Summary: Miss X complained that a carer working for Royal Mencap Society (Mencap) mistreated her son, Y while providing him with support. We found there was fault that warranted a remedy.

The complaint

1. Miss X complains on behalf of her son Y. They complained about the way Y was treated by his carer while on a visit to a museum. She disagreed with the conclusions Mencap came to when dealing with the complaint. She complains that:
• Y’s carer intimidated, bullied and humiliated him.
• The way Mencap investigated the complaint was biased towards the carer.
• The investigation did not take account of all the information Y provided and Mencap did not take proper account of what witnesses had seen.
• Mencap did not provide the carer with sufficient training or guidance to be able to meet Y’s needs.
• Further action should have been taken because Y’s carer is not suited to caring role and should have been dismissed.
2. Miss X stated Y has been affected significantly by the incident. He had harmed himself and needed therapy to deal with his feelings after it.

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The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. (Local Government Act 1974, sections 34B and 34C)
4. If an adult social care provider’s actions have caused an injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))
5. If we are satisfied with a provider’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)
6. Under the information sharing agreement between the Local Government and Social Care Ombudsman and the Care Quality Commission (CQC), we will share this decision with CQC.

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How I considered this complaint

7. I spoke to Miss X and considered the information she gave us. I asked Mencap for information and considered its response to the complaint.
8. Miss X and Mencap had an opportunity to comment on my draft decision. I considered the comments received before making a final decision.

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What I found

What happened

9. Mrs X complains about the way the Royal Mencap Society (Mencap) dealt with a complaint about an incident that occurred when one of its carers (Care Worker A) was providing support for her son, Y.
10. Care Worker A had been supporting Y for around four weeks prior to the incident, which occurred in early February. Y’s care plan states that a support worker was to help Y access social activities and sporting activities. It stated Y was very sociable and like to talk and it was important that he was able to make new friendships.
11. Y had visited a museum with Care Worker A on a number of occasions. On the day in question a manager approached Y and Care Worker A when they arrived. He explained that an incident had occurred when Y last visited the museum. The incident related to female staff members. The Manager stated they were happy for Y to continue to visit, provided the previous behaviour was not repeated.
12. Care Worker A spoke to Y in the foie of the museum about what the manager had said. Y told Mencap that the way Care Worker A addressed the issue with him was threatening and made him scared. Miss X stated Care Worker A had bullied and humiliated Y. Y wanted to end the visit following the incident.
13. After Care Worker A dropped Y at home, he was found lying on the kitchen floor and he had harmed himself. Miss X told us Y had been left fearful by Care Worker A and he needed long discussions with his family and therapy to deal with what had happened.
14. Mrs X complained to Mencap about the way Care Worker A acted.

Action taken by Mencap

15. Mencap told us after dropping Y at home, Care Worker A completed an incident reporting form. However, it could not locate this to provide us with a copy. It could not provide notes made by Care Worker A on the day of the incident.
16. When Mrs X complained, Mencap placed Care Worker A on restricted duties while it investigated and stopped him providing support for Y. It also referred the matter to the Council as a safeguarding issue.
17. The Council agreed to Mencap conducting a joint investigation which would cover the safeguarding issue and Mrs X’s complaint about Care Worker A’s conduct. The investigation was undertaken by a social worker and a manager from Mencap.
18. During March the investigators interviewed Care Worker A and Y. They also received evidence from someone who witnessed the discussion between Care Worker A and Y at the museum. I have seen the notes taken at both interviews and notes setting out what the witness said.
19. I have seen Mencap’s investigation report. The report considered;
• what Care Worker A said and what Y said at their interviews;
• what the witness reported and how this related to the accounts provided by Care Worker A and Y;
• information provided by Miss X in her complaint correspondence to Mencap about what had happened and what Y had said;
20. On 25 April Mencap wrote to Miss X to explain its findings. Mencap noted Care Worker A was still in his probationary period of employment. He had admitted feeling out of his depth and insufficiently experienced to deal with the concerns the museum manager raised with him. It stated Care Worker A was shocked and his response was emotional rather than calm and professional. He felt under pressure to act immediately following his conversation with the manager.
21. The investigation concluded that Care Worker A could have handled the situation better and that a calm and less judgemental approach was required rather than an emotional response.
22. Although Mencap found Care Worker A had not handled the situation correctly, they did not consider there was evidence that his approach was aggressive or bullying or that his actions were degrading or intimidating towards Y. For this reason, Mencap told Miss X that Y would retain his position, but with a number of recommendations for training and monitoring.
23. Miss X was unhappy with the outcome. She met the manager and social worker who conducted the investigation. At Miss X’s request, the Mencap manager visited Y and handed him a letter of apology.
24. Following the meeting Miss X told Mencap that she was unhappy that the Council would be paying for support provided by Care Worker A between January and February 2019. She continued to believe Care Worker A was not suited to the caring role. The issue of the care costs was escalated to a senior manager.
25. After a short delay Mencap responded to the point Miss X made about fees for support that Care Worker A had provided. It stated the care costs were for care received before the incident in early February, and the support had been provided. So, it did not consider it was appropriate for the care fees to be waived. It noted the care fees were paid by the Council.
26. Miss X asked that Care Worker A met with Y to apologise in person and enable closure. Mencap considered this request but decided it was not appropriate to ask him to do so.

CQC Fundamental Standards

27. Amongst other things CQC Fundamental Standards state service users should be treated with dignity and respect at all times. The standards also state service users should not suffer from any abuse or improper treatment while receiving care.

Was there fault by Mencap

28. Mencap has acknowledged Care Worker A did not deal with the situation properly when issues were presented to him by the museum manager. The evidence indicates Care Worker A did not maintain a calm and professional approach when speaking with Y. Mencap accepted this had impacted negatively upon Y. The way the matter was handled caused injustice to Y.
29. However, Mencap considered Care Worker A had not acted in a way which was bullying or intimidating towards Y. It decided Care Worker A should remain employed by Mencap subject to some training and monitoring. We would not expect specific details of decisions about disciplinary action to be shared with third parties. This is because it is a matter between an employer and an employee.
30. Miss X considers Mencap had been biased towards Care Worker A and they had not properly taken account of other evidence. I am not able share the details with Miss X, but I have seen the interview notes and Mencap’s investigation report and I have been able to consider the concerns Miss X raised. Although I understand that Miss X disagrees with the outcome of the investigation, the decision Mencap reached about Care Worker A’s employment is one it was entitled to reach. I am satisfied that Mencap did take account of Y’s views and the comments made by Miss X in her complaint. There is also evidence that Mencap had taken account of what a witness told the investigators.
31. It is not for the Ombudsman to seek or require disciplinary action to be taken by Mencap. Only an employer can determine what action to take if allegations are made about an employee.
32. There was also an issue raised about training. Care Worker A acknowledged that he felt out of his depth when faced with the feedback from the museum manager. Mencap considered Care Worker A could benefit from more training and support to deal with situations like this. It is very unfortunate that Care Worker A was not prepared for the situation that occurred, and that he did not handle the situation well. However, I do not consider the lack of specific training to cover this type of event was fault by Mencap. I say this because providing care and support for individuals in the community can lead to unpredictable situations. Training could not realistically cover all eventualities. Y’s care and support assessment made no reference to any specific needs Y may have in this type of situation.
33. It is concerning that Mencap have not retained an incident report document or notes made at the time. Documenting incidents at the time they occur is important as this is when details of the events can be recalled clearly. The failure to keep proper records of the incident constitutes fault. It is unclear why Mencap cannot provide these records.
34. I understand Miss X was unhappy that fees were paid for support provided by Care Worker A prior to the incident in February. I do not consider the events of 1 February mean that fees for other support provided should be refunded. However, given the incident was not handled appropriately by Care Worker A and this led to distress for Y, a payment should be made to recognise this.
35. Mencap should also review whether dealing with unexpected situations is an area it could cover when inducting new staff and it should review whether any changes to its processes are required to ensure records of incidents such as these are kept for an appropriate length of time.

Agreed action

36. Within four weeks of my final decision Mencap agreed to take the following action:
37. To recognise the distress caused to Y by the way Care Worker A handled the incident in February, Mencap should pay Y £500.
38. Mencap should review whether dealing with unexpected situations is an area it could or should cover when inducting new staff and it should review whether any changes to its processes are required to ensure records of incidents such as these are kept for an appropriate length of time.

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Final decision

39. There was fault by Mencap. I have completed my investigation on the basis that Mencap have agreed to take the action we recommended.

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Investigator's decision on behalf of the Ombudsman