Summary: Ms B complains that ProMedica24 UK Limited failed to provide adequate care for her mother, Mrs C. We found one of the carers behaved inappropriately causing Mrs C and her family distress and inconvenience. To remedy the injustice caused, ProMedica24 UK Limited has agreed to apologise to the family and waive its fees from the date of the incident.

The complaint

1. Ms B complains that ProMedica24 UK Limited ‘the care provider’ failed to provide adequate care for her mother, Mrs C in that:
• in February/March 2020 the live-in a carer was removed from the contract because she could not cope; and
• the replacement carer was found to be drinking alcohol and behaving inappropriately on 17 April 2020 causing Mrs C distress. As a result, the family had to take time off work to care for her causing stress and inconvenience. They ultimately had to place Mrs C in a residential care home at an additional cost. This was during the lockdown caused by the coronavirus pandemic, so the family could not visit her for several weeks causing additional distress.

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The Ombudsman’s role and powers

2. 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)
3. If an adult social care provider’s actions have caused an injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))

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How I considered this complaint

4. I have considered all the information provided by Ms B, made enquiries of the care provider and considered its comments and the documents it provided.
5. Ms B and the care provider had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.
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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What I found

Key facts

7. Mrs C is elderly and suffers from dementia. In December 2019 the care provider began providing live-in care for Mrs C.
8. Ms B says the first carer, Ms X, was removed by the care provider because she was inexperienced and could not cope. The care provider says the care worker was new but was appropriately trained and able to successfully support clients living with dementia. It says she was removed “because of the situation on this contract”. The contract was put on hold from 29 February 2020 and the family cared for Mrs C until a new carer, Ms Y, took over on 2 March 2020.
9. The family were happy with Ms Y but a third carer, Ms Z, took over on 1 April 2020.
10. Ms B says that, on 17 April 2020, the care manager contacted her to say Ms Z had had a difficult night with Mrs C and called the on-call team overnight saying she was not coping and wanted to go home. However, things were now calmer and she no longer wanted to go home. Ms B telephoned her brother and asked him to go to Mrs C’s home to see how things were. He arrived in the early afternoon and called Ms B immediately asking her to go round as well.
11. Ms B says that when she arrived Mrs C was very distressed and did not know what she had done wrong. Ms Z was crying and incomprehensible, unsteady on her feet and smelt strongly of alcohol.
12. Ms B says she telephoned the care manager and, while she was on the telephone, Ms Z fell down the stairs hurting her ankle. The care manager agreed to come round. Ms B’s brother tried to explain this to Ms Z but she refused to listen, repeatedly swearing at him. She then passed out on her bed and the family were unable to wake her.
13. Ms B says that, after Ms Z left the premises, she found empty gin and wine bottles hidden in the back of cupboards.
14. The care manager has provided a statement in which she says that, on the morning of 17 April 2020 she received the report made by Ms Z the night before in which she said Mrs C was refusing to take her medication and being aggressive towards her. She wanted to leave the placement. The care manager telephoned Ms Z and she said all was now well. The care manager gave her advice about how to encourage Mrs C to take her medication. She then spoke to Ms B.
15. The care manager says that, at about 4pm, Ms B telephoned saying that she and her brother were at Mrs C’s house, there was a problem and Mrs C was upset. The care manager asked the emergency team to speak to Ms Z to find out what the problem was. They responded saying Mrs C’s behaviour had been difficult, she was refusing to take her medication and been upset all day. Ms Z was now resting upstairs while Mrs C’s family were with her. The care manager then telephoned Ms B but, while they were talking, there was a loud noise and Ms B went to investigate. Ms B’s brother telephoned about 30 minutes later saying Ms Z had fallen downstairs and was drunk.
16. The care manager contacted the emergency team and asked them to tell Ms Z she was coming to collect her and she should pack her belongings. She says that, when she arrived at the house, Ms Z was asleep upstairs and the family could not wake her. She says it took her 20 minutes to wake Ms Z. She had not packed everything, so the care manager helped her do this and found a bottle of gin which was three quarters empty on the floor. She asked Ms Z if she had been drinking but she did not respond. The third time she asked her, Ms Z snatched the bottle and poured some over her hands and said she was using it to clean her hands.
17. The care manager drove Ms Z to a hotel. She says Ms Z kept talking but was not making any sense and, on arrival at the hotel, she was swaying.
18. The care manager completed a safeguarding form the same day briefly setting out her concerns. Social Services later contacted the family asking for more detail about the safeguarding referral because the information given by the care manager was insufficient. The care provider says the safeguarding form was not fully completed because, at the time, it did not have the family’s statement explaining exactly what had happened.
19. The family took time off work to care for Mrs C. The care provider offered a new carer but, having lost confidence in the care provider, the family ultimately decided to place Mrs C in a care home.
20. On 24 April 2020 Ms B sent a statement to the care provider about what had happened on 17 April. She said the family no longer wished to employ its services because they had lost confidence. They wanted charges for the one month’s notice period to be waived because they had been unhappy with the service provided by both Ms X and Ms Z. She said they would pay for services provided until 16 April 2020.
21. The same day the care manager added further detail to the safeguarding form including a copy of the family’s statement. She also confirmed Ms Z had been suspended and an internal investigation was underway.
22. When responding to Ms B’s letter of 24 April 2020 the care provider accepted Ms Z’s behaviour was not acceptable or appropriate but said it could not substantiate that she had been drinking alcohol. It confirmed Ms Z would be subject to its internal disciplinary process. It apologised for any distress caused and offered 14 days’ reduction of the charges for the notice period.
23. The outcome of the safeguarding investigation was inconclusive.

Analysis

24. Ms B says the care provider failed to provide appropriate care for Mrs C. She says Ms X was removed because she was inexperienced and could not cope with the position and Ms said was removed because she was drunk whilst caring for Mrs C.
25. Ms B says the situation was very stressful for the whole family. Mrs C was distressed by the behaviour of the carers and ultimately had to leave her own home to go into a care home. This was unsettling for her and distressing for the family. They were also put to inconvenience in having to take time off work to look after Mrs C after Ms Z was removed from the house.
26. The care provider says the registered manager discussed the issue concerning Ms X with Ms B who said she did not wish to make a formal complaint. However, it offered to waive charges for three days in recognition of the distress and inconvenience caused.
27. I consider this to be an adequate remedy for any injustice caused, so I do not propose to pursue this issue further.
28. The family was happy with the care provided by Ms Y.
29. As regards Ms Z, the care provider acknowledged her behaviour was unacceptable and acted appropriately by making a safeguarding referral, suspending her and completing an internal investigation.
30. There is a conflict of evidence in that Ms B is clear that Ms Z was drunk and that she could smell alcohol on her breath, but the care provider says it cannot substantiate this. Ms Z has denied drinking alcohol saying she bought the gin to clean the door handles in the property because she did not have access to alcohol gel.
31. Regardless of whether Ms Z was drunk, I find her behaviour was inappropriate and unacceptable when caring for a vulnerable person.
32. The incident caused Mrs C and her family distress. The family also suffered the inconvenience of having to take time off work to care for Mrs C and the stress of making the decision to place her in a care home as they had lost confidence in the care provider.

Agreed action

33. In recognition of the injustice caused by Ms Z’s unacceptable behaviour, the care provider has agreed that, within one month, it will:
• apologise to Ms B; and
• waive its fees from 17 April 2020 onwards and issue the family with a revised final invoice for the balance due up to and including 16 April 2020.

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Final decision

34. I uphold Ms B’s complaint. I have completed my investigation on the basis that the care provider has accepted my recommendation to take action to remedy the injustice caused to Mrs C and her family.

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Investigator's decision on behalf of the Ombudsman