London Borough of Tower Hamlets (20 002 305)

Category : Adult care services > Safeguarding

Decision : Upheld

Decision date : 05 Feb 2021

The Ombudsman's final decision:

Summary: Mrs B complained about how the Council dealt with allegations of financial abuse by a carer employed by an agency providing homecare on its behalf, and about how the Council dealt with the complaint about that. We have found there was fault by the Council in these matters and that as a result Mrs B was caused unnecessary distress and time and trouble seeking to have matters resolved. The Council has agreed to take appropriate action to remedy this injustice.

The complaint

  1. The complainant, whom I shall call Mrs B, complained about how the Council dealt with allegations of financial abuse of her late aunt, Mrs C, by a carer employed by an agency providing homecare on its behalf. She also complained about how the Council dealt with the complaint about the matter, and its failure to promptly agree to write off the outstanding debt for care costs.
  2. This matter caused considerable distress, concern about other vulnerable people potentially affected, and time and trouble seeking to have the matter satisfactorily resolved.

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What I have investigated

  1. I have investigated how the Council dealt with the matter when it was reported to it, and how it dealt with the subsequent complaint.

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The Ombudsman’s role and powers

  1. 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)
  2. We may investigate a complaint on behalf of someone who has died or who cannot authorise someone to act for them. The complaint may be made by:
  • their personal representative (if they have one), or
  • someone we consider to be suitable.
  1. (Local Government Act 1974, section 26A(2), as amended)
  2. If we are satisfied with a council’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)
  3. 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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How I considered this complaint

  1. I considered all the information provided by Mrs B about her complaint. I made written enquiries of the Council and took account of the information it provided in response.
  2. Mrs B and the Council had an opportunity to comment on my draft decision and I took account of all comments received before making this final decision.

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What I found

Legal and administrative information

  1. When a council commissions another organisation to provide services on its behalf it remains responsible for those services and for the actions of the organisation providing them.
  2. A council must make necessary enquiries if it has reason to think a person may be at risk of abuse or neglect and has needs for care and support which mean he or she cannot protect himself or herself. It must also decide whether it or another person or agency should take any action to protect the person from abuse or risk. (section 42, Care Act 2014)

Background

  1. Mrs C was receiving care at home, which the Council had arranged and which was supplied by an agency (‘the care provider’). Mrs C was responsible for the full cost of her care.
  2. In July 2018 Mrs B was checking her aunt’s bank statements with her and noticed three cheques had been drawn in April and May totalling £2900, to a payee who was unknown to the family.

Mrs B reports concerns to the Council

  1. Concerned by this, Mrs B contacted the Council on 30 July 2018. She had also contacted Mrs C’s bank, which had advised it would notify the police. When she contacted the Council Mrs B expressed concerns about her aunt’s mental capacity to decide how her finances were managed, noting that she had about 25 direct debits made out to various charities which added up to more than her monthly pension income. Mrs B was also concerned that her aunt’s telephone bills were very high, showing lots of calls to mobile numbers and the speaking clock, and that she was not screening callers at the door. In addition, Mrs B reported concerns about her aunt’s personal hygiene and the cleanliness of her home, and she questioned whether carers were properly carrying out their tasks.

Action in respect of safeguarding

  1. On the same day, the Council took the following steps:
  • It contacted the Mental Health Team for Older People (MHTOP), an integrated service providing mental health and social care, and sent details of the allegation to Mrs C’s allocated worker. The following day confirmation was received that a safeguarding enquiry had been initiated;
  • It telephoned the police; and
  • It telephoned the care agency to check if the person named on the cheques was employed by it as a carer. A return call was subsequently made by the manager stating the person named was not employed, though it seems this was not correct.
  1. On 3 August 2018 Mrs C’s allocated worker from the MHTOP visited Mrs C at home to obtain more details to inform any necessary decisions about safeguarding. Mrs B and another relative were present. It was noted that Mrs C was deemed a vulnerable adult by virtue of her mental and physical health needs, and she was at risk of abuse. Steps had been taken to manage risk of financial abuse: the bank and the police were involved, and Mrs B was helping with the necessary arrangements needed to meet her aunt’s expenses while she applied to the Court of Protection for Deputyship to manage her finances on her behalf. A plan was in place for the family to purchase a safe for future use. A key safe for the property and a camera doorbell were also suggested. In addition to these measures the action plan was for continued liaison with the police and with Mrs B, and to organise a safeguarding meeting with professionals and all involved at the beginning of September.
  2. I have seen no records of a safeguarding meeting in September 2019. The information provided to me shows reference to a safeguarding meeting being planned in January 2019, and then in February 2019 a safeguarding update meeting and care review at which it was noted that the plan was for the social worker to re-start the safeguarding alert and organise a safeguarding case conference. A further note in April set out the same plan, and another note in June referred to a case conference being organised. A safeguarding meeting was eventually arranged for 8 August 2019.
  3. Notes from that meeting show Mrs B reported further cheques having been fraudulently used and confirmed the bank had returned all monies from those which had been cashed. Mrs B now had deputyship enabling to deal with her aunt’s finances but was not prepared to pay the sum deemed owing for the homecare, some £9,100, until the matter was resolved. The safeguarding case was to be kept open until MHTOP was satisfied. The next safeguarding review meeting was to be held in November 2019.
  4. I have not seen evidence of any further safeguarding meeting until October 2020. I will return to this final meeting later in this statement.
  5. In respect of safeguarding, the Council says that due to the nature of the alleged concern a decision had been taken following the first case conference on 8 August 2019 to wait for the police to complete its investigation. I have not seen evidence of this decision-making or that Mrs B was specifically advised of this. It is the case that Mrs C was no longer at risk of financial abuse, having had plans put into place at the beginning of August and then having moved into residential care in September 2018. (Mrs C subsequently passed away, in June 2020). The Council accepts that it would have been helpful if regular safeguarding review meetings had been arranged while the outcome of the police investigation was awaited. It notes that such reviews would have been an opportunity to update Mrs B and give her the opportunity to ask any questions or raise any concerns. I find that the Council’s failure to progress matters in a timely manner, or alternatively to evidence its decision to place safeguarding on hold and to advise Mrs B accordingly, was fault.

Mrs B complains to the Council

  1. On 28 June 2019, almost a year after she reported the suspected theft to the Council, Mrs B had complained that nothing had been done. She referred to the debt of £9100 for the home care, which she understood had been put on hold but which she felt ought not to be paid until the matter had been fully investigated. Mrs B expressed concerns that the person allegedly responsible for the theft might still be working with vulnerable people.
  2. The Council’s published two-stage complaints process sets out that at each stage a response will be issued within 20 working days unless an extension is needed in which case the complainant will be advised. The Council issued a response to Mrs B on 3 February 2020. It includes an apology for delay and states that the previous service manager had left the Council’s employ and the complaint had not been redirected until the end of the year. That was incorrect as the complaint had been opened to the new service manager at the beginning of September. The officer went on to note that the matter was being investigated under safeguarding procedures, a process Mrs B had been involved in, and that the debt had been placed on hold and would not be pursued until the safeguarding enquiry had concluded.
  3. The Council also says that on 4 August 2020 the service manager contacted Mrs B to discuss her complaint. The Council says an apology was given for not having dealt with the complaint within the usual timeframes, and the officer agreed to ask the MHTOP to organise another safeguarding meeting to review the different strands of the enquiry.
  4. The delay in responding to the complaint was fault.

The final safeguarding meeting

  1. As noted at paragraph 20 above, there was a final safeguarding meeting in October 2020. The Chair of the meeting noted that the police had been leading on this case, but the Council offered apologies from those involved in safeguarding for the extended delay there had been and the distress this had caused. Regarding the debt of £9,100 owed to the Council for the home care, the Council said this would be referred for consideration of a write-off, and the care provider made an offer to pay it.
  2. Mrs B asked questions about what had happened and about what the Council was doing to protect other people from similar abuse. The Council explained that quarterly visits were being made to providers with more robust scrutiny including of Data Barring Service (DBS) checks. The care provider confirmed it had heavily scrutinised by commissioning and there had been a change of management structure: failings in keeping documentation, and the monitoring of the care documentation, were acknowledged and an electronic monitoring system was now in place.
  3. Action points from the meeting included:
  • The Council to establish if it could inform other providers about the carer involved in this case;
  • Consideration to be given to the care provider’s offer to pay the outstanding care charges deemed owing to the Council, or social care to confirm approval of write off that debt;
  • The care provider to examine its records to see who else this carer provided care for and to let the Council know so that other potential cases could be flagged up.
  1. The Council says it was agreed that the safeguarding enquiry would be closed and that together with the care agency it would continue to cooperate with the ongoing police investigations.

The current position

  1. The care provider has agreed to settle the outstanding debt with the Council. The Council no longer contracts with this care provider. Mrs C’s bank has given full reimbursement for the cheques which were fraudulently used.
  2. I have seen evidence of the checks the Council is now making with care providers. I have also seen evidence that checks were made which established the carer in question had three other clients provided through this agency, but their circumstances were different and there were no grounds to consider those clients were at risk of similar abuse and in need of safeguarding.

Analysis

  1. As noted above, there were faults by the Council in this case. There were delays and communication failings in the safeguarding process and in the handling of the complaint.
  2. Further faults acknowledged by the Council were a failure to inform the CQC or check that the care provider had done so, and a failure to inform the DBS or check that the care provider had done so.

Injustice to Mrs B

  1. As a result of the failings identified at paragraph 32, Mrs B was caused unnecessary distress and time and trouble seeking to have the matter progressed and resolved.

Agreed action

  1. In recognition of the injustice noted above, I recommended that within four weeks of the date of the decision on this complaint the Council:
  • Issues Mrs B with a formal written apology for the identified failings in this case and their impact;
  • confirms in writing to Mrs B that the £9,100 debt for the homecare is no longer outstanding;
  • confirms in writing to Mrs B the steps taken to improve processes as a result of her complaint; and
  • pays Mrs B £250.
  1. I further recommended that within three months of the date of the decision on this complaint the Council:
  • Confirms the steps taken to ensure relevant parties have been reminded of the need to inform CQC and DBS in appropriate circumstances; and
  • confirms all relevant staff have been reminded of the requirements of the complaints procedure and identifies and progresses any training needs in this regard.
  1. The Council should provide the Ombudsman with evidence that the above actions have been completed.
  2. The Council has agreed with my recommendations.

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Final decision

  1. I have competed my investigation on the basis set out above.

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Parts of the complaint that I did not investigate

  1. I did not investigate matters concerning the alleged theft of money by a carer. This is a criminal matter which is appropriate for investigation by the police. I understand that an investigation is underway, and for the avoidance of doubt the Ombudsman cannot investigate action taken by the police in connection with the investigation of crime. (Local Government Act 1974, Schedule 5/5A, paragraph 1/2, as amended)

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Investigator's decision on behalf of the Ombudsman

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