Plymouth City Council at fault for its handling of care provision and severe delay in the complaint response

Decision date: 10th January 2020

What Happened

Ms B complained on behalf of her father, Mr B.

In December 2017 Mr B was discharged from hospital after suffering a stroke, and received three visits a day from the council’s reablement team.

Three weeks later, in January 2018, the Council assessed his needs. Mr B’s family did not agree with the proposed plan, stating that it did not provide sufficient support. They asked the council to consider a move for Mr B into extra care housing.

A panel considered Mr B’ application in January, but needed more information about his needs.

A different officer assessed Mr B in the middle of February. A care and support plan was drawn up, which included three visits a day. Before that care package was put in place Mr B was admitted to hospital for a few days and when he was discharged, his family requested a period in residential care.

The Council arranged a care place, but after a few days Mr B was asked to leave as he was smoking in his room.

The Council arranged for care at his home but the LGO stated ‘this [offer] was lost as the family were not able to accept it quickly enough.’

Mr B returned home on 10 March and care was not in place until 15 March.

At this time the panel considered Mr B’s application for extra care housing. It was approved and Mr B moved to an extra care place at the end of March.

Ms B complained in January 2018 that the lack of proper support planning meant that an agreement for him to move to extra care housing was delayed. Ms B ended up chasing the Council for a reply and then complained to the LGO. The Council responded to the complaint in January 2019.

The Council accepted a number of faults:

  • Delay in carrying out an assessment of Mr B’s needs. It took three weeks when the target was 48 hours;
  • Delay in completing the assessment and referring it to the extra care panel;
  • Failures in communication and responses by the first social worker;
  • Failure to share the care plan with the family and Mr B;
  • Problems with carrying out the assessment for continuing health care funding;
  • Failure to make a referral for an advocate;
  • Sharing the care plan with the care home before the family; and,
  • Delay in responding to the complaint.

The Council provides its adult social care responsibilities through Livewell South West (LWS) which said it had made changes and improvements to the Discharge to Assess Service, in that people discharged from hospital to their own home are now seen, within 2 hours of discharge (it is not clear from the report whether that meant in their own home, or within 2 hours of being fit for discharge, at the hospital).

LWS said it would pay £500 for the faults but that she “would need to take legal advice on any claim for financial redress as that would not be considered through the complaint process.”

What was found

The LGO ultimately decided that there was fault in the Council’s handling of care provision for Mr B, in its consideration of his suitability for extra care housing, the handling of the respite placement and in its complaint handling.

The LGO found no fault in the care and support Mr B received. There was a delay in the initial assessment; however he had still received support from the reablement team. The LGO stated it ‘could not say the care that was in place over that period fell significantly short of what Mr B required’, and therefore found no fault. The LGSCO did not actually recommend reimbursement of the daughter’s travel costs back and forth because of finding that there was nothing inadequate or inappropriate about the care that WAS provided by the reablement team.

The delay did however have consequences for Mr B’s extra care housing request. The LGO stated the panel rejected his request in January because it was uncertain Mr B’s needs met the requirements for extra care housing. Had there not been a delay in carrying out his initial assessment, all the necessary information should have been before the panel by the February meeting. Mr B would therefore have been able to move a month sooner to extra care housing which was a place more suited to his needs. This month long delay was fault.

The LGO also found fault in the Council delaying implementing care for Mr B when his placement ended. From March 10th-15th he received no support, which was fault.

The LGO also found fault in the council’s significant delay in its complaint response. The Council stated that it took a year to respond because it had a ‘significant backlog’. The LGO asked the Council to prove there is no longer a backlog.

Lastly, the LGO agreed with the faults the Council accepted in its complaint response.

The LGO recommended the Council pay Mr B £500 to reflect the month delay for extra care housing and the five days where he and his family lacked support. It recommended a further £750 to Ms B in recognition of its poor complaint handling – she had had to buy leave from her job to cope with the delay. So this was more than its delegate, LWS, had offered.

Points for the public, families, service users, councils, complaints officers etc

This is one of those reports where we would have liked to see the author calling out breach of the Care Act for what it is.

If one takes the list of issues, one can add to those complaints, the section number that the wrongdoing was a breach of. That means that the council had acted unlawfully, not just with fault.

The LGO isn’t a court, but there is no obvious point or public interest, in our view, in NOT making the public aware of the obligations of any council.

  • Delay in carrying out an assessment of Mr B’s needs. It took three weeks when the target was 48 hours;

There is no time scale in the actual Care Act or the regulations (the Guidance says timely assessments are necessary) for assessment (or finalisation of a care plan) but the law says that it has to be done within a reasonable time, given all relevant considerations.

If a council proactively sets itself a 48 hour target, it is an arguable breach of a legitimate expectation to then fail to meet it and it suggests that the council has insufficient staff for the discharge of its functions, and that is in breach of the mandatory duty in s6 of LASSA 1970.

  • Delay in completing the assessment and referring it to the extra care panel;
  • Failures in communication and responses by the first social worker;
  • Failure to share the care plan with the family and Mr B;

It is the law that the care plan must be provided to the client and to any family member who the client asks it to be given to. Section 25(9) says so!

(9) The local authority must give a copy of a care and support plan to—

(a) the adult for whom it has been prepared,

(b) any carer that the adult has, if the adult asks the authority to do so, and

(c) any other person to whom the adult asks the authority to give a copy.

  • Problems with carrying out the assessment for continuing health care funding;
  • Failure to make a referral for an advocate;

This is a legal duty, if the criteria are met, to appoint an advocate, where the person has no-one else willing and able to support participation informally.

  • Sharing the care plan with the care home before the family; and,
  • Delay in responding to the complaint.

The expectation in the rules, although it is not a mandatory requirement, is no longer than 6 months!

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 of Plymouth City Council’s actions can be found here

https://www.lgo.org.uk/decisions/adult-care-services/assessment-and-care-plan/18-008-907

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