Social Care News and Features

A disabled man was left in unsuitable accommodation for 27 months and suffered other injustices because of council failings, an investigation by the Local Government and Social Care Ombudsman has found.

Though Wirral council had accepted since July 2017 that Mr C, who is severely autistic, has a learning disability and requires full support with daily living, was not in a suitable placement, he did not move to one until October 2019. The watchdog found that the authority did not use its best efforts to secure an alternative placement during this time, including due to staff sickness and resource pressures.

The ombudsman also found that the council had not complied with some of the terms of a July 2017 Court of Protection order, including by not using its best efforts to ensure Mr C received appropriate support from a speech and language therapist and was provided with a mix of activities. The watchdog’s report also listed two occasions where Mr C’s dignity was breached or he was put at risk due to care failings.

The council has agreed to the ombudsman’s recommendations to apologise to Mr C’s family, pay £7,000 to Mr C, as well as £500 to both his mother and sister, and report on the lessons learnt, along with actions taken to improve processes and services as a result.

Unsuitable placement

Mr C, who previously lived in a residential school, moved to provider X, a placement his family did not consider suitable, in 2016.

His mother applied to the Court of Protection (CoP) to challenge the suitability of the placement, which led to an order, in July 2017, in which the council agreed to:

• Place Mr C on the waiting list for provider Y and others in its group, considering him for a place should it become available.
• Use its best efforts to help his mother get a mobility vehicle for him.
• Make efforts to ensure Mr C’s privacy and dignity were maintained by ensuring he was indoors and out of sight of the street when unclothed.
• Use its best efforts to help ensure Mr C received appropriate support from speech and language therapy and other input for his sensory needs, and a mix of activities inside and outside his placement.

An external investigator (EI) – who examined a complaint brought by Mr C’s family against the council before the ombudsman’s investigation – concluded that the council had accepted since the CoP hearing that provider X was unsuitable.

‘Periods of inactivity’ in seeking placement

The EI’s report found the council made 25 approaches to alternative placements from May 2017 to October 2019 – though some were repeats – but there were some periods of inactivity, including due to staff pressures or inactivity.

A vacancy at provider Y arose in October 2017, however, the ombudsman found the council should have been more proactive in ensuring Mr C’s mother was aware of the placement and what was needed to progress it. It was subsequently taken up by someone else.

The ombudsman said that, given Mr C’s very complex needs, it would not have been easy for the council to find him an alternative placement, but this it meant “it would have been best practice for the council to approach as many potential providers, both inside and outside its area, at the earliest opportunity”.

The watchdog added: “It is not possible to say whether a placement for Mr C might have been found sooner had a different approach been taken and had there been no periods of inactivity. However, even if the council could evidence it had consistently made best endeavours to find a suitable placement in the relevant period, the failure to secure such a placement was service failure.”

The ombudsman also found that the council had not complied with some aspects of the CoP order, including by not chasing up a referral for speech and language therapy made in April 2017, and providing no record of how it sought to ensure he was provided with a suitable mix of activities after the CoP order was made.

Breach of dignity

The report also cited a serious breach of Mr C’s dignity in July 2018 when he was taken out into the community with 1:1 support – rather than 2:1, as specified in a risk management plan that said he was at risk of running off.

In a busy area, he ran off and undressed, was seen by members of the public and the police was called. The ombudsman found that he had been in a state or arousal or anxiety that morning, which should have alerted staff to the risks of taking him out into the community. And while the council considered this an “error of judgment”, the watchdog said it was much more serious than this, given there has been no review of his care plan to reduce his support to 1:1.

On another occasion, in April 2019, a carer took Mr X into the toilet with her while she used it, to avoid him and another service user being left with a single other carer, which the ombudsman said should never have happened.

Communication failures

There were also failures in communication with Mr C’s family, including not informing his mother when his social worker changed and a five-month period in which the family received no communication from his social worker at all. The authority also failed to communicate clearly with his mother over provider X’s decision to give him 28 days’ notice to terminate Mr C’s placement.

In response to the ombudsman’s findings, Yvonne Nolan, the chair of Wirral council’s adult social care and public health committee, said: “Wirral council aims to provide the best possible social care to those who require it and it is disappointing when it is found that standards fail to meet that threshold. In line with the ombudsman’s report the council has agreed to put in place changes to ensure services and processes are improved. The council has extended its formal apologies to the family.”