Summary: The Ombudsman’s has not found evidence of fault by the care provider regarding concerns Mrs K raised about the live in carer and about giving notice regarding the contract.

The complaint

1. The complainant whom I shall refer to as Mrs K, complains on behalf of her mother Mrs A that the care provider she employed to care for her mother at home:
• did not provide a contract for her to read in advance of the contract starting. She says it was not until 5 days after the care started that she received a contract.
• Did not give clear and concise costings for her mother’s care. She says the care provider told her that the charge was £973 per week inclusive of all costs but then it told her she must pay for the carer’s food.
• Failed to allay her fears regarding her mother receiving her daily medication.
• Stated she had been given an invoice on 11 July when this was not the case.
• Refused to refund any of the £3982 she paid in advance. She says she suggested paying a cancellation fee and out of pocket expenses.
• Did not address her concerns in its response of 21 September 2018. She says the provider did not advise her who was on the complaint panel.

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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. (Local Government Act 1974, sections 34B and 34C)
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 the copy correspondence provided by the complainant. I have made enquiries of the care provider and considered the comments and documents the provider sent me. I have also considered the complainant’s comments on my draft decision.

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What I found

5. Mrs K arranged an urgent care package from the care provider for her mother Mrs A, who has dementia. Mrs A had recently had a fall and Mrs K was unable to provide care as she lived too far away. Mrs K employed a live-in carer with the care provider to start work within two days of her call.
6. Mrs K says that on the day the carer was supposed to start she did not come at the time arranged. Instead an office worker from the care provider arrived and sat with Mrs A until the carer arrived. The office worker did not bring a hard copy of the contract for the care package. When Mrs K asked for it the care provider sent a copy of the contract by email. Mrs K emailed to confirm she had received the contract. However, she says was not able to open this, and so had not seen the terms and conditions before the start of the service. She says she did not receive a copy of the contract until five days after care started.
7. Mrs K emailed the care provider the evening that care started regarding the handover to say it had made a stressful situation more difficult. She said was unfair for it to expect her to hand over a cheque for 4 weeks care without having seen the contract. She said she did not know that food for the carer was not included as the care provider told her by telephone the fee was all inclusive. She felt it was not the best of starts.
8. After 8 days on 19 July 2018, Mrs K called the care provider to say that she did not want the carer to continue. The care provider’s note of the call stated that it offered her an alternative carer, but she refused.
9. Mrs K complained to the care provider. She said that Mrs A had become distressed in the last few days was depressed and uncooperative. She said her mother was hard of hearing and could not understand the carer because of her accent. She also said that Mrs A felt intimidated by the carer. When Mrs K asked the carer about her mother’s medication the carer seemed uncertain about it saying she had not received information. Mrs K said she had left written information. The carer then said that she had given the medication. Mrs K did not believe the carer had given the medication, and this may have accounted for her mother’s distress. She thought the carer did not know about her mother’s dementia because Mrs A kept asking for her cat. Mrs K said Mrs A’s mood improved as soon as the carer left, and that Mrs A said the carer had left her to struggle to get out of bed. She believed that there was a cause for concern regarding the carer.
10. The care provider called Mrs K to discuss the complaint. Mrs K said she was concerned the carer may not have given the medication. This may have caused her mother’s decline because one tablet was an anti depressant. However, she said that as the care provider did not keep records it was not possible to check. She also explained that she was not willing to accept a different carer because her mother was too upset. She did not believe it would be possible to get another carer at short notice in any case.
11. She had not signed the contract because the care provider had not given a hard copy on the day care started and she could not agree to the clause regarding early cancellation. She felt it was unfair of the care provider to profit from an elderly person because it had received a month’s fees for a week’s service.
12. The care provider responded in September 2018. It said that it provided a care package at short notice. It said the carer was experienced and fully qualified. It was surprised at the comments Mrs K had made about the carer because it had not received any other negative feedback. While it noted Mrs A was not happy with the carer, it said this could have been due to a number of things, such as Mrs A not accepting someone else in her home. The carer herself felt she had got on well with Mrs A. Therefore, it did not consider it could come to a conclusion regarding the reasons Mrs A was unhappy. It said it had offered to provide another carer, but Mrs K refused cancelling the contract without notice. It explained its terms and conditions required notice and in paying the invoice prior to the service starting she had agreed to the terms.
13. Mrs K complained to the Ombudsman because she was not satisfied with the care provider’s response.

Analysis

14. The care provider has provided evidence that the contract was sent by email on the day the care started. Given that the care package was arranged at very short notice I do not see that there is fault here. Mrs K could not open it and says she did not receive a copy until five days later. It is not clear why Mrs K could not open the contract, but the care provider believed it had been provided, albeit on the day that care started. I do not consider I can conclude that Mrs K would not have continued with the care provision even if she had received the contract.
15. As part of the learning from the complaint, the care provider says it will ensure that a hard copy of the contract is given to the service user or representative at the start of the service to ensure it is read and signed and the care package is correct. I consider this is an appropriate action.
16. Mrs K complained the care provider did not advise her that they must provide the carer’s food, and stated that the £973 per week was all inclusive. I can see that the contract does not refer to carer’s food. However, the information in the care provider’s leaflet regarding live in care does explain that there are no extra charges, but carers do not contribute towards utility bills, food and petrol. It is difficult to verify what was said as there is insufficient evidence. Therefore, I have not found fault here.
17. Mrs K complained that the care provider failed to allay her fears regarding her mother receiving her daily medication. When interviewed regarding the complaint the carer confirmed that all medication was given as prescribed. I asked the care provider to send me a copy of the MAR (medical administration record) sheet that the carer should have completed. The care provider says that it does not have this as it was left in Mrs A’s home when the carer left. I do not have documentary evidence of the medication that was given to Mrs A. However, while the carer may have appeared uncertain at first, she then confirmed the medication had been given. I do not consider that the uncertainty leads to a conclusion that the carer did not give the medication. The change in Mrs A’s mood and behaviour could have been due to a number of other reasons. I have not found fault here.
18. Mrs K complained the care provider stated she had been given an invoice on 11 July when this was not the case. I have seen the invoice dated 10 July 2018. It is not clear how this was sent to Mrs K. However, she did pay the amount of the invoice on 11 July 2018. If an invoice was not sent, I cannot see that there is a significant injustice due to this.
19. Mrs K complains the care provider refused to refund any of the £3982 she paid in advance. She says she suggested paying a cancellation fee and out of pocket expenses. The Ombudsman can only consider whether the terms and conditions are clear in an ordinary reading of the contract. In this case it appears the terms were clear and the notice period for cancellation was 4 weeks. The care provider offered another carer, but Mrs K refused this. In my view the contract terms are clear and while Mrs K was not satisfied with the carer, she did not accept the offer of a different carer. The contract was deemed as accepted despite the fact that Mrs K did not sign it because she had paid in advance and the service had commenced. There is no apparent fault by the care provider here. It was Mrs K’s choice to end the service early.
20. Mrs K complained the complainant did not address her concerns in its response sent in September 2018. She says the provider did not advise her who was on the complaint panel. It appears the care provider’s complaint process is a single stage and there is no complaint panel. I have considered the care provider’s response and while it did not respond to all Mrs K’s concerns, it addressed the key points regarding her dissatisfaction, which were the concerns regarding the carer and the contract. The care provider could have provided a more detailed response, but I do not consider that this was a fault or that it caused injustice.

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Final decision

21. I have not found fault by the care provider and so I have completed my investigation and closed the complaint.

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Investigator's decision on behalf of the Ombudsman