The Ombudsman's final decision:
Summary: Ms X complains about the care company’s failure to provide answers about the care it provided to her late sister. There was service failure which caused Ms X an injustice. I recommend Foremost Care UK reviews its complaints procedures; apologises to Ms X and offers her a time and trouble payment.
- The complainant, whom I shall refer to here as Ms X, is concerned about Foremost Care UK Limited’s failure to provide answers to her questions about the care it provided to her late sister.
- Ms X’s family are suspicious of the actions of Foremost Care’s workers on the day her sister died. Ms X wants the company to provide answers to her questions.
The Ombudsman’s role and powers
- We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. (Local Government Act 1974, sections 34B and 34C)
- If an adult social care provider’s actions have caused an injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))
- 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.
How I considered this complaint
- I considered the complaint and background information provided by Ms X. I discussed matters with Ms X by telephone. I sent a draft decision statement to Ms X and Foremost Care UK. I discussed matters with Foremost Care UK by telephone. I considered Foremost Care’s comments on my draft decision statement.
What I found
Fundamental standards of care
- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards those registered to provide care services must achieve. The Care Quality Commission has guidance to care providers on how to meet the fundamental standards.
- The Care Quality Commission is the statutory regulator of care services. It has guidance for care providers on how to meet the fundamental standards. It keeps a register of care providers who show they meet the fundamental standards of care, inspects care services and issues reports on its findings. It also has the power to enforce against breaches of fundamental care standards and prosecute offences.
Background to the complaint
- Ms X had power of attorney for her late sister who lacked capacity. Ms X’s family arranged a domiciliary care service from Foremost Care for her sister.
- Ms X made an enquiry to Foremost Care about what happened on the day her sister died.
- It appears Foremost Care’s initial response involved telling Ms X that one of its workers went to her sister’s home to conduct a risk assessment. It sent a copy of the risk assessment to Ms X. Ms X was dissatisfied with the response and wrote again to the company.
- The company responded by saying there was a delay in its response because the care worker who provided care for her late sister was traumatised by the loss of her sister. The company said the risk assessment it previously sent to Ms X was its initial assessment or a draft. This was a possible reference to queries Ms X made about missing information in the risk assessment document.
- The company said the care worker is its employee and so any information Ms X wanted would be provided by its office and its employee would report to it.
- Ms X asked the care provider to explain why it did not arrange to meet her or another sister when the risk assessment was done. She also queried the content of the risk assessment document as information such as the date, consent and signatures were missing.
- It appears the worker who conducted the risk assessment told the family only a care worker attended her late sister’s home on that day and omitted to say that she was there. Ms X queried the contrasting statements made by the worker.
- Ms X questioned the conduct of the care worker on the day her sister died. She wanted the care worker to provide a written account of the day. Ms X also queried entries made by the care worker in the communication book.
- Foremost Care did not reply. Ms X complained to the Ombudsman because she did not receive anything further from the company despite chasing a reply.
- There are regulations in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which care providers must meet. Regulation 16 on receiving and acting on complaints requires care companies to thoroughly investigate and act on complaints received. In this case, I find Foremost Care did not thoroughly investigate Ms X’s concerns. It did not respond to her complaint beyond a rudimentary reply. It did not provide information on its complaints process and signpost her to the Ombudsman.
- Regulation 20 sets out a duty of candour. The intention of this regulation is that service providers are open and transparent with people who use their services as well as people acting lawfully on their behalf. Service providers should provide truthful information and an apology when things go wrong. I find Foremost Care failed to meet the requirements of Regulation 20. I find there was service failure by Foremost Care and this caused Ms X an injustice.
- To address the injustice caused to Ms X, I recommend:
- Foremost Care issues an apology to Ms X.
- An explanation should now be given to Ms X in answer to the queries she has about events on the day of her sister’s death.
- It should also pay Ms X £100 to reflect the avoidable time and trouble she was put to in pursuit of this matter.
- Foremost Care institutes training for its staff on how to deal with complaints. It should be clear to all staff dealing with complaints that final complaint responses must refer to the complainant’s right to seek redress from the Ombudsman.
- I have completed the investigation and uphold Ms X’s complaint. Ms X has been caused an injustice by the actions of the service provider and I have recommended it takes action to remedy that injustice.
Investigator's decision on behalf of the Ombudsman