Summary: Mrs D complains that home carers were not wearing suitable personal protective equipment whilst caring for her during the COVID-19 pandemic. We have not found fault.

The complaint

1. Mrs D complains that home carers were not wearing suitable personal protective equipment whilst caring for her during the COVID-19 pandemic. She says this put her and others at risk of infection.

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The Ombudsman’s role and powers

2. 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)
3. 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)
4. We normally name care homes and other 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)
5. This complaint involves events that occurred during the COVID-19 pandemic. The Government introduced a range of new and frequently updated rules and guidance during this time. We can consider whether the council followed the relevant legislation, guidance and our published “Good Administrative Practice during the response to COVID-19”.
6. 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

7. I spoke to Mrs D about her complaint and considered the information the Council sent in response to our enquiries.
8. Mrs D 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

COVID-19 personal protective equipment (PPE)

9. In April 2020, Public Health England published several pieces of guidance for care providers in response to the emerging COVID-19 pandemic. These included Personal protective equipment (PPE) - resource for care workers delivering homecare (domiciliary care) during sustained COVID-19 transmission in the UK.
10. This provides guidance for care workers and care providers on the use of appropriate PPE when visiting people's homes to deliver care during the pandemic. It says when providing personal care, care workers should wear single-use disposable gloves, single-use disposable plastic apron, and a fluid repellent surgical mask. This applied whether or not the service user had symptoms of COVID-19. Use of PPE must be combined with hand and respiratory hygiene and standard infection prevention and control precautions.
11. On 24 Aril 2020 Public Health England also updated its guidance on infection prevention and control for COVID-19. This included guidance for care provided by health and social care workers in a person’s home when the person had symptoms of COVID-19. It says single-use aprons and gloves and re-usable masks were to be worn.

What happened

12. Mrs D has health conditions which may put her at risk of severe illness if she contracts COVID-19. She lives at home with her husband. The Council arranged for her to receive daily homecare visits to meet her care and support needs. This was provided by Niche Care (“the care provider”).
13. In November 2020 Mrs D complained to the care provider about the PPE being used by its homecare workers. She followed this up with a call to the Council on 25 November. Mrs D told a social worker the care workers were wearing masks and aprons but these were thin and easily ripped. She was concerned they were not wearing coveralls or gowns as she believed their arms and body should be covered to minimise the risk of spreading COVID-19.
14. The social worker sought advice and the Council spoke to the care provider. I have reviewed this correspondence. It says the care provider advised the Council that:
• disposable aprons, disposable gloves and masks were being used as per the Government’s guidance.
• staff were changing their equipment between calls and had been advised to shower if they had visited a service user who had COVID-19.
• the rounds had been changed to prevent the carers going between COVID-19 positive and non-covid service users.
15. The care provider replied to Mrs D's complaint on 14 December. It said the Council strongly supported that the personal protective equipment it was providing for care workers was the appropriate equipment for care services in the community which did not include clinical care. The letter does not explain what PPE was being worn or which guidance was being followed. It said the care provider would:
• Provide and maintain a sufficient stock of PPE.
• Provide and maintain training on the appropriate use of PPE.
• Carry out onsite observations to ensure staff are following the policy and procedure in relation to the use of PPE.
• Ensure care staff were aware of updated guidance.
• Test staff weekly for COVID-19.
16. Mrs D asked for her complaint to be escalated. The care provider sent her a further letter on 24 December, repeating its first response.
17. Mrs D remained concerned and complained to the Ombudsman. She told us care workers were changing PPE after visits, but they were concerned about visiting people with COVID-19 because they did not have proper PPE. Mrs D considered this was risky and unfair to the carers and other service users. She also said that when she had advised the care provider she was complaining, it had threatened to give notice on her care.

My findings

18. I understand Mrs D’s concerns about the risk of infection of COVID-19 and the adequacy of the PPE being used by the care workers. However, having reviewed the discussions between the Council and the care provider I have seen no evidence of fault in the PPE being used.
19. The Government’s guidance required homecare workers to wear aprons, gloves, and masks. There is no dispute that the care workers were wearing these, but Mrs D was concerned about their adequacy. The guidance does not specify the brand or quality of PPE to be worn. Indeed, it says they should be single use, which makes it more likely they would be made of thin material. Nor were homecare workers required to wear gowns or coveralls to cover their arms and backs. The PPE provided was in line with this guidance. It is perhaps unfortunate this was not explained to Mrs D in the care provider’s complaint response.
20. I can make no finding about Mrs D’s concern that the care provider said it would withdraw care if she complained as I have seen no records of that phone call and cannot say what happened.

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Final decision

21. There was no fault by the Council. I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman