Surrey County Council (18 004 653)

Category : Adult care services > Domiciliary care

Decision : Upheld

Decision date : 12 Feb 2019

The Ombudsman's final decision:

Summary: Mrs X says that care organised for her by the Council was inadequate. The Ombudsman has found some evidence of fault. He recommended the Council liaise with the care provider to ensure these failings do not reoccur and that it apologise to Mrs X and pay her £100 in recognition of the loss of service caused to her by the failings he has identified. The Council agreed.

The complaint

  1. Mrs X says the care organised for her by the Council has been inadequate. The Council uses a company (Agency Y) to provide her care. Mrs X says Agency Y provided inadequate care because it:
  • arranged her morning visits for 10.45 and her afternoon visit at 12.15;
  • did not tell her that care was not being provided on some days;
  • made her accept staff she had previously declined;
  • provided staff that were unprofessional; and
  • did not provide her with her preferred carer.

 

This left Mrs X either without care or with care she felt did not meet her needs.

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What I investigated

  1. I have investigated Mrs X’s concerns about the care provided to her. I have not investigated her concerns about her being provided with the details of another person’s care rota and the latter parts of my statement explain my reasons for not doing so.

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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. As part of my investigation I discussed the complaint with Mrs X. I made enquiries of the Council and considered its response and documents it provided including records of the visits to Mrs X’s home. I set out my initial thoughts on the complaint in a draft decision statement and invited Mrs X and the Council to comment.

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What I found

  1. Mrs X has a degenerative spine condition which has reduced her mobility and causes her significant pain.
  2. The Council carried out an assessment of Mrs X’s needs and agreed a support plan with her. The plan says Mrs X will receive the following support:
  • a 30 minute breakfast call seven days a week;
  • a 45 minute lunch call seven days a week;
  • a 30 minute tea time call seven days a week and;
  • a 60 minute domestic call once a week.
  1. Mrs X first raised concerns about the care provided by Agency Y in January 2018 following a change in management.
  2. Mrs X moved to new accommodation in late March. Mrs X’s new home is located in an area served by a different team to that of her previous address. This meant that Mrs X’s preferred carer no longer covered the area where she lived.
  3. Following the move Mrs X continued to report problems with the care she was receiving from Agency Y. This included problems with them carrying out household tasks such as emptying the bins and washing up. The Council arranged to meet with Agency Y to discuss matters.
  4. However the problems continued and in May Mrs X sent an email of complaint to the Council and Agency Y. The complaint included the following:
  • there was a personality clash between her and the local manager which began when the manager called unannounced early one morning to discuss Mrs X’s care needs with her. This was unsuitable as Mrs X’s medication makes it difficult for her to engage first thing;
  • care staff were rude and unprofessional. Reference was made to an incident where the carer advised she did not have time to undertake the duties of other staff and Mrs X’s husband felt pressured to say he would carry out her duties instead. This resulted in Mrs X declining care from the staff that acted in this manner;
  • calls were cancelled without Mrs X being notified. She was told this was because only carers she had declined were available. For this reason Mrs X agreed to accept one of the carers she had previously declined;
  • Mrs X’s rota was changed without her being told resulting in a carer she had a good rapport with being taken off her calls; and
  • Mrs X received another client’s rota.
  1. In its reply to the complaint Agency Y:
  • acknowledged Mrs X’s rota was changed without her being notified and offered an apology;
  • accepted it had cancelled a visit without notifying her and that it should not have assumed she would not want the visit simply because carers she had declined would attended;
  • explained that the care manager had emailed her about the carers she had declined to ask why Mrs X no longer wanted these carers to attend, as this is their usual practice;
  • offered an apology from one of the carers who Mrs X thought was unprofessional;
  • explained that one of Mrs X’s preferred carers would not be able to attend to her as frequently now that she had moved to an area served by another team. The letter explained it would take too long for the carer to travel to and from Mrs X’s home and her other clients; and
  • said that a supervision session had been arranged with staff involved and training arranged to help develop staff communication skills and promote professional development.
  1. Mrs X also contacted the Council to request that her call times be changed as they were too close together with her morning call and afternoon call being only an hour and half apart. She explained that, as she needs to take her medication with food, the timing of the visits was unsuitable for her needs. Agency Y says that visits were closer together so Mrs X’s preferred carer could attend. It says Mrs X was happy with this arrangement.
  2. A meeting between the Mrs X, the Council and Agency Y took place at the end of May. The meeting discussed Mrs X’s concerns and agreed a plan to address these.
  3. However in July Mrs X reported that problems with Agency Y were continuing. Matters escalated after Mrs X made comments on social media about the service she was receiving. The Agency decided that, despite working with the Council to resolve matters, it could no longer meet Mrs X’s needs and it gave her two weeks’ notice that they were terminating her contract.
  4. The Council helped Mrs X find a new care provider and a new service began in August.

Analysis

Agency Y arranged Mrs X’s morning and afternoon visits too close together

  1. The care plan for Mrs X says that she should receive a call in the morning for breakfast and another call for lunch. I understand from the Council that it commissioned the breakfast call for 8:00 and the lunch call for midday. However, breakfast calls sometimes took place at 10:45 and lunch visits at 12:15. This is significantly closer together than the times commissioned by the Council and I agree that these timings were too close together.
  2. While I am aware that staff from Agency Y were not administering Mrs X’s medication, this does not alter the fact that she needed to take her medication with food. As the morning and afternoon visits were to provide meals, changing the times of these would clearly impact on when Mrs X could take her medication. While I appreciate Agency Y altered the timings of visits to accommodate Mrs X preference for a particular carer it should not have done so if it meant altering the commissioned times that reflected Mrs X’s care needs.

Agency Y failed to tell Mrs X when visits would not take place

  1. It is agreed that Agency Y failed to notify Mrs X that a visit would not take place in May. Although Mrs X was not left without care on this occasion this was not because of any actions taken by Agency Y. Clearly such incidents should not occur.
  2. Care records provided as part of my enquiries show that Agency Y aborted more than 20 visits in the period from Mrs X moving to her new home and her changing providers. While I note that there is no indication that Mrs X was not informed in advance, the records show that less than 24 hours notice was provided. It is evident from the records that Mrs X was not receiving the service the Council had commissioned for her.
  3. I am aware the records also show that Mrs X cancelled a number of visits herself however I do not consider this offsets the injustice caused to her by Agency Y cancelling visits.

Agency Y made Mrs X accept carers she had previously declined

  1. I am aware that Mrs X felt it necessary to accept a carer she had previously declined following the incident when a visit was cancelled without her being told. I understand that staff at Agency Y explained that visits were likely to be cancelled again because she had declined three carers and this impacted on the availability of suitable carers. While I do not think this can be construed as Agency Y making Mrs X accept carers she had declined, I appreciate that she may have felt as though she had little option but to do so.

Agency Y provided staff that were unprofessional

  1. In its reply to her complaint Agency Y apologised if Mrs X felt staff had been rude and unprofessional. The Agency has arranged for training on how to communicate with service users for its staff but maintains that staff did not act inappropriately. Given that training that was arranged I consider, on the balance of probabilities, that staff could have communicated with Mrs X in a more professional way. It is unlikely that training would be arranged if a training need had not been identified.

Agency Y did not provide Mrs X with her preferred carer

  1. When Mrs X moved home she moved from the area covered by her preferred carer. For this reason her preferred carer could no longer be scheduled to carry out visits to Mrs X’s home. While I appreciate this was difficult for her, the Agency needs to organise its resources to ensure it provides care to all its service users. The Agency has explained that the travel time for Mrs X’s preferred carer to visit her home was too long. I do not find fault in this matter.

Agency Y terminated Mrs X’s contract

  1. It is clear that during the period April to July the relationship between Mrs X and Agency Y broke down. I understand the Agency felt the relationship was irretrievable and this was a decision it was entitled to make. I note that Mrs X was given a period of notice and the Council arranged a new care provider, so Mrs X was not left without care because of Agency Y’s decision.

The Council’s handling of Mrs X’s concerns

  1. Information provided by the Council shows that Mrs X’s Keyworker was in touch with Agency Y to try and resolve the problems she was experiencing. I note that she arranged a meeting between Mrs X and Agency Y in May which was received positively by both parties. The Keyworker also helped to arrange a new care provider for Mrs X once Agency Y ended its contract with her and did so in a timely manner to ensure she was not without care.
  2. I note that Mrs Y’s Keyworker was on annual leave when problems resumed in July. However I understand Mrs X wished to wait for her to return rather than have another officer address her concerns with Agency Y on her behalf. I do not consider the Council is at fault in this matter.

Agreed action

  1. I recommended the Council liaises with Agency Y to discuss the failings I have identified. I also recommended it ensures visits are provided at the times it has commissioned and that service users are notified when visits are cancelled. The Council agreed.
  2. I have identified that Mrs X has received a poor service because of the times her visits were undertaken and the cancellation (some without notice) of visits. In recognition of these failings I recommended the Council apologises to her and pays £100 in recognition of the injustice caused to her. The Council agreed.

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Final decision

  1. I have ended my consideration of this complaint because the Council has agreed to the above measures which I consider suitably address the fault I found and the injustice caused to Mrs X as a result.

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Parts of the complaint that I did not investigate

  1. I did not investigate Mrs X’s concerns that she received another person’s rota. This is because issues concerning personal data should be referred to the Information Commissioner as this is the body set up by Parliament to consider such matters.

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Investigator's decision on behalf of the Ombudsman

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