Summary: Care provided to Mrs Y during a residential respite stay was below an acceptable standard. We have made recommendations to address this.

The complaint

1. Mrs X complains a Care Provider failed to bathe or shower her mother during a residential respite stay.
2. Mrs X says the remedy offered by the Care Provider in acknowledgement of the above fault is insufficient.

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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 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

5. I considered the written complaint submitted by Mrs X together with the Care Provider’s complaint response, and information it submitted to our assessment team. Both parties have had the opportunity to consider a draft of this document. I have considered all comments made.

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What I found

6. 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. These include:

• Person-centred care: people must have care or treatment that is tailored to their and meets their needs and preferences. Providers must carry out an assessment of the needs and preferences for care and treatment of the service user. Each person's needs and preferences should be assessed by people with the required levels of skills and knowledge.

Key facts

7. Mrs Y is in her seventies. She went into a residential care home (The Lodge) for a respite stay of eight days. She had enjoyed previous stays at the home without any complaint.
8. The care plan completed by the care home records Mrs Y to have limited communication and mobility due to previous illness. It records her to be dependent on help with bathing, grooming, and dressing.
9. Mrs X says when she went to collect Mrs Y to take her home, Mrs Y was unkempt, she had not been showered or bathed during her eight day stay. Mrs X also noted the room was unkempt. Mrs X says Mrs Y was aware of her unkempt state and that this caused her some distress.
10. On the evening Mrs Y returned home, Mrs X telephoned the care home manager to complain and met with her the following day. Mrs X says the manager apologised that Mrs Y had not been offered a bath/shower and said she had requested that care staff shower Mrs Y, but carers had failed to carry out her instructions. The Care Provider acknowledges Mrs Y was not offered a bath or shower but says she was offered personal care daily.
11. Mrs X later received a written response from the care home manager. The manager acknowledged and apologised for the “…lack of showering…” and offered Mrs Y a discount of 15% in care fees on any future stay.
12. Mrs X is dissatisfied. She believes the manager has not taken the matter seriously enough. She says the manager should ensure that care staff are doing what is asked of them, and that when this does not happen, appropriate action should be taken. Mrs X says it is unlikely Mrs Y will return to the care home, and that she should receive a reimbursement of care fees paid, not a future discount.
13. The Care Provider says because of Mrs X’s complaint it implemented new measures to monitor baths/showers by amending “…staff allocation sheet to baths/ showers to be allocated to individual members of staff, to ensure that if residents do not have a bath/ shower in their respite stay, then this is addressed with the individual staff member”.

Analysis

14. People are entitled to safe, effective and high-quality care. In Mrs Y’s case, the Care Provider fell short of these standards and failed to reach the Care Quality Commission’s fundamental standards particularly in terms of person-centred care.
15. The Care Provider acknowledges care staff failed to support Mrs Y to bathe/shower. I note that a previous inspection of this care home by the Care Quality Commission (CQC) in June 2021 reported residents’ personal hygiene needs were not being safely met. The records show the Care Provider later informed the CQC that improvements had been made and hygiene charts had been introduced to monitor personal hygiene.
16. It is therefore concerning to hear of Mrs Y’s recent experience, and this would suggest the measures introduced above to be ineffective.
17. Mrs Y funded her care privately. She paid the Care Provider in full for her respite stay. However, she did not get the service she paid for, and this impacted on her dignity and sense of wellbeing.
18. The Care Provider offered Mrs Y a discount of 15% on any future stay. This is not sufficient. The Care Provider should, along with other actions, refund 15% of the care fees to Mrs Y.
19. Under the terms of our Memorandum of Understanding I intend to send a copy of the final decision statement to the Care Quality Commission.

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Agreed action

20. Within four weeks of the final decision the Care Provider will:

• apologise for the faults identified above and the distress this caused Mrs Y;
• refund Mrs Y 15% of the care home fees paid.

21. Provide this office with evidence of the above.

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Final decision

22. The Care Provider failed to offer an acceptable standard of care to Mrs Y during a residential respite stay. The remedy offered by the Care Provider was insufficient.
23. The above recommendations are a suitable way to remedy the injustice caused.
24. It is on this basis; the complaint will be closed.

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Investigator's decision on behalf of the Ombudsman