Summary: We found fault with the Council for the inadequate non-residential care provided to the complainant (Mr Y) by Premium Care Limited and its complaint-handling. We also found fault with the Council for not consulting Mr Y’s daughter (Mrs X) about proposed changes to Mr Y’s care plan. The Council has accepted its fault and the injustice caused to Mr Y and Mrs X and offered suitable remedies.

The complaint

1. Mrs X, acting for Mr Y, complains about the standards of care provided to Mr Y at his home by the care provider Premium Care Ltd (the Care Provider). The care was arranged by the Council and funded by Mr Y. Mrs X says the Care Provider’s staff:
1. Failed to follow procedures for giving Mr Y his medication and recording this;
2. Failed to properly fit and manage Mr Y’s catheter equipment;
3. Failed to provide acceptable personal care to Mr Y;
4. Continued inadequate care despite the assurances of improvements;
5. Failed to reply to Mrs X’s concerns;
6. Failed to recognise errors or apologise until prompted;
2. Mrs X also complains the Council granted the Care Provider longer visits for Mr Y without consultation with the family.
3. Mrs X says the Council’s failings caused Mr Y distress, loss of dignity and could have affected his health. Mrs X was upset about the level of care provided to her father. She spent much time for extra visits to Mr Y to check his care and advise the carers.

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The Ombudsman’s role and powers

4. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
5. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:
• we could not add to any previous investigation by the organisation; or

• there is no worthwhile outcome achievable by our investigation. (Local Government Act 1974, section 24A(6), as amended, section 34(B))

6. It is our decision whether to start, and when to end an investigation into something the law allows us to investigate. (Local Government Act 1974, sections 24A(6) and 34B(8), as amended)
7. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), as amended)
8. We normally name care homes and other care providers in our decision statements. However, we will not do so if we think someone could be identified from the name of the care home or care provider. (Local Government Act 1974, section 34H(8), as amended)
9. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).
10. 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

11. I spoke with Mrs X and considered the information she provided.
12. I considered the Council’s response to Mrs X’s complaint of 9 January 2024 and our Guidance on Remedies.
13. Mrs 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

What happened

Care services for Mr Y and the Care Provider’s complaint handling

14. In mid-July 2023 the Council arranged for the Care Provider to deliver care services to Mr Y in his house.
15. A week later Mrs X complained to the Care Provider about the level of care given to Mr Y. In response the Care Provider offered a meeting. It also said it had contacted the Council about amendments to Mr Y’s care plan.
16. Mrs X asked about the details of any amendments to Mr Y’s care plan. She gave some specific examples of the impact of the Care Provider’s staff not being sufficiently trained on the care given to her father.
17. At the beginning of August the Council told Mrs X it was reviewing the Care Provider’s request to increase Mr Y’s package of care. It confirmed that before any changes were made the Council would discuss the proposed support with the family.
18. In the response to Mrs X’s complaint in mid-August the Care Provider apologised for the delay in replying and explained:
• District nurses advised the batch of catheters prescribed for Mr Y was faulty and a new equipment had now been delivered. All staff were spoken to and some checks were completed;
• Mr Y’s care plan was updated and call times changed to better reflect Mr Y’s needs;
• The Care Provider’s coordinator was liaising with the Council about updated paperwork for giving medication.
19. Mrs X was not happy with the Care Provider’s response, which, she said, failed to address the details of her complaint and offer apologies for the Care Provider’s failings. She criticised the Care Provider’s failure to recognise flaws in the training of its staff as well as in the communication with its service users and their families. Mrs X was also still concerned about the administration of medication and Mr Y’s safety.
20. A week later the Care Provider apologised for the inadequate standards of care for Mr Y and listed proposed improvements to its services.
21. At the end of August Mrs X contacted the Care Provider with the evidence of further failings to adhere to protocols and best practise standards. She asked for the contact details of the Care Provider’s head of Governance. Having received no response she contacted the Care Provider again with the same request a few days later, complaining also about the care staff’s errors when giving medication to Mr Y.
22. Mrs X asked the Council to change a company providing non-residential care to Mr Y. The Council recognised Mrs X’s request and found a different care provider for Mr Y from the end of the third week of September.

The Council’s response to our investigation

23. The Council acknowledged our reasons for not expecting Mrs X to complain again to the Council about the matters already considered by the Care Provider. In December 2023 and early January 2024 it did, however, carry out its own investigation into the way the Care Provider supported Mr Y and dealt with Mrs X’s complaint.
24. In its letter to Mrs X of 9 January 2024 the Council fully upheld Mrs X’s complaint and apologised for the quality of care delivered to Mr Y by the Care Provider.
25. The Council proposed a course of action both for the Care Provider and its commissioning and monitoring services as follows:
• The Care Provider will train and educated its staff as well as provide them with the specific support when emptying leg bags and with the associated needs of people cared for when any leaks occur. The Council’s Quality Assurance team will monitor the staff training;
• The Council will fully refund the care fees of £1,828.85 paid by Mr Y for the Care Provider’s services in acknowledgement of the inadequate care and the Council’s failing to consult with the family about the increased care package;
• The Council will support the Care Provider in improving its care delivery and punctuality;
• The Council’s Commissioning and Quality Assurance teams will monitor communication between the Care Provider and its service users as well as its complaint-handling to ensure improvement.

Analysis

26. Councils are responsible for the care arranged for their residents with eligible care needs even if these residents pay for this care from their own funds. As explained in paragraph seven of this decision we hold councils into account for any failings of the care providers delivering services on councils’ behalf.
27. After carrying out its investigation the Council fully upheld Mrs X’s complaint and offered both personal remedies in the form of an apology and refund and some service improvements.
28. There is no reason for us to continue our investigation as the Council has accepted its fault and has acknowledged this fault caused injustice to Mr Y and Mrs X. The Council offered personal and service improvement remedies which are adequate and in line with our Guidance on Remedies. There is nothing to be achieved through our further investigation.

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Final decision

29. I uphold this complaint. The Council has accepted its fault and injustice caused to Mr Y and Mrs X and has offered suitable remedies. This investigation is at an end.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman