Essex County Council at fault for delays in assessment and sourcing care package resulting in a much longer than necessary stay in care home

Decision date: 18/10/19

What Happened

Mr Y was hospitalised in November 2017 with dehydration and malnutrition. He was an elderly man living independently in his own home, and was self-neglecting. The District Council’s Environmental Health Department raised concerns about the state of his property and required works to be carried out to improve the condition of the property.

In early January 2018 Mr Y was discharged from hospital into a care home as a temporary resident while his son Mr X carried out the required works to his property.

Mr X contacted the Council in February and notified them that he had completed the work to Mr Y’s house. The Council was aware that Mr Y was desperate to be discharged from the care home and wanted to return home with a care package. The Council contacted the care home who advised that the council should consider whether or not Mr Y had capacity to make his own decisions, as he needed prompting to eat, wash and dress. The Council agreed to assess Mr Y’s care needs.

In February 2018 the Council financially assessed Mr Y’s contribution to funding his temporary residential care stay.

At the end of February 2018, the District Council was satisfied Mr Y’s home was now habitable.

A council officer visited Mr Y at the care home in March 2018 to assess Mr Y’s needs, with Mr X and his wife also present. The officer noted Mr Y was able to mobilise independently with a frame and wished to return home. It was reiterated that although he had said he could manage independently, he was originally admitted to hospital due to self-neglect. The officer arranged to visit Mr Y’s property to assess the environment and plan for safe discharge to his home with Mr X at the end of March. Mr Y was not present. The officer noted that the District Council now considered the property habitable. However, Mr X expressed concern at the steep and narrow staircase.

In May 2018 the Council officer made a referral to the District Council for a DFG for Mr Y for a stair lift and level access shower.

Mr X complained to the Council in August as Mr Y was still in the care home 7 months after he had left hospital. Mr Y was very depressed and wanted to go home but a stairlift had not yet been fitted. The Council had also charged Mr Y for the first six weeks’ stay in the care home when he was told this would be free.

At the end of September 2018 the care home expressed to the officer that Mr Y was not co-operating with care staff. He would not let staff support him and was stating he wanted to return home.

The officer carried out a home visit with Mr Y shortly after to establish his ongoing needs and to determine what support he needed so he could return home safely. Mr Y reportedly ‘mobilised around his home without difficulty.’ Mr Y had agreed to a stair lift being installed which was being processed by the District Council at the time. However at the visit, Mr Y ‘mobilised up and down the stairs independently using the hand rails on both sides of the staircase for support’. They advised Mr Y to go up and down the stairs at a slower pace and recommended Mr Y limit going up and downstairs unless necessary. They recommended a commode be provided for Mr Y to use at night as the bathroom facilities were downstairs.

They noted Mr Y’s mental health and wellbeing had declined as a consequence of his not being in his own home and that Mr Y ‘clearly stated that he wanted to return to his own home’. They recommended he be supported to return home with a care package in place.

In mid-October 2018 the officer made a referral for a care package for Mr Y of one hour in a morning and one hour in an evening to support Mr Y with his personal hygiene and to support him with meals, snacks and drinks. Mr X contacted the Council shortly after to ask why it was taking so long to organise a care package for Mr Y.

The Council responded to Mr X’s complaint made in August 2018,in November. It apologised and accepted it should not have charged Mr Y for his first six weeks in the care home. It said waiting for equipment had delayed Mr Y’s discharge home, as had actually finding a care provider.

Mr Y’s case was reallocated to another officer, officer B, at the end of November 2018. Officer B visited Mr Y in early December 2018. They noted in their professional opinion Mr Y should return home and that Mr X was happy to continue supporting Mr Y at home.

Mr X contacted the Council mid-December as the shower was not yet ready. The Council agreed Mr Y could stay in the care home. Around this time the Council’s notes record the difficulties it was having finding carers to meet the care package.

The District Council confirmed it completed the works just before Christmas 2018. Mr X called the Council to advise Mr Y was going home.

Just after Christmas, Mr X contacted the Council to report Mr Y was not coping. He was confused and unable to use the microwave. He was staying in bed and not taking his medication.

Officer B visited Mr Y in late December 2018. They noted Mr X said Mr Y was not eating, washing or taking his medication. He refused to use the stairlift. They noted Mr Y was able to walk up the stairs without any difficulties. They noted Mr Y had capacity and did not want to go into a care home. He was willing to accept carers visiting.

Mr Y’s care package did not start in early January 2019.

Mr Y has yet to pay his residential care bill. He owes the Council £9,723.

What was found

The Council accepted it had wrongly charged Mr Y for the first six weeks of his care home stay, apologised and amended the bill appropriately. After the first six weeks, the Council was entitled to charge Mr Y for his stay in residential care. The Council carried out a financial assessment and Mr Y was expected to contribute his income minus any small amount for his personal allowance plus other expenses. The Council is not at fault in the way it calculated Mr Y’s contribution or for charging him, once it corrected its initial mistake.

However, Mr Y was in the care home for far too long. The Council blamed the delay on the need for specialist equipment and the delay in sourcing care.

The Council was at fault when it visited Mr Y’s property in late March, for not properly considering Mr Y’s care needs whilst waiting for the adaptions to be completed. There was also fault in the delay assessing Mr Y’s ability to manage the stairs.

The Council has agreed, within one month of the Ombudsman’s final decision, to apologise to Mr Y and reduce the bill for his temporary residential stay by £2800 to remedy the avoidable costs caused by the Council’s delays. It has also agreed to pay Mr Y £500 to acknowledge the significant distress caused by having to stay in the care home longer than necessary.

It has agreed to pay Mr X £150 to acknowledge the frustration and distress he was caused by the Council’s delay in responding to his complaint and in arranging care for Mr Y.

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

https://www.lgo.org.uk/decisions/adult-care-services/assessment-and-care-plan/18-018-480