Summary: The Council was at fault for failing to manage the family’s expectations about the transfer of staff from care provider A to care provider B. It was also at fault for delay processing the direct payments and delay responding to the complaint. The Council has agreed a financial remedy for the distress this caused to the family.

The complaint

1. Ms X complained the Council delayed planning her grandmother’s care during the transfer period when it knew her care provider was withdrawing care. It also failed to provide the same female carers for her grandmother, Ms G, as promised when they transferred her provision to a new care agency. The lack of continuity caused Ms G distress. The Council also delayed processing direct payments which caused the family additional distress. Ms X would like the Council to acknowledge the faults and reimburse the cost of her grandmother’s care.

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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 future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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)
4. 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)
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(1), as amended)

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What I have and have not investigated

6. Ms X complained to the Ombudsman in September 2025. Complaints must be made within 12 months of the person being aware of the problem unless we decide there are good reasons. In this case, Ms X complained to the Council in September 2024 about matters relating to the changes to her grandmother’s care which started earlier that year. The Council completed its investigation in August 2025, the month before Ms X brought her complaint to the Ombudsman. Any delay bringing the complaint to us is not because of any delay on Ms X’s part. I have therefore started my investigation in January 2024 to reflect the period of Ms X’s complaint.

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How I considered this complaint

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

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What I found

Relevant legislation

9. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards that registered care providers must achieve. The Care Quality Commission (CQC) has guidance on how to meet the fundamental standards.
10. Guidance 10 of the Regulations says when people receive care, all staff must treat them with dignity and respect. When providing intimate or personal care, the care provider must make every reasonable effort to make sure they respect the persons preferences about who delivers their care, such as requesting staff of a specified gender.
11. Direct payments are monetary payments made to individuals who ask for them to meet some or all of their eligible care and support needs. They enable people to arrange their own care and support to meet those needs. The council must ensure people have relevant and timely information about direct payments so they can decide whether to request them. If they do so, the council should support them to use and manage the payment properly

The Council’s policies and procedures

12. The Council’s complaint policy is available online. It says it will acknowledge receipt of a complaint within five working days and investigate complaints at stage one within ten working days. If an individual is not satisfied with the outcome, they can request a review by a senior manager. The manager will send a formal response within 28 calendar days from the date of the individual’s request.

What happened

13. I have summarised below the key events; this is not intended to be a detailed account.
14. Ms G lived in her own home and had the same carers, from provider A, for ten years. She had a care and support plan dated late July 2023.
15. In January 2024, the Council wrote to people who received home care and told them it was changing how it ran its care and wellbeing support service. The letter explained it would still provide care, and the individual did not need to take action. It said ‘In some cases, even if your provider changes, you will continue to see the same care workers as we expect many care workers to transfer to new providers.’ The letter explained how to contact the social care department for support.
16. In late February 2024, the Council wrote personally to Ms X about the change to her care arrangements. Around the same time, the Council’s records show Ms X called the Council about the changes. Ms X said she was concerned about them.
17. In March 2024, the Council wrote again about the changes, which it explained would change from June 2024. The letter provided further information and encouraged people to check online for updates. It also suggested individuals contact the Council by phone or email or to attend one of several drop-in sessions where it provided direct support.
18. In the middle of March, Ms X called the Council and asked if her grandmother could have direct payments to pay provider A directly, so she could stay with the same provider. The Council explained how direct payments work. It also told Ms X that provider A was no longer providing care in the area from June 2024, so she could not stay with the same agency. The Council suggested provider B. Ms X and Ms G agreed to this.
19. In the middle of April 2024, Ms X said her grandmother did not want to move to provider B. She said she heard bad reports about provider B and they were mostly male carers. Instead, Ms X asked the Council to make direct payments so she could choose and pay for her own care as she identified her own provider. Ms X said she would pay for her grandmother’s care while the Council arranged the direct payments and asked the Council to reimburse her, rather than using provider B. The Council sent a direct payment form to Ms X at the beginning of May to arrange this.
20. In late May 24, Ms X telephoned the Council and said her grandmother decided she would try using provider B. Ms G understood five of her original carers from provider A were transferring to provider B and would continue to provide her care.
21. At the beginning of June 2024, the Council transferred Ms G’s care to provider B. Within the first few days, provider B sent a male carer. Ms G was upset. She refused the care and refused to eat. Ms X called the Council and asked to transfer to direct payment and said she would find an alternative provider. Ms G received care for provider B for four weeks while Ms X looked for an alternative.
22. The Council contacted provider B and asked if it could provide Ms G with female carers. Provider B said it would accommodate this request as far as it was practical, but it was not always possible. This was because Ms G had two carers per visit and there were not enough female members of staff to cover every visit. If a male care worker was present, this was alongside a female carer.
23. Within the first week of June, Ms X found a new provider, provider C. Ms X said Ms G would pay using direct payments. Provider C later said they could not support Ms G.
24. In the middle of June 2024, Ms X emailed the Council and asked if provider D, which was more expensive than other providers, could provide care for her grandmother temporarily. The Council agreed and said it would meet the extra costs of a temporary arrangement while it explored alternative provisions. Provider D agreed to start providing Ms G care from the middle of July 2024; this was the earliest date provider D could start to provide care. The Council referred Ms G’s case to the finance department to set up direct payments.
25. Later in June, the Council assigned Ms G with a new social worker. Within a couple of days, the social worker completed a Care Act Assessment review and decided to amend Ms G’s care and support plan.
26. Ms G’s health declined in early July. The Intensive Home Care Team provided palliative care. The Council cancelled all other care.
27. Ms G died in the middle of July 2024.

The complaint

28. Ms X told the Council she was not satisfied with her grandmother’s care at the beginning of June 2024 and made an official complaint in September 2024. She complained the Council told Ms G her carers would transfer from provider A to provider B but they did not. She also complained the Council promised Ms G female carers that she knew but provider B often sent male carers who were unknown to her.
29. The Council issued a stage one complaint response in the middle of May 2025 and a stage two complaint response in late August 2025. It explained the changes to the service were because its contract for care and wellbeing had ended and it was legally required to look for new providers in a fair, transparent way. Provider A did not apply through this tender process.
30. The Council explained no staff transferred from provider A to provider B. It said this was not anticipated and accepted this impacted on Ms G’s continuity of care. The Council said ‘it appears that when you were given information on how the transfer could affect [Ms G’s] care staff, the complexity and uncertainties could have been explained better.’ The Council apologised for the upset this caused.
31. The Council confirmed 16 different carers attended to Ms G in June 2024. Some were male who stepped in to provide cover. The Council explained that provider B could not always guarantee a female carer but would try to do so. It said out of 104 calls, a male carer attended 32 times, always alongside a female carer. It also explained the number of different carers was within the contractual requirements but understood the family felt the variation was not good practice.
32. The Council accepted there was delay setting up the direct payments, this was because the small service was overwhelmed with a high number of requests. It recognised the frustration caused and apologised for this.
33. The Council apologised for the distress caused to Ms G and her family.
34. In the middle of September 2025, Ms X complained to the Ombudsman.

Response to my enquiries

35. In response to my enquires, the Council said it acted appropriately during the change in service. It provided the information in advance, responded to contact made by the family and ensured a service was in place for Ms G.
36. The Council said none of the care workers transferred from provider A to provider B. It also said it did not tell the family that individual carers would transfer and explained this was a matter for the individual care workers and the employer. The Council said it could not control the discussions between care workers and families.
37. The Council said provider B did not guarantee Ms X would have female carers although it aims to take account of expressed preferences as far as it can. Neither did it agree there would be a restricted number of carers providing care to Ms G. It explained as Ms G received double handed care three times a day, it is customary for several care workers to provide the care. The Council explained the number of carers in Ms G’s case was consistent with that expected.
38. The Council recognised consistency was important to Ms G and advised the family to consider direct payments so they could choose a care agency that met their preferences.

Analysis

39. Ms X complained the Council delayed planning for the transfer of her grandmother’s care during the period before the change to the service. I do not find this to be the case. The Council regularly updated Ms X and her family about changes to the service and invited them to contact the service to discuss the change to her care arrangements. The Council promptly told the family about changes to the service. It was not at fault.
40. The Council was supportive of the family during this stage. It suggested Ms G moved to provider B. When Ms G decided she did not want to move to provider B it agreed to Ms X’s request to make direct payments so the family could organise their own care. It then supported Ms G to transfer to provider B when she decided this was what she wanted in May. It also agreed to meet the additional costs of care with provider D when Ms G was not satisfied with the care provided by provider B. The Council responded to the family’s requests and altered Ms G’s care as asked. It was not at fault.
41. Ms X complained the Council took too long to sort her grandmothers’ direct payments. In its complaint response the Council agreed and apologised for the frustration caused. This was fault which the Council already accepted. In response to my enquiries, the Council explained this did not cause a delay in providing care which was maintained. The injustice was limited to distress.
42. Ms X complained the Council did not transfer staff from provider A to provider B as it said. Ms X said this was the reason Ms G decided to move to provider B. The transfer was a matter for the individual care workers and the employer and outside the Council’s control. The Council was not at fault.
43. In its complaint response, the Council said it had not anticipated this and accepted it impacted on the continuity of care for Ms G. It apologised for the distress caused and said it should have explained this better and managed the family’s expectations. This was especially the case as the Council said in its early correspondence that some carers might transfer across to new providers. This was fault which the Council has already accepted.
44. Ms X complained provider B sent several different carers, some of which were male. Regulations say a provider must make every reasonable effort to respect a person’s preference to receive care from a specific gender. The Council was not at fault as it made reasonable efforts to try to accommodate Ms G’s requests, which is in line with the regulations.
45. Ms X complained to the Council in September 2024. According to the timeframe set out in the Council’s complaint procedure, it should have completed the complaint process before the end of 2024. The Council provided a stage one response in May 2025 and a stage two response in August 2025. This is significantly longer than the timeframe set out in the Councils complaint procedure. This was fault causing distress.

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Action

46. Within four weeks of the final decision, the Council should:
• Apologise to Ms X for the delay in the complaints process.
• Pay Ms X £300 for the distress caused by failing to manage the family’s expectations about the transfer of staff, delay in organising the direct payments and delay in the complaint process.
47. The Council should provide us with evidence it has complied with the above actions.

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Decision

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

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Investigator's decision on behalf of the Ombudsman