Summary: The Care Provider failed to properly communicate with Ms X about the breakdown of a heating boiler at a care home her parents resided in. It acknowledged it could have dealt with her enquiries about this, and subsequent complaints better.

The complaint

1. Ms X complains about the Care Provider’s handling of issues with a heating boiler and hot water provision in a care home her parents resided in.

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The Ombudsman’s role and powers

2. We investigate complaints about adult social care providers. If there has been fault, we consider whether it has caused an injustice and, if it has, we may suggest a remedy. (Local Government Act 1974, sections 34H(3) and (4), as amended)
3. If we are satisfied with a care provider’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 Ms X
• considered the correspondence between Ms X and the Care Provider, including the Care Provider’s response to the complaint
• made enquiries of the Care Provider and considered the responses
• taken account of relevant legislation
• offered Ms 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

5. 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.
6. 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.
7. When investigating complaints about the standards of care in a care or nursing home, the Ombudsman considers if the 2014 regulations and the fundamental standards have been met. If they have not, we consider whether any identified faults have resulted in injustice.

What Ms X says

8. Ms X’s parents, Mr & Mrs Y, lived in two separate sections of Alice Grange residential care home, Mrs Y was cared for in the dementia section, and Mr Y in the nursing section. Mrs Y sadly passed away in December 2019.
9. Ms X was made aware of a problem with the heating boilers and hot water supply at the care home during an emergency resident’s/relative’s meeting in January 2020. The meeting was arranged by a director of the Care Provider. Ms X believes the problem may have been ongoing intermittently since May 2019.
10. Ms X was concerned that she had not been informed sooner. She was unaware if, or how it had affected her parents. She believes her father’s room was without hot water for at least seven days in January 2020. Following the residents meeting, Ms X sent an email to the Care Provider asking three questions:

• on which days over the past six months was there no hot water for showering/personal care for Mr Y & Mrs Y.
• on those days, how was personal care given to Mr & Mrs Y to maintain their personal hygiene and wellbeing.
• if this had affected her parents, why was she not informed and why is it not noted in Mr & Mrs Y’s care records.

11. Ms X says, despite receiving three separate complaint responses, the Care Provider did not fully answer her questions. In its initial response it said there had been no interruption to personal care. It said the issue had started in September 2019, was intermittent and only affected one boiler which had affected a third of the home. Where parts of the home were affected it offered personal care to residents in unaffected parts of the home, but if residents declined this then it would continue to offer personal care in their own room.
12. The second complaint response of 10 February 2020 says Mr Y was offered a shower in another room and when he had a wash in his own room he was brought hot water to use.
13. Ms X told the Care Provider she would withhold care fees until she had a satisfactory response to her complaint.

Evidence from the Care Provider

14. The Care provider acknowledges there have been issues with the boiler at the care home and that some rooms experienced a loss of heating and hot water.
15. The records show a reported boiler issue on 13 May 2019 & 26 July 2019. The care home also reported a partial loss of hot water on 24 November 2019. The care records show Mrs Y received personal care on each of these occasions. The records for Mr Y show he received personal care on 13 May 2019 & 24 November 2019. On 26 July 2019, Mr Y arrived back at the care home late afternoon after being discharged from hospital.
16. The Care Provider says it did not inform relatives at the time because the incidents were one-off and resolved the same day.
17. The care home experienced further issues with the boiler on five separate days in January 2020, 6, 18, 20, 22, 23. Mr Y’s room was affected. On each of these days he was without hot water. Care staff completed a risk assessment for the purposes of carrying hot water into Mr Y’s room. Personal care was also offered in communal bathrooms.
18. The care home did not inform residents of the boiler breakdown on 6 & 18 January 2020 because it believed the issues to be one-off. It says when it became aware this was not the case it contacted relatives on 21 January 2020 and held an emergency residents meeting, which Ms X says she only found about the meeting because she happened to be visiting Mr Y that day. The Care Provider says, with hindsight, it should have communicated with relatives sooner, and “...lessons have been learnt”.
19. Ms X submitted a formal complaint to the Care Provider on 21 January 2020. She asked the three questions set out above in paragraph 10. The Care provider responded by email the same day saying there had been no interruption to personal care during the boiler breakdown. Ms X was dissatisfied and contacted the Care Provider to reiterate her formal complaint. Subsequently, a senior employee at the Care Provider offered to meet Ms X but no date could be agreed. Ms X disputes this, and says she was not offered a meeting.
20. The Care Provider provided Ms X with a written response to her complaint on 10 February 2020. Ms X says it did not answer the points she had raised. She contacted the Care Provider the following day. The Care Provider responded the same day to say it would investigate further. Ms X did not receive a response, so she contacted the Care Provider again in April 2020 to complain, she also raised new concerns about the day-to-day management of the care home.
21. The Care Provider sent Ms X a formal acknowledgment of her complaint in June 2020 and provided a written response in July 2020. Ms X was dissatisfied. She informed the Care Provider and at the same time, raised new concerns relating to visiting rights and staffing. The Care Provider sent a formal acknowledgment of the complaint on 1 September 2020 and provided a formal written response on 4 September 2020. I have had sight of this letter. For the most part, it addresses Ms X’s concerns relating to visiting and the Coronavirus. It briefly responded to the issues Ms X raised about the boiler and hot water issues, saying the failure had impacted on the ambient temperature of some areas of the care home, it did not explain how this affected Mr & Mrs Y. It requested that Ms X pay outstanding care fees for Mr Y.
22. In response to enquiries from this office, the Care Provider acknowledged it failed to respond to Ms X’s complaints with sufficient detail and says “...we do extend our apologies to [Ms X] in this regard”.
23. Mr Y left the care home on 21 October 2020. The Care Provider agreed to waive the contractual 28-day notice period and fees in full.

Analysis

24. There are numerous aspects that require consideration, the issues with the boiler, if and how this affected Mr & Mrs Y, how this was communicated to Ms X, and how the Care Provider responded to Ms X’s complaints.
25. In respect of the mechanical failure of the boiler, initially these were one-off incidents which the Care Provider could not have foreseen. Such events are beyond human control. On each occasion the boiler failed, the Care Provider responded immediately to arrange repairs. Initially, the repairs were completed the same day the faults were reported. In such circumstances I cannot criticise the Care Provider for not informing relatives. It would be onerous on care staff and cause relatives’ unnecessary concern.
26. In early January 2020, the boiler failed again. At this point the Care Provider should have been concerned about the number of one-off failures that had occurred, the last being November 2019. It did not inform relatives until the middle of January 2020; it acknowledges it should have done so sooner.
27. When Ms X discovered the issues were not new her concern was understandable. She did not know exactly if and how this had impacted on Mr & Mrs Y. Ms X was also grieving the loss of Mrs Y who had passed away only weeks earlier. The Care Provider has apologised to the Ombudsman and asked that an apology be extended to Ms X.
28. I have considered if the boiler failure had a significant impact on Mr & Mrs Y’s wellbeing. I do not consider it did. Whilst it may have caused some inconvenience the care home took steps to ensure adequate personal care was provided and took action to mitigate the loss of heat in bedrooms. It could not have done any more.
29. The Care Provider acknowledges it could have dealt with Ms X’s enquiries and complaints better, and that its communication was not as clear as it should have been. It failed to provide adequate information in its complaint response and failed to address Ms X’s specific questions. Ms X also had to chase the Care Provider for a response. She should not have had to do so.

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Agreed action

30. The Care Provider should within one month:

• provide Ms X with a written apology for the failings highlighted above and make a payment of £100 in acknowledgment of the time and trouble Ms X has been put to pursuing this complaint with the Care Provider and the Ombudsman.

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Final decision

31. There is evidence of fault in this complaint. The Care provider failed to properly communicate with Ms X about the breakdown of a heating boiler at a care home her parents resided in. It acknowledged it could have dealt with her enquiries about this, and subsequent complaints better.
32. The recommendations above are suitable way to remedy the complaint.
33. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman