Summary: The complaint is about the way the care provider ended its care provision at short notice, not allowing the complainants time to find a new provider. The Ombudsman’s view is a contract allowed the care provider to end the contract giving the notice it did. Although the care provider has not got a signed copy of the contract, this is unlikely to have caused a significant enough injustice to warrant the public expense of further investigation.

The complaint

1. The complainant, who I shall refer to as Mr W, is represented by his Daughter, Mrs Y. They complain about the care provider’s decision to cancel the care provision, following an argument between a carer and Mr W’s other daughter (Ms Z). Mrs Y does not dispute that an argument took place, but complains:
• the decision to cancel the care was unreasonable, as it was disproportionate to the stated reasons. Mrs Y says they did not have a contract allowing the provider to cancel the care.
• The care provider did not give them enough time or notice to find a new care provider.
• The care provider did not tell Mr W directly about ending the care provision.
• The care provider did not consider their suggestion to have a different family member as a point of contact.
• The care provider did not respond to requests for information.

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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 an adult social care provider’s actions have caused an injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))
4. 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

5. As part of the investigation, I have:
• considered the complaint and the documents provided by Mrs Y;
• made enquiries of the care provider and considered its response;
• spoken to Mrs Y;
• sent my draft decision to Mrs Y and the care provider and invited their comments.

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What I found

6. 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.
7. The care provider has provided a contract dated around the start of the time it began providing Mr W care. Clauses in the contract included that the care provider:
• would keep a daily written record of care and any other significant information.
• Reserved the right to cancel the agreement with immediate effect in circumstances that made providing a service untenable. It gives the examples of verbal or physical aggression, or an unsafe environment.
• Could give seven days’ notice for any reason.

The copy in the care provider’s records is not signed by Mr W, Mrs Y or Ms Z. Mrs Y says they do not have any copy of the contract in their records.

What happened

8. The care provider began providing Mr W with home care in April 2018. Mr W has Parkinson’s Disease. He and his family had arranged the care, partly funded by a direct payment from the local Council. Mr W gave the care provider written consent for it to share information with Mrs Y and Ms Z.
9. An August addition to the support plan noted Mr W’s health had declined – he was more confused and falling more. Mrs Y added a note to Mr W’s file on 26 October. This said she was worried about Mr W’s state of mind and had told the care provider. It has a note of this confusion in its 26 October electronic record. The care provider’s 27 October record noted Mr W was ‘very confused’.
10. On 28 October, the care provider’s records note a dispute between its staff and Ms Z about whether they needed to alert the NHS’s non-emergency 111 number. Carers were concerned Mr W was even more confused and that he was hallucinating. Its records has a statement from a carer. This notes Ms Z was ‘shouty’ and verbally abusive, when the carer told her she had called the 111 line and that it had advised a doctor should visit Mr W, and that it would not cancel that visit.
11. Ms Z telephoned the care provider the following day, asking to set up a meeting. It advised this would not be needed, as it had decided to end its care provision, because of Ms Z’s abusive behaviour towards staff. Mrs Y says the care provider also telephoned her, at the beginning of a holiday.
12. Later telephone conversations between Ms Z and the care provider have conversations that discussed:
• whether calling 111 was necessary. The care provider’s view was it had a duty of care, because Mr W was worse than normal and was hallucinating. Ms Z’s view was there was nothing wrong with Mr W and the doctor who visited confirmed this.
• Ms Z says she accepted she was abusive towards the carer who visited Mr W. The care provider noted she had also been abusive to a member of staff in its offices.
• The care provider advised Ms Z it had contacted the City Council’s adult social care department to advise it that it was ending its care provision.
• In at least two calls, Ms Z asked the care provider’s Director to contact her. The care provider told her it had instead emailed Mrs Y.
• That Mr W was upset the care provider was ending its care, as he had got on well with all the carers. Mrs Y and Ms Z said he was in tears because of the decision.
13. On 30 October Mr W fell twice. He was admitted to hospital after those falls, where he stayed for two weeks. Ms Z contacted the care provider, cancelling the care, as Mr W was in hospital.
14. Also on 30 October the care provider wrote to Mrs Y cancelling the care. It says it emailed her, as Mr W’s next of kin and because hers was the only email address it had. The letter said it was cancelling its care provision, due to the ‘nature of the incidents’. It mentioned verbally abusive telephone calls.
15. Mrs Y complained. She also made a request for a copy of the care provider’s file as a Freedom of Information request. The care provider’s response advised it had a duty of care towards its staff, who felt unsafe. The cancellation was not a reflection on Mr W. Mrs Y says it did not supply a copy of the file.
16. Mrs Y complained to the Ombudsman. In response to my enquiries, the care provider advised:
• Its view remained that on 28 October it had a duty of care toward Mr W, as he was hallucinating. It maintained it was correct to contact 111.
• Ms Z advised it on 1 November they had found a new care provider.
• It would be willing to meet Mrs Y and Ms Z to discuss the matter.
17. Mrs Y says she does not see what would now be achieved by meeting with the care provider.

Was there fault by the care provider?

18. When something has gone wrong, the Ombudsman’s aim is to put the complainant back in the position they would have been in if no fault had occurred.
19. Here the fault I have identified is that the care provider did not have a copy of a signed contract in its files. But my view is any injustice from the unsigned contract is unlikely to have made a significant difference to the way events unfolded. By that I mean that, if the care provider had had a signed contract, the events of 28 October would unlikely to have been different. After those events, it was entitled to decide it no longer wanted to provide care. The stated reasons for cancelling were not unreasonable.
20. I can understand the care provider’s decision distressed Mr W. But the decision to cancel was one it was entitled to make and so is not something we can criticise.
21. I also note the care provider was trying to contact the local Council to advise it of its decision. Presumably it would have continued to do this if Ms Z had not cancelled the care and told the care provider they had found a new care provider. So I do not agree the care provider did not allow Mrs Y and Ms Z enough time to find a new provider.
22. Mrs Y complains about the care provider contacting her, rather than Mr W. But the care provider had concerns about Mr W’s mental state and confusion. The records in the time before 28 October, suggest Mrs Y also had concerns about Mr W’s confusion. In those circumstances, I cannot criticise the care provider for contacting Mr W’s next of kin, especially as he had given written consent for that to happen. Clearly its relationship with Ms Z was strained, so my view is it was appropriate to contact Mrs Y.

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Final decision

23. I do not uphold the complaint and I have completed my investigation. My view is there is insufficient evidence of significant injustice to investigate further.

Investigator’s decision on behalf of the Ombudsman

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Parts of the complaint I have not investigated

24. I have not investigated Mrs Y’s complaint that the care provider did not provide the information they asked for. Mr W can complain to the Information Commissioner about this. The Information Commissioner, an independent body, has been specifically set up by Parliament to consider complaints about Freedom of Information requests and so is ideally placed to deal with complaints such as this.

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Investigator's decision on behalf of the Ombudsman