Summary: There is no fault by the Council in the way it dealt with Mr X’s complaints about the domiciliary care he received from two different care agencies.

The complaint

1. Mr X complains about the quality of domiciliary care he received from two care separate care agencies. The care was commissioned and funded by the Council.

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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 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)
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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What I have and have not investigated

5. The 12-month period in which a person should complain to this office runs from the day the person had notice of the matters complained about, not from the date of the Council’s final response letter, so some aspects of the complaint are out of time. Complaints about matters occurring in 2021/22 will not be considered.
6. This investigation is limited to events occurring between January 2023 and 16 May 2023, the date Mr X received a final written complaint response from the Council.

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How I considered this complaint

7. I have:
• considered the complaint and supporting information submitted by Mr X;
• considered the correspondence between Mr X and the Council, including the Council’s response to his complaint;
• made enquiries of the Council and considered the responses;
• taken account of relevant legislation;
• offered Mr X and the Council an opportunity to comment on a draft of this statement.

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What I found

Relevant legislation

8. 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.

Background

9. Mr X is in his thirties and lives in his own home. He has physical health problems and mobility limitations, which impact on his ability to undertake daily living tasks.
10. Mr X has eligible care needs. He receives home care services commissioned by the Council, for support with personal care, meal provision, domestic chores, shopping, and laundry.

Care Agency 1

11. Care agency 1 provided Mr X’s care for several years. In February 2023, the care agency contacted the Council to raise concerns about some of Mr X’s expectations of carers, and that he had turned carers away.
12. In March 2023, Mr X contacted the Council to complain about the care agency. He said carers:

• were not changing gloves between tasks & not wearing masks;
• lacked common sense and on occasions had not correctly unpacked and stored the food delivery resulting in some items being ruined;
• had stolen five pieces of chocolate;
• dumped rubbish in his front garden;
• had issues with time keeping, did not provide a second carer & male carers attended when he wanted female carers only.

13. The Council acknowledged the complaint on 7 March 2023 and informed Mr X his complaint had been passed to its complaints team and its quality assurance team.
14. Care agency 1 gave notice to the Council to terminate the service on 16 March 2024 saying it was unable to meet Mr X’s expectations.
15. The care agency responded to Mr X’s complaint in writing on 23 March 2023. It referred to a monitoring visit completed on 7 March 2023 during which Mr X reported he was satisfied with the care he received. It acknowledged there had been issues when food had spoiled because of incorrect storage and reiterated its previous apology and that Mr X had been reimbursed for the food. It apologised if the timings of visits did not meet Mr X’s preferences but explained Mr X’s preferred timings differed from those stated at the outset. It said Mr X’s preferred specific carers and the requested change of times, may result in a change of carers. The care agency acknowledged Mr X had not had a double-up carer as he should have done and offered a free two-hour visit by way of an apology.
16. In respect of Mr X’s request for female carers only, the care agency said it had not been aware of this request as Mr X had had a male carer for some time and had not raised any issues about this. The care agency agreed to update its system to reflect Mr X’s preference. It also agreed to ask carers to wear masks.
17. In terms of rubbish in Mr X’s front garden the care agency agreed to arrange for it to be removed. The care agency asked Mr X to direct any concerns to it, before complaining to other bodies.
18. Care agency 1 ceased providing a service to Mr X on 30 March 2023.

Care agency 2

19. The Council commissioned a different care agency (care agency 2) to provide Mr X’s care, commencing on 31 March 2023.
20. Prior to commencement of the service, the care agency telephoned Mr X to discuss his care needs, and preferences. The care agency explained it employed mainly male carers.
21. Soon after commencement of the service, Mr X began expressing his dissatisfaction with the quality of support provided, which he reported to the Council. He said he received insufficient support with personal care, and meal provision. He said, the care agency sent male carers when he requested female, he was left without food so had to spend money on takeaways, and he was left sitting in his own excrement, which resulted in skin sores. He said a carer left his gas on, broke his TV and he had to call for help from others. He said he received a visit from a carer with symptoms of Covid which caused him to be unwell. Mr X also complained to the care agency.
22. On 5 & 6 April 2023, the Council telephoned Mr X to discuss his concerns. It also discussed the concerns with the care agency and raised the matter with the Council’s quality assurance team.
23. Mr X says as a result of complaint the care agency terminated his service as retaliation.
24. The records show care agency 2 reported concerns about Mr X’s circumstances to the Council on 5 April 2024, saying it was “…urgently reviewing the carer requirements for this package, but I wanted to ensure that in the meantime these serious concerns were fully raised with your team”.
25. Care Agency 2 gave notice to the terminate the service on 6 April 2023, saying its carers were refusing to work with Mr X, and that some his requests went beyond anything in his care plan. It also reported Mr X’s chosen sleeping arrangements placed him at risk of bed sores.
26. The care agency conducted a formal investigation into Mr X’s complaint. I have had sight of the investigation report. The report deals with each complaint individually and cross references records to support its findings, which did not concur with Mr X’s views about poor service. It acknowledged a cup had been damaged and that it had purchased a replacement.
27. The service from care agency 2 ceased on 19 April 2023.

Care agency 3

28. The Council commissioned a new care agency (care agency 3) to commence on 20 April 2023. Prior to commencement of this care agency a social worker and supervisor from the care agency visited Mr X on 18 April 2023 to discuss his support needs, his expectations of the service, and the care agency’s expectations of Mr X’s behaviour towards carers. A ‘behaviour contract’ was agreed between the care agency and Mr X. The Council told Mr X this would hopefully prevent a breakdown of the service.
29. Mr X submitted a formal complaint to the Council on 11 May 2023. The Council responded, in writing on 16 May 2023. The author of the letter confirmed care agency 1 & 2 had terminated the service, both saying its carers had been unable to work with Mr X The Council confirmed a different care agency had been commissioned to provide support with prior agreements about Mr X’s expectations and behaviours.

Analysis

30. The information I have seen shows to Mr X to have complex needs and that his expectations in some areas exceeded the service available from care agency’s 1& 2.
31. Care agency 1 acknowledged some failings in its service to Mr X and remedied this appropriately. It’s decision to terminate its service to Mr X is one which it was entitled to take. It gave adequate notice and provided a service throughout the notice period. The care agency provided Mr X with an adequate response to his complaint. The Ombudsman could not add to this.
32. I have seen no evidence which supports Mr X’s claim of poor care from care agency 2. It acknowledged a carer had damaged a cup and purchased a replacement. The records detail the care agency’s concern about Mr X’s expectations and circumstances from the outset, which it raised with the Council. It believed it was unable to meet Mr X’s needs/expectations and gave adequate notice to end the service because of this. It provided a service throughout the notice period. There is no evidence to support Mr X’s claim the notice was retaliation because of complaints Mr X raised.
33. The care agency conducted an adequate investigation into Mr X’s complaint and was able to evidence its findings. The Ombudsman could not add to this.
34. I have found no evidence in the way the Council dealt with the complaints Mr X raised about care agency 1 or 2.

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Final decision

35. There is no fault by the Council in the way it dealt with Mr X’s complaints about the domiciliary care he received from two different care agencies.
36. 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