Summary: Mrs X complains on behalf of Mr and Mrs Y that the Council has not dealt with adult social care properly, causing avoidable distress and Mr and Mrs Y’s needs not being met. The Council is at fault because Mrs X was not informed about bathing issues, Mr and Mrs Y missed some care and the Care Provider did not respond to the complaint properly. Mrs X suffered avoidable distress and had to provide some care to Mr and Mrs Y. Mr and Mrs Y suffered a lack of care. The Council should apologise to Mrs X and Mr and Mrs Y.

The complaint

1. The complainant, whom I shall refer to as Mrs X, complains on behalf of Mr and Mrs Y that the Council did not deal properly with adult social care for Mr and Mrs Y because:
• The Care Provider delivered poor care when it didn’t not inform Mr and Mrs Y’s family about bathing issues in July 2024;
• A carer shouted at Mrs X;
• The Care Provider served notice to end its delivery of care without warning on Mr and Mrs Y; and
• Complaints handling was poor.
2. Mrs X says she suffered avoidable distress and had to provide bathing care to Mr and Mrs Y. Mr and Mrs Y suffered missing care provision.

Back to top

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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating; or
• we could not add to any previous investigation by the organisation; or
• further investigation would not lead to a different outcome; or
• there is no worthwhile outcome achievable by our investigation.
  (Local Government Act 1974, section 24A(6), as amended, section 34(B))

5. Our role is not to ask whether an organisation could have done things better, or whether we agree or disagree with what it did. Instead, we look at whether there was fault in how it made its decisions. If we decide there was no fault in how it did so, we cannot ask whether it should have made a particular decision or say it should have reached a different outcome.
6. When considering complaints, we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
7. 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, sections 24A(1)(A), and 25 (7) as amended)
8. 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)
9. We may investigate complaints from the person affected by the complaint issues, or from someone else if they have given their consent. If the person affected cannot give their consent, we may investigate a complaint from a person we decide is a suitable representative. (section 26A or 34C, Local Government Act 1974)
10. 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)

Back to top

What I have and have not investigated

11. I have investigated that part of Mrs X’s complaint about the delivery of poor care and complaints handling.
12. I have not investigated the part of Mrs X’s complaint about a carer shouting, because we cannot add to any previous investigation. I have not investigated the part of Mrs X’s complaint about serving notice because there is not enough evidence of fault to justify investigating.

Back to top

How I considered this complaint

13. I considered evidence provided by Mrs X and the Council as well as relevant law, policy and guidance.
14. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

Back to top

What I found

Law, guidance and policies

15. 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. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.

What happened?

16. This is a brief chronology of key events. It does not contain everything I reviewed during my investigation.
17. Mr and Mrs Y lived at home. They were in receipt of a package of domiciliary care provided by Mobile Care Services Ltd, the Care Provider, which commenced at the end of June 2024.
18. At the end of July Mrs X complained about bathing arrangements for both Mr and Mrs Y.
19. Mrs X registered a complaint with the Care Quality Commission (CQC) about her concerns.
20. The Council completed a Mental Capacity Assessment (MCA) in regard to Mrs Y and determined she did not have capacity to make decisions about her own care and support.
21. In early August 2024 an Occupational Therapist (OT) visited Mr and Mrs Y. The OT recommended additional handrails and a bathlift for Mr and Mrs Y.
22. The Care Provider responded to Mrs X’s July complaint. It apologised for any distress caused.
23. At the end of August the OT visited again after the bathlift had been installed and instructed Mrs X how to use the equipment.
24. In October 2024, Mrs X raised concerns with the Care Provider about one of Mr and Mrs Y’s carers.
25. The Care Provider gave notice to terminate the provision of its package of care for Mr and Mrs Y.
26. Mrs X complained to the Care Provider in November 2024 and was accompanied by a letter from relatives outlining the impact on their family.
27. The Care provider responded to the complaint in early December 2024.
28. Mrs X told the Care Provider she was unhappy with the response and that it did not address the complained about bathing issues.
29. The Care Provider directed Mrs X to the Ombudsman. Mrs X complained to the Ombudsman.

Analysis

Poor care

30. The Care Provider considered Mrs X’s complaint in July 2024 concerning Mr and Mrs Y not being bathed properly for a period of time and a lack of communication with their family about the matter.
31. The Care Provider said it had informed one of Mrs X’s family who was in contact with the OT about the provision of aids to support or assist with bathing. It said Mrs Y was receiving assistance to have a full wash in the meantime.
32. The Care Provider apologised for any concern or distress.
33. Case notes show a referral for an OT visit was made in early July and that Mr and Mrs Y had received bathing care but not had their hair washed for over a month.
34. Both Mrs X and the family member the Care Provider said had been informed, stated they had found out by accident and had not been told about the bathing issues by the Care Provider.
35. On the balance of probabilities, Mrs X was not told about the bathing issues and Mr and Mrs Y did not receive care to wash their hair for over four weeks. This is fault. Mr and Mrs Y missed care. Mrs X and family had to provide this care.

Complaints Handling

36. Mrs X provided supplementary information associated with her complaint to the Care Provider, outlining the concerns about bathing for Mr and Mrs Y.
37. The Care Provider’s complaint response in December 2024 makes no reference to the specific issues around the concerns about bathing. This is fault. Mrs X’s complaint was not fully responded to. However, I do not consider that Mrs X suffered any significant ongoing injustice because this matter had already been addressed earlier in August 2024, the Care Provider had apologised and Mr and Mrs Y had received appropriate input and assistance from the OT by the end of August which remedied the problems.

Back to top

Action

38. To remedy the outstanding injustice caused by the fault I have identified, the Council should take the following action within 4 weeks of my final decision:
• Apologise to Mrs X and Mr and Mrs Y for the fault found. We publish guidance on remedies which sets out our expectations for how organisations should apologise effectively to remedy injustice. The organisation should consider this guidance in making the apology I have recommended in my findings.
39. The Council should provide us with evidence it has complied with the above actions.

Back to top

Decision

40. I find fault causing injustice. The Council has agreed actions to remedy injustice.

Back to top

Investigator's decision on behalf of the Ombudsman