Summary: The Council identified failings in some areas of care provided to Ms X. It also acknowledged a delay in dealing with Ms X’s complaint about this, but it failed to offer an adequate remedy for the injustice caused.

The complaint

1. Ms X complains the Council failed to provide her with adequate crisis care after her mother, Mrs Y had an accident and could not provide 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 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(i), as amended)

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How I considered this complaint

4. I have:

• considered the complaint and supporting information submitted by Ms X;
• considered information provided by the Council;
• taken account of 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. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards those registered to provide care services must achieve. The Care Quality Commission (CQC) has issued guidance on how to meet the fundamental standards below which care must never fall.
6. Regulation 9 Person Centred Care says Care Providers must do everything reasonably practicable to make sure that people who use the service receive person-centred care and treatment that is appropriate and meets their needs.

Background

7. Ms X has physical health issues and requires support with daily living tasks. She lives with her mother, Mrs Y, who is her main carer.
8. In December 2023, Mrs Y injured herself and was unable to care for Ms X. Mrs Y contacted the Council late evening to say Ms X needed carers for approximately six weeks. She requested am & pm visits to assist Ms X with personal care.
9. The Council told Mrs Y its crisis team would not be available that evening as the service ended at 10pm, and that a referral would be made to social services duty team the following morning. A family member provided to support to Ms X that evening. Ms X believed a family member should not have had to step in to provide emergency care.
10. The duty team contacted Mrs Y at 8am the following morning to confirm carers would attend Ms X that day.
11. Ms X was unhappy with the care provided. She was expecting support to shower, but did not receive it, the care team told Ms X they were not able to undertake support with showering that morning as it was a crisis call. Ms X says overall, the quality of care provided was poor. She cites inadequate support with personal care, issues with hoisting and poor knowledge on the use of the equipment. She says the care team had no regard for her individual needs and compromised her dignity.
12. Ms X complained to the Council on 14 December 2023. She expected to receive a response by 13 February 2024, but as she had not heard from the Council, she contacted it the day before the deadline date asking for an update. She was told that due to staff shortages, the investigation was taking longer than expected, and that an officer would contact her regarding an extension to the deadline date. Ms X told the Council she wanted to add complaint handing to her complaint.
13. The Council telephoned Ms X on 9 April 2024 to discuss the findings of the investigation, which it then followed up in an email. It did not uphold Ms X’s complaint about unavailability of the crisis team at the point it received a service request. It said Mrs Y had contacted it after the service had closed. In respect of the complaint about overall poor care the Council explained the crisis care team had not provided support with showering on the first visit, as this was not within their role that morning. The Council upheld complaints about moving and handling and personal care, saying these aspects of the service had been poor and had impacted on Ms X’s dignity. It said staff members would undergo training to ensure they maintained the dignity of service users whilst carrying out such tasks. The Council also apologised for the delay in the complaint response, and invited Ms X to contact it, should she be dissatisfied with the response.
14. The Council sent an email to Ms X on 23 April 2024, seeking confirmation of receipt of the complaint response, and asked if she was satisfied; and if there were any outstanding concerns. Ms X responded saying, she understood the response to be final. She said she was dissatisfied and explained why. She pointed out some factual inaccuracies, for example, the care team reported Mrs Y had told carers, that Ms X had expected the same carers who had supported her previously. Ms X said she not had carers from this Council previously. She last had carers in 2019, but it had been arranged by a different council.
15. Ms X submitted a complaint to this office in April 2024. Following contact from this office, the Council confirmed Ms X’s complaint had not exhausted its formal complaint process.
16. The Council sent Ms X an email on 9 July 2024, saying the officer dealing with her complaint would be in contact to update her on the progress of the complaint and confirm when she would receive a final complaint response.
17. The Council provided Ms X with a final written complaint response on 31 July 2024. The letter is detailed and responds to each point in turn referencing its records in support of its findings. The Council maintained its position on the response of the crisis team, saying it understood its legal duty to provide 24-hour care, however out-of-hours resources were finite and as Ms X request was made late at night, resources were allocated based on priority, and it was aware other support was available. It did not uphold this aspect of the complaint.
18. In respect of complaints about quality of care, the Council acknowledged there were differing interpretations of events, but accepted the service Ms X received should have been better. It acknowledged the impact and apologised for the upset caused. It also acknowledged and apologised for delays in the complaint handling process. A symbolic payment for of £150 was offered for the delay, and for the upset caused as a result of poor care. The Council said since Ms X’s complaint, the care team had undergone a program of refresher training.
19. Ms X remains dissatisfied with the Council’s response.

Analysis

20. Everyone has a right to receive good quality care and support which meets their needs. This is not what happened here. The Council acknowledged the care Ms X received fell short of acceptable standards. It also accepts a delay in dealing with Ms X’s complaint about this.
21. The Council has apologised and offered a symbolic payment of £150 by way of a remedy. I do not consider this adequately reflects the injustice caused to Ms X.
22. I cannot criticise the Council for its decision not to respond to a last-minute, late-night request for carers. The Council considered Ms X’s position, and the associated risks involved. It satisfied itself that there was a family member who could provide emergency support on this one occasion.
23. Mrs Y experienced a degree of inconvenience, but I do not consider her injustice to be significant.
24. In response to Ms X’s complaint, the Council has provided refresher training to the crisis care team. The Ombudsman welcomes this action.

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Agreed action

25. The Council should, within four weeks of the final decision:

• make a payment of £250 to Ms X to acknowledge her distress caused by the identified shortcomings in the quality of care, and;
• make a further payment of £250 to acknowledge Ms X’s time and trouble pursuing this complaint with the Council and this office;
• provide evidence of the refresher training referred to in paragraph 18 above;
• ensure complaints are properly identified, investigated, and responded to in a timely manner. The Council may wish to refer to the Ombudsman's guidance on good complaint handling;
• provide us with evidence it has complied with the above actions.

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Final decision

26. The Council identified failings in some areas of care provided to Ms X. It also acknowledged a delay in dealing with Ms X’s complaint about this, but it failed to offer an adequate remedy for the injustice caused.
27. The above recommendations are a suitable way to settle the complaint.
28. It is on this basis; the complaint will be closed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman