Summary: the complainant says a care provider commissioned by the Council failed to properly manage financial support for the client. The Council said its care provider responded to the complaint, but it had yet to complete a full investigation and offered to do so. We found the Council through its commissioned Care Provider acted with fault and recommended a proportionate remedy.

The complaint

1. The complainant, whom I shall refer to as Mr X complains through his representative Miss Y, that the Council commissioned Care Provider failed to properly tell Miss Y about a hospital visit, account for money withheld from Mr X and continued to accompany Mr X when he made bank withdrawals after the Care Provider’s contract had ended.
2. Ms Y says this compromised Mr X’s security and welfare and the Council and Care Provider have not answered her complaints or direct her to the Ombudsman’s service. Ms Y says ending Mr X’s service without warning or appropriate handover caused him significant distress.
3. Ms Y wants the Council and Care Provider to review her complaints, ensure complainants receive information about the complaints procedure with each response telling them about the next steps in that procedure.

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The Ombudsman’s role and powers

4. 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)
5. 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)
6. If 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

7. In considering this complaint I have:
• Contacted Miss Y and read the information presented with the complaint;
• Put enquiries to the Council and reviewed its responses;
• Researched relevant law, guidance, and practice;
8. I shared with Miss Y and the Council my draft decision and considered their comments before reaching this my final decision.
9. 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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What I found

10. Mr X does not have capacity to manage his own finances and in 2012 the Council became his financial appointee. The Council manages the receipt of Mr X’s Department of Work and Pensions benefits. The Council pays Mr X’s utility bills from this account. Under that arrangement the Council receives the benefits into a bank account held for Mr X his benefits. From that account the Council transfers into Mr X’s private bank account each month an allowance for personal spending. Each week to ensure Mr X had enough money for his weekly needs, staff placed money in separate envelopes marked for specific purposes. These included shopping, attendance at the day centre and taxis, and personal use.
11. The Council commissioned 11.45 hours per week support for Mr X from Care Provider Q from November 2018. In May 2020, the Council increased the support to 13 hours. The Council awarded a further 30 minutes a day support as needed to support Mr X during the Covid-19 pandemic lockdown for use during emergencies for example providing support getting medical attention.
12. Support in managing Mr X’s finances formed part of the service provided to him by Care Provider Q. The Council says that Miss Y and Care Provider Q agreed in June 2019 that two staff members from Care Provider Q would attend the bank with Mr X to help him withdraw his money. The bank registered the names of the staff who could escort Mr X. In commenting on my draft decision Miss Y says the Care Provider put the arrangement in place and told her, she did not agree it.
13. Under his support plan staff accompanied Mr X to hospital appointments. Usually Care Provider Q would tell Miss Y about these appointments.
14. Care Provider Q’s records show that in May 2020 Mr X needed medical support. Care Provider Q’s staff helped Mr X call his GP who prescribed antibiotics. Staff collected his medication. Staff developed a rota for seven days to ensure Mr X took his prescribed medication.
15. The Community Nurse assessed a wound on Mr X’s back and decided the best treatment would be to leave it uncovered. The Community Nurse said she would get a care plan written up so support workers would know what to do. Care Provider Q’s staff say in an email that it would not be in Mr X’s best interest to share information about the wound and treatment with Miss Y. Not until the parties agreed a formal information sharing agreement. The email’s author said Miss Y did not use information provided to Mr X’s benefit.
16. The GP told staff that if at the end of the course of antibiotics prescribed for Mr X, he experienced no improvement they should take him directly to the emergency department at the hospital. Mr X appeared in pain when staff visited on 8 May 2020. Staff took Mr X to hospital. In the Care Provider’s records it says staff acted in Mr X’s best interests. The record says “…at no point was its considered important to discuss the business with anyone else outside of [the Care Provider]”. The notes say however, but for the lockdown restrictions it may have been possible for Miss Y to go with Mr X to hospital. The note ends saying: “Informing [Miss Y] would have been of no immediate benefit to [Mr X] and [ Care Provider Q] in providing the excellent, timely and medically directed support.” In response to my enquiries the Council described this as an oversight by Care Provider Q.
17. On 28 May 2020 Care Provider Q gave notice to both Miss Y and the Council ending the agreement for its support services and saying Mr X needed an alternative service provider.
18. In June 2020 the Council spoke with Miss Y about her concerns about Mr X’s finances. Miss Y told the Council she wanted to ensure she protected Mr X against financial abuse and the Council agreed it would speak to Care Provider Q. The Council’s records show that on speaking with Care Provider Q, staff said Miss Y had constantly telephoned and messaged them to gather information about Mr X’s daily activity plan and his finances. Miss Y disputes this. Care Provider Q said it was reluctant to share information even though it recognised Miss Y as next of kin. The Council decided to meet with Mr X to see if he objected to daily updates being given to Miss Y.
19. The Council arranged a transition meeting at Mr X’s home with Miss Y, Care Provider Q and the new care provider, Care Provider Z. The case records say Care Provider Q asked for any handover to be with Care Provider Z or the Council because Care Provider Q did not trust the family. At the handover the key safe would not work with the numbers Care Provider Q had given and the Council asked Mr X’s landlord to install a new key safe. The landlord did not so Miss Y paid for a new key safe. Miss Y says lack of action put Mr X at risk.
20. The new service started on 26 June 2020. In August 2020 Miss Y presented a 14-point complaint to the Council about Care Provider Q. Miss Y’s complaint covered concerns about the key safe and errors in the handover document. It covered failure to update details of suitable people to escort Mr X to the bank and continuing to withdraw money when Mr X could not attend his day centre. It also includes the failure to tell Miss Y about the hospital visit, and concerns about items missing from Mr X’s home.
21. Under arrangements with care providers commissioned by the Council, any complaint about the service will first be considered by the care provider under its complaints’ procedure. If that does not resolve the complaint, then the Council will consider it. The Council says Care Provider Q responded to the complaint, but the Council has not completed its investigation. It is willing to do so.

Analysis – was there fault leading to injustice?

22. My role is to consider if in providing the commissioned service and considering any complaints about it the Council and its commissioned service acted without fault. If I find they acted with fault, then I must decide what impact that has had and what the Council should do to address the injustice.
23. Miss Y is recognised as Mr X’s next of kin. Therefore, she could expect the Council to consult her under the Mental Health Act should it need to make best interest decisions. Miss Y could also expect the Council’s commissioned care providers to communicate with her about Mr X’s health, wellbeing, and finances. Where significant events occur such as the need to go to hospital Miss Y could expect the care provider to tell Miss Y as soon as possible about that visit. There is no supporting evidence for the decision that telling Miss Y about Mr X’s visit to hospital was ‘unnecessary’. The record does not record any report to the Council or any evidence of safeguarding concerns that would support not telling Miss Y. I find the unsupported decision fault. Further I find the Council’s characterisation of the failure as an oversight as fault because the record clearly shows this was a deliberate decision.
24. The record suggests a poor relationship between Miss Y and Care Provider Q. That does not excuse unsubstantiated remarks in the record that Miss Y does not use information given her in Mr X’s best interests. I would expect the Council to investigate that comment and to ask for evidence in support of it so it can undertake any necessary safeguarding investigation.
25. I find the failure to follow up the safeguarding concerns raised by the broken key safe as fault. The Council could have considered replacing the key safe at its own cost with the landlord’s permission to reduce any risk. The failure to keep the register of approved people at the bank up to date with correct names and to explain why staff helped Mr X withdraw the same money during lockdown when Mr X could not attend his day centre I find as fault.
26. Miss Y has experienced avoidable anxiety and delay to a final review of the issues by the Council. I welcome the Council’s offer to fully investigate the complaint with Care Provider Q. I must decide if this is a proportionate response to the complaint and addresses any injustice. I find it does not fully reflect the injustice experienced, particularly the decision to deliberate withhold information.

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Agreed action

27. 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 Care Provider Q I have made recommendations to the Council. The Council agrees to within four weeks of my final decision the Council:
• Apologise to Miss Y for the poor service received and delay in investigation;
• Pay Miss Y £150 in recognition of the failings by its care provider;
• Open its investigation into the concerns raised, completing it within sixteen weeks of my final decision and to share its findings with Miss Y, Care Provider Q and its commissioning section and social workers;
• Open a review of its service agreements to ensure care provider’s complaints procedures and information set out how a complainant may escalate their complaint within that procedure, take it up with the Council and with the Ombudsman. The review to be completed within twelve weeks of my final decision.

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Final decision

28. In completing my investigation, I find the Council at fault causing injustice for which a remedy has been agreed.

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Investigator's decision on behalf of the Ombudsman