The Ombudsman's final decision:
Summary: Ms X complained on behalf of her mother, Mrs Y, that the Council failed to meet Mrs Y’s needs in line with her care and support plan. The Council was at fault and has agreed to reduce Mrs Y’s fees so that she does not pay for the days where her needs were not met. The Council has also agreed to apologise to Mrs Y and Ms X and pay a financial sum to remedy their distress, and the time and trouble it has taken for Ms X to complain.
- Ms X complained the Council:
- Did not provide care visits for her mother, Mrs Y in line with her care plan.
- Delayed its response to Ms X’s complaint.
- Failed to properly respond to Ms X’s complaint issues.
The Ombudsman’s role and powers
- 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)
- 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)
How I considered this complaint
- I have considered Ms X’s complaint and the Council’s response to Ms X and to my enquiries.
- Ms X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.
What I found
The Care Act 2014
- The Care Act outlines how local authorities should undertake care and support planning. It identifies what is meant to meeting someone’s needs because these are specific to them. It states the local authority should record in the care and support plan which needs are to be met by a carer. These should provide step by step instructions to the care staff so that they can provide the correct support without any previous knowledge of the person. Carers should make sufficient records to evidence the support it provides is in line with the care plan.
- In October 2019, the Council assessed Mrs Y’s care and support needs when she was in hospital and produced an Individual Care and Support Agreement. This specified that care and support workers would visit Mrs Y in her home twice a day at 8.30am and 9.00pm. Each visit would last 30 minutes and the carers role would primarily be to assist Mrs Y to get up, shower, get ready and prepare breakfast in the morning, and assist her to get ready for bed in the evening.
- Mrs Y’s care commenced on the evening of 24 October when she was discharged from hospital. The next day, the Council contacted Ms X to check how the initial visits had gone. Ms X said the carers did not arrive until 11am on 25 October by which time Mrs Y had already got herself up and dressed.
- On 8 November, the Council carried out an initial review of Mrs Y’s care and support needs. This was done over the phone with Mrs Y’s daughter. She reported that the carers’ visits have been ad hoc this week, sometimes coming as late as 10.30am and only staying for 10 minutes. In response to this, the Council spoke to the care agency. It apologised for the ad hoc calls and reassured the Council it was because Mrs Y’s regular carer was on leave.
- From the evidence I have seen, the carers continued to operate on an ad hoc basis. Ms X kept a log of the carers’ visits which show they frequently arrived late in the morning, and too early on an evening. Ms X tried to resolve this with the Council, but matters did not improve. On 30 December, Ms X cancelled the care package.
- In January 2020, Ms X complained to the Council. She complained about the ad hoc carer visits and said her mother should not pay for those days where the carer did not visit in line with the times agreed in the care and support plan.
- The Council’s records show it investigated Ms X’s complaint at the end of March 2020. The Council said its delayed response was because it was waiting for information from the care agency. In response to my enquiries, the Council apologised for the delay and accept it took too long to respond to Ms X.
- Ms X said she had not received a response to her complaint by August 2020. She said she had only received outstanding invoices for her mother’s care and had informed the Council she would not pay these until the Council had considered her complaint.
- Ms X contacted the Council who said it had responded to her complaint on 29 March 2020. Ms X said she never received this and considered the Council should have enquired why she had not paid or responded in the period March-August. The Council sent a copy of its response (dated 29 March) to Ms X on 19 August.
- The Council’s response contained a summary of the care agency’s response to Ms X’s complaint. This stated there was nothing in Mrs Y’s care plan about specific visit times. It also stated that Mrs Y should pay for all the visits as the agency has a 24-hour cancellation period. The Council did not uphold Ms X’s complaint and referred Ms X to the Local Government and Social Care Ombudsman if she remained unhappy.
- Ms X complaint to LGSCO in September 2020. Upon being allocated Ms X’s complaint, I contacted the Council. In response to my enquiries, the Council agreed that Mrs Y did not receive the care and support which should have been delivered at the times agreed with the care agency. The Council agreed to reduce Mrs Y’s charges from £992 to £481.
- The Council was at fault for failing to meet Mrs Y’s care and support needs as identified in her care and support plan. The Council now admits this and has agreed to reduce her fees from £992 to £481.
- In addition, the Council was at fault for failing to respond to Ms X’s complaint in line with the timescales in its complaint’s procedure. I am basing this on the response being sent on 29 March 2020. The Council could have followed up as to why Ms X had not responded or paid the outstanding invoices before she contacted them in August. However, I consider this to fall short of fault as Ms X could have equally chased the Council for its complaint response when she heard nothing.
- Mrs Y’s care and support plan specified times for the carers to visit. These times were specific to Mrs Y’s needs for getting up and going to bed. Mrs Y suffers from dementia and is identified as vulnerable. When the carers did not arrive at the agreed times (or within 30 minutes of these times), this caused Mrs Y an injustice as she could become distressed and confused.
- Ms X experienced personal injustice as a result of the Council’s fault. The uncertainty as to when the carers would visit and whether her mother would be adequately cared for caused Ms X avoidable distress.
- The Council has agreed to apologise to Mrs Y and Ms X and pay them both a financial remedy in line with the LGSCO Guidance on Remedies.
- In response to my enquiries, the Council has agreed to reduce the charge for Mrs Y’s care from £992 to £481.
- It has agreed to implement this within 4 weeks of my final decision.
- In addition, within 4 weeks of my final decision, the Council has agreed to:
- Apologise to Mrs Y for failing to meet her needs;
- Pay Mrs Y £200 for the avoidable distress she experienced when the carers did not visit at the times agreed in her care plan;
- Apologise to Ms X for the distress and uncertainty she experienced for the three month period that the carers visited her mother on an ad hoc basis, and for the delay in responding to her complaint;
- Pay Ms X £100 for the time and trouble it has taken her to pursue her complaint.
- I have completed my investigation. The Council did not provide the care Mrs Y needed; this was fault. This fault caused an injustice, and the Council has agreed to take action to put it right.
Investigator's decision on behalf of the Ombudsman