Ombudsman slams Milton Keynes Council over 'injustice' of care failings

Council officers involved with the care of the man who has Huntingdon’s Disease had consistently – and wrongly – believed that they had a policy that they would not pay for help for Mr Y at home.

They had also failed to involve experts in deciding what care they needed, until June 2018, after a review. After this he received a much enhanced package of care. His care is now being handled by the NHS.

Over the course of more than one year while his care had been cut, he lost weight. This caused distress to his family as they watched his care needs failing to be met, it was found.

The council has apologised for the errors and says it has changed the way it looks at decisions to provide the help that people need.

The Local Government and Social Care Ombudsman has ruled that Milton Keynes Council had been acting “not in accordance with the Care Act 2014” and that they had caused “significant injustice” to Mr Y, who has the progressive neurological condition.

The names of Mr Y and a Mrs X who made repeated complaints to the council, and who was supported by an MP, have been withheld by the Ombudsman. A question from Mrs X to the council’s monitoring officers uncovered the fact that the council’s own officers had been making the wrong decisions.

The Ombudsman, whose decision was announced on Thursday said: “I consider the council had communicated to officers an instruction or policy that the council would not meet shopping and domestic eligible needs. This is fault.

“The council cannot have a blanket policy to not fund identified eligible needs if those needs cannot be met in an alternative way. Any such decision must be based on the service user’s eligible needs and the care and support planning process to determine how their eligible needs can be met.”

The council had cut the care package in April 2017, and confirmed it in January 2018, but effectively reversed it in June 2018. The Ombudsman said that this had in effect been an admission of fault. “The council did not provide an adequate care package to meet Mr Y’s needs,” the Ombudsman decided.

This was “detrimental to Mr Y’s well-being and could have contributed to his weight loss”, the ruling continued.

It also caused “significant injustice” to Mrs X, and distress to their children as “they witnessed Mr Y losing weight, did not have sufficient support when visiting him and missed out on activities with Mr Y.

“I consider it is likely the inadequate care package caused some distress to the children as they witnessed Mr Y’s needs not being met.”

The council should remedy the injustice to Mrs X, Mr Y and their family and to Mr Y’s PA, the Ombudsman ruled.

The council agreed to apologise and pay £3,000 to Mr Y, and apologise and pay £1,000 to Mrs X, reimburse Mrs X for paying for Mr Y’s personal assistant, and pay £200 to the PA for doing Mr Y’s shopping and home tasks between April 2017 and June 2018.

The council agreed to review procedures for carrying out care needs assessment, and its policies on meeting eligible needs to make sure it is not instructing officers that it will no longer pay for shopping, domestic and meal preparation tasks if those needs cannot be met in an alternative way.

It’s also got to ensure that no-one else is lacking support, and pay them if their needs were not met. It’s agreed to take action over six months and to keep the Ombudsman informed of what it’s doing.

A council spokesperson said: “We have apologised for this mistake and offered compensation. We are sorry to have got it wrong.

“We do help people with eligible needs to shop, clean, prepare meals and similar tasks. We’ve since introduced a different working model with more scrutiny and ongoing reviews of how our clients are supported to make sure everyone gets the right domestic help.”

Timeline:

> In 2016 the council assessed Mr Y as requiring a 35 hour-a-week care package and support to be provided by his personal assistant and a care agency. For a number of years he had been paid to be able to employ a PA to help him maintain his nutrition and a “habitable home environment.” He needs help to be able to use a microwave to cook food.

> In April 2017 a social work assistant reviewed Mr Y’s care and support needs. Despite finding that he was unable to get food and drink on bad days, she advised that benefits would be cut as the council did not fund shopping, domestic, and making meals. A council officer recommended cutting his care package from 35 hours to 23.5 hours each week, including support for seeing his children.

> In August 2017 the health service became involved to determined if he was eligible for funding from the NHS, and decided that he was not eligible. Mrs X told visiting official that Mr Y could not afford to pay for shopping and cleaning services and he needed prompting to eat.

> A review of Mr Y’s care and support needs was carried out in January 2018. But they found that he would have to pay for cleaning and keeping his house free of spills and other hazards.

> Also in February 2018, Mr Y had a Speech and Language Therapy (SALT) assessment. The therapist concluded that Mr Y was at risk of choking while eating due to his illness and this could be minimised with supervision.

> Later on in February Mrs X told the council that Mr Y suffered regular falls and choking on food. Council officers said they wouldn’t take any action until the SALT assessment came through.

> In March 2018, the council received and discussed the SALT assessment which recommended time for supervision of Mr Y’s eating. The SALT therapist was asked to further assess whether Mr Y understood the risks of choking.

> In April 2018 a council officer recommended increasing Mr Y’s care package to 26 hours to give carers time to supervise Mr Y eating his main meal. Another meeting was held and his care package was increased to 36 hours per week because the council believed Mr Y’s needs were increasing.

> They increased his care package to 52.5 hours per week after carrying out a further assessment of Mr Y’s needs after consulting medical professionals, including his dietician, and specialists in Huntingdon’s disease.

> The health service also had a look at Mr Y’s needs and found him eligible for NHS funding. It took responsibility for Mr Y’s care.