Summary: Mr X complained he was left without care at home for six weeks because the Council could not source a care provider. He said this caused him distress and put him in danger. The Council was not at fault.

The complaint

1. Mr X complained he was left without care at home for six weeks in 2019 because the Council was not able to source a care provider. He says the reason for not identifying a care provider was because the Council were not willing to pay enough to secure one.
2. As a result, Mr X says he was left without essential care, which caused him distress and put him in danger. He says he was then put to the time and trouble of finding a care provider himself.

Back to top

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)

Back to top

How I considered this complaint

5. I considered
• the information provided by Mr X and the Council
• relevant law and guidance, as set out below
6. Mr X and the Council had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

Back to top

What I found

Relevant law and guidance

7. The Care Act 2014 says councils must assess all adults with an appearance of need for care and support. Where the adult has “eligible needs”, the council must meet those needs. It can do so by providing the care itself, by commissioning care or by making direct payments to the person for them to arrange the support themselves.
8. The support the person needs should be set out in a care and support plan. The plan should also set out the personal budget, which is the amount allocated to meet their needs. The personal budget must be sufficient to meet the person’s care and support needs.

What happened

9. Mr X needs care to help him manage a physical disability and his diabetes. Mr X can manage the mediation for his diabetes but needs assistance in the morning with dressing, and food preparation. If he does not get an early morning call this interferes with his ability to manage his diabetes. He also needs help with domestic tasks, such as cleaning and laundry.
10. Mr X was receiving care from the Council’s in-house team. The Council wrote to him in January 2019 to say it was making changes to its service and in future it would only provide care through its in-house service for those needing short-term help with reablement. This is where people require short term help after an accident or a hospital admission.
11. Council records show it assessed his care needs and identified a new care provider to provide longer term support in late February 2019. Mr X asked the Council to ensure the new care provider shadowed the current in-house service for a short period to understand his needs, which the Council agreed to. The new care provider took over the support for Mr X in April 2019.
12. Mr X was unhappy with the new care provider because it could not always call as early as he wanted in the morning. The Council tried to resolve the matter with the new care provider, who reported it had difficulties arranging care workers to provide care for Mr X because it said he was verbally aggressive. The Council later acknowledged the care provider had not been able to ensure continuity of staff visiting Mr X and had not been able to visit as early as Mr X wanted.
13. On 26 June 2019 the records state Mr X refused care from the care provider, which Mr X disputes. This meant he was without support until the Council could arrange an alternative, which started on 4 July 2019. The records show the Council offered him respite care in the meantime, which Mr X refused.
14. There were difficulties with the new arrangement almost immediately. The new care provider said it had difficulty finding staff to visit Mr X because he lived in a rural location and because of Mr X’s attitude towards the care workers who visited. In addition, Mr X wanted female care workers, but the care provider had said at the outset it could only provide male care workers. However, the care provider agreed to continue to provide support until an alternative provider was identified.
15. The Council had difficulty identifying an alternative care provider because some care providers did not provide services in the rural location where Mr X lives and others would not provide care because of difficulties they had experienced providing care to Mr X in the past. The Council therefore suggested Mr X receive direct payments, which would be managed on his behalf by a charity. The charity would also help to identify a care provider for him. The Council also agreed to provide a cleaning company to help with cleaning and laundry, which would make it easier to find a care provider to meet Mr X’s personal care needs.
16. A new care provider was identified and started to provide care to Mr X in late August 2019. It soon gave notice because it said it had not been paid. The Council contacted it to resolve the payment issue, but the care provider said there were other reasons for not wanting to continue the arrangement. As a result, Mr X was without personal care from 7 October to 24 November 2019. The Council offered Mr X a respite stay, and meals on wheels but Mr X declined. The Council increased the domestic support during this period to provide as much support as possible. It also checked on him regularly by telephone.
17. The Council understands the new arrangement, which started on 25 November 2019, is working well.

My findings

18. The records show the Council had difficulty in identifying care providers who were willing to provide care to Mr X due to the rural location where he lives, because it involves additional travel time for them. There is no indication that the difficulty was as a result of the Council setting a personal budget that was not sufficient to meet Mr X’s needs. There was sufficient flexibility within Mr X’s personal budget to pay a higher rate due to the difficulty of finding alternative providers. The Council was not at fault.
19. As a result of the difficulties in identifying a care provider, the Council offered Mr X direct payments, which would be managed by a charity that would also assist him to identify a care provider. I understand Mr X chose a care provider the charity identified for him. It was appropriate for the Council to offer direct payments in the circumstances.
20. Mr X was without care from 26 June to 4 July 2019 as a result of his decision to refuse to allow the care provider to provide care, after it had not been able to make the calls at the time he wanted. The Council took appropriate steps to resolve the issues with the care provider and the care provider was willing to continue to provide care until an alternative was identified. The records state Mr X refused to have the care provider in his house again because he was unhappy with the care provided. Therefore, although I appreciate the lack of care caused various problems for Mr X, I cannot say this was because of fault by the Council.
21. Mr X was again without care between 7 October and 24 November 2019. At this stage, the care was being provided through direct payments, which a charity was assisting with. The Council offered Mr X a period of respite in a care home, which would meet his needs whilst an alternative care provider was identified. It also offered a meals on wheels service and telephoned to check on his welfare regularly. This was appropriate. In addition to the charity attempting to identify an alternative provider, the Council also took appropriate steps to identify one but without success. The Council satisfied its duty to meet Mr X’s needs in the meantime by offering respite care. It was not at fault.

Back to top

Final decision

22. I have completed my investigation. The Council was not at fault.

Back to top

Investigator's decision on behalf of the Ombudsman