London Borough of Hillingdon (202103112)

REPORT

COMPLAINT 202103112

London Borough of Hillingdon

2 September 2021

Our approach

The Housing Ombudsman’s approach to investigating and determining complaints is to decide what is fair in all the circumstances of the case. This is set out in the Housing Act 1996 and the Housing Ombudsman Scheme (the Scheme). The Ombudsman considers the evidence and looks to see if there has been any ‘maladministration’, for example whether the landlord has failed to keep to the law, followed proper procedure, followed good practice or behaved in a reasonable and competent manner.

Both the resident and the landlord have submitted information to the Ombudsman and this has been carefully considered. Their accounts of what has happened are summarised below. This report is not an exhaustive description of all the events that have occurred in relation to this case, but an outline of the key issues as a background to the investigation’s findings.

The complaint

The complaint refers to:
1. The landlord’s handling of adaptations needed within the resident’s property.
2. The resident’s concerns about the recommendations made by Occupational Therapy.
3. The landlord’s handling of the associated complaint and record keeping.

Jurisdiction

What we can and cannot consider is called the Ombudsman’s jurisdiction. This is governed by the Housing Ombudsman Scheme. When a complaint is brought to the Ombudsman, we must consider all the circumstances of the case as there are sometimes reasons why a complaint will not be investigated.
After carefully considering all the evidence, in accordance with the Housing Ombudsman Scheme, the following aspect of the complaint is outside of the Ombudsman’s jurisdiction.

The resident’s concerns about the recommendations made by Occupational Therapy.

Paragraph 39(m) of the Scheme states:

“The Ombudsman will not investigate complaints which, in the Ombudsman’s opinion fall properly within the jurisdiction of another Ombudsman, regulator or complaint-handling body.”

In her complaint to this Service, the resident has stated that her needs have not been met as expected by Occupational Therapy. Whilst this Service does not doubt the resident’s experience, this aspect of the resident’s complaint is outside of the Ombudsman’s jurisdiction to consider as it is better suited for the Local Government and Social Care Ombudsman (LGSCO). This is because the LGSCO can look at complaints about local authority’s activities (aside from their responsibilities as social landlords), including complaints about Occupational Therapy and the provision of Disabled Facilities Grants. In view of this, this Service will address the resident’s concerns regarding the landlord’s handling of adaptations needed within the resident’s property within its role as a social landlord, including whether it acted in line with the recommendations provided by Occupational Therapy. We will not comment on whether the Occupational Therapy recommendations were sufficient or correct as it is outside our remit to assess this.

Background and summary of events

The resident is a tenant of the landlord, which is a local authority. The property is a house. The resident has medical conditions which affect both her respiratory function and her mobility. For clarity, this report will refer to the local authority as ‘the landlord’ when carrying out its role as a social landlord.
On 4 March 2019, a request for major works to the resident’s property was raised by Occupational Therapy (OT) on the basis that the resident needed an adaptation to her bathroom to suit her respiratory and mobility issues. OT recommended that the shower in the resident’s upstairs bathroom was removed and replaced with a walk-in bath. OT found the area to fit the tub and a tiled boxed-in area to be approximately 172cm x 62cm.
A further OT report was issued on 18 November 2019. OT recommended that a stairlift was installed at the property to aid the resident’s mobility.
On 28 November 2019, OT made additions to its initial recommendations. It said that a wall mounted fan heater should be installed to provide additional heat whilst the bath was in use. It added that if grab rails were not included on the bath, an additional grab rail should be installed horizontally to support the resident’s transfer in and out of the bath. The landlord emailed the resident on 5 December 2019 to provide the design plan for her bathroom adaptations.
The resident emailed the landlord on 10 February 2021 and expressed concern about certain aspects of her bathroom adaptation. She said she had been advised that she would have a new toilet rather than having her current toilet repositioned and asked that the landlord ensure this was the case. She added that the design for the bathroom did not include any extra heating despite OT’s recommendation for additional heating. She said that she would not be able to pre-fill the bath as she needed to use the door on the bath for access, leaving her cold whilst waiting for the bath to fill. She asked for the taps to be on the other end of the bath so that she would not be near the toilet when lying down. Alternatively, she asked for the landlord to place the sink in the proposed toilet position. She also asked that the contractors took care when carrying out the work as any additional dust may affect her breathing difficulties.
It is unclear if the resident received a response to her concerns; however, the landlord’s internal records from 16 February 2021 show that it would replace the toilet rather than reposition it. It noted that the bathroom had a radiator which would allow for heating of the room. It said that it had no information from OT about additional heating being required so it would not add heating to the room. It said that it could not position the taps on the other end of the bath, as the bath door would then not open and it had already been ordered as per the design specifications.
The resident emailed OT on 19 April 2021 and explained the following:
1. She explained that the current bathtub, measuring 150cm x 70cm, was too narrow for her needs. She added that the door to access the bath was too close to her sink, so she had to twist to access it. She said that the current bath also had no locking system, and her child had opened the door, causing the bathroom to flood. She also said that the toilet was too small, which was causing difficulty.
2. She confirmed that she had researched a larger bathtub and toilet following a conversation the previous week. She provided links to alternative bathtubs and toilets which she believed would be suitable for her needs. This included a wider toilet and a wider bathtub with a central access door. Her proposed bathtub had a locking system which she felt would be safer.
3. She added that she had difficulty using the two single taps on the bath as it was not easy to regulate the temperature. The single taps also meant that one foot was being burnt by the hot tap and one was frozen by the cold tap. She asked for these to be replaced with a mixer tap. She also asked for a grab rail to prevent any slips when entering and leaving the bath.
The resident emailed the landlord on 27 April 2021 and explained the following:
1. She asked to raise a formal complaint about the handling of her adaptations. She said that every time she tried to contact a member of staff, she could not get through. She had left messages asking for call-backs, but this did not happen. She said that this matter was very stressful, which was in turn affecting her medical conditions.
2. She expressed concern about the installation of her stairlift. The stairlift manufacturer had said that her staircase was very narrow and it would not be possible to have a full footrest. If this was installed, the rail would need to be higher, which meant that the resident was at risk of bumping her head on the stair bulkhead. She expressed concern that having half a footrest would not meet her needs as she would need to twist to use the stairlift. She said that had she known of the problems she would face, she would have asked for a grant to fit a downstairs bathroom so she would not have difficulty using the stairs.
The resident sent a series of emails to the landlord on 29 April 2021 and asked to raise a formal complaint. She explained the following:
1. She said that the works to her bathroom adaptation had started, and she had concerns about the size of the bathtub, the size and position of the toilet and her request for bath mixer taps rather than single taps. However, a visit had occurred the previous day with OT and the local authority’s grant surveyor and all three of her concerns were dismissed despite her claims that these were causing hardship.
2. Regarding the bath, she said that the bath provided was too narrow, leaving her very cramped. She had been told that it was not possible to fit a larger bathtub due to the size constraints of the bathroom. She disagreed with this and said there would be more room if the boxing around the bathtub was cut back. She felt that this was not investigated by OT or the landlord. She added that the door to the current bath was easily opened and that her child had opened the door, causing the bathroom to flood. The surveyor had said that it would attempt to find a locking mechanism for the current bath but had ignored her other concerns.
3. Regarding the toilet, she said that the small toilet meant that it was uncomfortable for her to use. She was told that it would not be possible to fit a larger toilet due to the size constraints of the bathroom but she disagreed with this. She had asked if the stair bulkhead could be cut into slightly to allow her more legroom, but the surveyor had refused. The resident believed that this could be done without damaging the structure of the stairs.
4. She added that OT had agreed to her request for mixer taps in a telephone conversation, but the surveyor had refused, stating that it was not in line with policy to fit mixer taps and the manufacturer of the bath would not allow this.. She said that she needed to clean herself multiple times a day and the taps were causing hardship. She felt that this had again been dismissed by the landlord.
5. She felt that her medical conditions were not being taken into consideration in the adaptations and she felt pressured to accept the adaptations. She felt that the current bathroom adaptation was leaving her in a greater hardship than before and asked for another occupational therapist to assess her needs to provide a second opinion. She added that she still had concerns about the stairlift and said that if the bathroom could be completed but the stairlift could not then she would be in the same position as before.
The landlord issued its stage one complaint response on 5 May 2021 and explained the following:
1. The resident’s request that a bathroom be installed downstairs was considered by OT and the local authority’s grant surveyor who found that this was not feasible as there was not enough space under the stairs to fit a full bathroom downstairs.
2. It acknowledged her concern that the stairlift, when installed, would not provide enough headroom. It was satisfied that the stairlift would suit the resident’s needs as this was made to the resident’s measurements and a full foot plat would be installed six weeks after the stairlift, meaning that the resident would not need to twist or bend her legs. It encouraged the resident to work with its contractor to get the adaptation work completed as soon as possible.
3. It noted that the OT had recommended that the shower was replaced with a walk-in bath to reduce the risk of a fall. It confirmed that the resident had asked for the work to be put on hold on the basis that she was not satisfied with the size of the bath and access to the toilet. It explained that there was not enough room to increase the size of the bath or change the access to the toilet. It attached the plan of the bathroom for reference. It confirmed that it had attended the property the previous week to try and resolve this matter and agreed to provide a grab rail for the bath. It confirmed that if the resident remained dissatisfied, she could escalate her complaint to the next stage of its complaints process.
The resident asked for her complaint to be escalated on 10 May 2021 and explained the following:
1. She said that she was satisfied that her stairlift adaptation would be completed and that she would not have a half footrest. However, she felt that the landlord’s response did not take her medical illness and difficulty using the current bathroom adaptation into consideration. She expressed dissatisfaction that the landlord had not addressed her requests, including a second opinion from another surveyor and OT, her request that the stair bulkhead was cut into to allow for more legroom or her request for a mixer tap to be installed.
2. She did not feel that the landlord had fully read or understood her complaint and advised that OT had not assessed the downstairs of her property. She had not asked for a full bathroom to be fitted under her stairs but stated that there was room at the side and back of the property to extend her current downstairs bathroom and add a bedroom so she would not need to use the stairs as much.
3. She felt that OT had not fully taken into consideration the new hardships she faced because of the adaptations and she felt demoralised by this. She added that the adaptations were meant to help and facilitate her independence but were causing additional hardships.
The landlord issued its stage two complaint response to the resident on 26 May 2021and explained the following:
1. It acknowledged that the resident felt that it had not taken into consideration the illness and hardship the adaptation to her bathroom would cause and that her suggested solutions had not been considered. It explained that it had to be guided by the expertise of professionals when carrying out any adaptations. It confirmed that OT had recommended that the shower was replaced with the walk-in bath. OT had completed two assessments independently of one another and it was OT’s view that the original recommendation had met her needs. The landlord confirmed that its position remained and offered to install a rail for the bath. It said that it would not provide a mixer tap for the bath.
2. It noted that the resident had asked for her downstairs bathroom to be enlarged and explained that this was not feasible as there was insufficient space. It said that this decision was made after a joint visit by the grant surveyor and OT. It was for this reason that the stairlift was to be installed so that she could use the adapted upstairs bathroom. The landlord confirmed that this was its final response, and, if the resident remained dissatisfied, she could contact the LGSCO.
As the resident was not satisfied with the landlord’s position, she referred the matter to this Service for consideration. Within her referral, the resident said the landlord’s decision on 25 May 2021 regarding her bathroom adaptations did not take into consideration her medical needs. The resident has advised that she was satisfied with the landlord’s response to her concerns about the stairlift installation and as such, the assessment will not focus on this issue because it appears that it has been resolved.

Assessment and findings

Scope of investigation

The Ombudsman does not doubt the resident’s comments regarding her health and how this has been affected by the new bath and toilet. However, this Service is unable to draw conclusions on the causation of, or liability for, impacts on health and wellbeing. The resident may be able to make a personal injury claim against the landlord if she feels her health has been affected by its actions or inactions. A personal injury claim is a legal process and the resident may wish to seek independent legal advice if she wishes to pursue this option. The Ombudsman cannot give legal advice and therefore we cannot comment on this matter further. However, consideration has been given to the general distress and inconvenience which the situation affecting her bathroom has caused the resident.
There is limited evidence available to explain the delay in proceeding with the adaptation work between March 2019 and early 2021. However, it is likely that the restrictions in place due to the Covid-19 pandemic would have had some impact on the landlord’s ability to carry out the necessary work during part of this time. The evidence suggests that the resident also asked for the work to be put on hold on more than one occasion. The delay in completing the work did not form part of the resident’s formal complaint to the landlord or the Ombudsman and as such, this report will not consider whether this delay was reasonable.

The landlord’s handling of the adaptations needed to the resident’s property.

When carrying out any adaptations, the landlord would be expected to act in line with the recommendations made by OT. The landlord would not be expected to carry out any adaptations at the resident’s request without supporting evidence from OT that the work would be suitable to meet their needs. This is because OT are qualified and best placed to make such recommendations.
There are certain limitations a landlord may face when carrying out any adaptations and a landlord must consider whether the recommended adaptations are reasonable and practical, taking into account the age, size, layout and condition of the property. The landlord is not obliged to carry out adaptation works recommended by OT if it would not be reasonable or practical to do so. It may not be disputed that recommended adaptations might be required by the resident, however, the landlord may not be able to provide such changes due to limited resources or physical constraints within the building.
In this case, the landlord acted appropriately by installing a walk-in bath in line with the recommendation given by OT in March 2019. OT measured the available space in the resident’s bathroom, including a tiled boxed in area, to be 172cm x 62cm. The newly installed bath measures at 150cm x 70cm, which is wider than the initial space OT deemed to be available. Once the bath was installed, the resident explained that she did not feel it was suiting her needs as it was too narrow for her to lie comfortably. The Ombudsman does not doubt the resident’s comments; however, the landlord has explained that the size of the bathroom would not allow for a wider bath. This explanation is reasonable from a practical point of view. The resident disagrees with this finding, but the landlord was entitled to rely on the opinion of its qualified staff and contractors when deciding whether it would be possible to fit a larger bath.
Furthermore, the landlord would not be expected to make additional changes to the adaptation without the qualified opinion of OT. There is no evidence of any further recommendations made by OT following the visit on 28 April 2021 that suggest the bath was not suitable the resident’s needs. If the resident feels that this is still the case, she may wish to pursue this matter directly with OT and ultimately with the LGSCO as explained above.
The OT report did not state that the resident would need a new toilet or include any recommendations about the size or width of this. There had also not been any further reports from OT to suggest that the size or position of the toilet was failing to meet the resident’s needs. It was therefore reasonable that the landlord would not make any alterations to this once the adaptation was completed to fit the bath. It was reasonable for the landlord to replace the resident’s former toilet and fit a standard sized toilet in the absence of any recommendations which stated that it should do otherwise, taking into account the available space in the bathroom.
It is noted that the resident had asked for the landlord to cut into the stair bulkhead, which affected the size of her bathroom, to allow for more legroom when using the toilet. There is no evidence to suggest that this was recommended by OT or necessary to meet the resident’s needs. It was therefore reasonable that the landlord would not consider this. Furthermore, the landlord would only be expected to make reasonable adjustments in line with the recommendations made by OT. Structural changes to a property, including the repositioning of walls would not be considered a reasonable adaptation. As such, the landlord would also not be expected to extend the property to allow room for a downstairs bathroom and bedroom. If the resident feels that a property without stairs may be more suitable to meet her needs then she may wish to discuss the possibility of a property transfer with the landlord and OT.
The resident has also expressed concern that the landlord had not considered her medical conditions when declining her request for a mixer tap to be fitted to the bath. The landlord has explained to this Service that it would not usually install mixer taps on baths. It had established that due to a low water pressure within the area, mixer taps were not installed in any adapted bathroom as they may cause issues for the resident in the future. It would have been helpful for the landlord to explain this within its complaint responses; however, the resident was not significantly disadvantaged by this as the overall decision would not have changed if this had been explained to the resident. There is no further evidence to confirm that a mixer tap had been recommended by OT and the landlord has acted reasonably by considering the resident’s request, however it would not be obliged to fit a mixer tap if it is not practical to do so.
It was appropriate for the landlord to say that it would fit a grab rail in the bathroom in its complaint response as this had previously been recommended by OT in November 2019. If the resident still has concerns about the heating in her bathroom, she may wish to contact the landlord to discuss this. It is recommended that the landlord considers the resident’s request and responds appropriately. If it is not willing to install additional heating it should explain why.
In summary, there has been no maladministration by the landlord in respect of its handling of the adaptations needed to the resident’s property. The landlord has acted appropriately by carrying out adaptations as recommended by OT. The landlord would not be expected to make further alterations to the adaptations at the resident’s request without supporting evidence from OT that any changes are needed.
No further evidence has been provided which states that OT has identified any requirements of the adaptation to meet the resident’s needs. If the resident disputes this, she may wish to discuss this with OT directly and ultimately pursue this matter with the LGSCO. The landlord should consider any future recommendations made by OT and provide a clear explanation to the resident if it is not practical to carry out such adaptations.

The landlord’s handling of the associated complaint and record keeping.

The landlord’s complaints policy states that it has a two stage policy for handling complaints. At stage one, the landlord should respond within ten working days. If the resident remains dissatisfied they can ask for their complaint to be escalated to stage two, where the complaint should be reviewed by a director. At stage two, the landlord should provide a response within ten working days. If at any stage there is likely to be a delay, the landlord should write to the resident to explain the reason and provide a new timeframe. The landlord would be expected to address each of the resident’s concerns in its complaint responses.
In this case, the landlord provided its response at both stages within a reasonable timeframe. However, it failed to fully address each aspect of the resident’s complaint in its responses. Both complaint responses failed to address the concerns the resident had raised regarding he landlord’s communication. Its stage one complaint response also failed to address her more specific requests for a mixer tap on the bath or her concerns about the bath door. It also failed to respond to the resident’s request that another surveyor and OT visited the property to provide a second opinion or her request that the stair bulkhead was cut into to provide more legroom. This is likely to have caused inconvenience for the resident in that the landlord had not provided any further explanation or demonstrated that it had considered her requests.
As part of this investigation the landlord was asked to provide documents, correspondence, and any other evidence relevant to the resident’s complaint. Only limited information was received, which did not include significant items such as call logs or communication between the resident and the landlord regarding the adaptations. The omissions indicate poor record keeping by the landlord in that it was not able to provide the relevant information when asked. This is likely to have caused inconvenience for the resident in that the Ombudsman is unable to fully investigate her concerns about the landlord’s communication. As such, the landlord has not provided sufficient evidence to show that it communicated effectively during the adaptations and has not demonstrated that it took adequate steps to investigate her concerns or explain its position to her.
In conclusion, there has been service failure by the landlord in respect of its handling of the associated complaint and record keeping. The landlord did not fully address the resident’s complaint at each stage and has failed to provide evidence to this Service to show that it communicated effectively with the resident regarding her adaptations. In view of this, the landlord should offer the resident compensation for the inconvenience caused by its poor complaint handing and record keeping. It is recommended that the landlord take steps to establish a system of record keeping that ensures that all contact from a resident (and any representatives) is recorded and retained so that it can be provided to this Service upon request, in response to a complaint.

Determination (decision)

In accordance with paragraph 54 of the Housing Ombudsman Scheme, there was no maladministration by the landlord in respect of its handling of the adaptations needed to the resident’s property.
In accordance with paragraph 54 of the Housing Ombudsman Scheme, there was service failure by the landlord in respect of its handling of the associated complaint and record keeping.

Reasons

The landlord has acted appropriately by carrying out the adaptations recommended by OT. There is no further evidence to suggest that OT feels the current adaptation was not meeting the resident’s needs. As such, the landlord would not be expected to take any further action at this stage.
The landlord has failed to address certain aspects of the resident’s complaint at each stage which is likely to have caused some inconvenience and frustration for the resident. The landlord has also failed to provide sufficient evidence that it had communicated effectively with the resident during her adaptation and has not demonstrated that this aspect of the complaint was fully investigated. This indicates poor record keeping by the landlord and the landlord should pay compensation to the resident in view of this, as set out below.

Orders

The Ombudsman orders that the following actions are taken within four weeks:
1. The landlord is to pay the resident £150 in recognition of the inconvenience caused by its complaint handling and poor record keeping.

Recommendations

The landlord should consider any future recommendations made by Occupational Therapy and provide a clear explanation to the resident if it is not practical to carry out such adaptations.
If the resident still has concerns about the heating in her bathroom, she may wish to contact the landlord to discuss this. It is recommended that the landlord considers the resident’s request and responds appropriately. If it is not willing to install additional heating it should explain why.
It is recommended that the landlord take steps to establish a system of record keeping that ensures that all contact from a resident (and any representatives) is recorded and retained so that it can be provided to this Service upon request, in response to a complaint.