The Ombudsman's final decision
Summary: Ms X complained about the Council’s decision to not recognise her role as a carer, and award her a carer’s personal budget after completing her carer’s assessment. Ms X said this has caused her stress, uncertainty, and has had a financial impact due to the loss of a personal budget. We found no fault with how the Council reached its decision.
The complaint
Ms X complains about the Council’s decision to not recognise her role as a carer, and award her a carer’s personal budget after completing her carer’s assessment. Ms X said this has caused her stress, uncertainty and has had a financial impact due to the loss of a personal budget.
The Ombudsman’s role and powers
We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended) We cannot question whether an organisation’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended) If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)
How I considered this complaint
I spoke to Ms X, and I reviewed documents provided by the Council.
Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.
What I found
Carer’s assessment The Care Act 2014 says where someone provides or intends to provide care for another adult, and it appears they may have needs for support, councils must carry out a carer’s assessment.
Carers’ assessments must seek to establish not only the carer’s needs for support, but also the sustainability of the caring role itself, which includes both the practical and emotional support the carer provides to the adult.
The carer’s assessment must also consider the outcomes that the carer wants to achieve in their daily life, their activities beyond their caring responsibilities, and the impact of caring upon those activities (Care and Support Statutory Guidance 2014).
Eligibility criteria for carers The national eligibility criteria set a minimum threshold for adult care and support needs and carer support needs which local authorities must meet. All local authorities must comply with this national threshold.
Councils must consider whether the carer’s need for support arises because they are providing care to an adult. Carers can be eligible for support whether or not the adult they care for has eligible needs.
In considering whether a carer has eligible needs, local authorities must consider whether: the needs arise as a consequence of providing necessary care for an adult; the effect of the carer’s needs is that any of the circumstances specified in the The Care and Support (Eligibility Criteria) Regulations 2015 apply to the carer; and as a consequence of that fact there is, or there is likely to be, a significant impact on the carer’s wellbeing.
A carer’s needs are only eligible where they meet all three of these conditions (Care and Support Statutory Guidance 2014) Necessary care If the carer is providing care and support for needs which the adult is capable of meeting themselves, the carer may not be providing “necessary care”.
In such cases, local authorities should provide information and advice to the adult and carer about how the adult can use their own strengths or services available in the community to meet their needs (Care and Support Statutory Guidance 2014) Eligibility Criteria Regulations Councils must consider whether the carer’s physical or mental health is, or is at risk of, deteriorating, or whether the carer is unable to achieve any of the following outcomes: carrying out any caring responsibilities the carer has for a child; providing care to other persons for whom the carer provides care; maintaining a habitable home environment in the carer’s home (whether or not this is also the home of the adult needing care); managing and maintaining nutrition; developing and maintaining family or other personal relationships; engaging in work, training, education or volunteering; making use of necessary facilities or services in the local community, including recreational facilities or services; and engaging in recreational activities.
Councils must also regard a carer as unable to achieve an outcome if they are: unable to achieve it without assistance; able to achieve it without assistance but doing so causes the carer significant pain, distress or anxiety; or are able to achieve it without assistance but doing so endangers or is likely to endanger the health or safety of the carer, or of others (Care and Support Statutory Guidance 2014).
Carer’s personal budgets Everyone whose needs are met by a council must receive a personal budget as part of their support plan. The carer’s personal budget must be an amount that enables the carer to meet their needs to continue to fulfil their caring role.
It must also consider what the carer wishes to achieve in their day-to-day life. Part of the planning process should be to agree how the carer will use the personal budget to meet their needs (Care and Support Statutory Guidance 2014).
Council’s complaint policy The Council has information on its complaint policy on its website.
The Council will acknowledge a complaint within three working days and provide a response within 10 to 20 working days, although sometimes this may take longer.
If someone remains unhappy with the response, they have an opportunity to tell the Council what else might put things right and the Council will consider this.
If after this, someone remains unhappy, they can contact the Ombudsman.
Principles of good administrative practice In 2018 the Ombudsman published its ‘Principles of good administrative practice’ guidance for local authorities. Principles include an expectation local authorities will act on: ‘Being open and accountable’ by stating the criteria for decision making and giving reasons for decisions.
‘Acting fairly and proportionately’ by explaining clearly the rationale for decisions.
What happened Ms X had a carer’s assessment each year from 2015 to 2020, completed by the Council for care she provided to her mother, Mrs Y.
Each year following the assessments, the Council awarded Ms X a carer’s personal budget to help her in achieving her outcomes and improve her well-being as a carer.
Request for a carer’s assessment review In May 2021 Ms X telephoned the Council to ask for a review of her carer’s assessment as she found her caring role had become more intense.
Ms X also anticipated an increase in Mrs Y’s care needs after her return home from a rehabilitation centre where she was currently staying.
The Council contacted Ms X the same week and advised her to wait for her carer’s assessment due in June. Mrs Y would then be home from the rehabilitation centre, and it would be clear how much Ms X’s caring role had changed. Ms X agreed with this suggestion.
Mrs Y returned home in June and Ms X completed a carer’s self-assessment on the Councils’ online portal. She said the care she provided to Mrs Y included, among other things, emotional support, arranging house maintenance, dealing with paperwork, housework and personal care, including washing and assisting to the toilet.
The carer’s assessment Ms X called the Council in July to seek an update on her carer’s assessment. A member of the assessment team called her back to conduct the assessment over the telephone.
Ms X explained she found her caring role stressful, and it affected her mental well-being. She had little time to herself, and the role was dominating her decisions in daily life.
Ms X asked the Council to consider a carer’s personal budget of £400 towards the cost of massages and to provide a break from her caring role.
Mrs Y was now home, receiving support from a joint rehabilitation service provided by the Council, comprised of staff from both the Council and the NHS.
An internal email provided by the Council shows a review was undertaken with Mrs Y after her return home, establishing she was able to meet her own care needs. The email is dated 14 July and appears to have been sent on the day of the review.
Council records show it contacted Ms X in July to discuss her carer’s assessment and her request for a carer’s personal budget.
Ms X did not answer but did return the call and leave a voicemail. She said she was unsure why someone from a different service, which does not know her, was involved in her assessment, and past Council workers, who knew her well, should be dealing with it.
Council records said Ms X made it clear she did not want to discuss her carer’s assessment and it arranged to send a letter advising Ms X of the outcome.
Outcome of the assessment The Council sent Ms X a letter on 6 August. It explained the relevant department tried contacting her about the assessment, however communication had not been productive, and a meaningful conversation about the assessment could not take place.
It explained the national eligibility criteria, used to work out who it should offer support to.
It said based on information from Ms X’s assessment and from information provided by its rehabilitation service about Mrs Y’s level of ability, the care Ms X provided did not meet the Council’s criteria for “necessary care”. It did not further explain why this criteria was not met.
It said as Ms X was not eligible for support she was no longer entitled to a carer’s personal budget and directed her to its website for more information on support available to her.
Complaint Ms X called the Council on 7 August asking for a call back to discuss the letter and the outcome of her carer’s assessment. Council records show details of the call were passed to a Council officer.
Shortly after, Ms X called the rehabilitation service and asked to speak to the manager about the letter. She advised she would be taking the matter further and then ended the call.
Council records show Ms X called the Council again on 14 August asking for an appointment with the Head of Department. The staff member that took the call sent an email to the Council’s complaint department to advise.
Ms X called the Council on 18 August querying a call she had missed and asking again to speak with the Head of Department. Council records show the call she missed was not related to her complaint.
On 25 August, the Council wrote to Ms X. It said it had already provided a response to her complaint, about her carer’s assessment, in writing on 6 August. This said Mrs Y’s current level of care needs and the care that Ms X provided to her did not meet Adult Social Care’s criteria for providing necessary care. In turn, this meant she was not currently eligible for support from Adult Social Care and, no longer entitled to a carer’s personal budget.
It also noted Ms X had asked to speak with the Head of Department but did not provide a response to this and directed Ms X to the Ombudsman if she remained unhappy.
Ms X then contacted a local MP, who contacted the Council on her behalf.
The Council responded to the MP in November. It explained, based on information about Mrs Y’s level of ability and information provided by Ms X in her carer’s assessment, the care Ms X provided to Mrs Y did not meet the Council’s eligibility criteria for providing necessary care. It explained she was not eligible for support, nor eligible for a personal budget.
Ms X received a copy of the Council’s response and emailed her MP again. She expressed confusion at the Council not recognising her as a carer and asked for clarification on what rehabilitation services had said about Mrs Y to inform the carer’s assessment. Her request was sent on to the Council.
The Council responded to the MP’s further contact in December. It said it had reviewed its records and suggested it contact Mrs Y again to offer her a Care Act assessment. It said it would provide a starting point to understand any eligible care and support needs for Mrs Y.
It said it could then explore how Ms X may be supporting Mrs Y with any necessary care needs and planned to offer Mrs Y an assessment in January 2022.
It also said that while it was not an immediate change of its view, it did wish to gain a further understanding of Mrs Y’s needs and Ms X role in supporting her.
The Council confirmed this was its final complaint response.
Ms X remained unhappy and brought her complaint to the Ombudsman.
When I spoke to Ms X, she explained she had received a carer’s personal budget for the last seven years. She considers herself as the chief carer of Mrs Y and should be entitled to a carer’s personal budget.
Ms X says her previous assessments were completed at Mrs Y’s home, with Council officers seeing both Mrs Y and Ms X at the same time, and they knew the care Ms X provided for her mother.
She said when the rehabilitation service became involved it all changed, as the Council used information from the service, which was inaccurate, to decide about the assessment and carer’s personal budget.
Council’s response to our enquiries The Council said when it assessed Ms X for a carer’s personal budget in 2021 Mrs Y’s care and support needs were met by its rehabilitation service.
The review undertaken with Mrs Y in July showed she could meet her own care needs.
The Council confirmed it considered Mrs Y’s review in its assessment of the appropriateness of a carer’s budget for Ms X.
It said the rehabilitation service did not observe Ms X provide any of the physical support to Mrs Y she mentioned in her carer’s self-assessment.
The Council said it tried to contact Mrs Y to offer her a Care Act assessment on three occasions, however the calls were answered by Ms X and no assessment was arranged. On the last call Ms X informed the Council Mrs Y was unwell.
The Council intend to contact Mrs Y again to offer her an assessment when she is well.
Analysis I cannot say the Council’s decision on Ms X’s carer’s assessment was right or wrong. My role is to consider whether the Council followed a proper decision making process; that is whether it took account of relevant information and decided in line with law and policy. It is not my role to gather further information and reach my own decision on what the outcome of the assessment should have been.
The Council completed a carer’s assessment for Ms X in 2021 in line with the Care Act 2014. It made its assessment, that Ms X did not provide necessary care to Mrs Y, with information provided by staff that directly supported Mrs Y at the time. While I cannot disclose details for confidentiality reasons, the Council provided a contemporaneous written record of its review of Mrs Y’s support in July. There is nothing to suggest this information relied on was inaccurate. As it appears the Council took into account relevant information and decided in line with the law, I find no fault in its decision making process.
The Council’s decision letter of 6 August lacked full and clear reasons for its decision and did not explain why the care Ms X provided was not considered “necessary care”. However, the Council provided further details in its letter of 25 August. Bearing this in mind I do not find fault.
Ms X was unhappy with the decision and wanted to complain. She contacted the Council several times, and while the conversations did not produce meaningful discussion, the Council was aware Ms X was unhappy with its decision on her carer’s assessment.
The Council wrote to Ms X on 25 August. It said her complaint had been answered on 6 August and directed her to the Ombudsman. The letter the Council sent on 6 August provided Ms X with the outcome of her assessment, not a complaint response. However, I am satisfied the Council further addressed the complaint in its letter of 25 August and then repeated this response in later correspondence. Bearing this in mind, I consider the shortfall in the initial response does not reach our threshold for a finding of fault.
Final decision
I have found no fault in the actions of the Council. I have now completed my investigation.
Investigator's decision on behalf of the Ombudsman