Summary: There was fault in the Council's handling of some of Ms X's concerns. This along with the Council’s inadequate complaint response caused Ms X avoidable frustration.

The complaint

1. Ms X complains about her Council arranged domiciliary care provision from two separate care providers.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. 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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How I considered this complaint

4. I have:

• considered the complaint and discussed it with Ms X;
• considered the correspondence provided by Ms X, including the Council’s response to the complaint;
• made enquiries of the Council and considered the responses;
• considered relevant legislation;
• offered Ms X and the Council an opportunity to comment on a draft of this document, and considered the comments made.

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What I found

Relevant legislation

5. Under sections 9, 18 and 24 of the Care Act 2014, councils must assess eligible care and support needs and, where those needs are eligible, arrange services to meet them. Care and support planning should be person-centred and take account of the individual's wishes, preferences and wellbeing.
6. The Care and Support Statutory Guidance states care and support should be personalised, proportionate and designed around the individual's needs and preferences. Councils remain responsible for the quality of commissioned services and must monitor arrangements to ensure providers deliver care appropriately.

Background

7. Ms X is in her late sixties and lives in her own home. She has several health conditions and reduced mobility, which cause pain and make it difficult for her to move around. These difficulties affect her ability to carry out daily living tasks. Ms X has eligible care and support needs under the Care Act 2014 and received domiciliary care from two care agencies commissioned by the Council.
8. A care plan completed by a care provider sets out the support Ms X required and the outcomes she wished to achieve. The care plan recorded that Ms X preferred to do as much for herself as possible and that she benefited from a consistent daily routine.
9. Ms X says care workers did not always attend at the expected times. She also raised concerns about their skills and knowledge, particularly in relation to food preparation. She referred to an incident where she says a care worker placed an unopened tin of soup in a microwave, causing it to smoke and had she not intervened it would have exploded.
10. Ms X also complained that care workers did not consistently wear gloves when providing care and did not always wear uniforms or identification badges. She considered this poor practice and raised concerns about hygiene and professionalism.
11. Ms X says inconsistent visit times affected her ability to manage her medication and meals. She says one of her medications must be taken one hour before eating, meaning she needed advance notice of when carers would attend to prepare meals. She also says some medications needed to be taken four hours apart and that variations in care visits sometimes made this difficult.
12. Ms X says her social worker did not listen to or properly address her concerns about the care she was receiving. She says the social worker suggested she arrange her own care through a direct payment, which she did not wish to do. Ms X says she wanted the Council to continue arranging her care through reliable and professional care providers who attended at agreed times.
13. Ms X also raised concerns that some care workers spoke English as an additional language, which she says occasionally made communication difficult. The Council says it asked providers to allocate English-speaking carers where possible, although staffing constraints meant this could not always be achieved. The Council says it found no evidence that care tasks were not completed because of communication difficulties.
14. The Council met with a care provider to discuss concerns about the care arrangements. It raised concerns about comments it alleged Ms X made regarding the nationality of some carers, which it considered discriminatory.
15. Ms X says she was at times very upset and frustrated by the poor standard of care and this occasionally spilled out in her berating of the carers. She says this never involved any racial slur. She believes the care provider wrongly alleged her to have made racial slurs to detract from the carers lack of ability.
16. Following the meeting between the care provider and the Council, a behaviour agreement was introduced. The Council says the aim of the agreement was to reduce the risk of the care package breaking down. Ms X says the Council accepted the care provider’s allegations against her without question and without investigating the substance of her complaints.
17. The agreement set out the times within which the care provider would attend:

• 7:00 am – 11:00 am
• 11:00 am – 3:00 pm
• 3:00 pm – 7:00 pm
• 7:00 pm – 11:00 pm.

18. The care provider also agreed to supply advance rotas so Ms X would know which care workers were expected to attend. The agreement noted rotas could change because of illness or emergencies and that any changes would be communicated to Ms X. The Council reviewed information provided by Ms X's GP regarding her medication and concluded the medication was not time critical. It considered that care visits could reasonably take place within the agreed times rather than at fixed times.
19. Care records show some variation in attendance times, generally within approximately one hour either side of the expected visit time.
20. Care records show occasions when Ms X challenged carers about visit times and declined to discuss meal choices until the time she expected the visit to occur. The records also refer to an incident in which Ms X asked a care worker to heat an out-of-date microwave meal. The care worker declined because they considered it a health risk. The care provider recorded that Ms X became verbally abusive and telephoned the office to complain while the care worker was present. The records state the call ended with abusive language.
21. The Council says it investigated Ms X's concerns through its complaint’s procedure. In relation to the allegation that a care worker placed an unopened tin in a microwave, the Council says it found no record of such an incident being reported to or investigated by the care provider. The Council says the only recorded food-related incident concerned the out-of-date meal referred to above. It says this matter was addressed by the care provider in accordance with its procedures.
22. A physiotherapist who visited Ms X on 7 May 2025 recorded that Ms X denied making racist comments to care workers. The physiotherapist also recorded that Ms X said she had asked a care worker to prepare out-of-date food because she did not believe it posed any risk, but the care worker had refused.
23. On 15 May 2025, Ms X submitted a formal complaint to the Council. She said the care provided had been poor and that her concerns had not been properly addressed. Her complaint included concerns about:

• poor training;
• carers not wearing uniforms;
• carers not wearing gloves;
• carers not displaying identification;
• poor hygiene standards;
• concerns about personal safety; and
• a lack of knowledge regarding the safe use of a microwave.

24. Ms X also questioned the Council's commissioning arrangements and asked how it monitored providers, what quality assurance processes were in place, and what standards and criteria were used when recruiting and employing care workers.
25. A second care provider began supporting Ms X on 15 May 2025. On the same day, it contacted the Council to report that Ms X had been aggressive towards care staff, including shouting and swearing. It contacted the Council again on 19 May 2025 to give notice to end its service citing Ms X’s unacceptable language towards carers and to office staff over the telephone. The provider agreed to continue delivering care until alternative arrangements could be made.
26. On 16 May 2025, Ms X contacted the Council after receiving a visit from a male care worker. She asked for an all-female care team. The Council advised this could not be guaranteed. The second provider subsequently ended its involvement because it was unable to meet this requirement.
27. In response to enquiries from this office, the Council said Ms X had requested female-only carers but she had been advised this could not be guaranteed because care provision depended on staff availability. The Council described Ms X's expectations as exceeding what could reasonably be provided within the commissioned care package.
28. The Council says it raised Ms X's concerns about food hygiene with the care provider, which it says confirmed care workers received food hygiene and safe practice training. The Council says it found no evidence within the care provider records to substantiate allegations of unsafe food preparation, although it reinforced expectations to the care provider.
29. The Council also says both providers confirmed that staff were required to wear uniforms and appropriate personal protective equipment in line with care standards. It says Ms X was advised to report any individual incidents so they could be addressed directly with the provider.
30. The Council responded to Ms X's complaint on 16 June 2025. It explained that several providers had been involved in delivering her care between February and May 2025. It said providers had repeatedly raised concerns about Ms X's behaviour towards staff, including allegations of verbal abuse, threatening conduct and racially offensive comments. The Council said many of Ms X's requests related either to tasks outside her agreed care plan or tasks she had been assessed as being able to undertake independently. It said concerns about visit timings, medication schedules and cream applications had been investigated, including consultation with her GP, and it had concluded that time-specific visits were not clinically necessary. The Council stated that two care providers had withdrawn because of concerns about staff welfare and an inability to meet Ms X's expectations. It said alternative care arrangements had subsequently been made. The Council's response did not specifically address the questions Ms X had raised about commissioning and quality assurance.
31. Ms X remained dissatisfied with the Council's response. She said it failed to answer her concerns and contained inaccuracies, including allegations that she had behaved in a racist manner.
32. On 4 August 2025, the Council wrote to Ms X again and said it considered its previous response to be a full reply and had nothing further to add.
33. In response to enquiries from this Office, the Council said that although it had not upheld Ms X's complaint, it had reminded care providers of the importance of:

• maintaining clear communication with service users;
• presenting professionally and adhering to hygiene standards; and
• promptly escalating concerns raised by people receiving care.

34. The Council says it considers it took reasonable and proportionate steps to address Ms X's concerns and to ensure care was provided in line with her assessed needs and the commissioning arrangements in place.
35. Ms X now receives care from a different care provider. She is satisfied with the care provided by all of the carers, some of which she says are internationally recruited.

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Analysis

36. The Ombudsman's role is not to determine whether every allegation made by either party is true. Rather, the Ombudsman considers whether the Council acted properly, followed relevant law and guidance, made decisions based on available evidence, and responded appropriately to concerns raised.
37. The Care Act 2014 and associated guidance emphasise the importance of person-centred care and effective communication with people receiving care and support. Good communication is an important part of delivering safe and appropriate care. The absence of missed care tasks does not necessarily mean communication difficulties had no impact on Ms X. A person receiving care should be able to understand and engage with those providing their care. Where a service user reports difficulties communicating with care workers, the Council should consider whether those difficulties affect the quality of the service, the person's dignity, wellbeing or ability to participate in decisions about their care.
38. Service users are entitled to express preferences regarding the gender of their care workers, and care providers should consider such preferences where it is reasonable and practicable to do so. However, there is no absolute right to receive care exclusively from carers of a particular gender. The Council should nevertheless ensure that any agreed arrangements or expectations are clearly communicated and managed appropriately.
39. I am unable to make a finding on the disputed interactions between Ms X and the care workers. I was not present when the events occurred and the available evidence consists of differing accounts from those involved. In the absence of independent evidence to corroborate one version of events over the other, I cannot reach a sound conclusion about what happened. My investigation has therefore focused on whether the Council responded appropriately to the concerns brought to its attention, rather than attempting to determine the precise nature of those interactions.
40. The behaviour agreement stated that Ms X would be provided with advance rotas so that she would know which care workers were scheduled to attend her visits. I have seen no evidence to demonstrate that this arrangement was followed. In the absence of such evidence, I cannot be satisfied the care provider ensured compliance with this aspect of the agreement.
41. In relation to visit times, the Ombudsman generally considers a variation of up to one hour either side of an agreed visit time to be acceptable, unless specific circumstances indicate otherwise. The records I have reviewed show the visits took place within this timeframe. I therefore find no fault in this aspect of the complaint.
42. The Council’s complaint response focused primarily on Ms X’s conduct towards care workers. While it was appropriate for the Council to address concerns about interactions between Ms X and care staff, its response did not adequately address the specific issues Ms X raised regarding the standards expected of care workers and care agencies or explain how the Council monitored and assured itself that those standards were being met.
43. The Council says Ms X should raise day-to-day concerns directly with the care provider. Whilst Ms X may not always express her concerns appropriately, this does not mean the concerns themselves should be dismissed without consideration. The Council should take reasonable steps to understand and respond to the issues being raised, while also addressing any inappropriate behaviour where necessary.

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Agreed Action

44. Within one month of the final decision, the Council should:

• Write to Ms X explaining the standards it expects commissioned care providers and care workers to meet, including standards relating to communication and person-centred care, and how it satisfies itself that those standards are being met.
• Remind relevant officers that complaint responses should address all substantive issues raised by a complainant, even where there are concerns about the complainant's conduct.
• If it has not already done so, discuss with the care provider and Ms X whether there is a suitable method for sharing information about scheduled care workers, taking account of the arrangements previously agreed between the parties.

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Final Decision

45. There was fault in the Council's handling of some of Ms X's concerns. This along with its inadequate complaint response caused Ms X avoidable frustration
46. The above recommendations are a suitable way to settle the complaint.
47. It is on this basis; the complaint be closed.

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Investigator's decision on behalf of the Ombudsman