Norfolk County Council at fault for failing to complete a follow-up of a newly reduced support plan

Decision date: 19/09/2019

What happened

Ms C had a support plan which included attendance at a sewing group one day per week to meet her social needs. The support plan also included specialist taxi transport to attend the group.

In June 2018 the Council completed a review of Ms C’s care and support needs with Ms C and her mother. The review documented how much Ms C enjoyed the sewing group. The Council asked Ms C if she had any friends at the group; she said most of the people that attend were a lot older and that she didn’t have a lot in common with anyone, other than a love of sewing.

The Council then produced a new support plan which removed the sewing group and replaced it with a development referral to source a cooking group so that Ms C could meet new people preferably of a similar age. The Council removed transport from the care plan because the review identified that Ms C could get out and about on her own and could use public transport.

Mr B (father to Ms C) told the Council the review contained some errors. The Council met with Ms C, her mother and Mr B five months later and completed a further review. This review found that if more information around social activities and employment support agencies was provided, it would prevent the need for care and support as this would hopefully build Ms C’s confidence and further her skills of independence. The Council said it would send information to Ms C about a suggested charity providing social, leisure and learning opportunities. Ms C’s reviewed support plan identified her needs would be met by non-commissioned services.

Mr B said that the Council did not send them any information about community groups to meet Ms C’s needs following this assessment. However, shortly after the assessment meeting the Council did send Ms C the draft assessment form and included a link to a charity offering activities.

Three months later the Council also sent Mr B an e-mail with links for a ‘life connector’ sort of a service which could help Ms C find potential clubs, groups and activities in the local community where she could meet people and engage in social activities.

Mr B said the services which the Council suggested in replacement could not meet Ms C’s needs as she cannot attend without transport, and that they did not offer activities that she could take part in, or that she wished to take part in.

What was found

Although the Council had originally provided the sewing group as part of Ms C’s support plan, no council is legally obliged to continue to provide forever. The Council had funded it to meet Ms C’s need to socialise, as her only real social engagement was with her parents. At the annual review it was decided that Ms C would benefit from socialising with people her own age, and that the sewing group did not really meet this need.

National guidance says the Council has a duty to keep support plans under review. When a support plan is revised the Guidance says that the Council should consider a light touch review 6-8 weeks after signing off to ensure the new plan is working as intended. The Council’s own procedure was to review a support plan 4-6 weeks after a new plan started, which it failed to do until eight months after the November review. The Council accepted this was fault, claiming it was unsure what to do because Mr B had made a complaint.

Mr B had given valid reasons why the groups the Council suggested were not adequate to meet Ms C’s needs.

If the Council had completed a follow-up as recommended by the Guidance (unless there was a very good reason for not following that recommendation, that being the obligation with regard to acting under this Guidance), these concerns would have been addressed. The Council did eventually complete a follow-up in July 2019, but it had not been meeting Ms C’s social needs since June 2018. The family had continued to fund the sewing group, and transport to it, as it was the only way they felt Ms C’s social needs would be met appropriately.

The Council only has to meet assessed eligible needs; it does not have to meet a person’s ‘wants’. It was acknowledged that Ms C enjoyed the sewing group and wanted to keep on attending. However, it was sensible to try and find a way of meeting Ms C’s need to socialise that also met her need to socialise with people her own age. The Ombudsman found no reason to question or criticise the Council’s decision as it followed a proper process; it met with Ms C and her parents to complete an assessment of Ms C’s abilities, wants and needs. It completed a further review after Mr B raised concerns. It was found that the Council had appropriately directed Ms C to other ways of meeting her social needs.

The Council had re-instated Ms C’s direct payment to cover the cost of the sewing group and transport.

Although the Council can refer those with eligible support needs to organisations that might be able to meet those needs, the Council must then follow-up to ensure (through a competent member of staff) that those groups are suitable to meet the individual’s assessed eligible needs. It must demonstrate there is a suitable way to meet Ms C’s social needs (commissioned or otherwise secured) in order to discharge its duty.

At this stage it was still unclear whether the suggested groups were appropriate to meet Ms C’s individual needs, due to the rural location where she lives and the time and difficulty it would take to travel to those activities by public transport, or the cost by taxi.

The Council would not have been at fault if it had shown that the groups were meeting Ms C’s social needs appropriately even though Ms C had chosen not to take part in those activities.

Agreed action

The Council will apologise to Ms C and Mr B for failing to review whether the amended support plan was sufficiently meeting Ms C’s eligible needs.

It will pay Mr B the amount he has paid for the sewing group and transport since the Council removed it from Ms C’s support plan.

It should continue to pay this until it can evidence it has taken all reasonable steps to reach agreement with Ms C and her parents about how to meet her eligible care needs, and demonstrate the groups it has suggested have suitable activities for Ms C, at a time and location it is possible and suitable for her to attend.

The council would remind relevant staff to follow the procedure to complete appropriate adult social care reviews and follow-ups, especially after a new support plan is implemented, or there are changes to an existing plan.

The Council should complete the above actions within one month of the Ombudsman’s final decision, and evidence its compliance to the Ombudsman.

Points for the public and the council sector

The Guidance is clear on the sort of approach taken in this report:

Considering the person’s strengths and capabilities

6.63 At the same time as carrying out the assessment, the local authority must consider what else other than the provision of care and support might assist the person in meeting the outcomes they want to achieve. In considering what else might help, authorities should consider the person’s own strengths and capabilities, and what support might be available from their wider support network or within the community to help. Strengths-based approaches might include co-production of services with people who are receiving care and support to foster mutual support networks. Encouraging people to use their gifts and strengths in a community setting could involve developing residents’ groups and appropriate training to support people in developing their skills.

6.64 Local authorities might also consider the ways a person’s cultural and spiritual networks can support them in meeting needs and building strengths, and explore this with the person. Any suggestion that support could be available from family and friends should be considered in light of their appropriateness, willingness and ability to provide any additional support and the impact on them of doing so. It must also be based on the agreement of the adult or carer in question.

10.41 Local authorities should have regard to how universal services and community-based and/or unpaid support could contribute to the factors in the plan, including support that promotes mental and emotional wellbeing and builds social connections and capital. This may require additional learning and development skills and competencies for social workers and care workers which local authorities should provide.

10.42 Authorities are free, and are indeed encouraged, to include additional elements in the plan where this is proportionate to the needs to be met and agreed with the person the plan is intended for. For example, some people may value having an anticipated review date built into their plan in order for them to be aware of when the review will take place. As detailed in the review chapter, it is the expectation that the plan is reviewed no later than every 12 months, although a light-touch review should be considered 6-8 weeks after the plan and personal budget have been signed off.

The LGO’s report usefully said that if someone is unhappy that is even more reason to complete a follow-up of the changes. The LGO could have referred to the advice in para 10.86 of the Guidance that that is the main way of resolving a dispute, stating reasons and looking back, before referring someone to the complaints system. A complaint does not suspend statutory duties!

This report has great significance for all those councils frenziedly signposting clients BEFORE assessment or after assessment as part of care planning to all those assets and strengths supposedly existing within the community or the person’s own network, suggesting that these things OFFSET need.

It is true that a council does not have to meet need that is otherwise met. Assets and strengths based advice and information and assessment practices have been predicated upon the idea that when those things have been tried, the person will feel genuinely in less need than they did, and thus the impact of their unavoidable deficits may have been reduced to less than before, and of course that makes perfect sense.

However, that obviously requires the organisations to whom people are signposted

  1. To be viable, despite grant cuts over the last 10 years
  2. To have a vacancy – as all have a capacity limit
  3. To be prepared to admit the person – councils can’t tell autonomous organisations that they MUST admit people who have been signposted, not even in grant conditions if still grant funding
  4. To be affordable: they may or may not charge, and a client cannot be told to meet their own needs by paying privately, however rich they might be. This can be suggested, and it might be taken up. But this has to be willingly, before any council could regard the suggestion as having offset need by the time of the assessment proper, or as having the potential to continue to go on meeting need, if it is going to offer nothing else at the care planning and funding stage.
  5. To be reasonably accessible, regarding getting there and back. A council cannot suggest that something could meet a person’s needs if it does not also address how the person is going to get there. A council cannot simply say ‘Use your Mobility Component’: that’s telling a person to spend money that the council is not even allowed to count, for financial assessment purposes. A council can’t just say ‘Go there by Public Transport’ if the timing isn’t workable, or the person can’t be left to their own devices and has no willing informal escort in order to be able to manage that. It’s all common sense, and councils are in short supply of that, we find, right now.

CASCAIDr’s personnel have always trained councils on the footing that needs can be regarded as reasonably able to be met even if the means suggested are not the first choice of the individual in question BUT ONLY IF THE SUGGESTION IS RATIONAL IN THE FIRST PLACE. We are using straightforward principles of public law here: the Guidance is based upon these, and even says that

If the person doesn’t WANT to take up the suggestion, then that’s a matter for them, but it does suggest that the impact on the person is not so significant as to be intolerable, if they are exercising a choice NOT to take up that opportunity.

Councils have duties of market management and market influence, since councils do not buy EVERY aspect of social care, and a large part is privately funded without resort to the State.

4.43 Local authorities must have regard to ensuring a sufficiency of provision – in terms of both capacity and capability – to meet anticipated needs for all people in their area needing care and support – regardless of how they are funded. This will include regularly reviewing trends in needs including multiple and complex needs, outcomes sought and achieved, and trends in supply, anticipating the effects and trends in prevention and community-based assets, and through understanding and encouraging changes in the supply of services and providers’ business and investment decisions.

If you want help, please consider seeking advice from CASCAIDr via our referral form on the top bar menu of the site.

The full Local Government Ombudsman report on the actions of Norfolk County Council can be found here:

https://www.lgo.org.uk/decisions/adult-care-services/assessment-and-care-plan/18-019-224#point1