Summary: Mr B complained about care agencies and says they stopped providing care to him because he complained about them. He said the Council did not address this properly. We have not found fault with the way the agencies provided support or ended the support but there was a service failure during two months as one of the agencies was not able to provide a service during the afternoon. The Council has agreed to provide an apology and a financial remedy.

The complaint

1. Mr B says he complained about the care provided by five care agencies. He says that, as soon as he made a complaint, the agencies would stop providing care. He says the Council would then transfer him to a different agency without properly investigating what happened. He also says that the care package with one of the agencies was reduced without good reason.

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What I have and have not investigated

2. I have investigated Mr B’s complaints about four of the five agencies. One of the agencies that Mr B complained about has closed down. The Council has been unable to obtain any records relating to this complaint. I have therefore been unable to further investigate this complaint.

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The Ombudsman’s role and powers

3. We investigate complaints of injustice caused by ‘maladministration’  and ‘service failure’. I have used the word fault to refer to these. Service failure can happen when an organisation fails to provide a service as it should have done because of circumstances outside its control. We do not need to show any blame, intent, flawed policy or process, or bad faith by an organisation to say service failure (fault) has occurred. (Local Government Act 1974, sections 26(1), as amended)
4. 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)
5. If we are satisfied with an organisation’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

6. I have discussed the complaint with Mr B. I have considered the records from the Council and the agencies, the relevant law, guidance and policies and both sides’ comments on the draft decision.

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What I found

Law, guidance and policies

7. The Care Act 2014 and the Care and Support Statutory Guidance 2014 (updated 2017) set out the Council’s duties towards adults who require care and support. The Council also has its own policies.
8. The Council has a duty to assess adults who have a need for care and support. If the needs assessment identifies eligible needs, the Council will provide a support plan which outlines what services are required to meet the needs and a personal budget which sets out the costs to meet the needs.

What happened

9. Mr B is an elderly man who lives at home. In June 2020 Mr B went to hospital after he had a stroke.
10. Mr B was discharged from hospital with a care package. Mr B’s care plan said care workers had to assist him with personal care, laundry, making the bed, preparing meals and snacks and assisting in medication. Mr B had a dog so the care worker should also feed the dog and let the dog out. Mr B received four visits a day and some of the visits required two care workers to attend.
11. Mr B received care from five agencies from September 2020 to September 2021. The care package was funded by the Council with a financial contribution from Mr B.
12. I have summarised Mr B’s complaint and the evidence I considered for each agency.

Agency 1 – September to October 2020

13. Mr B said:
• The care workers did not have enough time with him and, as soon as he made a complaint, the agency handed his care package back.
• Mr B said he gave a coat to one of the care workers and was then accused of a crime and called a liar.
• He overheard care workers talking about him being ‘a rotten so and so’.
• One of the care workers called Mr B a racist. The agency’s manager then rang him and also called him a racist.
14. Agency 1 made the following comments in response to Mr B’s complaint.
15. Agency 1 said Mr B’s recovery from the stroke had progressed towards the end of September 2020 and he did not need two carers for some of the visits. The agency informed the Council as it felt that the care package could be reduced. The social worker visited Mr B on 1 October 2020 to observe the visit and reassess his needs.
16. The Council amended the care plan from 9 October 2020 and increased the morning visit to one hour, but said all the visits would require one care worker only. Agency 1 said Mr B did not agree with the change in his care package and ‘became agitated’ towards the manager because of this change.
17. There was then a further issue when Mr B gave a jacket to one of the care workers. The agency explained to him that it had a gifting policy which meant that the care workers should not accept gifts from the clients. The agency said it explained to Mr B that it was a nice gesture, but unfortunately the care worker would have to return the jacket.
18. Agency 1 said Mr B accepted this and did not raise a complaint about it at the time. However, Agency 1 said that, after the jacket incident, the relationship between Mr B and the agency deteriorated. It said Mr B would ‘telephone the office and, on many occasions, would be aggressive towards staff members…’ It said that, due to the breakdown of the relationship and the increasing verbal aggression, the agency gave notice that it would end the care package.
19. Agency 1 said Mr B did not make a formal complaint to the agency at the time, but then later raised the issues with the Council.
20. Agency 1 provided records of the telephone calls between Mr B and the agency which led to the agency giving notice. Agency 1’s manager denied calling Mr B a racist.

Agency 2 – March to May 2021

21. Mr B said:
• One of the care workers, care worker 1, was unable to provide care, because of her own mobility problems, but the agency kept sending her. On one occasion, she dripped soap from her hands into his tea.
• Care worker 2 cancelled calls without notice. The Council acknowledged this and reduced the bill by 10 hours.
• There was an argument with care worker 2, who called him a racist and this led to the agency ending the care package.
22. Agency 2 responded and said care worker 1 was fully trained and competent and had been at the agency since 2015. No concerns had been raised about her ability to carry out her work.
23. Mr B was rude towards care worker 2 and would often cancel calls when care worker 2 arrived to provide care. Agency 1 provided records which showed the statements made by Mr B which led to the agency ending the care package. It also provided records showing that Mr B cancelled the calls when care worker 2 attended.

Agency 3 – May to July 2021

24. Mr B said:
• One of the care workers refused to let his dog out. A friend of Mr B then showed the care worker the care plan and the care worker complied.
25. The agency says Mr B had not made a complaint about this at the time. Also, as it was not known when the incident took place, it would be difficult to comment. Agency 3 has sent the care records which showed the care workers let the dog out.

Agency 4 – July to September 2021

26. Mr B said:
• One of the care workers used the ‘f’ word four times when asked to let Mr B’s dog out. Mr B challenged him about this and the care worker accused him of being a racist. The agency then handed Mr B’s care package back to the Council.
• The agency reduced the time for the care call from 1.5 hours to 1 hour. He says the social worker agreed to this change.
27. Agency 4 has sent me an incident report dated 26 July 2021. The care worker said Mr B asked him to let his dog out. The care worker did so but closed the door behind him when he came back into the house. The care worker said Mr B became ‘very angry shouting and swearing and told him to get out.’ The care worker did so and said he did not really understand what happened but reported it to the office.
28. The care worker’s note of the visit said: ‘’…started saying bad things about me said F words and said to him please be polite with care you don’t need saying F word to carer. Said to get out. Is not a good man. I report to [manager].’
29. Agency 4’s manager rang Mr B to find out what happened. Mr B said he got angry as the care worker had closed the door before letting the dog back in. Mr B said the care worker swore at him. Mr B said the care worker should be immediately dismissed, or should be suspended without pay as ‘that would teach him.’
30. Agency 4 gave four weeks’ notice on 3 August 2021. The reason for this was that agency 4 only had three care packages in the area and two of those packages were being transferred to another agency.
31. The other agency did not want to take on Mr B’s package so the Council had to find an alternative agency to provide the care.

Further information

32. The Council has provided the following information. It said that, at the end of August 2021, agency 4 said it could no longer perform Mr B’s late afternoon call. Agency 4 said it did little during that call except let Mr B’s dog out and make him a cup of tea. The Council agreed a reduction in the care provided from 10.5 hours to 7 hours a week.
33. The Council then set up direct payment agreement for Mr B to be managed by a third-party money manager. A different agency was found to take over Mr B’s care package and they started on 1 November 2021. The care package went back to two calls a day and a total of 10.5 hours.
34. The Council has sent me Mr B’s care plan dated 5 October 2021 which said Mr B needed two calls a day.

Analysis

35. In terms of agency 1, the agency contacted the Council as it felt the care package could be reduced and asked that Mr B’s needs be re-assessed. That was an appropriate action.
36. I find no fault in the way the Council decided to reduce Mr B’s care package. The social worker visited Mr B and observed one of the care calls, she assessed his needs and decided that he no longer needed two carers for the morning and evening call, but extended the length of the morning call. I appreciate that Mr B was not happy about the change in the care plan but I cannot question the merit of a decision if there is no fault in the way the decision was made.
37. In terms of agency 1 and the gift of the jacket, there is no fault in the agency’s actions. I presume the agency has a no-gift policy in place to protect employees from allegations of theft. I am not sure why the relationship between Mr B and the agency broke down after the incident as the agency was not criticising or accusing Mr B of anything.
38. In terms of agency 2 , there is no evidence that care worker 1 was not able to perform her role.
39. I have seen the records which showed that Mr B would cancel calls at the last moment if care worker 2 turned up and I have seen the records of the interactions between Mr B and care worker 2. I find no fault in respect of the agency’s actions.
40. Overall, in terms of agencies 1 and 2, I find no fault in the agencies’ decision to hand back the care package. The records showed that the relationship between Mr B and the agencies had broken down.
41. I cannot say there was fault in terms of agency 3’s actions. The records that I have seen show that the care workers let Mr B’s dog out and there is no further information about the incident Mr B complained about.
42. In terms of agency 4, I find no evidence of fault in terms of the agency’s interactions with Mr B. I find no fault in its decision to end the care package. It appears to me that the decision was made as part of a wider decision to hand over the care package to a different agency, presumably to make matters more efficient.
43. However, there were two months, September and October 2021, when agency 4 said it could no longer provide the afternoon call, that Mr B did not receive an afternoon call. There is no indication that Mr B’s needs changed during that time and I note the package went back to two calls and 10.5 hours when the new agency started on 1 November 2021.
44. Therefore, there was a service failure during that time. A service failure occurs when a Council fails to provide a service as it should have done because of circumstances outside its control. We do not need to show any blame, intent, flawed policy or process, or bad faith by an organisation to say service failure has occurred.
45. Although I note that agency 4 said that it did very little during the afternoon call apart from letting Mr B’s dog out and providing him with a cup of tea, I do note that the afternoon call was restored as soon as possible and therefore I conclude that Mr B suffered an injustice by not having that call for two months.
46. In a case such as this one, where the person has not suffered any financial injustice as a result of the fault, we can recommend a small symbolic amount to remedy the injustice.

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Agreed action

47. The Council has agreed to take the following actions within one month of the final decision. It will:
• Apologise in writing for the service failure.
• Pay Mr B £200 for the service failure or, if Mr B has any outstanding debt with the Council in his contribution to the cost of the care package, deduct £200 from the outstanding debts.

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Final decision

48. I have completed my investigation. The Council has agreed the remedy to address the injustice caused by the service failure.

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Investigator's decision on behalf of the Ombudsman