The Ombudsman's final decision:
Summary: Mrs X has complained about the care and support provided to Miss Y. She is also unhappy with the Care Provider’s decision to terminate its service agreement with Miss Y. There is evidence of fault by the Care Provider.
- Mrs X has complained on behalf of Miss Y about the care and support she received from Inspiration Care Limited (the Care Provider). Mrs X has also complained about how the Care Provider dealt with her complaint and its decision to terminate its service agreement with Miss Y.
The Ombudsman’s role and powers
- 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)
- If an adult social care provider’s actions have caused an injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))
How I considered this complaint
- I have considered all the information from Mrs X (on behalf of Miss Y) and the Care Provider. A copy of this decision was sent in draft to Mrs X and the Care Provider. I have considered the comments received in response.
- Miss Y receives care and support at home. Between May 2015 and October 2018, Miss Y arranged and paid for the Care Provider to deliver her care package using the direct payments she received from her Local Authority. As part of Miss Y’s care package, she received 56 hours support a week which included overnight support and assistance with daily tasks. She also received an escort to and from her work placement.
- In June 2018, the Care Provider had several staff changes over a short period of time. Mrs X complains that she was not told about the staff changes in advance and therefore could not prepare Miss Y for the changes to her care. Mrs X says the standard of care and support Miss Y received deteriorated after June 2018.
- She says:
- before the staff changes the Care Provider arranged an on-call service so Miss Y could contact support workers if she was feeling unwell or anxious. Mrs X says this service ended without any warning;
- the Care Provider escorted Miss Y to and from her work placement. Mrs X has complained about one occasion when the support worker did not arrive and says this caused Miss Y considerable distress;
- Miss Y has capacity to manage her own finances. However, the Care Provider restricted access to her money, financial records and care notes;
- Miss Y’s support hours were used inappropriately by staff for their personal commitments;
- the Care Provider lost the keys to Miss Y’s home;
- after sending its complaint response, the Care Provider terminated its service agreement with Miss Y giving 28 days’ notice. Mrs X says the Care Provider did not explain why it ended the agreement and did not give Miss Y enough time to find an alternative care provider. This meant Miss Y had to move into a residential care home for two weeks;
- the Care Provider arranged a meeting to discuss Miss Y’s complaint at short notice and therefore she did not have the opportunity to have a representative present.
What I found
- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards that 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. The Ombudsman considers the 2014 Regulations and guidance when looking at complaints about standards of care.
- Mrs X has raised several concerns about the care and support Miss Y received after June 2018. The Care Provider disputes many of Mrs X’s claims. It says it did tell service users about the staff changes and tried to contact Mrs X and Miss Y’s sister to let them know about the changes. The Care Provider also says the on-call service did not end and it provides this to service users every day from 5 pm. The Care Provider does not agree that support workers failed to collect Miss Y from her work placement and says it did not keep a copy of Miss Y’s house keys. The Care Provider accepts that Miss Y was taken to a member of staff’s slimming class but says Miss Y agreed to this and they were only there for a short time.
- Mrs X and the Care Provider do not agree on many of the issues complained about, and I cannot know for certain what happened. However, regardless of which version of events is correct, many of the matters complained about would not meet the threshold for fault or have caused Miss Y any significant injustice. I am also satisfied that the Care Provider’s notes show that Miss Y was told about staff changes and a care rota was kept in her kitchen so she knew who would be providing her support each day. Mrs X says the Care Provider used Miss Y’s support hours inappropriately as a member of staff took Miss Y to a private appointment and to her home for dinner. The Care Provider’s case notes support Mrs X’s claims, but as Miss Y agreed to both visits, I cannot say this was fault or that it caused any injustice.
- Mrs X has also complained the Care Provider restricted Miss Y’s access to her finances. She says it locked financial information, money and care notes in a filing cabinet and restricted access to this information for about two months. The Care Provider accepts that Miss Y has capacity to manage her own finances and says it removed the locks from the filing cabinet after a few days. It says it put the restrictions in place to protect Miss Y’s personal information following the introduction of the General Data Protection Regulation (GDPR). However, it accepts that it had misunderstood the GDPR requirements and has now given its staff further guidance.
- Restricting access to Miss Y‘s finances was fault. However, I have needed to consider what, if any, injustice this caused. Mrs X and the Care Provider disagree about how long Miss Y’s information was locked in the filing cabinet. But, regardless of this, I cannot say any significant injustice has been caused. Miss Y received support each day and therefore could still have daily access to her information.
- I have also considered Mrs X’s concerns about how the Care Provider dealt with her complaint and its decision to end the service agreement. Mrs X says the Care Provider arranged a meeting to discuss Miss Y’s complaint at short notice and therefore she did not have the opportunity to have a representative attend.
- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 16 says that any complaint must be investigated, and necessary and appropriate action taken in response to any failures identified. The Care Provider’s complaint policy says it will acknowledge complaints in writing within five days and a member of its management will talk to the complainant about their concerns. I understand Mrs X says the meeting to discuss Miss Y’s concerns was arranged at short notice. But it did give Miss Y the option to postpone this for a later date so she could have a representative attend. As Miss Y was happy to go ahead, I cannot say the Care Provider was at fault for not rearranging the meeting or insisting that other parties attend. I am also satisfied the Care Provider did address Mrs X’s concerns, even if she did not agree with the responses.
- Mrs X has also raised concerns about the Care Provider’s decision to end its service agreement with Miss Y. Mrs X says the Care Provider did not explain its reasons for ending the agreement and did not provide enough time for her to arrange alternative care. The Care Provider’s service agreement says it will not normally end the agreement unless the service user agrees. However, it lists the circumstances that may lead to it terminating the service. The contract of services between the Care Provider and Miss Y says 28 days’ notice will be given in writing to terminate the contract. The Care Provider says that Miss Y made it clear that she wanted to use a new provider. It also says it had a meeting with Miss Y to discuss the termination of the service agreement and confirmed the 28 day notice period. It says the written minutes from this meeting were sent to Miss Y.
- Miss Y had to move into a residential care home for two weeks as there was a delay before her new provider could arrange care, but I cannot say the Care Provider was at fault in this regard. This was outside of its control and the notice period it gave was in line with the contract for services. However, while the Care Provider was entitled to end the service agreement, the reason for ending the service is a little unclear and does not seem to fall within the circumstances listed in its service agreement. I understand the Care Provider sent Miss Y the written minutes confirming her notice period, however it may have also been beneficial to send Miss Y a letter to confirm this and the reasons for ending the agreement.
- The Care Provider has agreed to apologise to Miss Y for not ending the service in line with the service agreement. This action should be taken within one month of this decision.
- There is some evidence of fault with the care and support the Care Provider gave to Miss Y.
Investigator's decision on behalf of the Ombudsman