Summary: The Council commissioned care provider was not at fault for the way it served Mr X notice on his residential care placement and was not at fault for the way it considered his reasonable adjustments.

The complaint

1. Mr X complained the Council commissioned care home in which he resides served him notice unfairly. He said the care provider failed to take into account his impulse-control difficulties related to a stroke, which constituted a failure to consider his reasonable adjustments. Mr X said the care provider did not allow any appeal process. As a result, he said it affected his mental health and he said he is losing what he thought was his long-term home. Mr X wants to be able to stay at the care home.

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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. 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 s34H(1), as amended).
3. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended).

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How I considered this complaint

4. I considered:
• the information Mr X and his representative Ms Y provided;
• the information the Council provided and its response to my enquiries; and
• relevant law and guidance, as set out below.
5. Mr X and the Council had an opportunity to comment on my draft decision. I considered comments received before making a final decision.

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What I found

Relevant law and guidance

Contract

6. Section eight and section nine of the contract between Mr X and Care Home 1 set out the termination agreement. Section eight said the agreement would continue until terminated by either party giving the other four weeks’ written notice before termination. Section eight also said early termination of the contract may be sought by both parties in exceptional circumstances including a serious breach of the contract.
7. Section nine of the contract set out the terms of termination by the care provider. Section 9a iii. said the care provider may give notice requiring the resident to leave the home under the following circumstances: ‘any circumstances or behaviour which the Care Provider feels may be seriously detrimental to the Home or the welfare of other residents. This will be subject to consultation and appeal by a resident or his/her representative…’.

What happened

8. Over five years ago Mr X had a stroke and started to live at a Council commissioned care home, Care Home 1.
9. The Council carried out Mr X’s needs assessment. It noted he had mild communication difficulties with understanding or expressing himself and had some short-term memory concerns. It noted Mr X occasionally displayed aggressive behaviour and his emotional well-being was low most days which impacted on his behaviour.

Background

10. In 2021 and 2022 Care Home 1 wrote to Mr X about his challenging behaviour including inappropriate language towards care staff at Care Home 1 and his behaviour at Care Home 1 following a complaint by Mr X. Care Home 1 told Mr X his behaviour was unacceptable and would not be tolerated, it said it had an action plan in place to support his needs which had been written in consultation with his doctor. It said it was moving Mr X to a different part of Care Home 1 and if there were further incidents it would result in Mr X being issued with a Notice to Leave, which gave four-weeks notice for him to leave Care Home 1.

2024 onwards

11. Mr X was able to make decisions about where he should live.
12. Between March and August 2024 Mr X raised several complaints against Care Home 1 relating to restrictions put in place regarding his behaviour, whether he was allowed out of Care Home 1 to attend family occasions and the use of prescription creams. Mr X’s daughter, Ms Z, was concerned about Mr X going outside of Care Home 1. In response, Care Home 1 said:
• Mr X was able to make his own decisions so it could not stop Mr X from going outside of the care home and adaptions were made;
• it had ordered the correct amount of prescription creams and requested Mr X’s doctor review his creams; and
• Mr X’s care plan was reviewed regularly and was agreed in consultation with Mr X’s doctor.
13. Mr X’s case notes also commented on Mr X ringing Care Home 1 reception ‘relentlessly’. Mr X disputed this.
14. In September 2024 and early October 2024 case notes showed Mr X’s continued challenging behaviour towards care staff when they offered to help with his personal hygiene and preparing food.
15. In mid-October 2024 a meeting was arranged to discuss Mr X’s communication needs. Care Home 1, Mr X’s social worker, Mr X, Mr X’s advocate, Ms Y and Mr X’s daughter, Ms Z were all present at the meeting. At the start of this meeting Care Home 1 handed Mr X an eviction notice, it was also read out to Mr X. The meeting did not discuss Mr X’s communication needs.
16. The eviction notice said because of a breakdown in the therapeutic relationship a move to a new care home would be in Mr X’s best interest. It said it could no longer meet his needs due to complaints made about his care arrangements and due to his continued challenging, inappropriate and abusive behaviour towards care staff. It said despite its best efforts with its duty of care Mr X remained unhappy. Care Home 1 said as per section nine of the contract it gave Mr X 28 days-notice to vacate Care Home 1, by mid-November 2024.
17. In mid-October 2024 Mr X’s social worker reviewed Mr X’s care and support plan. It said Mr X had capacity to make his own decisions. Mr X said his physical needs were being met, he had good contact with his family and he had support from his advocate, Ms Y. It noted Mr X’s communication needs and said ‘it has been suggested [Mr X’s] brain injury from his stroke may contribute to his inability to control outbursts/language’. It said Mr X knew it was wrong but felt ‘unable to stop himself’. It said the care staff were to be made aware of this and to consider strategies for managing situations that may occur as a result of his outbursts.
18. In late October 2024 Mr X sent a formal complaint to Care Home 1. He complained about the notice letter served in mid-October 2024. The next day Care Home 1 responded to Mr X’s complaint and said it was clearly explained on the day the reasons why the decision had been made. Care Home 1 said Mr X disagreed but it had provided clear documented evidence in relation to Mr X’s concerns about his care plan, him refusing care from certain staff members, ringing the unit numerous times, disputes over creams and threats to staff. It said it had previously made Mr X aware that notice would be given if his challenging behaviour did not improve. It said there would be no further consideration of the matter and the notice still stood from mid-October 2024, providing him with 28 days’ notice to find alternative accommodation.
19. In November 2024 the Council searched for new accommodation for Mr X. The Council initially searched for new accommodation close to Care Home 1 and his family, following conversations with Mr X about his preferred location. The Council contacted over five local care homes but they either did not have any vacancies or could not accommodate Mr X because of his challenging behaviour.
20. In mid-November 2024 Mr X’s notice period ended but alternative accommodation had not been found and Mr X continued to live at Care Home 1.
21. In late 2024 and in 2025 the Council continued to search for new accommodation for Mr X and widened its search area. A care home said it could accommodate Mr X but he declined the offer because it was too far away from his family members.
22. In February 2025 Mr X’s social worker contacted Mr X’s doctor about Mr X’s impulse control difficulties following his stroke. It asked whether these were related to his stroke and if they could help to emphasise to care homes that Mr X’s communication needs required careful advanced consideration during care planning. Mr X’s doctor responded to the social worker to say they had discussed Mr X’s impulse control difficulties with Care Home 1 and Mr X, and it had been an issue since Mr X moved to Care Home 1. The doctor said Mr X’s behaviour went up and down and had recently been better since the eviction notice which indicated he did have control over his behaviour but strokes could cause a lack of self-control at times. The doctor could not say if that was the problem with Mr X.
23. Mr X remained unhappy and complained to us.
24. At the time of writing this decision Mr X remained living at Care Home 1.

Enquiries

25. In response to my enquiries about what reasonable adjustments or impulse control strategies had been put in place to support Mr X’s communication needs the Council said:
• Mr X had been assigned an advocate, Ms Y. It said Ms Y worked closely with Mr X to support his understanding of his rights and available options and she played a key role in constructive discussions between Mr X and Care Home 1; and
• Mr X told his social worker maintaining timely communication was important and to support this Mr X has his social workers direct contact details.
26. The Council also responded to say Care Home 1 senior management agreed to Mr X’s eviction notice. Mr X would still like to live at Care Home 1.

My findings

Eviction

27. The Ombudsman considers whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome.
28. The evidence shows Care Home 1 followed section eight and nine of the contract. In 2021 and 2022 it considered Mr X’s challenging behaviour towards care staff and worked with Mr X’s doctor regarding elements of his care plan. It moved Mr X to a different part of Care Home 1 and warned him if his behaviour continued he would be served an eviction notice. Mr X’s behaviour continued to be challenging in 2024 towards care staff and management and it served Mr X with an eviction notice. When Mr X complained it explained the reasons it had made the decision. It was not at fault.
29. The Council acted appropriately when it searched for new accommodation for Mr X. It considered Mr X’s wishes to live locally to Care Home 1 which was also close to his family. When local care homes were unable to accommodate Mr X it contacted care homes in a wider search area. The Council should continue to take steps to identify and offer suitable alternative accommodation for Mr X that meets his needs.

Reasonable Adjustments

30. Mr X said his stroke caused impulse control difficulties and he did not feel reasonable adjustments were made to support his communication needs. Mr X’s needs assessment from 2022 indicated Mr X had mild communication difficulties with occasional aggressive outbursts. Mr X’s doctor, in consultation with Care Home 1 and Mr X considered Mr X’s behaviour and an action plan was put in place to help reduce Mr X’s challenging behaviour. Care Home 1 monitored this regularly. In response to my enquiries the Council also said Mr X had communication support through his advocate Ms Y and his social worker. There was no fault in the way the Council and Care Home 1 sought to support Mr X.

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Decision

31. I have completed my investigation finding no fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman