Derbyshire County Council (21 010 325)

Category : Adult care services > Assessment and care plan

Decision : Upheld

Decision date : 21 Mar 2022

The Ombudsman's final decision:

Summary: The Council acknowledges there were delays when Ms A requested help for her mother Mrs X. The Council has now apologised and taken action to remedy the consequent injustice to Mrs X. It also agrees to make a payment in recognition of the frustration and loss of dignity caused by the delay in responding and increasing Mrs X’s care, and consider ways in which her personal hygiene needs can be better met .

The complaint

  1. Ms A (as I shall call the complainant) complains the Council failed to respond in a timely way to her requests for more assistance for her elderly mother Mrs X. In particular she complains about a failure to respond to her requests for an extra call to assist with Mrs X’s incontinence.

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The Ombudsman’s role and powers

  1. 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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
  2. If we are satisfied with a council’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

  1. I considered the information provided by Ms A and the Council. Both Ms A and the Council had an opportunity to comment on an earlier draft of this statement before I reached a final decision.

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What I found

Relevant law and guidance

  1. Once a person’s eligible needs for care have been identified through the assessment process the Council must produce a care and support/support plan.
  2. The plan should be kept under review at least annually. The service user, family member or carer can also ask the Council for a review. Reviews should consider whether improvements could be made to achieve better outcomes.

What happened

  1. Mrs X has Alzheimers disease. She lives with her husband. Ms A lives locally and provides support.
  2. The Council funds a care package for Mrs X of two care calls a day at lunch time and teatime to ensure Mrs X has a meal available. The care plan says carers should assist Mrs X to shower daily and assist her with her continence needs.
  3. In July 2021 Ms A contacted her mother’s social worker to advise that Mrs X needed more help. She said Mrs X was struggling with her continence needs and the carers had suggested a third call a day might be needed, as well as more help with cleaning the house. Ms A says the social worker told her she would undertake a review of Mrs X’s needs but she did not do so. She says when she rang the Council to speak to a manager no-one called her back.
  4. In September 2021 Ms A complained to the Council about the lack of response to her requests for more help. She asked for a different social worker to be allocated.
  5. A manager responded to Ms A’s complaint on 30 September. He apologised no-one had returned her calls. He said the social worker had visited Mrs X several times but on at least one occasion had not been able to gain access. He said the social worker had carried out a joint visit with the Fire Service at the start of September. She had identified several actions which needed to be taken – asking about meal delivery services, requesting an extra care call, referring to the local voluntary services for help with cleaning, referring to the GP for continence advice, contacting Mrs X’s Community Psychiatric Nurse – but due to her planned leave had not taken action on them all. He said he saw no reason to allocate a different social worker
  6. Ms A remained dissatisfied. She complained to the Ombudsman. She said the only actions the social worker had taken was to refer her mother to the GP for continence advice when what Mrs X needed was more assistance with more incontinence pads. She said a promised joint visit with a cleaning service had not happened. She said the carers were supposed to help Mrs X with washing but frequently that did not happen.
  7. The Council acknowledges there was an unacceptable delay in responding to Ms A’s requests from July 2021. A different social worker undertook a review of Mrs X’s needs and an increase in care was provided from December 2021 as a result.
  8. The Council apologises to Ms A for the unacceptable delays. It acknowledges the need to allocate a different social worker in view of the breakdown in relationships between the previous social worker and the family. It has now done so.
  9. Carers’ diary notes provided by the Council show that Mrs X often declines help with showering.

Analysis

  1. There was fault on the part of the Council in the way it delayed responding to Ms A. That delay caused injustice to Ms A in terms of frustration and meant that a necessary increase in Mrs X’s care was delayed.
  2. The daily care notes show Mrs X often declines help with showering but do not identify in what way carers seek to overcome her objections.

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Agreed action

  1. The Council has taken action in respect of the requested additional care, has apologised to Ms A and has allocated a different social worker.
  2. Within one month of my final decision the Council will offer £250 to Ms A in recognition of the frustration and distress caused by the failure to respond in a timely manner, and £250 to Mrs X for the unnecessary loss of dignity caused by the delayed increase in her care.
  3. Within one month of my final decision the Council will also consider ways in which carers can enable Mrs X to shower as planned, and let me know what plans it puts in place.

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Final decision

  1. I have completed this investigation on the basis that fault on the part of the Council caused injustice to Ms A and her family, which completion of the recommendations at paragraphs 19 and 20 will remedy.

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Investigator's decision on behalf of the Ombudsman

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