Summary: The Council frequently failed to complete adult social care calls on time or failed to turn up at all. On many occasions the Council still met Mrs H’s needs, but on other occasions it did not. Mrs H was paying in full for the poor service. The Council will waive 50% of the care fees and pay £100 each to Mrs H and her daughter in recognition of their distress, time and trouble.

The complaint

1. The complainant, who I will call Ms G says, Allied Healthcare, commissioned by the Council, breached its contract. It failed to turn up at the agreed times, failed to give medication at agreed times, a carer was rude to her mother (Mrs H), and the Care Provider failed to deal adequately with the complaint. Because the carers turned up late Mrs H would not get to bed at her preferred times which left her disorientated and upset. Sometimes the care calls would clash with a privately arranged carer, so the care call was pointless. The family were upset to see carers be rude and raise their voices at Mrs H because she could not understand them, and on a couple of occasions the family asked the carer to leave. This left them worried about what was happening when they were not present.

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The Ombudsman’s role and powers

2. 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)
3. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), 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. I considered information provided by Ms G and the Council.
6. Ms G and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

7. Mrs H lives at home. The Council arranged two care visits per day to help Mrs H prepare meals and take medication. Mrs H paid the Council in full for these care visits, she also paid someone else to visit her at lunchtime. Ms G and her brother provide support to Mrs H as well as the services Mrs H pays for.
8. The care was originally provided by Allied Healthcare, who in November 2018 transferred its service to Allied Health Services.
9. The care visits were scheduled to take place at 10am and 5pm. The Care Provider says there was an agreement that these calls could take place within 30 minutes either side, so should start anywhere between 9.30 – 10.30am and 4.30 – 5.30pm.
10. Approximately 75% of the care calls did not start on time. On the worst occasion the carer was two and a half hours late. The care records show that sometimes when the carers were late Ms G had already done Mrs H’s meal and medication. Sometimes Mrs H had already done her meal herself. Sometimes the other care worker was present. Sometimes Mrs H had already gone to bed or was ready for bed so refused services. So, Mrs H was not always getting a benefit from the carer visit she was paying for because of late arrival.
11. The care records also show that on many occasions a carer did not turn up at all. Allied Healthcare missed two consecutive visits, leaving Mrs H from 10.30am one day until 6.30pm the next day.
12. Ms G says the carers were sometimes rude to Mrs H, this upset Ms G and her brother, and they asked the carers to leave. There is no evidence in the care records to support that family ever asked carers to leave.
13. The medication was generally given as agreed at the morning and evening visits. There are a couple of times where medication is not mentioned in the care records and is not recorded on the Medication Administration Record, so the Care Provider failed to give it on those times. There were times when the medication was not available, so the carers were unable to complete the task. However, there were many missed calls, so the medication was not given. There were also many late calls, so sometimes family members had given Mrs H the medication. Ms G has not explained that there was any impact on Mrs H from not having her medication, or from receiving it late. But clearly, this is poor service.
14. Although the care calls were often late, at most of them the Care Provider did complete food and medication for Mrs H, so she did have her needs met. Though on many occasions because of late or non-arrival by the Care Provider, Mrs H or her family met her needs. Mrs H likes to go to bed early, so late evening calls meant she was late to bed and became disorientated and upset.
15. The Care Provider credited 12 care calls which were either late, no shows, or where they clashed with a private carer. The Council has offered to credit a further 14 calls. I have identified many more calls than 26 that were either late or no shows.
16. The Care Provider apologised to Ms G for poor communication when she first raised concerns. It acknowledged this and said it would ensure all complaints and concerns are addressed in a timely manner going forward.
17. Ms G asked the Care Provider to send letters to her, but letters were sent to her mother because the computer system automatically uses the clients address as the correspondence address. The Care Provider acknowledged this issue and now has a workaround in place.

Agreed action

18. To acknowledge the impact of the poor service, the Council will:
1. Waive 50% of the total care fees for the period 1 September 2018 to 31 January 2019. The Council will issue a revised invoice or provide a refund accordingly.
2. Apologise to Mrs H and Ms G for the consistently late or missed care calls.
3. Pay Mrs H £100 to acknowledge her distress, time and trouble. This can be offset from any outstanding care fees.
4. Pay Ms G £100 to acknowledge her distress, time and trouble.
19. When a council commissions another organisation to provide services on its behalf it remains responsible for those services and for the actions of the organisation providing them. So, although I found fault with the actions of the Care Provider, I have made recommendations to the Council.
20. 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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Final decision

21. I have completed my investigation on the basis the agreed action is sufficient to acknowledge the impact of the fault.
22. The Council should complete the agreed actions within one month of the Ombudsman’s final decision, and evidence its compliance.

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Investigator's decision on behalf of the Ombudsman