Summary: There is evidence to show the Care Provider failed to provide adequately trained live-in carers for Mr Y.

The complaint

1. Mr X complains about unsatisfactory home care services to his father, Mr Y. He says carers were inexperienced and /or unwilling to provide a satisfactory service in line with the care plan. He disputes the care agency’s requirement that he pay it a termination fee.

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The Ombudsman’s role and powers

2. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. If they have caused a significant injustice or that could cause injustice to others in future we may suggest a remedy. (Local Government Act 1974, sections 34 B, 34C and 34 H(3 and 4) as amended)
3. 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

4. I have:

• considered the complaint and discussed it with Mr X;
• considered information provided by the Care Provider;
• taken account of relevant legislation;
• offered Mr X and the Care Provider an opportunity to comment on a draft of this document, and considered the comments made.

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What I found

Relevant legislation

5. The Care Quality Commission (CQC) is the statutory regulator of care services. It keeps a register of care providers who show they meet the fundamental standards of care, inspects care services and issues reports on its findings. It also has power to enforce against breaches of fundamental care standards and prosecute offences.
6. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards those registered to provide care services must achieve. The Care Quality Commission (CQC) has issued guidance on how to meet the fundamental standards below which care must never fall.
7. Regulation 9 states Care Providers should provide person centred care that is specific to their service users.

Key facts

8. Mr Y lives in his own home with his wife. He received services from Promedica 24 (Lancashire Limited) between April & November 2022.
9. A live-in-carer was provided to support Mr Y.
10. Mr X says he had issues with three of five carers provided. Two of the carers had insufficient relevant experience, so they could not be left alone with Mr Y. Mr X says one carer had no previous relevant experience. Another carer told him she had no experience of caring for a person at home and was nervous doing so. And another carer informed him she had no experience of preparing and cooking the food Mr Y required.
11. Mr X says the Care Provider falsely assured him that one carer who had been satisfactory and had been absent for a short time would be returning; when the carer had already left the company. Mr X only discovered this when he contacted the carer directly.
12. From May 2022, Mr X submitted numerous complaints to the Care Provider. I have had sight of the Care Providers responses. The Care Provider confirms it ‘dealt with’ a complaint submitted in May 2022. It confirmed one carer had not followed the care plan and said it would ensure the “carer receives further training in relation to person entered care and apologise for any distress this may have caused”. It partially upheld another complaint submitted in June 2022 about a carer’s conduct and offered to reduce the invoice by £50 as a gesture of goodwill. It acknowledged another carer had no experience as a live-in carer but said she had received training in moving and handling.
13. In an email sent to the Care Provider, dated 28 April 2022, Mr X said “I understand your point regarding care workers coming from various different backgrounds and cultures, and that some may need a little time to get used to living and working in the UK. Perhaps it would be useful for all care workers to have access to the recipe book you mention, especially those who have not been in the UK for long…We have waited a couple more days to see how [carer] gets on, but separate from the issues I mentioned in my previous email, we now have other concerns that unfortunately lead us once again to the conclusion that [carer] isn't really the right person for this particular assignment. I would be happy to discuss these concerns in person or by phone at some point, but to avoid any misunderstandings I would prefer not to try to explain by email”.
14. Mr X says the cumulative effect of the failings left him with no option but to terminate the contract on the grounds of continued unsatisfactory service. The Care Provider requested payment of a termination fee of £3,912.86, which Mr X has refused to pay.

Analysis

15. The Care Provider acknowledged some of the care provided to Mr Y was below an acceptable standard. It also appears to accept that some carers did not have sufficient training or experience to meet Mr Y’s needs, including his dietary needs. This is not acceptable and places the carer and service user in an unfair situation.
16. The Care Provider has a duty to ensure all carers are adequately trained to a consistent standard and able to undertake the tasks set out in the care plan.
17. This is not what happened here. Sending unsuitable carers into service users homes causes disruption and distress. In this case there were occasions that Mr Y did not receive the service he paid for.
18. The matter of the termination fee is not one I can consider. This is a contractual matter and one which the Court should determine.

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Agreed action

19. The Care Provider should:

• provide Mr X with a formal written apology for the failings set out in paragraphs, 15,15 & 17, and make a payment of £250 in acknowledgement of his time and trouble pursuing the complaint with the Care Provider and this office;
• pay Mr Y £300 in acknowledgment of poor service;
• consider the training needs of carers; and ensure carers have appropriate skills to meet the individual needs of service users.
• provide this office with evidence it has complied with the above actions.

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Final decision

20. There is evidence to show the Care Provider failed to provide adequately trained live-in carers for Mr Y.
21. The above recommendations are a suitable way to address the injustice caused.
22. It is on this basis; the complaint will be closed.
23. Under the information sharing agreement between the Local Government and Social Care Ombudsman and the Care Quality Commission (CQC), we will share a copy of the final decision with CQC.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman