Summary: The Ombudsman found fault by the Council with regards to the failure of a care agency acting on its behalf to provide an agreed care visit to a vulnerable elderly woman. The Council agreed to apologise for this and pay a financial sum to the woman and her daughter in recognition of the distress the fault caused them.

The complaint

1. The complainant, who I will call Miss F, is complaining about the care provided to her mother, Mrs G, by a domiciliary care agency acting on behalf of Shropshire Council (the Council).
2. Miss F complains that Approved Care and Support (the care agency) left Mrs G without care for a 24-hour period from 30 April to 1 May 2019. Miss F says the care agency claimed it told her during a telephone call on 17 April 2019 that it would not be able to provide this care. However, Miss F says this is untrue and that she did not speak to the care agency on that date.

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The Ombudsman’s role and powers

3. 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)
4. 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)

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How I considered this complaint

5. In reaching this final decision, I considered information provided by Miss F and discussed the complaint with her. I also considered comments and documentation provided by the Council. Furthermore, I considered comments from Miss F and the Council on my draft decision statement.

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What I found

Legal and administrative background

6. The Care Act 2014 is the legislation that sets out local authorities’ powers and duties in respect of adult social care. The Care Act places a duty on local authorities to promote the wellbeing of people in their area.
7. Sections 9 and 10 of the Care Act require local authorities to carry out an assessment of any adult who appears to need care and support. Where a local authority has determined that a person has eligible needs, it must meet those needs.
8. In some circumstances, a local authority may commission another organisation to provide care services on its behalf. However, it remains responsible for those services and for the actions of the organisation providing them.

Key facts

9. Mrs G has eligible care and support needs under the Care Act 2014. At the time of the events Miss F is complaining about, Mrs G required support with personal care and meal preparation. She also required support to access activities in the community. Miss F supported Mrs G with many of her care needs, including assisting her to take regular pain relief medication.
10. In addition, the Council commissioned a package of care from the care agency. This included one four-hour care visit each week, along with an extra four hours every fourth Saturday and Sunday. In addition, the care package included one night of overnight care per month. The care package was intended to be flexible to give Miss F respite from her caring duties and coincide with any periods when she would be absent from the home.
11. On 15 April 2019, Miss F emailed the care agency to advise that she planned to be away overnight from 8.00am on 30 April to 5.00pm on Wednesday 1 May. She queried whether the care agency could provide care during this period.
12. An officer from the care agency (Officer A) responded on the afternoon of 17 April. Officer A confirmed the care agency would be able to provide the requested care.
13. On the same day, Officer A contacted the Council to request clarification regarding Mrs G’s care hours balance.
14. Miss F emailed Officer A the following day to confirm the arrangement. She attached a spreadsheet setting out the agreed dates and asked the care agency to confirm she had calculated Mrs G’s care hours correctly. Officer A did not respond to this email.
15. On 30 April, Miss F left her home as planned. She returned at 5.00pm on 1 May. Miss F checked Mrs G’s care notes and found that a carer had visited between 8.00am and 5.00pm on 30 April. However, nobody from the care agency had stayed with Mrs G overnight or visited her during the day on 1 May.
16. Miss F complained the following day. In its subsequent response, the care agency acknowledged there had been confusion and apologised for this. However, the care agency said it did not believe it had left Mrs G without care. This was because a member of staff at the care agency office had overheard Officer A telling Miss F during a telephone conversation on 17 April that the care agency would be unable to provide the requested overnight care.

Analysis

17. In her email to the care agency of 15 April, Miss F explained that she was planning to be away overnight and asked if it would be possible for the care agency to provide care “Tuesday 30/04/19 from 0800 to Wednesday 1700”.
18. Officer A responded to Miss F at 3.05pm on 17 April. She said that “[t]he care you have requested is no problem to fit into our schedule.”
19. At 3.17pm that day, Officer A contacted the Council by email. She explained that “I have sent [Miss F] an email as we are able to accommodate the hours she has requested but I need to find out about the hours outstanding”.
20. The following day, Miss F sent a further email to Officer A. She wrote “[t]hank you so much for fitting in my requests it is much appreciated…I have attached a spreadsheet showing the dates so far please check that I have calculated the hours correctly?” I found no evidence of a reply from Officer A to this email.
21. This evidence appears to show that Miss F explained when she intended to be away and what care she required for Mrs G during this period. It also seems to show that Officer A confirmed the care agency would be able to provide the requested care.
22. This sequence of events has been challenged by the care agency. In particular, the care agency said a member of staff had overheard a telephone conversation on 17 April between Miss F and Officer A. In her statement, this member of staff said Officer A greeted Miss F by name during this conversation. She recalled “I didn’t hear what [Miss F] was saying but [Officer A] replied that we are sorry but we can’t do the sleep over”. The care agency said this showed it advised Miss F in advance that it could not provide the overnight care.
23. This is directly disputed by Miss F, who said she did not call the care agency on that date.
24. In reaching a view on this complaint, it is necessary to consider whether Miss F made the telephone call referred to above and, if so, whether the member of staff accurately recalled what was discussed.
25. In the evidence Miss F provided to the Ombudsman, she included copies of the itemised call logs for both her home and mobile telephones. These show Miss F did not make a telephone call to the care agency from either line on 17 April.
26. The care agency was unable to provide itemised call logs in response to my enquiries. As Officer A no longer works for the care agency and did not keep a contemporaneous note of the alleged call, there is no further evidence to support the care agency’s account.
27. In my view, the available evidence appears to support Miss F’s account. The emails on file show Officer A informed both Miss F and the Council that the care agency would be able to provide the care Miss F had requested. Both emails were sent on 17 April, the date of the alleged call.
28. Furthermore, it is difficult to explain why Miss F would have sent an email on 18 April thanking Officer A for accommodating her request if she had been advised the previous day (during the alleged call) that this would not be possible.
29. I am unable to completely rule out the possibility that Miss F called Officer A on 17 April as described by the care agency. However, for the reasons I have explained above, I consider it unlikely, on balance of probabilities, that she did so.
30. It is clear, based on the correspondence on file, that Miss F was led to believe the care agency would be able to provide the care she had requested.
31. In my view, it is likely Officer A simply misunderstood Miss F’s initial request of 15 April and believed she was asking only for care to be provided to Mrs G between 8.00am and 5.00pm on 30 April.
32. There was a further opportunity to clarify matters when Miss F emailed a spreadsheet to Officer A on 18 April confirming the requested hours. However, Officer A did not respond to this to email or challenge Miss F’s understanding of the agreed care hours.
33. The evidence suggests the care agency failed to provide Mrs G with the agreed care from 5.00pm on 30 April to 5.00pm on 1 May. This is fault.
34. This meant Mrs G was left without food, medication or support for around 24 hours. This caused both Mrs G and Miss F significant distress.
35. In its responses to my enquiries, the Council explained that the care agency has now made improvements to its procedures since these events occurred. The care agency now logs telephone calls appropriately. In addition, the care agency has introduced a process whereby one member of staff is now allocated to book requested care visits. In my view, this should reduce the risk of similar problems occurring in future.
36. Nevertheless, there is a personal injustice to both Miss F and Mrs G that has not yet been remedied. This is addressed by the further actions the Council has agreed to undertake.

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Agreed actions

37. Within one month of my final decision statement, the Council will:

• Write to Miss F to apologise for the care agency’s failure to provide Mrs G with the agreed care and support visits on 30 April and 1 May 2019.
• Pay Miss F and Mrs G £100 each (£200 in total) in recognition of the distress this caused to them.

38. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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Final decision

39. I find fault by the Council with regards to the care agency’s failure to provide care to Mrs G as agreed on 30 April and 1 May 2019.
40. In my view, the actions the Council has agreed to undertake represent a reasonable and proportionate remedy for the injustice caused to Miss F and Mrs G by this fault.
41. I have now completed my investigation on this basis.

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Investigator's decision on behalf of the Ombudsman