Council agrees £2k payout over mental capacity assessment delays

Warwickshire County Council has agreed to pay a man who suffered a stroke £2,000 over delays in carrying out mental capacity assessments and not considering fully all the options available to him.

The payout follows an investigation by the Local Government and Social Care Ombudsman (LGO), who found that the man had been prevented from living independently for too long because the county and Nuneaton and Bedworth Borough Council “had failed to follow correct procedures”.

The LGO said Warwickshire had 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 meanwhile delayed considering his housing application.

The LGO said 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.

Warwickshire met with him in early 2014 to discuss moving from the care home and considered extra care housing to be his best option.

However, Nuneaton and Bedworth did not have extra care schemes and its supported housing was generally for people older than 55.

A 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 LGO said.

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.

However, his social worker believed he lacked insight into the kind of support he needed but again 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 Nuneaton and Bedworth’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 Ombudsman.

The LGO concluded that:

• Warwickshire failed to consider properly the man’s ability to make decisions until it made a proper capacity assessment in May 2015;
• The county council “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 county council missed “numerous opportunities” to assess the man’s capacity at times when key decisions were made about his care and accommodation.
• Nuneaton and Bedworth failed to tell the county council about its decision to remove the man from its waiting list in December 2014.
• The borough council 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.
• It also raised the man’s expectations he might be allocated extra care housing, despite him never meeting its criteria.
• The borough council 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.

In addition to the £2,000 payout, Warwickshire has agreed to apologise to the man and review its practices to ensure that mental capacity assessments are carried out at the appropriate times and documented properly.

Nuneaton and Bedworth 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. 

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.”