oh and managers will be following them out the door afterwards too. Why have highly paid managers being the doormats when you can replace them too with software that costs a fraction of their salaries and is more efficient as well in calculating the pennies. Used to be that managers had a tad more independence in them. Careers top that now it seems Whether they’ve become managers to turn into bank tellers or turn into them because of their supine adherence to the ‘rules’ the reality is that managers are just that. How else to describe practice that knows the cost of everything but the value of nothing?
If your staff are completing assessments on the basis of provider reccomendations, and not their own critical and professional judgement, they need training better.
The frustration in my neck of the woods is not managers trying to keep budget. It is the false, fronting narrative (lie) that we are keeping things ‘person centred’ when what is really happening is job cuts and service cuts as the client group grows and grows. It’s not much to do with managers in that sense really, rather the overarching DHSC narrative and the drive to pretend everything is fine, and improving, when it really, really isn’t.
It has everything to do with managers. They are the enforcers they are the ones bullying us by offensive suggestions that we are useless and just regurgitate what providers con us to do. Managers thinking that they have a thankless task really should have the humility to listento their staff. It’s not that some of us font want to become managers, it’s that we don’t want to make the same compromises, do the bidding of service heads whose decisions erode professional accountability and have to justify decisions and follow the ‘rules’. Less offensive stereotyping by managers might get them the sympathy they seem to crave. Just doing my job is being a bank teller. Be openly contemptuously the people you manage and you will be rewardedwith cynicism, sarcasm and laughter.
I’m also now a manager and though sympathetic to your position, note you’ve missed the point. It’s not your workers or social workers at large identifying issues with assessments and care planning but the ombudsman. I also have fresh experience of being a social worker and note some appalling management decisions where if people were more educated on their rights or processes like SARs weren’t in effect marking ones own homework their would be significantly more rulings and damping reports. I’ve seen horrendous decisions where I’ve had to park a case and say clearly I’m standing by my recommendations and that’s the end, if you want a second opinion please seek one. One that sticks in mind specifically was a demand that someone be dragged out their home and 136 (manager not an AMHP arguing with social worker who is an AMHP on legality of it), then suggesting an elderly carer with own care and support needs move into a hotel to escape their cares for person rather than address the need for urgent respite. Another clanger was a debate about night time needs and being pushed to add a lunch call to see if it would help (it clearly wouldn’t and you don’t need to be particularly skilled to realise such).
Where I struggle and see reoccurring is that there is a lack of understanding about what amounts to evidence if need. I’ve seen longstanding carers completely dismissed without grounds and had it suggested that only failed care is considered evidence for more care. Clearly a ridiculous position to take. I also note when it comes to skills and knowledge re the care act long standing managers who perhaps have not carried out an mca assessment in over a decade or never actually practiced under the care act are some of the least equipped to actually “lead” social workers on it and the culture of poor practice continues.
No doubt skills and training are an issue and I’ve been a vocal advocate of better training opportunities within LAs for years for social workers, but the issues the ombudsman are highlighting tend to stem from poor management decision making and lack of awareness of what the care act and the care and support statutory guidance actually require of LAs. Yes you have your budget, but that doesn’t. Give you a free pass to completely ignore your statutory duties.
I too am a manager. I too get exasperated often by the blind lashing out at managers. But I also recognise the frustrations experienced by social workers. The vilification they are often subjected to publicly in panels and the like is not because they are too incompetent to identify actual needs and unable to recommend proportionate services but because as managers we are driven by predetermined budgets. As actually intentionally or otherwise demonstrated by Anonymous. As for councils potentially being bankrupted by unrealistic care packages, the evidence actually is that councils are more than capable of doing that themselves. Not even the most expensive recommendation from a social worker can match the millions wasted on vanity projects and senior managers playing hedge fund roulette. There are days when I can happily eviscerate people I manage but what use are social workers if they don’t challenge and make their managers uncomfortable.
Well said Anna, all true.It is more about cost than Safeguarding!!!
Someone asked if repeated Ombudsman findings against councils were regarded as an irritant rather than damning given managers appear to ignore them at worst and respond defensively if pressed. It would be useful to hear a management response to that. I know our manager reads and contributed and she cannot be the only one. A measured response not one justifying falling foul of the Ombudsman on just council finances would take the heat out of social workers disgruntlement hopefully.
The Ombudsman appears to be pointing to processes that don’t point people at the centre of their care and care that the person has to fit into rather than care structured around them.
Doesn’t this ring true? People receiving care at home being given three hour windows for when the morning call might arrive; little or no choice about care home options; standardised ‘conversations’ as part of the assessment process; funding panels used as the norm, rather than the exception; delays in reviews, as people are too busy answering the people knocking on the front door.
The whole system is undervalued, underfunded and un- cared for.
We can change our own individual practice, we can change what we think about the reality facing us, and we can press for change, but it seems counter-productive to to enter into internecine attrition of social workers against managers.
Holding managers accountable for the decisions they take purely on cost grounds, and that is all they do whatever gloss they try to put on, isn’t internecine attrition. Our fundamental role as social workers is to question, challenge and advocate. When the whole bureaucracy around this is designed to iron out choice, independence, dignity, compassion and reinforce cost as the first principle it’s fundamental that as social workers we confront that. However uncomfortable it makes are managers. They are the ones pushing this through. I have worked in 3 local authorities. In none of them did my managers behave let alone frame their thinking as social workers. Bank tellers might be an offensive description but the behaviour and mindset it highlights is not inaccurate. Infinite number of Friday Doughnuts can’t disguise that managers are bureaucrats in this and in turn are turning social workers into ineffectual form fillers. So, much as I appreciate the gestures and the occasional invite to the pub from our manager I have zero respect for their endless strategies to de-skill and knock out independent thinking from us. It’s not attritional to expect managers to rediscover what social work is. Nothing more complicated than that. And that isn’t being vindictive.