Summary: We will not investigate this complaint about the Care Provider’s actions when Mr Y declined care. The Care Provider has already taken suitable action to remedy the injustice caused, and we could not achieve anything more meaningful.

The complaint

1. Mrs X (Mr Y’s granddaughter) complained about neglect of her grandfather by a Council-commissioned domiciliary care provider. She said the Care Provider:
• did not properly communicate with family;
• passed blame; and
• did not handle the complaint properly.
2. Mrs X said the Care Provider’s actions exacerbated Mr Y’s condition and he died alone and confused in residential care. Mrs X said the matter also caused her significant distress. She wanted acknowledgement of fault and service improvements to be made. She also wanted the Care Provider to refund costs of Mr Y’s care and pay an additional financial remedy.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• 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))

4. We may decide not to start or continue with an investigation if we are satisfied with the actions an organisation has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended)

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How I considered this complaint

5. I considered information provided by the complainant and the Council.
6. I considered the Ombudsman’s Assessment Code.

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My assessment

7. Mr Y received care at home between 2023 and 2024. Mrs X’s complaint is about the Care Provider’s actions towards the end of his domiciliary care, and includes concerns about Mr Y not having been supported properly with his personal care and eating. Mrs X says Mr Y was known to self-neglect and had delirium.
8. I have considered the care and support plans and purchase orders the Council provided to the Care Provider when commissioning Mr Y’s care. Before September 2024, these focused on Mr Y’s physical difficulties and did not say
   Mr Y was known to self-neglect or that there was any concern about his cognitive abilities.
9. The Care Provider accepted in its complaint response that it did not take action when Mr Y was showing signs of self-neglect. The Care Provider understood
   Mr Y had mental capacity and therefore had the right to decline support. We could not say now whether Mr Y had capacity at the time of these events or not, given that the Council’s needs assessments did not identify any concern relating to his cognition.
10. The Care Provider nonetheless said in its complaint response carers should have escalated their concerns about Mr Y refusing care. It acknowledges it should have discussed its concerns with his family. The Care Provider also accepted it had accidentally cancelled Mr Y’s care package for a two day period due to an administrative error.
11. We could not say the Care Provider’s actions worsened Mr Y’s condition or contributed to his death some time later in residential care. We also cannot remedy injustice to a person who has died. If we investigated this complaint, it is likely we would make recommendations in line with those the Care Provider has already suggested. It has apologised and offered a refund for a two-month period of care. A financial remedy to recognise the impact of loss of service or poor service acknowledges the associated distress caused to Mrs X. Despite some other areas of complaint where disagreement remains, it is unlikely we would improve on the remedy the Care Provider has already offered.
12. Mrs X has not yet accepted this offer due to the Care Provider’s reference to it being a ‘goodwill gesture’. This statement by the Care Provider is inconsistent with it having accepted fault causing an injustice, and if we made this recommendation it would be as a remedy to recognise the injustice caused. However, this alone is not a good reason for us to investigate the matter further. Doing so would not result in a different outcome.
13. The Care Provider has also listed service improvements it intended to make as a result of the complaint. These include producing a register of clients at risk of self-neglect and malnutrition, and staff training in several areas including recognition of food refusal. It is unlikely we could recommend anything more meaningful if we investigated the complaint further.

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Final decision

14. We will not investigate Mrs X’s complaint because the Care Provider has already taken suitable action to remedy the injustice caused by fault, and we could not achieve anything more meaningful by investigating the matter further.

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Investigator's decision on behalf of the Ombudsman