Decision Date: 24Th September 2020
Ms C complained on behalf of her client, Ms B.
Ms B was deafblind within the meaning of the Assessment Regulations 2014.
Ms B had a care needs assessment in 2018. This assessment was completed by an assessor who was qualified to level 6 in deafblind assessments. The assessor said they had been advised not to specify hours of care deemed appropriate, as this gave rise to raised expectations, but she provided a guideline and the woman received a care plan that provided for 49 hours of support a week.
In 2019 Ms B was allocated a different social worker to complete a review (although the report calls it a reassessment. It’s not clear from the report whether that process was really just a review, (a look at how the care plan was working) or a reassessment because a review had considered that the care plan needed to change, in which case s27 requires a re-assessment of a proportionate nature.
This time around, the officer was qualified to level 3 in deafblind assessment.
Ms B complained to the Council that a higher qualified assessor was needed, but the Council disagreed.
On the 11th September 2019 a judge (in unrelated proceedings) ordered that any social care assessment for Ms B should be carried out by an assessor qualified to at least level 5.
The ‘re-assessment’ was paused, pending correspondence with the court, and finding a level 5 assessor.
In November 2019 a new social worker was allocated to Ms B who was not qualified to level 5 or above. The records stated that the need for a level 5 qualified assessor was being actioned, but noted: “There is no immediate requirement for an unscheduled reassessment as I’ve not been made aware that her Care Act needs have changed, but she is due a formal review. She does have health needs however, and we need to establish those in order to apply for health funding.”
Ms B received an email in January 2020 from the Council stating that health funding had been secured and asking whether Ms B required any further support from adult social care at this time. The Council did not receive a reply.
The Council said that having neither a reply from Ms B nor a referral for reassessment it could not arrange an unscheduled review, so the next reassessment would be the scheduled 2020 annual review.
The Council also said the court order did not specify that the Council had to complete a reassessment, only that any assessment should be completed by a level 5 qualified assessor.
What was found
The LGO stated that the Council was not at fault for using a level 3 qualified assessor to undertake the assessment it began, before the court order was made. The statutory guidance to the Care Act 2014 refers to assessors for the deafblind being qualified to level 3, or above where needs are complex, however the statutory guidance does not define complex needs. The LGO highlighted that this means that the statute allows for a level of professional judgement as to what qualifies as ‘complex’.
However the Council was still at fault, because the 2019 ‘re-assessment’ process was not ever completed. An appropriately qualified assessor had still not been allocated, therefore the whole Care Act process was incomplete, resulting in no updated care plan. This was fault.
The LGO recommended that the Council apologise, pay her £150 and begin the process of engaging a level 5 or above deafblind assessor in order to complete the reassessment.
Points for the public
To our minds, this is an unsatisfactory complaint report.
There are two legal questions here, not differentiated.
The first is whether the 2019 process was a review or a re-assessment after a review. In the latter case, it would have needed to be completed by a properly qualified assessor even if no change of the plan were to be required. If it was just a review, then it was wrong of the investigator to call it a re-assessment; and the guidance appertains to assessments, and not to reviews, which can be done by a wider range of people, without specific training.
The second question was whether a re-assessment was actually needed (regardless of whether the beginning of the process had been a review or a re-assessment AFTER a review) in order to apply for health funding.
The investigator ought to have been clear about whether the social worker was relying on previously documented ‘health needs’ from 2018 for the CHC full funding (or part funding from the CCG) application (or checklist, if one was used), or whether there was an acknowledgement by the council by then, of a deterioration or intensifying of need which was thought to take meeting her needs over the limits of social care services into the concept of ‘primary health need’ or services that could not be said to be social care services. That thinking would have required a re-assessment.
We think it is typical of the Covid era that the Family Court thought it could tell a council what to do by way of decision-making about the level of training above the minimum for a particular person who is owed a duty by the council. It is in the council’s discretion, as long as level 3 staff are available – complexity could be indicated in any number of ways.
But regarding training and qualifications generally for the assessors of this client group, the definition of deafblind matters, for those who might come within it. It is the ONLY condition specifically referred to in the Assessment Regulations as compelling an assessor with specific qualifications related to that condition. It’s not the NHS definition on its site here, NHS stance on deafblindness but a regulations-based definition – see reg 6(3) below:
Requirement for specialist expertise – deafblind individuals
6.—(1) An assessment which relates to an individual who is deafblind must be carried out by a person who has specific training and expertise relating to individuals who are deafblind.
(2) A local authority must facilitate the carrying out of the assessment by providing any person carrying out such an assessment with any relevant information which it may have—
(a) about the individual whose needs are being assessed; and
(b) in the case of—
(i) a carer’s assessment, about the adult needing care;
(ii) a child’s carer’s assessment, about the child needing care;
(iii) a young carer’s assessment, about the adult needing care.
(3) In this regulation, an individual is “deafblind” if the individual has combined sight and hearing impairment which causes difficulties with communication, access to information and mobility.
Specific training is referred to in the Guidance as follows:
6.92….This specialist assessment must be carried out by an assessor or team that has training of at least QCF or OCN level 3, or above where the person has higher or more complex needs.
6.93 Training and expertise should in particular include; communication, one-to-one human contact, social interaction and emotional wellbeing, support with mobility, assistive technology and rehabilitation. The type and degree of specialism required should be judged on a case by case basis, according to the extent of the person’s condition and their communication needs. Local authorities should also recognise that deafblindness is a dual sensory condition which requires a knowledge and understanding of the 2 respective conditions in unison, which cannot be replicated by taking an individual approach to both senses.
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The full Local Government Ombudsman report of Sefton Metropolitan Borough Council’s actions can be found here