Summary: Based on current evidence, we will not consider Ms C’s complaint on behalf of her partner, Mr D about Universal Care Services UK Limited. There is not enough evidence that any fault by UCS caused Mr D an injustice to justify our involvement.

The complaint

1. Ms C complains that Universal Care Services Limited UK (UCS) did not robustly assess her partner’s (Mr D) ability to decide his care and support, before it started supporting him. She says UCS did not explore Mr D’s wishes and feelings, when it was clear he did not consent to their care. Ms C says that caused Mr D distress when carers entered his home. Ms C would like UCS to recognise its failings, apologise, make systemic changes and service improvements, and make a payment to recognise Mr D’s distress.

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The Ombudsmen’s role and powers

2. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe the fault has not caused injustice to the person who complained. (Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

3. I considered evidence provided by Ms C and UCS, as well as relevant law, policy and guidance. This includes the Mental Capacity Act 2005 (the MCA) and associated statutory guidance (the Code of Practice).
4. Warwickshire County Council (the Council) and the local NHS integrated care board (not subject to this investigation) jointly funded the UCS care package. I consider UCS acted on the Council’s behalf and as a health provider itself.
5. Ms C 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

6. In mid-April 2024, an NHS Trust (not subject to this investigation) admitted Mr D for emergency dental care. Ms C, alongside Mr D’s children, held the Lasting Power of Attorney for his health and welfare.
7. On 30 April 2024, the Trust referred Mr D to the Council for support on discharge. It noted his ability to make decisions wavered due to his delirium. While Mr D could understand some of the risks going home and was aware of his own confusion, he could not retain information well. The next day, the Trust decided it was in Mr D’s best interests to move home on discharge with a reablement care package. Reablement is a service to help people live independently in their own home with support from care professionals. The Trust noted it consulted Ms C and Mr D’s daughter.
8. UCS agreed to support Mr D from 3 May 2024. It noted Mr D “lacks capacity to understand, process and retain information” so could not sign his care plan. Therefore, Mr D’s daughter signed the care plan on his behalf, and UCS noted: “best interest decision, [Mr D] lacks capacity to understand”.
9. After 10 days, UCS ended its support. Mr D refused carers and said he could support himself.
10. Following Ms C’s complaint, UCS accepted it did not act in line with its own policy. It did not robustly assess Mr D’s understanding to accept their support. Instead, UCS said it relied on the Trust’s assessment, which felt Mr D could not make decisions around his care and support. UCS agreed to review its policy around mental capacity and share that learning with staff.
11. I do not consider we should investigate Ms C’s complaint. I will explain why.
12. We do not investigate all complaints we receive. In deciding whether to investigate we need to consider various tests. These include the alleged injustice to the person. We only investigate the most serious complaints.
13. When responding to Ms X’s complaint, UCS accepted it acted with fault when it decided Mr D could not make decisions about his support and what was in his best interests. It also accepted it did not properly record its decision, UCS has already learnt from what happened in Mr D’s case.
14. However, if UCS had acted in line with the MCA and Code of Practice, I could not say what the outcome of Mr D’s assessment and best interest decision would have been. UCS may still have decided he should have received its support in his best interests. So I cannot say the claimed distress was avoidable, or that Mr D suffered any other injustice. Therefore, I do not consider we should investigate this complaint.

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Decision

15. We will not investigate Ms C’s complaint because there is not enough evidence that any fault by UCS caused Mr D an injustice.

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Investigator's decision on behalf of the Ombudsman