Summary: There is evidence of fault by the Council, in that domiciliary services provided on its behalf fell below an acceptable standard. The Council acknowledged this and offered Mrs Y an appropriate remedy before the complaint came to this office. However, the Council failed to acknowledge the injustice caused to her daughter, Mrs X.

The complaint

1. Mrs X complains about the quality of domiciliary care provided to her mother, Mrs Y since March 2023.

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The Ombudsman’s role and powers

2. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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)
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 have:

• considered the complaint submitted by Mrs X;
• considered the correspondence between the Council and Mrs X, including the Council’s final response to the complaint;
• made enquiries of the Council and considered the responses;
• taken account of relevant legislation
• offered Mrs X and the Council an opportunity to comment on a draft of this statement.

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What I found

Relevant legislation

6. 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.
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. The Council had a duty under section 8 of the Care Act 2014 to meet Mrs Y’s eligible needs. It did so by an arrangement with the care agency. Any failings in the care agency’s service to Mrs Y were fault by the Council because the care agency provided services on the Council’s behalf under section 8.

Background

9. Mrs Y is a senior citizen and lives in her own home. She has a diagnosis of Alzheimer’s disease and receives domiciliary care from a care agency, commissioned by the Council.
10. The Council transferred Mrs Y’s domiciliary care provider from one agency to another on 20 February 2023. This arrangement did not go smoothly, and the ongoing care provision was not to an acceptable standard.
11. Mrs X first alerted the Council to her concerns about the quality of care provided by the new care agency (care agency 1) on 27 February 2023. Following enquiries made by a duty social worker the Council concluded the concerns to be valid and decided to source an alternative care agency.
12. Mrs X submitted a formal complaint to the Council about care agency 1 on 7 March 2023. The Council investigated the allegations and concluded the quality of care provided by the new care agency failed to meet the standards expected by the Council and was in breach of its contract with the Council.
13. The Council provided information to this office about the action taken against the care agency 1.
14. The Council cancelled all care charges Mrs Y incurred from 20 February 2023 to 3 March 2023.
15. The Council arranged for its intermediate care team to provide Mrs Y care until a new care agency could be found. Mrs X said she made clear to the intermediate care team that Mrs Y preferred female carers, but male carers attended on some occasions. Mrs X contacted the service to complain and reiterate Mrs Y’s preferences, despite this, male carers attended again.
16. The Council commissioned a new care agency (care agency 2) to provide Mrs Y’s care from 9 March 2023.
17. Information submitted to this office by care agency 2 show there was some initial confusion on visit times. It says it was advised by the Council to follow the care plan used by the previous care agency, which stated am and teatime visits, but the care plan from the Council stated am and bedtime visits. Whilst the care agency waited for clarification it provided four visits to assist with medication. The care agency submitted details of these visits to this office.
18. Mrs X says despite the above difficulties Mrs Y has no allocated social worker and the problems with quality of care continue.
19. The Council confirms that because of ongoing issues it allocated Mrs Y a named social worker on 9 June 2023, prior to this any concerns had been dealt with by a duty social worker.
20. Mrs X submitted a complaint to this office in June 2023.
21. Mrs Y’s social worker reviewed her care needs, and the care arrangements. Mrs X expressed concern about some aspects of the care provided by care agency 2.
22. The social worker relayed Mrs X’s concerns back to the Council. Following this, senior council officers met with care agency 2 on 28 July 2023 to discuss Mrs X’s concerns. The Council concluded care agency 2 had responded appropriately to the concerns and expected that it would be able to resolve the issues going forward.
23. The Council says Mrs X made numerous requests for changes to the level of care provided to Mrs Y, some of which it says it disagreed with. It says this is still under review.
24. Mrs X submitted a complaint about care agency 2 to the Council on 4 August 2023. Mrs X contacted the Council again on 16 August 2023 to say she had further information on the complaint. The Council says it advised Mrs X to forward the information and that it would be passed to an investigating officer. It says the information was never received and Mrs X submitted a complaint to this office before it had the opportunity to properly investigate all complaints about care agency 2.

The Council’s complaint response

25. I have had sight of the Council final complaint response to Mrs X dated 3 April 2023. The response refers to complaints about care agency 1 and the intermediate care team. The author of the letter acknowledges failings in the management of the transfer of Mrs Y’s care provider in February 2023 and failings in the ongoing care provision from care agency 1. The author says the “…concerns form part of a wider pattern of organisational concerns and poor care delivery by [Care Agency 1]. Many of the issues raised by you and others relate to similar themes”.
26. The author apologised for the failings and set out the action the Council had taken to improve standards.
27. The author acknowledged and apologised for failings by its intermediate care team and explained the procedural changes implemented as a result.

Analysis

28. When Council’s commission care services for a person they remain liable for the service failures of the service provider. So even though Mrs X complains about a care agency, it is the Council that is responsible for any failings.
29. I am satisfied the Council responded appropriately to the complaint Mrs X submitted in March 2023. It acted promptly and robustly in addressing matters with care agency 1. It also provided Mrs Y with an adequate remedy, in reimbursing all care fees paid during the period in question.
30. The Council also apologised for the issues relating to the Council’s intermediate care team. I find this an adequate response.
31. Although the Council has not had the opportunity to fully consider Mrs X’s complaints about care agency 2. I am satisfied with the action it has taken to date. Senior council officers met with the care agency to address the issues and were satisfied with the care agency’s ability to deal with the issues raised.
32. Overall, there is evidence of fault by the Council, in that domiciliary services provided on its behalf fell below an acceptable standard. The Council acknowledged this and offered an appropriate remedy for Mrs Y before the complaint came to this office.
33. However, the Council failed to acknowledge the injustice caused to Mrs X. She experienced unnecessary worry and uncertainty about the care arrangements for her elderly mother from February 2023, when her care transferred to care agency I, and then again when care transferred to the Council’s intermediate care team. She was also put to time and trouble raising valid complaints during this period.

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Agreed action

34. The Council should, within four weeks of the final decision, apologise to Mrs X for the failings highlighted in paragraph 33 above and make a symbolic payment of £100.
35. The Council should provide this office with evidence it has complied with the above actions.

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Final decision

36. There is evidence of fault by the Council in this complaint.
37. The recommendations above are a suitable way to settle the complaint.
38. It is on this basis; the complaint will be closed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman