When the facts change, I change my mind. A timely PSOW Report.
A recent Public Services Ombudsman for Wales (PSOW) report[1] concerned a family with two disabled sons. In March 2023 their mother approached the Council seeking support and the subsequent social care assessment noted that the family was “desperate for support”: that the parents were unable to work as they were full-time carers for their sons, both of whom were unable to tolerate social settings.
The mother suggested that their sons might benefit from having support to attend a farm that specialised in supporting autistic children. The Council produced care plans for the sons which recorded that “without support there is every chance of a breakdown”. These provided for 6 hours of direct payments each week to enable the sons to access the local community as a form of respite.
The family hoped to be able to employ a personal assistant (PA) to provide this support but the one they had in mind was found to be no longer available. The Social Worker advised his manager that “this is a family in dire need of support and due to the location they live are really going to struggle to get a personal assistant”.
The mother asked if she could take on the PA role, but the Council considered this to be inappropriate, as it would not allow her the respite she needed from her caring responsibilities.
In July the Social Worker commenced parent carers’ assessments (ie after the sons’ care plans had been finalised). Although by then, the PA position had been advertised (and companies from outside the area approached) no one had been appointed. The mother again asked about becoming the PA – as if she took on the role “she would be able to apply for benefits, which would assist the family who were struggling financially”. The Social Worker supported this request but it was refused as it did “not meet the needs for a break within the care and support plan”. The Social Worker recorded “I have explored all options in regard to supporting the family… but there are no suitable options”.
The family, being dissatisfied with the outcome of their complaint to the Council referred the matter to the Ombudsman. In this, the mother explained that the decision not to allow her to become her sons PA was based on a care plan she had neither seen nor agreed to. She said that there had been a lot of discussions regarding her sons’ support needs but that these did not translate into changes in their care plans: that in consequence the family were left without appropriate support for 18 months.
The ombudsman’s sought advice from a specialist adviser, and agreed with her findings / conclusions, which included:
- That she was unable to identify any evidence that revised care plans had been shared with the mother, nor any records of discussions about these plans including any agreements or disagreements about them or signed approval of amendments. In her opinion care plans and any revisions to these plans should be routinely shared with families, records should be kept showing when plans have been discussed, when copies have been issued, any agreements or disagreements and reasons why signatures are absent.
- That the Act requires that care plans should provide support that is realistic, deliverable and capable of meeting assessed needs. That while the care plans identified many of the sons’ needs appropriately, they did not sufficiently address the barriers to meeting these. These included the rural location the family lived in, travel difficulties, recruitment of PAs and inability to access funded services.
- That support plans for rural families should include explicit consideration of transport needs, travel time, workforce availability and geographical barriers. That if it becomes apparent that the planned support cannot be realistically accessed, plans should be amended and alternative arrangements considered: that once the difficulties in recruitment became apparent, consideration should have been given as to whether the care plan required amendment.
- That the Council’s initial decision to refuse the mother’s request to take on the PA role was not unreasonable. However, the exceptional pressure on the family including financial hardship, risk of housing instability and the mother’s inability to access employment because of her caring responsibilities – meant that the Council should have adopted a broader consideration of well-being outcomes and the possibility that alternative arrangements were required.
- That when decisions regarding relatives acting as PAs are made this should include documented balancing of all well-being considerations. These should include respite outcomes, financial well-being, family stability, impact on employment and practical availability of alternative support.
- That, while not legally required, in order to comply with the principles of the Act, the mother should have been informed that the Social Worker was a trainee.
The Ombudsman noted, in addition that:
- While some of the circumstances of the case were unique, “issues that would face many rural families such as transport needs, travel time, workforce availability and geographical barriers were not considered. This is particularly concerning given the proportion of the local authority area that is rural”.
- When it became apparent that that the care plan was undeliverable, it should have been reviewed with a view to agreeing support that could be provided.
- The Council’s reasoning for not appointing the mother to the role of PA was that it would not have met the outcomes of the care plan. “Whilst this is a decision the Council is entitled to make, it was based on [plans] that had been drawn up without appropriate input from [the mother]. They had also not been amended when it became apparent that some elements were undeliverable”.
- “I have seen no evidence that carers assessments were offered to the parents until they requested them in July 2024. This is despite the Council being aware from the outset of the significant strain that their caring responsibilities were having on them. Had these assessments taken place earlier, opportunities to reduce the pressure of being carers may have been identified, which would have been beneficial to both [parents] wellbeing and that of the family as whole. These assessments could also have formed part of the considerations as to whether [the mother] should be appointed personal assistant”.
For a copy of the Ombudsman’s report – click here.