Man spends too long in care home because of councils’ delays
A Warwickshire man, who had suffered a stroke, was prevented from living independently for too long because two councils failed to follow correct procedures, the Local Government and Social Care Ombudsman has found.
Warwickshire County Council made assumptions about the man’s capacity to make decisions about where he wanted to live and about what property would be suitable for him, without carrying out the proper assessments. Nuneaton and Bedworth Borough Council delayed considering his housing application.
The man was in his forties when he had a stroke in December 2012. He was placed in a care home in June 2013 as he required 24 hour support, but he was unhappy as he wanted to live independently.
The county council met with the man in early 2014 to discuss moving from the care home and considered extra care housing to be his best option. However the borough council did not have extra care schemes and its supported housing was generally for people older than 55. The social worker discussed with the man the option of moving to another care home with more access to the community and activities, but it did not have a place available.
The man’s psychologist asked whether a move to his own property was an option, but the social worker said the man lacked mental capacity regarding care needs and accommodation. No formal capacity assessment was carried out to determine this.
The man remained in the care home until March 2015, when he was hospitalised with an infection. He refused to return to the care home when he was ready for discharge the following month, still wanting to live independently. His social worker believed he lacked insight into the kind of support he needed but no formal mental capacity assessment was carried out.
A second social worker became involved and felt the man did have capacity to make decisions. This was backed by the man’s consultant who assessed him as having ‘full capacity’.
He agreed to move to a different care home as a temporary measure in May 2015. In November 2015 the borough council’s extra care housing panel rejected his application for extra care housing as he did not meet the age criteria, his needs could be met in the community and he did not meet its exceptional criterion of a rapidly deteriorating condition.
The man continued to contact the borough council over the following months and bid on different properties, but it was not until December 2016 that he finally gained a tenancy.
The man complained about his treatment by both councils to the Local Government and Social Care Ombudsman.
The Ombudsman investigation found the county council failed to consider properly the man’s ability to make decisions until it made a proper capacity assessment in May 2015. It fundamentally failed to support the man through the care planning process. It delayed considering all the options available. By focusing solely on the belief the man’s best option was extra care housing when none was available in his preferred area, it delayed finding appropriate accommodation for him. The investigation also found the county council missed numerous opportunities to assess the man’s capacity at times when key decisions were made about his care and accommodation.
The Ombudsman found fault with the way the borough council failed to tell the county council about its decision to remove the man from its waiting list in December 2014. It also delayed making his later housing application live: it accepted his application in June 2015 but he was unable to bid on properties till December 2015. The borough council also raised the man’s expectations he might be allocated extra care housing, despite the man never meeting its criteria. It failed to properly consider whether the man may be suitable for sheltered accommodation due to his exceptional circumstances before July 2016.
Both councils failed to take an overview of the man’s needs and to work together to ensure the best possible outcome for him.
Michael King, Local Government and Social Care Ombudsman, said:
“Mental capacity assessments should be carried out to determine whether people are able to make proper decisions about themselves and their care. It is not enough for social workers to deny people the opportunity to make their own life decisions and simply act on their belief that something is in a person’s best interests without making a formal assessment.
“In this case the man made clear his unhappiness at being left in a care home when he wanted to live in the community, and has had the injustice of not knowing whether he could have moved to live independently sooner had both authorities acted appropriately.
“Both authorities have agreed to my recommendations, and I hope that they will fully take on board the learning from this case to ensure others avoid being affected by similar issues in the future.”
The Local Government and Social Care Ombudsman’s role is to remedy injustice and share learning from investigations to improve local public, and adult social care, services.
To remedy the complaint the county council has agreed to apologise to the man and pay him £2,000 to recognise the frustration and distress caused by the delays in carrying out mental capacity assessments and not considering fully all the options available to him. It has also agreed to review its practices to ensure that mental capacity assessments are carried out at the appropriate times and documented properly.
The borough council has agreed to apologise to the man and pay him £300 for the frustration and time and trouble caused by the delays in dealing with his housing application.
Additionally the two councils have agreed to review how they work together to ensure that in future they provide a timely and co-ordinated approach to cases involving social care and housing.
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