Summary: Mr X complained the Care Provider, SNE Care Services consistently failed to provide adequate care for him and his son Mr Y. He said this caused him and Mr Y distress. The Care Provider was at fault when it sent carers to attend to Mr X and Mr Y who were late and changed appointments without forewarning. The Care Provider is also at fault for failing to take Mr X’s complaint through its complaints process. The Care Provider will provide Mr X with an apology and remind its staff of the importance of following its complaints procedure. The Care Provider will also provide training to its staff to ensure they complete records accurately and deliver a timely service.

The complaint

1. Mr X complained the Care Provider did not provide sufficient care for him and his son Mr Y. Specifically he said the Care Provider:
• provided carers who were regularly late, changed appointment times without warning and missed appointments;
• failed to communicate with him; and
• refused to meet with Mr X to discuss his concerns.
2. Mr X said this matter caused him and Mr Y distress and inconvenience.

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The Ombudsman’s role and powers

3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a care provider has done. (Local Government Act 1974, sections 26B and 34D, as amended).
4. When considering complaints, if there is a conflict of evidence, we make findings based on the balance of probabilities. This means that we will weigh up the available relevant evidence and base our findings on what we think was more likely to have happened.
5. If we are satisfied with a care provider’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)
6. We normally name care homes and other providers in our decision statements. However, we will not do so if we think someone could be identified from the name of the care home or care provider. (Local Government Act 1974, section 34H(8), as amended)
7. The Care Quality Commission (CQC) is the statutory regulator of care services. 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 power to enforce against breaches of fundamental care standards and prosecute offences.
8. 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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How I considered this complaint

9. I spoke to Mr X and discussed his view of the complaint.
10. I made enquiries of the care provider and considered the information it provided which included, care notes, Mr Y’s care and support plan and Mr X’s risk assessment.
11. I provided the Council and Mr X with the draft decision and the opportunity to comment. I considered the comments I received before I wrote the final decision.

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What I found

Law

12. The Care Quality Commission (CQC) is the statutory regulator of care services. 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 power to enforce against breaches of fundamental care standards and prosecute offences.
13. 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 (CQC) has issued guidance on how to meet the fundamental standards below which care must never fall.
14. Regulation 9 states Care Providers should provide person centres care that is specific to their service users.
15. Regulation 16 states Care Providers must have an effective and accessible system for identifying and responding to complaints from service users.
16. Regulation 17 states Care Providers must maintain accurate, complete and detailed records in respect of every person using the service.

Complaints procedure

17. The Care Provider aims to respond to all written complaints within 48 working hours.
18. Investigations into written complaints should begin within 5 working days and a formal written response issued within 28 days.
19. If issues are too complex for the Care Provider to keep to the above timescales, it should inform the complainant of the delays.

what happened

20. Mr X and his son Mr Y both suffer from several physically limiting medical conditions.
21. Mr X and Mr Y were receiving a 17 hours per week package of care from the Care Provider for several years which included daily care visits to assist him and Mr Y with their personal care.
22. In October 2020, Mr X terminated the care package due to a dispute between him and a member of staff. Mr X says the carer scheduled to attend a visit that day did not turn up on time and refused to discuss the matter with him. The Care Provider disputes this and says Mr X was unwilling to wait for the member of staff to finish a meeting before talking to him.
23. Mr X formally complained to the Care Provider on 18 January 2021. He said carers often arrived several hours late and would change the appointment times without giving him notice or asking his permission. He said he had found carers falsifying care notes and he was also unhappy the Care Provider did not respond to the complaints he raised about this.
24. Mr X also complained to the Council on 6 April 2021 when he did not receive a response to his complaint.
25. Mr X ultimately referred the complaint to the Ombudsman as he remained unhappy with the Care Provider’s actions.
26. In response to the Ombudsman’s enquiries, the Care Provider said Mr X began complaining about the service he was receiving shortly after the COVID-19 pandemic began. The Care Provider explained the restrictions implemented by the pandemic, staff sickness and annual leave have led it to make changes to Mr X’s call times. The Care Provider said it sent letters to all clients informing them of this. The Care Provider concedes staff have been late to calls on occasion but it has apologised and offered extra care time to address this. The Care Provider concluded its response advising that Mr X has been verbally abusive and biased towards carers and staff, which contributed to the breakdown in communication between the two.
27. The Care Provider has produced care notes between 31 December 2019 and January 2020. The notes mention Mr Y’s unhappiness with rota changes and lateness several times but do not mention any offers of additional care time to address this.

Findings

Carers conduct

28. Mr X has complained the Care Provider sent carers who regularly attended visits late and falsified care notes. The Care Provider is required to provide person centred care and to record accurate notes detailing the services it has carried out. The Care Provider has provided a selection of care notes which do not pertain to the period covered by this investigation and has not provided an explanation for this. In the absence of this evidence and based on the balance of probabilities I consider it likely the carers were late to appointments and made changes to visits without giving appropriate notice on multiple occasions. This is fault. Mr X and Mr Y are likely to have experienced frustration and inconvenience due to this. I cannot comment on Mr X’s view that carers falsified notes as I do not have enough evidence to make a finding on this.

Complaint handling

29. Mr X brought his complaint to the Ombudsman after failing to receive a formal response from the Care Provider. Mr X has complained that the Care Provider failed to communicate with him. The Care Provider’s complaints policy requires it to acknowledge all complaints and respond in writing to set timescales. I have seen no evidence which indicates it did this. I also have seen no evidence the Care Provider has explained the lack of communication or offered to meet with Mr X to discuss his concerns. This is fault. The Care Provider’s failure to communicate effectively with Mr X has likely caused Mr X further frustration and contributed to the breakdown in trust between Mr X and the Care Provider.

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Agreed action

30. Within 3 months of the date of the final decision, the Care Provider will apologise to Mr X in recognition of the stress and inconvenience caused by its actions.
31. Within 3 months of the date of the final decision, the Care Provider will provide evidence showing it has sent a written reminder to all staff reminding them of the importance of acknowledging and responding to complaints in line with its complaints policy.
32. Within 3 months of the date of the final decision, the Care Provider will provide evidence showing it has arranged training for its staff focusing on the importance of punctuality and accurate record keeping.

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Final decision

33. There was fault in the Care Provider’s actions. I have made recommendations to address this. I have completed the investigation.

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Investigator's decision on behalf of the Ombudsman