Decision Date: 01 November 2019
Mr X had dyslexia, learning difficulties, depression and anxiety. He wears an orthopaedic boot as a result of a broken ankle some years ago.
A social worker carried out a needs assessment in November 2018. Mr X raised numerous concerns, for example:
- He had no motivation to clean but took the rubbish out weekly
- He found cooking difficult and would graze on fast food instead
- He had no difficulty using the toilet, but did not use his shower as he didn’t like washing at home
- He found it difficult to deal with post or correspondence because of his mental health problems and dyslexia
- He said he needed new clothes, but had no spare money. He felt he did not wear the right clothes for the weather.
The assessor decided Mr X was not eligible for adult social care. Although it was noted he did struggle to look after himself at times because of low motivation, he generally managed to maintain his home, personal care, nutritional intake and safety to a reasonable standard.
Mr X was told he could ask for support with correspondence from the manager of the housing scheme and he already used an advocacy service to help with doctors’ appointments. He was told he should continue to see his GP about his mental health issues and that money advice services can help him to manage his money. He was given details of organisations to help him socialise and learn skills.
Mr X told the assessor he disagreed with the decision and he did not want to use the services suggested. His assessment was amended to reflect his views, but the opinion of the assessor did not change.
Mr X’s advocate complained to the Council on Mr X’s behalf on 22 January 2019.
The Council responded on 6 February 2019. It said the assessor had told Mr X how he could get help and support for his needs and he could contact the Council for another assessment if his needs changed.
Mr X remained unhappy with the Council’s response.
What was found
The LGO concluded that the Council was not at fault. The Council told a suitably qualified officer to carry out the assessment and it covered the full range of outcomes set out in the Care Act. Mr X, with the support of his advocate, gave his views about each relevant outcome and the assessor then came to a professional judgement on whether Mr X could meet them. There was no fault in this process and Mr X was fully involved in it. Mr X may have disagreed with the decision, but this was a conclusion the assessor was entitled to reach.
Points for the public, services users, family members and councils
The definition of ‘unable to achieve’ across any of the domains of daily living, in the Care Act eligibility regulations, is not whether someone can manage the task, but whether they can manage it without assistance (and without it taking significantly longer than for a person without the difficulty, amongst other things).
It seems to us that if the council’s whole approach during assessment focuses on signposting applicants for services to services that involve assistance, it is self-evident that the assessor thinks that the person needs assistance.
In that situation, one ought to go on to consider the impact to their well-being of not being able to achieve, as defined.
Significant impact would make the person eligible, albeit not in need of a care plan that involved funding.
There is a school of thought that is not wrong, on its own, however, that holds that a person who will not try things that are suggested, or at least consider them as potentially solving some of the impact, or who can offer only unconvincing reasons for the suggestions not being suitable, is a person for whom the impact of the difficulty, is simply not all that significant. Hence a person of that perspective might legitimately be assessed as not in fact eligible.
That wasn’t the line taken explicitly by the assessor in this case, however. It seems to be one that the LGO was persuaded to infer had been taken, so as not to stray onto the sphere of the assessor’s expertise.
Or it might be that that the LGO investigator saw a distinction between the kind of assistance that an individual provides, whether paid or informally, and the kind of obligatory or voluntary but still human assistance that another agency or another entity can and will reliably provide.
We understand that that sort of approach can easily result from Strengths Based Assessment, but we are not sure that there is any justification for that specific approach to eligibility, if the individual is still presenting as in need or might struggle to take up suggestions because of their condition.
We think it telling that the report records as follows:
Mr X had a further assessment by telephone with a new assessor on 31 May 2019. The outcome was that Mr X does have eligible needs, which will be met with community support at home. He was referred for further assessment.
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The full Local Government Ombudsman report of Brighton and Hove City Council’s actions can be found here