Summary: Ms X complained about the delays with her occupational therapy assessment and for the time the Council said it would take to complete the adaptations to her property. There was no significant excessive delay for the overall adaptations works to be completed. However, there is fault by the Council with delays processing Ms X’s occupational therapy assessment referral and this caused uncertainty, distress, and frustration for her. The Council has agreed to a revised financial payment to remedy the injustice caused.

The complaint

1. Ms X complains about the Council’s delays with her occupational therapy assessment and complained the Council said it would take a further three to six months to adapt her property for a walk-in shower and stairlift. She said the delays and poor service caused her significant pain, distress and frustration as she was struggling in her home.

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The Ombudsman’s role and powers

2. 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)
3. 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)

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How I considered this complaint

4. I discussed the complaint with Ms X and considered her views.
5. I made enquiries of the Council and considered its written responses and information it provided.
6. Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Administrative background and relevant guidance

Disabled Facilities Grants

7. Disabled Facilities Grants (DFGs) are capital grants that are available to disabled people of all ages and in all housing tenures (i.e. whether renting privately, from a social landlord or council, or owner-occupiers) to contribute to the cost of adaptations to enable eligible disabled people to continue living safely and independently at home.
8. Before approving a grant, a council must be satisfied the work is necessary and appropriate to meet the disabled person’s needs and it is also reasonable and practicable to carry out the works.
9. In this case, the Council’s Occupational Therapy (OT) service conducts assessments for individuals to assess their need for any disabled adaptations.
10. In March 2022 the government issued non-statutory guidance “Disabled facilities Grant (DFG) Delivery: Guidance for local authorities in England”. This identifies five key stages to delivering home adaptations:
• Stage One: First contact with the service. Councils should ensure the public has access to information and advice about the DFG process.
• Stage Two: First contact to assessment and identification of the relevant works through an OT assessment.
• Stage Three: Identification of the relevant works to submission of the formal grant application.
• Stage Four: Grant application to grant decision.
• Stage Five: Approval of grant to completion of works. The works are arranged and carried out and the necessary quality checks made.
11. The guidance says a council should decide a grant application as soon as reasonably practicable. In addition, the timescales for moving through the stages will depend on the urgency and complexity of the works required. But the guidance gives the following working day timescales for urgent and complex adaptations as:
• Stage One (20 days), Stage Two (45 days), Stage Three (5 days), Stage Four (60 days). Total: 130 days.

Background

12. Ms X lives in a Council owned property. She has asthma, several health conditions, and mobility issues. She lives with her adult children and she said she had relied on them to help bathe her. She said she went through significant pain and distress, impacting on her mentally and physically, whilst waiting to get support from the Council to adapt her home.
13. She said she had contacted her MP and Mayor about the matter, and she also had the support of a representative from a charity trust who had written to the Council on her behalf.

What happened

14. The Council’s records show the Council’s Occupational Therapy (OT) service received a referral from Ms X’s GP in July 2022. It responded it only accepted referrals from health care professionals through an online form. Ms X’s GP sent a completed form a few weeks later.
15. Ms X said she received a phone call from the service who explained there was a waiting period for OT allocation of three to four months.
16. The Council records show in September 2022, Ms X’s OT referral was accepted.
17. In October, after separate phone conversations with Ms X and her representative with complaints about delays, the Council prioritised allocating her case to an OT as she reported high levels of pain. Ms X also said she had tried to call the Council’s OT services a number of times but could not get an answer after waiting for hours.
18. Two days later, an OT visited Ms X at her home and completed an assessment. He recommended a major adaptation to install a stairlift, remove a bath, and install a wet floor shower facility. A week later, the Council approved the adaptations.
19. In mid-October, the Council sent Ms X’s representative its complaint response. It said it had seen a large increase in referral numbers to its OT service. It said it had made good progress to recruit staff and it was working on reducing the waiting times. It apologised for the wait and also for Ms X’s frustration with her phone calls. It said at times of high volumes of calls or staff sickness, standards may fall short of what was expected. It upheld her complaint.
20. The Council said the works had now been approved and it was advised from its Adaptations Team it would usually take between three to six months for adaptations to be carried out.
21. In November, Ms X complained to us. She was dissatisfied with the further proposed delays in getting the work completed, on top of the delays she had already experienced to get an OT assessment. She said she was also unhappy as the representative from the stairlift company had missed an appointment to visit her home and no-one had contacted her to rearrange it.
22. At the beginning of December, an asbestos survey was completed, and the Council’s Adaptation team approved the works to proceed. At the end of the month, the stairlift company provided a quote to the Council.
23. By the end of January 2023, the stairlift had been installed and the wet floor shower completed.

The Council’s response to my enquiries

24. The Council provided me with its complaint response to Ms X’s representative from October 2022. It said it could not locate any other correspondence with Ms X or anyone else on her behalf.
25. It acknowledged Ms X’s frustration with her unanswered phone calls and had apologised to her. It reported there had been significant improvements with response times in the call centre.
26. It accepted there were delays with processing Ms X’s referral as it needed additional information. Some of this was because it could not make contact with Ms X on the telephone number provided. It said there was difficulty in tracking the progress of referrals due to the system it used at the time, especially where follow up screening was needed. The Council said it had moved to a new system and all referrals are now prioritised daily, with urgent cases being assessed within one to two days.
27. The Council also accepted there was a delay in progressing the approval of the works due to the availability of contractors and backlogs. It acknowledged the stairlift company representative had been slow to respond to the case and had not turned up to an appointment due to Covid-19.
28. It said it had taken action to address the OT shortage and its service was now fully staffed following an intensive recruitment drive.

Analysis

29. Ms X said to me her representative had written to the Council a few times and received unsatisfactory responses. In response to my draft decision, the Council provided an email from Ms X’s representative. She said she had written to the Council once when she made the complaint on Ms X’s behalf. I have not seen further evidence to support Ms X’s concerns about this aspect of the Council’s communication. I do not find fault.
30. Ms X struggled with phoning the Council’s OT service to which the Council has already apologised for. I consider this an appropriate remedy to this part of the complaint.
31. It took nearly 70 days for Stage One (first contact to assessment and identification of the relevant works) and nearly 40 days for Stage Three (grant application to grant approval). These are notably outside of the guidance timescales of 20 days for the former and 5 days for the latter. However, I note for Stage Two (submission of grant application) and Stage Four (approval of grant to completion of works); these were completed well within the timescales. Overall, the whole process took 147 days. I am not satisfied the Council have good reasons for not meeting the guidance timescales. But whilst there is fault with some of the delays, in my view, this is not excessively outside of the 130 total day target.
32. The Council acknowledged it took around seven months from the point of referral to the works being completed, and there were delays at some stages within the process. It offered £200 to reflect this with a further apology.
33. The Council said it initially gave Ms X standard priority based on the information given by her GP and there were issues with trying to make contact for further screening. It said her it reprioritised her as urgent after she provided additional information highlighting her pain level and risk of falls in October. I’ve considered this but note the Council also accepted it delayed with processing the referral and tracking the process because of its system. This leads me to conclude Ms X could have been prioritised earlier and she waited longer for an OT assessment than she should have. This is fault.
34. I cannot say if it were not for this, Ms X would have had her adaptations done sooner. But this uncertainty for her is an injustice, and she experienced significant distress with waiting for support because of the pain she was suffering. For this reason, I consider £250 is a more appropriate remedy to acknowledge this, instead of £200.
35. I recognise the Council has identified learning from this case and it has said it has taken action to reduce the waiting times for OT assessments in general. I would expect the Council to monitor this. It has also said it has a new system in place where referrals are prioritised daily, which I welcome.

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Agreed action

36. To reflect the injustice set out above, the Council has agreed to, within one month of the final decision:
• Send a written apology to Ms X for the distress, uncertainty, frustration caused to her because of the delays and pay her £250 to reflect this.
37. The Council should provide us with evidence it has complied with the above actions.

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Final decision

38. I found fault with the Council which caused injustice to Ms X. The Council has agreed with my recommendations to remedy this, and I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman