Summary: Ms X complained on behalf of her mother, Mrs Y, about the standard of care provided and that the Council is unreasonably demanding payment for the poor care. The information provided shows there were some late calls and visits with only one carer. While this is fault, Mrs Y received care in excess of the amount she was charged and so there is no basis to recommend a refund of charges.

The complaint

1. Ms X, on behalf of her mother Mrs Y, complains about the standard of domiciliary care provided by the Council and that it is unreasonably demanding payment for this poor care.
2. Ms X say the poor care meant family members or a private carer had to step in to provide the care and that there was a lack of dignity for her mother.

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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. As part of the investigation, I have:
• considered the complaint and the documents provided by the complainant;
• made enquiries of the Council and considered the comments and documents the Council provided;
• discussed the issues with the complainant;
• sent my draft decision to both the Council and the complainant and taken account of their comments in reaching my final decision.

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What I found

6. Mrs Y was discharged from hospital in September 2019. A care package was arranged by the Council for two carers to visit four times a day. On discharge the care package was provided by a company called Mears Care. They provided care from 20 to 30 September. On 1 October 2019, a company called Holistic Community Care took over the care package for Mrs Y. The Council has explained that Mears Care exited the homecare market at the end of September and so the move to another care provider was planned.
7. Ms X complained about the care provided during September and October and before her mother was re-admitted to hospital on 27 October. Ms X says that due to the needs of her mother, the family employed a live-in carer in addition to the Council’s care package. The care package was suspended when Mrs Y went into hospital and did not resume because Mrs Y died in hospital on 8 November.
8. On 21 October the Council wrote to Holistic with the outcome of the complaint investigation. It upheld the complaint about timekeeping saying the two care workers did not always arrive at the same time meaning one worker would complete the tasks with the help of the live-in carer. It says it also found evidence of care workers arriving outside of the planned times. It said the complaint about false recording of times was concluded as inconclusive as no evidence was presented which could be checked. Holistic agreed to undertake certain actions to ensure the issues did not occur again.
9. Ms X made a formal complaint to the Council on 23 December 2019. She had received an invoice for payment of the care costs. Ms X told the Council she would not pay the invoice as the care received from both care agencies was poor. Ms X said there were times when only one carer, rather than two, turned up; she said carers arrived late; carers were rude; on one occasion refused to allow her mother to use the commode; failed to change the bed or wash clothes unless prompted; never carried out any cleaning in the house and asked her mum to sign time sheets that were not accurate.
10. The Council replied to the complaint on 31 January 2020. It acknowledged that the majority of the matters were raised with the Council at the time the care was being provided and were investigated by both Mears and Holistic.
11. In respect of Mears Care it acknowledged carers arrived late on occasion and that calls were missed but it does not provide details. It says the complaint about carers not completing domestic tasks was upheld against Mears. It has since explained that it did not actually commission Mears to provide this service though the need was identified on the care plan.
12. The complaints about the conduct of care workers and how they treated Mrs Y were found inconclusive. The Council says this is because Mears exited the care market in October and have now closed their office. Holistic says that the allegations made were not specific regarding dates or the name of the carer. It has transpired that the communication book was not retrieved from Mrs Y’s home and so there is limited information for Holistic to check to see what tasks were undertaken at each visit.
13. In respect of the care fees, the Council explained that the financial assessment for Mrs Y required her to pay a contribution of £82.26 per week towards the cost of the care provided. The Council paid the full amount to the care agencies and so the outstanding contribution is owed to the Council. It provided information to show that the full cost of Mrs Y’s care for the period 20 September to 8 November was £6,825.88 and her contribution was £434.80.
14. The Council acknowledged there had been issues with some of the care but it did not accept all the care provided was inadequate. It said it did not accept the reasons for disputing the invoices and found the charges were justified and it expected the invoices to be paid.
15. Ms X wrote to the Council again on 28 February. She said she was confused because the Council was upholding some of the issues but still considered her mother owed £434.80. She said she was surprised the Council was not seeking a refund knowing the care was of a poor standard.
16. Dissatisfied with the Council’s response, Ms X complained to the Ombudsman.

Analysis

17. Ms X complains about the standard of the care provided to her mother and she believes she should not have to pay for this.
18. The information provided shows that Ms X complained about the standard of care at the time it was being provided in September and October 2019. While some of the complaints were upheld, the matters were not fully investigated at the time. This applies to both Mears and Holistic but for different reasons
19. Mears only provided services for 10 days. The agency was leaving the care market and had provided notice to the Council. There is nothing to suggest this caused any disruption to the service provided to Mrs Y as the change was planned. However, the fact the local office closed meant the complaint investigation was limited.
20. I have now seen the care records for the 10 days care was provided to Mrs Y. The records show that most calls were carried out as required. The notes on 24 and 27 September say that Mrs Y’s daughter had to assist the carer. They also indicate some basic domestic tasks were completed even though the Council accepts Mears were not commissioned to provide domestic services.
21. Holistic has provided details of three dates during the period it provided care when one carer was late and so the live-in carer assisted. It also interviewed the care workers in respect of other issues raised. Both workers said they never used cold water to wash Mrs Y. The investigation found that there were times when carers attended to Mrs Y with the door open but they said the position of the bed would prevent anyone seeing Mrs Y.
22. Holistic were not able to collect the communication book which would provide details of the care provided at each visit. I am not persuaded there is fault by the care agency. The communication book is the property of the care agency and so should be removed if the care stops. In this case the visits were suspended when Mrs Y went into hospital. I would not expect Holistic to recover the book immediately as it would be unknown when or if the care package would restart. Mrs Y died in hospital just over a week after she was admitted. Again, I would not criticise the agency respecting the family in their grief and not collecting the book immediately. It seems the book then went missing when the house was emptied. While it is unfortunate the book was not recovered by Holistic, I am not persuaded this was fault.
23. The evidence provided shows that there were some issues with some of the care visits provided by both care agencies. While I appreciate Ms X’s frustration that the care package was not delivered exactly as planned, I take the view that the vast majority of care visits were on time, with both carers in attendance and that the appropriate care was provided. The issues identified do amount to fault. However, as the majority of care visits were properly provided I consider there was a limited injustice caused to Mrs Y.
24. Ms X does not consider her mother should pay for the inadequate care. The information provided shows that Mrs Y was assessed to pay a contribution towards the care costs, not the full amount. I would only consider a reduction in her charge to be appropriate if the amount of care she actually received in any week was less than the amount paid. While there is evidence of some late calls and calls with only one carer, I am satisfied Mrs Y received care every week that cost more than her contribution. As Mrs Y received more than £82.26 worth of care every week, there is no basis to recommend a reduction in the cost and I consider the Council is entitled to pursue the amount outstanding.

Agreed action

25. To remedy the injustice caused as a result of the fault identified in this case, the Council should provide a written apology to Ms X.

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Final decision

26. I will now complete my investigation as an appropriate remedy for the injustice caused is agreed.

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Investigator's decision on behalf of the Ombudsman