The Ombudsman's final decision:
Summary: Mr B complains that the Care Provider wrongly charged him for care it delivered to his mother and that it did not appear to have a complaints procedure. The Care Provider was at fault because Mr B was given unclear information about care charges and Mr B’s complaint was not responded to. The Care Provider has agreed to refund half the care charges and review its website and documents to make sure its complaints procedure is clear and visible.
- The complainant, whom I shall refer to as Mr B, complains the Care Provider did not charge for his mother’s care as it said it would. Mr B says that care provision was charged in 30 minute blocks of time, rather than by the minute and that care visits were sometimes significantly under 30 minutes long. Mr B also says the Care Provider did not appear to have a complaints procedure.
The Ombudsman’s role and powers
- We investigate complaints about adult social care providers. If there has been fault, we consider whether it has caused an injustice and, if it has, we may suggest a remedy. (Local Government Act 1974, sections 34H(3) and (4), as amended)
- 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)
- Under a memorandum of agreement with the Care Quality Commission (CQC) the Ombudsman shares all decisions about adult social care and so we will share this decision with the CQC.
How I considered this complaint
- I spoke to Mr B and considered his complaint. I looked at documents the Care Provider sent about its involvement in Mr B’s case.
- I have written to Mr B and the Care Provider with my draft decision and given them an opportunity to comment.
What I found
- An adult social care provider within our jurisdiction is one which carries out ‘regulated activities’ relating to providing adult social care. The activities include personal care or other practical support provided in the place where the person lives.
Fundamental Standards of Care
- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards 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.
- Regulation 16(1) of the 2014 Regulations says any complaint received must be investigated and necessary and proportionate action must be taken in response to any failure identified by the complaint or investigation.
- Regulation 16(2) of the 2014 Regulations says Care Providers must establish and operate effectively an accessible system for identifying, receiving, recording, handling and responding to complaints.
- Mrs C, Mr B’s mother, suffered from a stroke in 2018. She was living independently in her own home but suffered from further serious medical problems. Services from the Care Provider were privately arranged and paid for.
- The contract was for domiciliary care services delivered to Mrs C. Each visit to Mrs C was made by two care workers, once in the morning and once in the evening. Mr B says that some visits by care workers lasted only 10 to 15 minutes.
- Mr B says he was informed when the care plan was drawn up initially that charges for care would be calculated on a per minute basis. He says this was confirmed by office staff in a telephone call.
- The Care Provider invoiced Mr B for care provided by each care worker in 30-minute time periods. Mr B complained to the Care Provider by email about the inconsistent advice he had received about charges for care. The Care Provider did not reply to his complaint.
- Mr D is Mr B’s brother. He had suffered stress because of handling his mother’s care needs and Mr B says he was vulnerable. Mr D paid the invoice despite the Care Provider having made no response to Mr B’s complaint.
The charges for care
- The contract stated that the fees payable were per half hour. It was not clear whether that was the total charge for care or for the time of each carer who attended. This was fault by the Care Provider and caused injustice to Mr B, because its contractual charges were not clear.
The complaints procedure
- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 16 covers ‘receiving and acting on complaints.’ The Care Provider says the complaints procedure was in the information pack in the client’s house. I have not been able to verify this during my investigation because the Care Provider offered a remedy very quickly. Information on the complaint procedure was included in a blank service user guide the Care Provider sent to me but this did not contain any contact details.
- Mr B said there was no information on the Care Provider’s website about its complaints procedure. When I investigated I could not find this information on the Care Provider’s website either.
- Mr B sent his complaint by email to the Managing Director of the Care Provider because those were the contact details which were published on the website. The Care Provider was unable to say why it had not received and responded to Mr B’s email complaint. It speculated that Mr B’s email had possibly gone into a junk email folder and been deleted after a week.
- The evidence shows that there was not an accessible complaints procedure and the Care Provider did not respond to Mr B’s complaint.
- This was fault by the Care Provider and caused injustice to Mr B, because its complaints procedure was not clearly available and his complaint was not responded to. This was not in accordance with the law, and its regulator’s fundamental standards.
The Care Provider’s response
- When the Care Provider responded to the Ombudsman’s enquiries it voluntarily acknowledged that the contract was not clear that it charged for contracted time and that in the event of there being two carers then time was charged for each carer.
- To its credit, the Care Provider has already offered to refund a proportion of the care costs and review the information provided about its complaints procedure in its documentation and on its website.
- Mr B is satisfied with the Care Provider’s response.
- The Care Provider has already said it will:
- Refund Mr D £630 because the payment terms in its contract were unclear.
- Review the information in its Service User Guide and contract to ensure it is relevant and fully explains its procedures. The revised complaints procedure will be published in a prominent position on its website. This should be completed within one month of my final decision.
- The Care Provider’s charges were unclear and it didn’t respond to Mr B’s complaint. The Care Provider has agreed to my recommendations and I have completed my investigation.
Investigator's decision on behalf of the Ombudsman