London Borough of Ealing (20 011 169)

Category : Adult care services > Domiciliary care

Decision : Not upheld

Decision date : 06 Sep 2021

The Ombudsman's final decision:

Summary: Ms D complained the Council did not properly investigate safeguarding concerns about her mother, Ms C, and the care she was receiving from an independent care agency. Ms D says this caused her anxiety, stress and depression. We found no fault with the Council.

The complaint

  1. The complainant, who I shall refer to as Ms D, complained the Council did not properly investigate safeguarding concerns about her mother, Ms C, and the care she was receiving from an independent care agency. Ms D says this caused her anxiety, stress and depression.

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The Ombudsman’s role and powers

  1. 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)
  2. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
  3. 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

  1. I considered:
    • Ms C’s complaint and the information she provided;
    • documents supplied by the Council;
    • relevant legislation and guidelines; and
    • the Council’s policies and procedures.
  2. Ms C and the Council commented on a draft decision. l considered their comments before making a final decision.

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What I found

Legislation and Guidance

  1. Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. (Department of Health and Social Care, care and support statutory guidance)
  2. The Council’s safeguarding duties apply to adults who:
    • have needs for care and support;
    • are experiencing, or at risk of, abuse or neglect; and
    • because of those care and support needs cannot protect themselves from either the risk of, or the experience of abuse or neglect
  3. The care and support statutory guidance tells Council’s how to respond to safeguarding concerns. A Council must make enquiries, or cause others to do so, if it believes an adult is experiencing, or is at risk of, abuse or neglect. An enquiry should find out whether any action needs to be taken to prevent or stop abuse or neglect and if so, by who. The Council should involve any relevant partners (for example, the Police or NHS) or other persons relevant to the case.
  4. The adult should be involved from the beginning of the enquiry unless there are exceptional circumstances that would increase the risk of abuse. If the adult has great difficulty being involved, and there is no one appropriate to support them, then the Council must arrange for an independent advocate to represent them.
  5. Once the Council has completed its enquiries, it should decide what, if any, further action is necessary and acceptable.
  6. The Court of Protection deals with decisions or actions taken under the Mental Capacity Act. The Court can remove an attorney or a deputy under lasting power of attorney.

Pan London safeguarding adults policy and procedure

  1. I have set out below relevant points from this policy.
  2. The information in some referrals may be sufficiently comprehensive that it is clear the criteria are met for a formal safeguarding enquiry. In other cases, additional information gathering may be needed to establish if the criteria are met.
  3. If a pressure ulcer is believed to have been caused by neglect it is reported as an adult safeguarding concern. The NHS, Council and other relevant parties decide if a safeguarding enquiry is required. The Council takes the lead in any safeguarding enquiries.

What happened

  1. This chronology includes key events in this case and does not cover everything that happened.
  2. Ms C has three children, Ms D, Mr E and Mr F. Ms C has dementia and does not have capacity to make decisions about her own care. Ms C lives with Mr E and Mr F has power of attorney for Ms C’s property and affairs. Mr F commissioned an independent care agency to provide Ms C with domiciliary care.
  3. In January 2020, Ms D contacted the Council with concerns about her mother. She was worried about the care provided to Ms C by the independent care agency. She said her brothers were stopping her seeing her mother, and she was unhappy they did not include her in the arrangements for their mother’s power of attorney.
  4. Ms D made a formal complaint to the Council in February 2020. She said the independent care agency was abusing and neglecting her mother and the Council had a duty to protect her.
  5. The Council told Ms D it had investigated her safeguarding concerns and found no evidence to substantiate her allegations. It told her as she had raised her concerns again, it would make further enquiries and contact Ms C’s doctor.
  6. The Council updated Ms D with the result of its enquiries. It told her it did not have evidence to substantiate her allegations. It suggested she raise her concerns with Mr F. The Council closed the case.
  7. Ms D contacted the Council in April 2020. She said it had not investigated her concerns or updated her. She said the Council had recommended the independent care agency to the family. She asked the Council to clarify its position.
  8. The Council told Ms D it had investigated her concerns, and it had closed her mother’s case. It told her it would not investigate the concerns she had raised any further.
  9. In November and December 2020 and January 2021, Ms D raised concerns about her mother. These included:
    • Mr E’s refusal to share information about Ms C.
    • Mr E’s behaviour towards Ms C.
    • Ms C’s care and those providing the care.
    • Ms C developing pressure sores.
    • Mr F not monitoring the situation.
  10. Ms D asked the Council to arrange for Ms C to have an advocate.
  11. In November 2020, the Council allocated a social worker to the case to undertake safeguarding enquiries. It updated Ms D.
  12. The social worker made safeguarding enquiries to professionals and family members involved in Ms C’s care. None of the professionals nor the family members, other than Ms D, had any concerns about the care delivered to Ms C. Medical professionals confirmed Ms C’s pressure sores were because of her medical condition and not due to neglect or abuse. The social worker asked Mr F to provide a copy of the power of attorney and care records for Ms C, which he did. The social worker considered the evidence and wrote a safeguarding report The report recommended Ms D’s allegations were not substantiated.
  13. Ms D raised further concerns in February 2021, including:
    • Mr F’s behaviour towards Ms C.
    • Mr F’s management of Ms C’s financial affairs.
    • Safeguarding concerns being considered unsubstantiated by the Council.
    • An advocate not being provided to Ms C.
  14. The Council responded in detail to each of Ms D’s concerns. It advised her she could raise her concerns about Mr F being the power of attorney for Ms C’s property and affairs with the Court of Protection.
  15. The Council made further enquiries. It contacted the medical professionals and family members involved in Ms C’s care. The professionals had no concerns about the care Ms C was receiving.
  16. The Council asked its reablement team to carry out a welfare visit to Ms C to check the standard of care the independent care agency was delivering. Ms D wanted to attend the reablement teams visit. The Council said this was not suitable as it was a home visit to assess Ms C and not a meeting. Ms D attended the reablement team’s visit and raised her safeguarding concerns. The team told Ms C’s social worker it had no concerns about the care delivered by the independent care agency.
  17. The Council held a safeguarding meeting in February 2021. Attendees included professionals from the Council and the NHS. Attendees reviewed Mrs C’s care and how her pressure sore was managed. They decided Ms D’s allegations were unsubstantiated and the Council should close the safeguarding investigation.
  18. The Council updated Ms D and offered to meet her with a representative from the NHS to explain their decision. Ms D could not attend on the dates offered. Ms D was unhappy with the result of the safeguarding enquiry. The Council told her how to make a complaint.
  19. Ms D continued to raise concerns about Ms C’s care. The Council told her Ms C’s case was closed and told her how to make a complaint if she was unhappy. In April 2021, the social wrote to Ms D asking her to cease and desist contacting her because it was bordering on harassment.

Analysis

  1. The Council investigated Ms D’s safeguarding concerns. It made enquiries of the professionals and family members involved in Ms C’s care. Other than by Ms D, no concerns were raised about Ms C’s care.
  2. Ms C could not take part in the safeguarding enquiries because she lacked capacity. Mr F, who had power of attorney, provided information on her behalf. Professionals did not raise any concerns about Mr F supporting Ms C. There was no evidence to suggest Ms C needed an independent advocate.
  3. In November 2020, the Council decided Ms C met the criteria for a safeguarding enquiry. The Council made relevant enquiries and discussed the case at a professionals meeting. The attendees decided Ms C’s safeguarding concerns were unsubstantiated. The Council decided to close the safeguarding enquiry.
  4. The Council followed the correct procedure to investigate Ms D’s concerns. On each occasion, it decided Mr D’s allegations were unsubstantiated and Ms C was not at risk of harm. These were decisions the Council was entitled to make. There was no fault in how it made its decisions, so I cannot question their merits.
  5. Each time the Council considered Ms D’s safeguarding concerns, it updated her with the result.

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Final decision

  1. I have completed my investigation and do not uphold Ms D’s complaint.

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Investigator's decision on behalf of the Ombudsman

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