Summary: Mrs X says a care plan drawn up by a care provider did not address her friend’s complex needs and he did not receive the service from the care provider even though he was charged for it. There was fault by the Council because it identified a need for her friend to be dealt with by a complex needs team but did not act on it. The Council agreed to waive outstanding charges and offer a partial refund of payments made by Mrs X’s friend.

The complaint

1. I refer to the complainant here as Mrs X. She acts on behalf of her friend Mr Y. Mrs X complains about the care Mr Y received from a care provider which had been commissioned by the Council.
2. Mrs X says:
• The care plan drawn up by the care provider did not address his complex needs. The plan commented on his hoarding and home maintenance but does not address them.
• Mr Y needs routine but the care provider could not guarantee times and staff arrived at different times.
• Mr Y made a request for one carer not to attend his home but the company still sent this carer.
• The carers’ notes show they do not know him well.
• There was an outstanding invoice of £515.91 for his care which is unsatisfactory. The Council offered to reduce this by 50% but it has not acknowledged or apologised for its mistakes.
• Communication with Mr Y was poor.
• Mrs X stepped in as informal carer but received no handover notes and is now concerned about a lack of support from the Council.
3. Mrs X wants the Council to offer an apology and explanation to Mr Y preferably face to face or by video. Mr Y wants the outstanding care charges waived and wants a refund of £1091.88 he paid for care between July 2019 and January 2020.

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The Ombudsman’s role and powers

4. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
5. 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 council/care provider has done. (Local Government Act 1974, sections 26B and 34D, as amended)
6. 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)
7. 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

8. I examined the complaint and background information provided by Mrs X and the Council. I sent a draft decision statement to Mrs X and the Council. I considered the Council’s comments on it.

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What I found

9. In her submission to the Ombudsman, Mrs X refers to the actions of the Council and carers going back to 2016. I do not propose to go back as far as 2016 because of the legal restriction on the Ombudsman’s power to investigate complaints. Complaints must be made within 12 months of a complainant’s awareness of the matter.
10. Mrs X complained to the Ombudsman in May 2021. I have exercised discretion to consider the complaint from July 2019 which is a material point of time in this complaint. I will however refer to the period before July 2019 as background.
11. Before July 2019, Mrs X had contacted the Council to express concern about the social worker assigned to work with Mr Y. Mr Y was also unhappy with the cost of the domiciliary care he was receiving. Their dissatisfaction had been a running theme of relations with the Council from 2016.
12. At the same time, the care provider had concerns about Mr Y’s hoarding as well as his conduct with carers. The Council also had concerns about Mr Y’s mental health. The Council had considered Mr Y’s case as a safeguarding matter.
13. A financial assessment conducted in July 2019 led to Mr Y being asked to make a financial contribution towards the care costs. Prior to July 2019, Mr Y received 6 hours a week of care. He did not like that and continually asked for it to be reduced. From July 2019, the Council reduced this to 3 visits a week.
14. Mr Y signalled at an early stage that he did not want even the level of reduced service. Given the difficulties its carers were experiencing with Mr Y, the care provider asked the Council to pull out of the service but the Council insisted the 3 visits should continue and Mr Y should pay his contribution.
15. It is clear that Mr Y did not want help.
16. The care provider asked for Mr Y’s case to be transferred to the Council’s complex needs team. The social worker initially agreed to do so but later declined the request. There is no explanation for the change in the correspondence.
17. The situation continued until 2020 when Mr Y refused the domiciliary care service and Mrs X took on the position as his carer. Mr Y refused to pay the outstanding care charges and now wants a refund of the contributions he made.

Finding

18. I recognise Mrs X wanted the Council to respond to all the criticisms she made of it and now refers these matters to the Ombudsman. The Council did not expressly address her criticisms of its role although it referred to the complaint about the care provider.
19. I do not now propose to provide a line by line analysis of Mrs X’s grounds of complaint. Our role is not to provide answers to each and every criticism a complainant may have about a council. Instead it is to consider allegations about what the authority has done wrong and whether the alleged fault has caused a significant injustice to the complainant.
20. I find fault because the Council had identified the difficulties it and the care provider faced in dealing with Mr Y before July 2019. Mr Y was a hoarder. It considered Mr Y was possibly autistic but had not received a definitive diagnosis. There were concerns about his mental health. It was aware of the breakdown in the relationship between the care provider and Mr Y. It was a difficult situation for the social worker to address Mr Y’s ongoing needs on the one hand and the problems posed by his behaviour on the other.
21. It appears now that the Council chose not to do anything and therein lies the fault in this case. There was a proposal to refer the case to the complex needs team but this was then stopped without an explanation.
22. The Council may also not have explained its role properly to Mrs X when she assumed caring for Mr Y formally. This includes an explanation of any support that she may also be entitled to as a carer.

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Agreed action

23. Where we find fault by a council we must consider the injustice and a possible remedy for the injustice.
24. Here, I recommended the Council waive the outstanding care charge. It should also issue a partial refund of £1091.88 to Mr Y. The partial refund being half the amount or £545.94. This reflects the injustice caused to Mr Y by the Council’s inaction on this case. The Council should formally apologise to Mr Y in writing.
25. I also recommended officers should offer an explanation of any support that it can offer to Mr Y and Mrs X in her role as carer for Mr Y.
26. The Council agreed with the recommendations.

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Final decision

27. There was fault by the Council because it did not take decisive action on Mr Y’s case. It agreed a remedy for the injustice to Mr Y.

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Investigator's decision on behalf of the Ombudsman