Summary: Mr B says the Care Provider failed to properly investigate or explain what caused his father’s fall and unreasonably charged him for the extra care required following the fall when the fall was the Care Provider’s fault. There is no fault in the Care Provider’s investigation or in its decision to charge for additional care.

The complaint

1. The complainant, whom I shall refer to as Mr B, complained the Care Provider:
• failed to properly investigate or explain what caused his father’s fall in January 2021; and
• unreasonably charged him for the extra care his father required following the fall when the fall was the Care Provider’s fault.
2. Mr B says fault by the Care Provider has left him with questions about what happened to cause the fall and led to his father having to pay more for his care.

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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 we are satisfied with a Care 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)

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How I considered this complaint

5. As part of the investigation, I have:
• considered the complaint and Mr B's comments;
• made enquiries of the Care Provider and considered the comments and documents the Care Provider submitted.
6. Mr B and the Care Provider had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Background

7. Mr B’s father was discharged from hospital in February 2020 following a fall. From that point the Care Provider started a live in care service.
8. An occupational therapist assessed Mr B’s father in February 2020. The occupational therapist concluded Mr B’s father should receive single-handed care with support from another agency on occasion. The aim at that point was to transition to personal care in the morning and evening.
9. Mr B’s father had a fall in June 2020 but received no injuries.
10. In December 2020 the live-in carer reported concerns about Mr B’s father’s deteriorating mobility and his difficulty in weight bearing. An occupational therapist completed a further assessment later that month. The occupational therapist concluded carers could continue to use the existing mechanical lift to transfer Mr B’s father. The occupational therapist recommended if carers identified any changes in Mr B’s father’s functional abilities they should liaise with the care manager before moving to a mini lift.
11. In January 2021 Mr B’s father fell while using the mechanical lift. Mr B’s father remained on the floor for six hours waiting for an ambulance. The ambulance took Mr B’s father to hospital but did not identify any injuries other than a pressure sore. Mr B’s father returned home the following day.
12. The occupational therapist completed a further review following the fall. The occupational therapist recommended two carers for all transfers using a mobile hoist as Mr B’s father could no longer use the mechanical lift due to pain in his shoulder.
13. Mr B raised concerns about the circumstances of the fall and told the Care Provider he considered the carer had not secured the safety strap properly which is why his father had fallen. The Care Provider began an investigation which included interviews with the carer, contact with the second care agency, discussions with the occupational therapist, discussions with Mr B and consideration of the documentary records. That included the carer’s manual handling training documentation which noted she was a competent manual handler and hoister. The Care Provider concluded there was no evidence the carer had done anything wrong to cause the fall.
14. Mr B’s father sadly died in February 2021.

Analysis

15. Mr B says the Care Provider failed to properly investigate or explain what caused his father’s fall in January 2021. For the investigation, I am satisfied the Care Provider investigated the circumstances of the fall properly. The Care Provider has produced a detailed report following the investigation which included speaking to Mr B and his father, obtaining the relevant records, speaking to the carer involved, considering the carer’s training on manual handling and transfers and speaking to the occupational therapist. I therefore could not say the Care Provider had failed to properly investigate.
16. I recognise Mr B is mainly concerned the outcome of the investigation did not establish exactly what happened which led to the fall. I understand Mr B’s concern and why he would want some certainty about that. However, it is not the Ombudsman’s role to determine what caused the fall. That is a liability matter which can only be determined by the courts. The Ombudsman’s role is to consider whether there is administrative fault in the process by which the Care Provider reached its conclusions. I have found no evidence of administrative fault here. The Care Provider investigated the circumstances of the fall properly and took into account all the relevant evidence. The Care Provider was satisfied after considering all that evidence there was nothing to suggest the carer had done anything wrong on the day of the fall, taking into account her experience, her training and the fact the occupational therapist had found her to be competent at manual handling and transfers. The Care Provider also took into account Mr B’s father’s age and his deteriorating mobility. All that evidence the Care Provider considered is supported by the documentary evidence.
17. I recognise that conclusion continues to leave Mr B with some concern about what caused the fall given the equipment was not faulty. As I have made clear though, my role is to consider how the Care Provider assessed the evidence and I cannot comment on the Care Provider’s conclusions when I have found no evidence of fault in how those conclusions were reached. I appreciate it is difficult for Mr B to accept this was simply an accident and nobody was at fault. However, as the Care Provider has considered all the relevant evidence in reaching that conclusion there are no grounds on which I could criticise it.
18. Mr B says the Care Provider unreasonably charged his father for the extra care required following the fall. Mr B says this was inappropriate as the fall was the Care Provider’s fault. The evidence I have seen satisfies me the reason the costs for Mr B’s father’s care increased following his fall in January 2021 is because he was reassessed by an occupational therapist who identified he now needed two carers to transfer him. I understand why Mr B would believe his father’s deterioration was due solely to the fall in January 2021. However, there is also other documentary evidence showing carers raising concerns about Mr B’s father’s deteriorating mobility before the fall in January 2021. Given that, plus the fact the Care Provider’s investigation did not identify any fault on the part of the carer, I could not say the extra costs were incurred as a result of fault by the Care Provider. Consequently I cannot make any recommendation for financial remedy.

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Final decision

19. I have completed my investigation and do not uphold the complaint.

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Investigator's decision on behalf of the Ombudsman