Summary: Mr X complained about the care provided to his wife by a care provider arranged by the Council. Mr X also complained the Council did not appropriately consider his concerns. He says the Council’s actions caused avoidable distress and worry and resulted in him having to complete his wife’s care. We found no fault by the Council.

The complaint

1. Mr X complained about the care provided to his wife by a care provider arranged by the Council. Mr X complained:
1. Carers signed in to say they provided care on occasions when they had not attended the address;
2. Carers did not always stay for the time specified by the care plan, with some visits lasting only about five minutes, and
3. Carers did not always carry out the number of visits specified by the care plan as they missed numerous morning and evening visits.
2. Mr X also complained the Council did not appropriately consider his concerns. He says the Council’s actions caused avoidable distress and worry and resulted in him having to complete his wife’s care. He would like the Council to acknowledge his concerns and provide an apology.

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The Ombudsman’s role and powers

3. 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)
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 considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
7. Mr X and the Council had an opportunity to comment on a draft of this decision. I considered any comments received before making a final decision.

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What I found

Care Act 2014

8. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to everyone regardless of their finances or whether the council thinks the person has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
9. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. 
10. We can investigate complaints about actions by adult social care providers that can be regulated by the Care Quality Commission. Such activities include giving personal care or other practical support in the place where the person lives.
11. The law defines ‘personal care and other practical support’ as ‘physical assistance (or prompting and assistance) given to a person in connection with:
• eating or drinking;
• toileting;
• washing or bathing;
• dressing;
• oral care; or
• the care of skin, hair and nails (except for nail care provided by a chiropodist or podiatrist)’.

The care provider’s check-in and check-out policy

12. The care provider uses an online application operated via carers’ mobile devices to log home visits to service users. The care provider’s policy sets out the check-in and check-out process. In brief, the process consists of:
• Locate the QR code provided by the care provider. This is normally placed at the service user’s address. The QR code is specific to the service user.
• Scan the QR code via the relevant application on the carer’s mobile device. This automatically records the carer’s check-in time and location.
• Carry out the required tasks and log them in the application.
• When all tasks are complete, scan the QR code via the check-out section of the application. This automatically records the carer’s check-out time and location.
• Submit the details to the care provider via the application.
13. The policy says if the QR code is not functioning, the carer must immediately report the issue to the office and log the visit manually through the mobile application. It says the system uses GPS to record the exact location and time of check-ins and check-outs.
14. The policy says the system also records how long before the check-in/check-out button was pressed that the location was collected by the mobile device; this is to help determine the reliability of the location data.

Background

15. In 2022, the Council carried out a needs assessment for Mr X’s wife, Mrs X. The Council identified that Mrs X required care and support due to her health condition.

What happened

16. This chronology includes key events in this case and does not cover everything that happened.
17. In 2023, the Council arranged for Mrs X to receive care at home from a third-party care provider. The care provider started to provide care to Mrs X in September 2023. The care provider produced a care plan which set out the care and support to be provided to Mrs X. This included daily visits from carers for 60 minutes in the morning and 30 minutes in the evening.
18. In January 2024, the Council asked the care provider if it could increase the care package for Mrs X due to a decline in Mr X’s health.
19. In February 2024, the care provider increased its visits to Mrs X to provide transport to and from the regular activities she attended.
20. In March 2024, the police service attended Mr and Mrs X’s home following a report of a safeguarding concern. The police removed Mr X from the property as a result.
21. The care provider increased the number of daily visits to Mrs X to include night-time care.
22. In early April 2024, Mr X emailed the Council to complain about the actions of one of the carers. Mr X said one of the carers had signed into the care provider’s application to record that they had taken Mrs X to one of her activity groups on a specific day in March 2024. Mr X said the carer had not taken Mrs X to the activity group on that date because he and Mrs X had attended a hospital appointment at that time. Mr X said the carer had a copy of the QR code and had used the application to sign in for care visits when they had not even been to Mrs X’s home. Mr X said the carer had failed to attend multiple morning and evening calls, leaving him to provide care for Mrs X instead.
23. Mr X met with the Council in June 2024. The Council says in response to Mr X’s concerns, its care coordinator and team manager requested a review of the care provider from the local authority’s commissioners. It says it also met the care provider to discuss the issue.
24. Mr X returned to the family home in late June 2024. In early July 2024, Mr X emailed the Council. He requested the outcome of the Council’s investigation regarding the carer, and said the times recorded for the carer’s visits were false as none of the evening calls lasted longer than five minutes.
25. Mr X made a formal complaint on 3 July 2024. He raised several concerns about the care provided to Mrs X and the Council’s role in providing the care package.
26. The Council provided its complaint response on 17 July 2024. It said it was unable to comment on the findings of the investigation regarding the carer as investigations relating to individuals are usually confidential. The Council said however the findings would be made available to the Council’s commissioning department. The Council said it had responded to Mr X’s emails and visited Mrs X about her care package on numerous occasions. It said it provided additional care to Mrs X for the period Mr X was not living at the property and said the Council and the care provider were satisfied the care plan met Mrs X’s needs. The Council offered to meet Mr X to discuss his concerns further if he wished.
27. Mr X remained dissatisfied with the Council's response and brought his complaint to us.

Analysis – Mr X’s complaint that carers signed in to say they provided care on occasions when they had not attended the address

28. Mr X says one of the carers signed in to say they provided care when they had not attended the address, and claimed to have taken Mrs X to one of her group meetings at a time when Mrs X was not at home. He says this happened on at least two occasions, one in January and the other in March 2024.
29. I have reviewed the care provider’s records regarding the visits made to Mrs X. Regarding the date in January 2024, the care records show a start and end time for the visit as well as details of the tasks carried out. Regarding the date in March 2024 when Mr X says the carer could not have taken Mrs X to her group meeting, the records show an arrival and departure time for the transport support. The record for this visit shows these times were entered manually as the QR code was not available.
30. The care provider says manual check-ins are typically used when GPS or the QR code is not available. It says carers are unable to use the QR code (and have to check-in manually) when attending transport calls because they are not at Mrs X’s home at the time. The care provider says the system it uses to log carer’s visits records the precise GPS location of carers when they check-in and check-out of a call. It says the information recorded provides full visit details and includes alerts for any location mismatches or irregular visit durations.
31. I acknowledge Mr X says the above visits/transport calls did not take place. However, the care provider’s records show the times of the visits and the actions taken at the time. The Council says it investigated Mr X’s concerns and says the care provider was able to evidence the carer attended all assigned calls. It also says that having carried out a review of the care provider (as a result of Mr X’s concerns), it highlighted no areas of concern.
32. Whilst I acknowledge Mr X’s comments, the evidence does not support his explanation. The evidence shows the times and dates of the visits and support provided, and I have seen no evidence to indicate these records are incorrect or contain false data. As a result, there is not enough evidence of fault regarding this aspect of the complaint.

Mr X’s complaint that carers did not always stay for the time specified by the care plan

33. Mr X says the carers often did not stay for the required period of time; he says evening calls in particular often did not last longer than five minutes.
34. Mrs X’s care plan specified 60-minute morning visits and 30-minute evening visits. These visits were required for carers to assist Mrs X with washing, dressing, oral care and to check if anything else was needed.
35. I have reviewed the care provider’s records which provides details of the visits. Some visit times are recorded as shorter than the specified duration. However, the records indicate Mr X cancelled some visits at short notice, sometimes on the day, and in some cases when the carers arrived at the address. It is possible this may account for some of the shorter visit times.
36. The majority of the visit times recorded are in accordance with the duration specified by the care plan. I acknowledge Mr X says some visits only lasted about five minutes, however, the care records do not support this. I acknowledge Mr X has provided audio recordings of some visits which he says demonstrates some visits were shorter than the required timeframe. However, I am unable to verify the recordings as visits by carers from the specific care provider and am unable to verify the dates and times of the recordings. As a result, whilst I acknowledge Mr X’s comments, and acknowledge some visits did not take as long as the time specified by the care plan, the evidence shows the carers attended most of the visits for the required duration.
37. The National Institute for Health and Care Excellence (NICE) guidance on home care says contracts should allow home care workers to provide a good quality service without being rushed or compromising the dignity or wellbeing of the person. It also says calls should be no less than half an hour unless:
• The home care worker is known to the person, and
• The visit is part of a wider package of support, and
• It allows enough time to complete specific, time limited tasks or to check if someone is safe and well.
38. The evidence indicates on some occasions the carers did not stay for the time specified by the care plan. However, the visits were made by carers known to Mrs X, (the same carers attended regularly), and the visits were part of a package of support. Having reviewed the care records, there is no evidence to indicate the occasional shorter visit times were not sufficient to complete the carer’s tasks or to check if Mrs X was safe and well. As a result, the Council is not at fault regarding this aspect of the complaint.

Mr X’s complaint that carers did not always carry out the number of visits specified by the care plan

39. The care records show some visits were not completed. The Council says Mr X cancelled several visits and there were times when Mr X refused entry to the carers. The care records support this explanation.
40. The care provider says it operates a live rostering system and that it monitors care calls daily. It says the rota manager also confirms the care calls and its processes would therefore have immediately picked up any calls missed by the carers.
41. Mr X says there were more and more days where the carer never came to see Mrs X, leaving him to complete his wife’s care. I acknowledge Mr X’s comments; however, the care records do not support this as they show regular care visits were completed. I acknowledge Mr X says carers used the application to log calls when they were not actually attending. However, as previously stated, I have seen no evidence to indicate the care records are incorrect or contain false data.
42. Whilst I acknowledge Mr X’s comments, the care records indicate the carers carried out visits in accordance with the care plan. As a result, there is no evidence of fault regarding this aspect of the complaint.

Mr X’s complaint that the Council did not appropriately consider his concerns

43. The Council’s complaint response addressed each of the concerns raised by Mr X as part of his complaint. It also provided the Council’s rationale for its actions and explained how it liaised with the care provider to address Mr X’s concerns.
44. In addition, as part of its response to our enquiries, the Council says its allocated worker and team manager had consistent oversight of Mrs X’s care. It says it carried out home visits to check on her care and wellbeing, checked with other family members to obtain their views, and sought feedback from Mrs X’s activity groups.
45. As a result, the Council appropriately considered Mr X’s concerns regarding the care provided to Mrs X. The Council is therefore not at fault regarding this aspect of the complaint.

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Decision

46. I have found no evidence of fault by the Council and have concluded my investigation.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman