Summary: Mr X complains about poor homecare provided by Healthvision (UK) Ltd on the Council’s behalf, causing him distress. The Council and Healthvision (UK) Ltd accept there was some fault in some of the home visits. There was also a failure to keep daily record sheets and to respond to two emailed complaints. The Council will apologise for the failure to respond to the complaints and take whatever action is necessary to ensure daily records are kept. There was no fault in the other matters complained of.

The complaint

1. The complainant, whom I shall call Mr X, is represented by his son, Mr Y.
2. Mr Y complains on Mr X’s behalf that:
1. A care worker acted without due care for Mr X’s blindness on 9 October 2018 by leaving a knife blade exposed in a dishrack, leaving a trip hazard and failing to complete cleaning as required;
2. Healthvision (UK) Ltd (the care agency) falsely alleged Mr X had made inappropriate comments to a carer on 9 October 2018 when Mr Y asked it not to send her again;
3. The care agency refused to provide further care when Mr Y complained again about several incidents of poor care after care workers were changed;
4. The care agency failed to investigate Mr Y’s complaints properly; and
5. The Council has failed to take responsibility for what happened or to challenge the care agency.

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The Ombudsman’s role and powers

3. 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)
4. 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)
5. Under the information sharing agreement between the Local Government and Social Care Ombudsman and the Care Quality Commission (CQC), we will share this decision with CQC.

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How I considered this complaint

6. I read Mr X’s complaint and spoke to Mr Y on the telephone. I considered the Care Act 2014 and made written enquiries of the Council. I considered the Council’s response to those enquiries. I shared a draft of this decision with both parties and invited their comments. I have considered those I received.
7. The failure to keep proper records is a matter that might amount to a breach of the CQC’s fundamental standards for care services, which is why I have referred the case to that body.

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What I found

8. Mr X is blind and receives care visits at home arranged by the Council.

Care provided on 9 October 2018

9. In its response to my enquiries, the Council confirmed hazards had been inadvertently left and cleaning not completed, though it maintained this was partly due to the way Mr X treated the care worker. Leaving the hazards was fault. The Council apologised for the care provided on 9 October 2018.
10. I cannot say if Mr X treated the care worker well or not as there were no other witnesses. So, I cannot say if any actions by Mr X led to the care worker leaving early. However, that is not the key issue in this complaint. This is because Mr X did not suffer any lasting harm and the Council’s apology is sufficient to remedy the injustice caused in the form of risk and minor injury.

Comments allegedly made on 9 October 2018

11. As stated above, there were no witnesses to what was said by Mr X and the care worker. I cannot therefore reach any view whether Mr X made any inappropriate comments or if the care worker falsely alleged this.

Refusing to provide further care in November 2018

12. In its response to my enquiries, the Council confirmed there had been a number of minor problems with care visits to Mr X between February and October 2018. Mr Y does not consider these issues were minor. They included mis-timed care visits, changes to times at late notice or without notice and a couple of incidents of care not being completed. There had also been a couple of incidents involving a lack of sympathy by a co-ordinator during phone calls. These were fault. The Council apologised for these. This apology is sufficient remedy for the inconvenience caused.
13. Although Mr X did not complain of this, the Council confirmed the care agency did not have the daily record sheets of the care visits. These are the sheets care workers fill out so there is a record that food has been prepared, medication prompted etc. Mr X confirmed he did not have them. I am therefore led to the view that the care agency failed to keep proper records of the visits. This was fault. However, I do not find this had any impact on Mr X.
14. The Council confirmed the care agency decided not to provide further care after the incidents mentioned. The documents it provided show the reason for this was because it felt its relationship between Mr X and the care agency had broken down. It referred to a manager witnessing Mr X shouting at a care worker.
15. Ending care just because someone complains is likely to be fault because such action carries with it an impression of punishing a person for complaining. But ending care where trust has broken down over a period is different. The Council’s response to my enquiries gave details of several workers being unwilling to return to Mr X. And Mr Y’s complaints, while mostly upheld, suggest that he had lost confidence in the care agency by November 2018. It is not relevant whether there were care failings or not in deciding if it was fault for the care agency to end care. Instead, it is a question of whether the care agency was right to take the view the relationship had broken down.
16. It seems to me from what I have seen that both parties had lost confidence in the other by November 2018. Therefore, I do not find the Council at fault for the care agency’s decision to end care. Even had I done so, I would note the Council’s comment that there have been no further issues with care provided by a new agency. That suggests to me that changing the care agency was beneficial to all.

The care agency’s investigation

17. Mr Y provided two examples of emailed complaints to the care agency, dated 23 March and 25 June 2018. I have seen no evidence of a reply to these complaints at the time Mr Y made them. However, the care agency responded to Mr Y’s complaints in writing on 31 October and 19 November 2018. It also met Mr X and Mr Y. The responses of 31 October and 19 November 2018 appear a reasonable summary of the issues raised, many of which were examples of the same issues, such as time-keeping. However, as I have seen no evidence of responses to the emailed complaints of 23 March and 25 June 2018, I find the Council at fault for this omission by the care agency. I also find the failure to reply would have caused Mr Y frustration.

The Council’s response to what happened

18. In response to my enquiries, the Council explained that its system is to ask care agencies to investigate complaints about that care they have provided, then to check the draft responses before they are sent to the complainant. The Council told me it had no concerns about the responses of the care provider as given in the letters of 31 October and 19 November 2018. It said this was because the care agency had offered explanations and offered apologies for things that went wrong. I also note that the issue of the missing daily records has only now come to light. I do not therefore find the Council failed to hold the care agency to account.

Mr Y’s response to the draft decision

19. Although he agreed with the findings of fault, Mr Y felt further investigation would reveal inconsistencies in what Healthvision (UK) Ltd reported. He wanted answers to questions about incidents that occurred. However, investigating further would not affect my decision as it is already clear and accepted by the Council and Healthvision (UK) Ltd that there was fault. And it is not possible to decide what passed between Mr X and carers where there is no corroborating evidence.

Agreed action

20. The Council has confirmed both it and Healthvision (UK) Ltd are prepared to apologise again for the upset caused to Mr X and Mr Y by the incidents that happened. As they have already apologised, I do not find this necessary.
21. Without evidence of a response by the care agency to the emailed complaints of 23 March and 25 June 2018 at the time Mr Y made them, the Council will apologise for that omission within one month of the date of the final decision.
22. To reduce the risk that the investigation of any future complaint will be compromised by a lack of the daily records of care visits to service users the Council will, within one month of the date of the final decision, check if Healthvision (UK) Ltd has these records for a small sample of service users. Should it not have them, the Council will take whatever action it finds necessary to ensure there are daily records of care visits to all service users.

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Final decision

23. I have upheld the complaint and completed my investigation as the Council has agreed to take the recommended action to remedy fault caused by injustice.

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Investigator's decision on behalf of the Ombudsman