Summary: Mrs X complains about the Care Providers delivery of care over four days, and its consideration of the concerns she raised. She says the provider conducted a biased investigation and unreasonably ended the care. The Ombudsman finds no fault with the Care Provider.

The complaint

1. Mrs X complains the Provider unreasonably ended Mr X’s care after it conducted a biased investigation into incidents that took place in June 2022.
2. Mrs X complains this caused Mr X severe distress and disruption to his care. It also caused distress and upset to Mrs X who felt the provider had not taken on board her concerns about the events.

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The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. If they have caused an injustice we may suggest a remedy. (Local Government Act 1974, sections 34 B, 34C and 34 H(3 and 4) as amended)
4. 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

5. I considered Mrs X’s complaint and information she provided. I also considered information from the Care Provider.
6. I considered comments from Mrs X and the Care Provider on a draft of my decision.

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What I found

Legislation and guidance

7. 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.

What happened

8. Mr X was in hospital and was discharged home. On his discharge, the local authority required that he have support at home to manage his daily needs.
9. The Care Provider was appointed to provide four calls a day to Mr X for personal care in 2018.
10. In June 2022, there were several incidents which Mrs X say left her and Mr X unhappy with the standard of care he was receiving. These included

• on 3rd June 2022 carers attending outside of agreed hours, which meant Mr X did not receive the care as Mrs X was not home to let them in. Despite this, they were charged for the care.
• carer’s attended on the 4th June and Mrs X did not agree with the events of the previous day, and thus disagreements occurred with the carers. The carers also refused to place Mr X in an alleged broken chair, however, the Care Provider later agreed it could be used.
• There continued to be hostility between Mrs X and the carers attending Mr X’s care during the rest of the visits. Both sides allege distressing behaviour from the other side.
• On 7th June the Care Provider decided to end the care agreement as it could no longer meet Mr X’s needs. It told the local authority of its intent to serve notice. The Care Provider sent the notice of termination to Mrs X’s email address.
• Mrs X says she was not aware of the termination of care until a carer mentioned it as the email had gone to her junk mail. Therefore, they did not have the enough amount to time to arrange a new Care Provider and Mr X was left distressed.

11. Mrs X complained to the Care Provider about the events that occurred between 3rd June to 7th June. She complained about the missed call, the carers behaviour, and the allegations made towards her. She also complained about the handling of the notice to end care.
12. The Care Provider investigated the complaint. It took statements from the carers. In its response to the complaint, the provider confirmed that

• Carers had attended 3 minutes outside of the agreed timeframe, however, it judged this reasonable and said that it would still charge for the care. This was because the carer’s had been able to deliver the care if they had been given access.
• The complaint response also gave the carers accounts of the visits that followed and the allegations of distressing behaviour from Mrs X.
• About the alleged broken chair, the provider said the carers at first refused to use the chair, but resumed using it after seeking advice and information from management.
• The Care Provider said it had sent the notice to end care to Mrs X’s email address, which was the same one they had used for all correspondence. It said there was no reason to believe she had not received it. It had also told the local authority with the intent to end the care so the local authority could support Mr and Mrs X with arranging new care.
• The Care Provider apologised for the delayed response in complaint handling and said this was due to COVID-19.

13. Mrs X remained unhappy and bought her complaint to the Ombudsman.

Was their fault causing injustice?

14. A large part of Mrs X’s complaint and the Care Provider’s response centres around the behaviour of both parties during care visits that took place between 3rd June 2022 and 19th June 2022. It is not possible to know for sure what happened on these visits as both parties provided conflicting views and there is no video or audio recordings of the visits. Therefore, I cannot make a finding on fault in this regard.
15. However, I can consider the Care Providers handling of the concerns. The Care Provider took statements from staff, which it used as its basis to inform its decision making. It also considered the concerns of Mrs X and the assessments done jointly by the NHS and the Local Authority when it agreed to provide Mr X’s care. The Care Provider believed that on the “balance of probability”, Mrs X’s behaviour towards staff was unacceptable and meant the providers could not deliver the care safely to Mr X. Therefore, it would need to terminate care.
16. The Ombudsman cannot question decisions made where there is reasonable evidence relied upon during the decision-making process. The Care Provider is entitled to make its decisions based on the evidence it has available. In this case, the Care Provider investigated the concerns, weighed up the evidence it had and decided based on the evidence it had available. It told Mrs X of the allegations and invited a meeting between all parties, however, this did not take place as the carers did not wish to meet with Mrs X. I appreciate Mrs X disagrees with the findings and feels the investigation was biased because she was not invited to give a statement. However, Mrs X had already given her view and account when she raised concerns.
17. Where there is no flaw in the decision-making process, I cannot find fault with the decision the Care Provider made with its reasons to terminate care. The Care Provider served the notice the same way it had always communicated with Mrs X, therefore I find no fault for that part of the complaint.
18. In respect of the visit out of hours, the Care Provider felt it was reasonable that carers had attended three minutes early. The initial call was scheduled for 16:30pm, and the care agreement allows for calls to be made 15 minutes early or late. The carers attended at 16:11pm. When no access was given at the property, the carers sought advice from their management who advised them to move on to other users. It is not unreasonable for a discrepancy of three minutes, and therefore I do not find fault with the Care Provider for charging for this call.
19. Regarding the alleged broken chair, the carers believed chair was broken and refused to move Mr X into it. Mrs X reassured them it was still safe, however, the carers refused to do this. The carers sought advice from their management, who also spoke to Mrs X about the issue. The management decided the chair was safe and the carers resumed using it. I find no fault in how the Care Provider managed this concern. The carers would have been concerned about the health and safety of the chair and effects of using it.
20. In its complaint response, the Care Provider recognised there had been a delay in providing a final response. The Care Provider apologised for this. I consider this to be the most suitable remedy for the delay.

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Final decision

21. I have completed my investigation. I find no fault with the Care Provider for its handling of care for Mr X and its handling of termination of care.

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Investigator's decision on behalf of the Ombudsman