Summary: Mr X complained Helping Hands sent inexperienced carers to look after his father, Mr Y. He said this caused his father distress and put him to unnecessary time and trouble. There was fault in the Care Provider’s actions because the carers were inexperienced, there was no up to date care plan in place and some visits were late and poorly spaced out. This caused some injustice for Mr X and Mr Y.
The Care Provider has put forward a satisfactory remedy for Mr Y.
It has agreed to make a payment to Mr X and remind staff of the need to accurately complete care visit records.

The complaint

1. Mr X complained about the quality of domiciliary care provided to his father Mr Y, by the Care Provider, Helping Hands. Mr X says the carers lacked confidence and experience and were unsure of how to care for Mr Y. He also said Helping Hands failed to finalise Mr Y’s support plan, there was a lack of continuity of carers, care visits were late and poorly spaced out.
2. He said his father was unsettled and distressed by the care he received.

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The Ombudsman’s role and powers

3. 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)
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. I contacted Mr X and discussed his view of the complaint.
6. I made enquiries of the Care Provider and considered the information it provided.
   This included the Care Provider’s final response, Mr Y’s support plan, Mr Y’s daily care logs and emails shared between Mr X and the Care Provider.
7. I wrote to Mr X and the Care Provider and considered their comments before I made the final decision.
8. 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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What I found

Care Provider Policy

9. The Care Provider’s policy is to ensure a care and support plan listing the needs of the customer is in place prior to when the care begins.
10. Mr Y’s support plan, from 15 May 2019, states he should receive four daily visits at morning, noon, teatime and night-time from a carer to help him perform tasks such as eating, cleaning himself and taking his medication.
11. Mr Y’s support plan states he should be contacted if a carer is going to be late.

What happened

Background

12. Mr X and the Care Provider met in March 2019 to discuss and agree upon Mr Y’s
    support needs.
13. The Care Provider was contracted to begin providing Mr Y’s care on 22 April 2019. The Care Provider has confirmed it had not finalised Mr Y’s support plan by this point.

Mr Y’s complaint

14. From the outset, Mr X was unhappy with the care his father, Mr Y, received.
    He said the Care Provider:
• did not finalise a care plan for Mr Y, requiring his sister, Ms W to write one;
• sent several inexperienced, underconfident employees to care for his father;
• failed to tidy and clean his father’s home as required;
• failed to attend scheduled visits or arrived late to visit his father on several occasions without giving Mr X or Mr Y notice;
• misplaced Mr Y’s medication; and
• generally failed to communicate properly with Mr X and Mr Y.
15. The Care Provider has supplied a record of daily logs kept by Mr Y’s carers during April and May 2019.
16. The logs show Mr Y received visits from several carers over the course of approximately six weeks. The records show that some of the carers were late to visit Mr Y by several hours on several occasions and that Mr Y was upset by this.
17. Not all entries shown in the logs detail which times the carer attended, and it is often not possible to confirm whether the carers attended all four visits each day as required. Mr X raised his concerns with the Care Provider in late April. He was also unhappy there had been a high turnover of staff, leading to his father receiving inconsistent care.
18. The Care Provider apologised to Mr X and sent a more experienced staff member to monitor Mr Y’s care. However, the staff member took several weeks leave for personal reasons. The Care Provider sent another more experienced employee to assist Mr Y but has conceded it had trouble finding a permanent solution to this issue.
19. Mr X decided to remove his father from the service and raised a formal complaint in May 2019. He was unhappy the Care Provider repeatedly sent inexperienced employees to attend to Mr Y and failed to finalise Mr Y’s care plan.
20. The Care Provider responded to Mr X in late May 2019 and agreed Mr Y did not receive the standard of care set out in his support plan. The Care Provider accepted that carers had been new to the job and/or attended Mr Y up to two hours late on several occasions. It said this was because of staff going on sick leave and it being unable to source consistent carers who could attend to Mr Y’s needs.
21. The Care Provider said it would retrain staff and apologised for not having finalised a care plan by the time it began providing support for Mr Y, as this was not in line with its protocols. To address Mr X’s upset the Care Provider told him he did not have to pay for the last week of his father’s care.
22. Mr X did not accept the Care Provider’s explanation for why it had not finalised
    Mr Y’s care plan. He said the Care Provider should have been better prepared for the staff shortages and he did not find the reimbursement offer sufficient to address his concern.
23. The Care Provider maintained the offer it had made was adequate to address the shortfalls in service Mr Y had experienced. Mr X referred his complaint to the Ombudsman as he remained unhappy with the Care Provider’s response to his complaint.
24. During the course of the investigation, the Care Provider provided evidence it had:
• reminded staff of the need to accurately and consistently complete daily records at each care visit;
• reviewed its procedures regarding the timing of carer visits;
• provided evidence it has reminded its staff of the need to ensure a care plan is in place at the start of a new care package and instructed staff to familiarise themselves with this; and
• confirmed it has retrained some of its staff to ensure they are confident in providing care to their customers.

My findings

25. Mr Y’s care plan required his carers to contact him if they were going to be late.
    The logs show his carers were late on several occasions. I have reviewed the logs and there is nothing to suggest the carers contacted Mr Y ahead of time to let him know. In addition, there were omissions in the care records which made it difficult to determine if all calls took place. This is fault. However, the Care Provider has confirmed it has reviewed its process to ensure, in future, carers who are late to visit a customer communicate this. The Care Provider has also stated it is in the process of implementing technology that will alert it if a carer is late or does not attend a scheduled visit. These are satisfactory actions for the Care Provider to take.
26. There were instances where carers were not adequately prepared to support
    Mr Y either because they were new in post, had not shadowed more experienced carers or had not read the care plan. This is fault. The Care Provider has conceded it was short staffed and this led it to provide several different carers to ensure Mr Y received appropriate care. Continuity of carers helps promote the delivery of person-centred care. The continual change in personnel added to Mr Y’s distress and frustration.
27. The Care Provider has confirmed its process is to finalise a care and support plan prior to providing care. Mr X has advised that the lack of a care plan led his sister, Ms W, to write one and the Care Provider has not disputed this. The Care Provider did not follow its own process, and this is fault. I consider it likely that Mr Y’s care suffered as a result.
28. The faults identified caused Mr Y distress, uncertainty in not knowing if carers would turn up and inconvenience. The Care Provider has already offered to reimburse Mr X for one week’s care fees. This is appropriate. However, in addition, the faults also caused Mr X inconvenience and time and trouble in having to chase up missed calls and support Mr Y.
29. A significant aspect of Mr X’s complaint is the perceived lack of experience of the carers sent to tend to Mr Y. The Care Provider has acknowledged that some of the carers were new employees and required monitoring by more experienced staff members.
30. During my investigation, the Care Provider provided an update on actions it had carried out following Mr X’s complaint. These service improvements are satisfactory to address the fault I have found.

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Agreed actions

31. Within one month of the final decision the Care Provider has agreed to:
• pay Mr X £150 to acknowledge the time and trouble he was caused by the faults identified. The Care Provider has already refunded a week’s care charges to Mr Y and this was appropriate.
32. The Care Provider has agreed to provide the Ombudsman with evidence to show it has done this.

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Final decision

33. There was fault in some of the Care Provider’s actions which has caused injustice. The Care Provider has agreed to my recommendations. Therefore, I have completed my investigation.

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Investigator's decision on behalf of the Ombudsman