Summary: Miss X complained about failings in the service the Care Provider, Walfinch provided to Mr Y. The Care Provider’s failure to carry out all scheduled care visits caused an injustice for which we have recommended a proportionate remedy.

The complaint

1. The complainant, whom I shall refer to as Miss X complained about the service provided to her father, Mr Y. In particular she complains the Care Provider:
• failed to provide reliable and trained carers;
• failed to attend all scheduled care visits, sometimes without notice;
• failed to provide Mr Y with appropriate personal care for his catheter;
• allowed a carer to bring her husband with her to calls;
• asked Mr Y/ his family to contribute towards travel costs for carers, in addition to the agreed fees;
• left care notes for another client at Mr Y's house;
• left Mr Y's care notes out for anyone to see;
• left Mr Y's medication on the floor next to a sink; and
• changed soiled sheets but did not put them in the wash.

Back to top

The Ombudsman’s role and powers

2. 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)
3. 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)
4. 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)

Back to top

How I considered this complaint

5. As part of the investigation, I have:
• considered the complaint and the documents provided by Miss X;
• made enquiries of the Care provider and considered the comments and documents the Care provider provided;
• Miss X and the organisation had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

6. Mr Y’s family had supported him for a number of years but following a decline in Mr Y’s health in 2022 they were unable to cope. The family employed the Care Provider to provide Mr Y with the specialist care he needed. The Care Provider supported Mr Y from 6 to 22 September 2022 when he was admitted to hospital, and again following his discharge on 9 December 2022.
7. On 19 December 2022 Miss X and her sister, Ms Z had a meeting with the Care Provider to discuss Mr Y’s future care. The notes of this meeting say the Care Provider informed Miss X and Ms Z it was facing problems with the availability of care workers and suggested the family find an alternative care provider. Miss X confirmed the family would look for an alternative and it was agreed the Care Provider would continue to provide Mr Y’s care until a new package was in place.
8. At this meeting Miss X raised concerns that one of the carers was unreliable and arrived late or did not attend some visits at all due to transport issues. When this happened the family had to step in to provide support. Miss X also raised concerns the carer had mentioned needing money for a taxi to Mr Y and that although the Care Provider had confirmed this was not acceptable, it had then asked the family to contribute towards taxi money for the carer. The Care Provider confirmed they had recently increased their hourly rate for most clients but had not increased Mr Y’s. It had instead asked for taxi money in the spirit of partnership, but as the family felt this was inappropriate the Care Provider apologised and confirmed it would bear this cost.
9. Ms Z subsequently set up a WhatsApp group to improve communication between the family and carers. These messages show that Ms Z had to provide Mr Y’s morning care and support on Christmas Eve and Christmas Day as the carer had left unexpectedly. The Care Provider also asked the family to support one of the visits on Boxing day. As this was not possible the Care Provider informed Miss X that the carer’s husband would also attend the call as he was acting as her driver. The Care provider confirmed it had completed a DBS check for the carer’s husband and that they had received relevant care training.
10. Miss X and Ms Z then raised concerns that the carer had only stayed for 20 of the scheduled 45 minute evening visit on 30 and 31 December 2022. They were not prepared to pay for the full cost of the visits. The Care Provider confirmed the invoices would be adjusted.
11. Mr Y’s care and support plan required carers to assist Mr Y with personal care and to empty his catheter bag and change between day and night bags. The care records and WhatsApp messages show the carers noted and reported concerns about the catheter to the family, they also note that Mr Y was receiving medication for an UTI.
12. The care notes for 3 January 2023 record Mr Y still had a UTI and that the catheter needed changing as Mr Y had an infection. Ms Z contacted Mr Y’s GP regarding the infection and then took him to hospital later that day. Ms Z subsequently told the Care Provider the doctor at the hospital was shocked by the state of Mr Y’s catheter area. The doctor said it looked like Mr Y had not been washed in that area for weeks. The Care Provider noted carers had been monitoring the catheter and reporting on it, and that the district nurses should be visiting as well. Ms Z confirmed she intended to contact the district nurses and confirm how often they visited.
13. The records show the carer did not attend for the morning visit on 5 January 2023 and Ms Z had to support Mr Y. This prompted the family to contact a new care provider who confirmed they could provide care from 7 January 2023. Miss X and Ms Z informed the Care Provider who ended their care on 6 January 2023.
14. Miss X has asked the Ombudsman to investigate the family’s concerns about the service provided by the Care Provider.
15. The Care Provider acknowledged a carer had on a few occasions not turned up and the family had had to step in to support Mr Y. It says these issues were discussed with the family at the time, and the carer is no longer employed by the Care Provider.
16. It also acknowledged that the family had brought the issue of soiled sheets not being washed to its attention. The Care Provider says it addressed this with carers and apologised to the family. It says it continued to deal with the laundry according to infection control procedures.
17. In relation to notes found on the floor at Mr Y’s property, the Care Provider says these were a summary of care notes from another client that had slipped out of the carer’s pocket during a visit. The Care Provider says it discussed this with Ms Z to ensure there was no risk of the information being used by anyone. It was satisfied the information could not have been accessed and read or used to cause harm to the client. The Care Provider says the carer will take extra precautions to ensure this does not happen again.
18. It was not aware of the concerns about medication being found on the floor as it says this was not brought to its attention.
19. The Care Provider reiterated its main duty in relation to Mr Y’s catheter was to change the night bag for a day bag. It would also ensure intimate personal care was carried out around the catheter site, but this was dependant on Mr Y’s consent and compliance. The carers would observe outflow and report and concerns of blockage, leakage, infection, or discoloured urine to the family or district nurses. The Care Provider noted the district nurses were responsible for the insertion, maintenance, and management of the catheter.
20. The Care Provider confirmed all of its carers had completed training on catheter care and it was satisfied the personal care provided was satisfactory.

Analysis

21. There is no dispute that carers did not attend all of the scheduled care visits and that other visits were late and/ or shorter than they should have been. The Care Provider has apologised and adjusted it invoices so that Mr Y is not changed for support he did not receive, which is to be welcomed. The Care Provider has also confirmed that the staffing issues it experienced in December 2022 have been resolved. However, these failings in service meant that the family had to provide support at short notice, disrupting their plans and commitments.
22. Miss X has raised concerns about the adequacy of personal care Mr Y received, particularly in relation to his catheter. The daily care records state that Mr Y was routinely assisted with his personal care and catheter bag. Some records say Mr Y was assisted to the bathroom where he completed his own personal care, other entries suggest carers provided personal care, including full body washes. These records also show carers noted and informed the family of concerns for example on 21 December 2022 the carer informed Mr Y’s family the site of the catheter was sore and red, and on 23 December 2022 the carer informed the family the urine in Mr Y’s catheter bag was very dark and had evidence of blood. On 3 January the carer noted Mr Y had an infection and would need the catheter changing.
23. The evidence available suggests the Care Provider provided Mr Y with appropriate personal care.
24. The family’s concerns about soiled sheets not being washed were addressed by the Care Provider and daily care notes do include references to washing and hanging up Mr Y’s laundry.
25. I also consider the Care Provider has addressed Miss X’s concerns about the request for taxi money, the carer’s husband attending a visit, and the care notes. There is nothing more I can add to this.

Back to top

Agreed action

26. The Care Provider has agreed to pay Miss X £100 as a symbolic payment to reflect the difficulties and distress caused to Mr Y’s family by missed care visits.
27. The Care Provider should take this action within one month of the final decision on this complaint and should provide us with evidence it has complied with the above actions.

Back to top

Final decision

28. I have ended my investigation and uphold Miss X’s complaint. I have made recommendations to remedy injustice the organisation has agreed to carry out.

Back to top

Investigator's decision on behalf of the Ombudsman