The Ombudsman's final decision:
Summary: Mr X complains about the care Creative Support provided for his son. Creative Support accepts the care it has provided and the way it responded to complaints has not been adequate. Creative Support needs to increase its offer of financial redress to reflect the significant injustice it has caused.
- The complainant, whom I shall refer to as Mr X, complains about the care Creative Support provided for his son.
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 34B, 34C and 34H(4), as amended)
How I considered this complaint
- I have:
- considered the complaint and the documents provided by Mr X;
- discussed the complaint with Mr X; and
- shared a draft of this statement with Mr X and Creative Support and taken account of the comments received.
What I found
- Mr X’s son lives in his own home. He received direct payments which he used to buy 10 ½ hours of support from Creative Support, which sent its support workers to his home.
- Mr X says the problems started in August 2017. He complained to Creative Support in January 2018 but it did not respond. He sent a further letter in February, and had a meeting with Creative Support which then sent him a response in March. Mr X says his son’s support improved for a while. But by August Mr X says his son was having problems with some of his support workers, and recommendations made by an Occupational Therapist (OT) and a Speech and Language Therapist (SALT) were not being taken seriously. He made another complaint and received a response later in August. He had a meeting with Creative Support in October and received a further response later that month. Mr X had a meeting with Creative Support in January 2019. He says they had no rotas and then its support reduced to three hours a week. He made his final complaint in February.
- Cretaive Support stopped supporting Mr X’s son in February. During the last few weeks it only provided three hours of support a week. It says this was because Mr & Mrs X would only allow one member of staff to work with their son.
- Following a meeting with Mr X on 28 February, Creative Support sent its final response on 4 April.
- Creative Support accepted:
- it should have raised a safeguarding concern when his son said he may as well kill himself;
- it should have investigated concerns about one of its carers when he first raised them but could not do so now as the carer had left;
- another carer had not followed the son’s action plan and did not make a record of his visit;
- a Service Director’s response to a complaint had not met the expected standards;
- Mr X should have received a response to a complaint about a carer who called his son “Sir” against his wishes;
- a carer had not helped his son properly on a shopping trip and left his perishables outside the fridge for four hours;
- a carer had got his son to buy a bag of rice for him, called him “old chap” and touched him on the shoulders against his wishes;
- it had taken a long time to respond to his concerns and not all its responses had been as comprehensive as they should have been;
- it could not explain why it had told him there was a number for his son to call if he needed urgent support, as that was not the case;
- a meeting to address his son’s concerns resulted in a member of staff making complaints about his son and leaving before addressing his son’s concerns;
- the transition did not go smoothly when two members of staff left;
- despite receiving his letter of 6 January 2018, it did not respond to it;
- a document Mr X had produced to help the support workers care for his son had not been discussed with the team;
- it had not responded to a request for an urgent review meeting in January;
- it had not given his son an up-to-date handbook as it had not checked and updated his file regularly;
- it should have reviewed his son at least every six months but did not do so;
- his son’s file was out of date and did not contain the OT and SALT reports, so their importance was not taken account of;
- a new support plan was implemented without his son’s agreement or his parents receiving a copy;
- it could not explain why 1 ½ hours of his son’s 10 ½ hours had been put in place for administration without an adequate explanation;
- it should not have had his son’s cheque book when it used it to pay itself for its services;
- it had not responded in a timely manner to Mr X’s correspondence and its responses had not addressed all his points;
- it had failed to manage support workers as well as it should have done;
- it had not managed his complaints in a caring and professional manner and should not have closed them when it had not responded to them;
- although Mr X sent comments on an advert to recruit support workers and asked to receive the advert, it did not respond;
- it was wrong to cancel a meeting without warning or consultation;
- a support worker had called his son, despite a request that he have no contact with him;
- it had suggested his son contact someone he did not know and for whom he did not have a number when his support worker was away;
- a new support worker missed a shadowing shift when she came off a night shift;
- it failed to change his son’s welfare call from 10.30 to 09.30, despite being asked to do so;
- it had not always provided a support rota to his son, as needed;
- it should have consulted Mr X before cancelling training for support workers from an OT;
- it had been difficult to recruit support workers willing to use their own cars to drive his son to appointments and for shopping;
- it had altered regular support arrangements which disturbed and disrupted his son;
- at times support workers had not prompted his son properly to clean his flat but it was not their job to do the cleaning for him;
- support workers had not been robust enough in supporting his son to clean the bathroom or the outside rubbish area;
- it had stopped supporting his son with his finances, despite this being part of the agreement from the start;
- it had not supported his son to keep his electricity meter topped up, resulting in it running out;
- support workers should have been more robust in prompting his son to take his medication;
- it had not supported his son to give up smoking or find a job.
- it had failed to send notice of a rate increase, as it did this on 31 October 2018;
- it had been at fault for allowing a support worker who had only done an introductory session with his son to introduce another support worker;
- it had received his complaint before a meeting on 13 February 2018;
- it had been wrong for an officer to say he had been on annual leave, despite Mr X not having leave and having to provide support to his son because of its failings.
- the complaints set out in their letter of 3 February 2019;
- complaints about a Manager;
- the basis of their son’s support;
- the issue of banked/overcharged hours between 2015 and 2017;
- overcharged invoices dated 22 January and 28 February 2019;
- the notification of an increase in the hourly rate charged;
- the level of compensation;
- concerns about records.
- Mr X’s complaint of 27 March 2018 included a complaint that Creative Support had always invoiced for 10 ½ hours of support a week but did not always provide this. He estimated 200 hours could not be evidenced. He discussed this with Creative Support at a meeting on 25 April. When Creative Support wrote to him on 24 August 2018, it said:
- he had accepted there were many occasions when it had overprovided support;
- he therefore suggested Creative Support honour 50% of the 200 hours;
- Creative Support had agreed to this;
- it had created a contact sheet for use of the 100 hours, which showed 17 hours had been used since 2 May 2018.
Did the care provider’s actions cause injustice?
- There is no dispute over the fact there have been significant problems with Creative Support’s service for Mr X’s son. This is reflected in the fact that Creative Support has upheld almost all Mr X’s complaints. These failings have caused significant injustice to Mr & Mrs X and their son since 2017. Mr & Mrs X have had to step in when Creative Support has not provided the care it should have done. They have also been put to significant time and trouble in pursing the complaint on behalf of their son. Their son has not had all the support he should have done, due to cancelled and altered care arrangements. Some of his needs have not been met in the way that they should have been (e.g. the failure to take account of the SALT and OT advice).
- The key issue for me to consider is whether the remedy offered by Creative Support is sufficient for the injustice it has caused. My view is that it is not. It does not sufficiently reflect the length of time over which there have been problems and impact that the failings will have had on Mr and Mrs X and their son.
- With regard to the banked hours, the evidence shows an agreement was reached in March 2018. This took account of the difficulty of working out precisely how many hours had been charged for which care had not been delivered. Nothing has changed since then. There is therefore no basis for me to say Creative Support should pay more than the £1,161.71 it has offered to pay.
- I recommend Creative Support within four weeks:
- pays the son £1,500 and refunds £1,1616.71 relating to the banked hours;
- pays Mr & Mrs X £500 each.
Creative Support has agreed to do this.
- I have completed my investigation on the basis that Creative Support will take the action I have recommended.
Investigator's decision on behalf of the Ombudsman