GBK & Anor v Ceredigion County Council

The First Claimant is an adult with quadriplegic cerebral palsy, a learning disability, kyphosis and scoliosis. She is doubly incontinent and is dependent upon her parents for all aspects of daily living, including personal care and transfers. She lacks capacity and proceeds by her father as litigation friend. Her mother is the Second Claimant. I shall for ease of reference but with respect refer to them in this judgment by their familial relationship. They live together in an adapted home. Daughter and mother make an oral renewal of an application for permission to bring judicial review proceedings against the Defendant Council for failures of its duties under the Social Services and Well-being (Wales) Act 2014 the to provide care for them. The decision challenged is a risk assessment carried out in November 2025 and what is said to be ongoing failure to provide for the needs of daughter and mother under sections 35 and 40 of the 2014 Act. Specifically, the failure relied upon is a failure to provide a toilet in a wet room which has just been extended in the home.

Daughter has a care and support plan, dated 16 July 2025. Mother has several lung conditions. She needs to pass water urgently at times. She is the subject of carer’s assessment, dated 27 June 2025.

The path to those plans and as to what adaptations were needed in the home was a difficult one. The then existing wet room had a toilet, but the parents had to lift their daughter onto a hoist and then onto a trolley for her to use the shower in the wet room. The adaptions being discussed included a single rail track hoist which would enable them to hoist their daughter from her bed and from there onto the trolley and into the shower. This is a trolley with padded sides, which restricts, but does not eliminate, the risk of their daughter falling, her conditions give rise at times to involuntary movements.

Occupational therapists attended the home in the latter part of 2022. One of the difficulties identified was that there was insufficient space to manoeuvre the trolley with the toilet located where it was. The therapist concluded that if mother used the toilet in the wet room, there was a risk that her daughter might fall from the trolley. A solicitor became involved on behalf of daughter. She did not act for mother, who had to make her own representations. She did not want the toilet removed, as this may mean she would suffer the indignity of having to pass water whilst still attending to her daughter, as she said had happened in the past. Negotiations carried on, and there was a mediation. The therapist by October 2024 was maintaining that a toilet in the wet room was unnecessary for daughter’s needs and that use of it by mother while attending to her daughter in the wet room may involve risks.

By March 2025, the parents were becoming concerned about the delay in making the adaptions and of installing the single track hoist which would make the transfer of their daughter to the wet room considerably easier. Father therefore agreed with the plans to remove the toilet. Mother was still not happy. She asked for a further risk assessment. This was carried out by the Council in November 2025 as a paper exercise. The terms on which it was carried out are explained in the Council’s email of 13 October 2025 as follows;

“… we are prepared to carry out a formal MDT risk assessment to score and outline specific risks associated with [mother] using the toilet mid-way through showering [daughter].”

The risk assessment was carried out by a social worker, two occupational therapists and the corporate health and safety team. The risks identified to daughter whilst mother was using a toilet in the wet room included risk of limb injury due to athetoid movements, the risk of daughter reaching over the side of the trolley and falling to the floor, that at full reach from a toilet mother would only be able to touch the outer side of the trolley and not her daughter, and the risk of scalding by a sudden change of water temperature which mother may not be able to detect and respond to whilst using a toilet. The assessment also took into account of the risk of injury to mother if she atempted while on a toilet to save such a fall

It was concluded that control measures would not reduce these risks. Suggestions considered to be reasonable adjustments which do not place daughter at unacceptable risk if mother needed the toilet in those circumstances, were set out as follows;

“a.

Carer to seek intervention to resolve toilet urgency need (if not already done so). b. Task performed by alternative carer(s). c. Carer considers use of continence products for duration of task.”

Where a person is assessed to have eligible care needs, and to require support in order to meet a care need, under section 35 of the 2014 Act, a local authority must provide support to meet that need, if certain conditions are met. Under section 40, it must also meet the needs of a carer who is an adult if it is satisfied that certain conditions are met.

The challenge is put by Mr Gardner for the Claimants on four grounds, in which there is some overlap. In dealing with these, it is worth emphasising that in these proceedings it is not for the court to substitute its own view for that of the Council, to whom Parliament has entrusted this decision. Permission can only be given if it is arguable that there was a flaw in the decision making process in a public law sense.

The first ground is that the risk assessment was a paper exercise, which did not involve talking to the family or visiting the property or witnessing the showering of daughter and did not engage with the welfare of mother or daughter.

In my judgment, there is nothing in this ground. The risk assessment had a very narrow ambit, namely whether a toilet should be installed in the wet room. Aa Ms Jones for the Council submits, it came after an agreed position was accepted on behalf of daughter, and after a long process of engagement which include statements, emails, a visit, plans with dimensions and a mediation. The risk assessment was carried out by professionals who were entitled to take the view that in this context a paper exercise on this narrow issue was sufficient.

The second ground is that the risk assessment failed to take into account material considerations such as the dimensions of the wet room, the fact that daughters movements were better controlled with up to date medication, the fact that the trolley has high padded sides, dimensions of a toilet possible combined with the sink, and that the showering does not involve constant running water.

In my judgment, there is nothing in this ground either. The dimension of and in the wet room were clearly marked on agreed plans. It was not suggested by mother that the risk of movement has been eliminated or that there was no risk of a fall. Her position was that if daughter began to fall this would be a slow process and that she could reach her daughter in time. There does not have to be constant running water to give rise to a risk of a sudden change of temperature.

The third ground is that mother’s need were not identified. The risk assessment was a detailed seven page assessment in which mother’s needs were sufficiently identified and the contrary is not arguable.

Finally, it is said that there is no confirmed position as to external carers to assist. The risk assessment suggested as one of the options, an alternative carer. In my judgment, that reference means alternative to mother, not necessarily an external carer. It was one of three suggestions made.

The situation is clearly a difficult and sensitive one. In my judgment however, the challenge is in essence a disagreement with the professionals who carried out the risk assessment in the context of a long process to agree what provision should be made. There are no arguable grounds for the grant of permission.

The Council also raises the issue of delay, on the basis that the real challenge is in respect of the agreed position in the July 2025 care plan that there should be no toilet in the wet room. That issue may be arguable, but that does not impact on the refusal of permission, which I refuse on the substantive reasons given above, notwithstanding the thorough and clear submissions of Mr Gardner, for the Claimants, to the contrary.