Summary: Mr H complained about how the Council investigated and responded to safeguarding allegations made against Mrs J. Mr H said this caused Mrs J to lose employment with a new employer and affected her mental health. We did not find fault with the Council’s actions.

The complaint

1. The complainant, whom I shall refer to as Mr H, complains on behalf of his wife Mrs J. He complains about issues surrounding the way the Council investigated and responded to safeguarding allegations made against Mrs J. These are:

• that the Council failed to adequately investigate or review evidence about an allegation of abuse;
• that the Council wrongly substantiated the allegation despite the Disclosure and Barring Service (DBS) deciding differently; and
• that the Council told Mrs J’s current employer not to allow her to work at the care home.

2. Mr H says this caused Mrs J to lose employment with a new employer. Mr H also says this has adversely affected Mrs J’s mental health which has then caused stress to all family members.

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The Ombudsman’s role and powers

3. 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 34H(i), as amended)

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How I considered this complaint

4. I have discussed this complaint with Mr H and considered the information he provided. I have also considered the information the Council provided in response to our enquiries.
5. Mr H and the Council had the opportunity to comment on my draft decision.

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What I found

Legislation and Guidance

Safeguarding

6. A council must make enquiries if it thinks a person may be at risk of abuse or neglect and has care and support needs which mean the person cannot protect themselves. An enquiry is the action taken by a council in response to a concern about abuse or neglect. An enquiry could range from a conversation with the person who is the subject of the concern, to a more formal multi-agency arrangement. A council must also decide whether it or another person or agency should take any action to protect the person from abuse. (Section 42, Care Act 2014)
7. The Council is part of the Rochdale Borough Council Safeguarding Adults Board. The board has developed a procedure and guidance document for managing allegations made about professionals who work with adults with care and support needs. This highlights the employer should undertake its own internal investigation to consider if its member of staff poses a risk of harm to adults with care and support needs. The employer should conclude its internal investigation with consideration of the police and Adult Care information if applicable. The employer should make a decision on the ‘balance of probability’ whether the allegations made against their employee is substantiated, unsubstantiated, unfounded or malicious/false.

Care and Support Statutory Guidance (CSSG)

8. The Care and Support Statutory Guidance states that when an employer is aware of abuse or neglect in their organisation, then they are under a duty to correct this and protect the adult from harm as soon as possible and inform the local authority, Care Quality Commission and Clinical Commissioning Group where the latter is the commissioner. Where a local authority has reasonable cause to suspect that an adult may be experiencing or at risk of abuse or neglect, then it is still under a duty to make (or cause to be made) whatever enquiries it thinks necessary to decide what if any action needs to be taken and by whom. The Council may well be reassured by the employer’s response so that no further action is required. However, a Council would have to satisfy itself that an employer’s response has been sufficient to deal with the safeguarding issue and, if not, to undertake any enquiry of its own and any appropriate follow up action.
9. The employer should investigate any concern (and provide any additional support that the adult may need) unless there is compelling reason why it is inappropriate or unsafe to do this. 

Summary of key events

10. Mrs J was employed by a care provider (Care Provider 1) within a care home. In late 2022 there was an anonymous referral to the Care Quality Commission (CQC) about concerns relating to Mrs J’s conduct with a service user that lived with Care Provider 1. CQC shared these concerns with the Council.
11. In December, a social worker from the Council visited the service user and summarised she had no concerns.
12. During the same time, Care Provider 1 completed an enquiry under the managing allegations process. On 5 January 2023, the Council chaired an allegation management meeting. Care Provider 1 shared the evidence that had led it to conclude the allegations made against Mrs J were substantiated. The minutes of the meeting show that Care Provider 1 “explained on the balance of probabilities, evidence indicates emotional and psychological abuse, physical abuse and organisational [sic].”
13. Because of this, Mrs J was dismissed from her employment with Care Provider 1. The DBS and the Nursing and Midwifery Council were informed.
14. In May, the managing allegations process was started for a second time due to new concerns being raised about Mrs J. The NHS continuing health care team informed the Council that HM coroner had directed the Police to investigate the death of a different service user at Care Provider 1. Mrs J was named as a significant person of interest after the coroner heard her evidence at the inquest.
15. By this time Mrs J was employed by a new care provider (Care Provider 2). Care Provider 2 decided to suspend Mrs J.
16. On 26 July, a managing allegations meeting took place. Staff from the Council, NHS, Police and Care Provider 2 attended. The minutes show that a statement of confidentiality was discussed at the meeting.
17. During the meeting, the allegations from December 2022 and the most recent allegations were considered. Care Provider 2 stated it had decided that Mrs J should remain suspended from work.
18. Mr H complained to the Council. After seeing a copy of the minutes of the first managing allegations meeting, he stated the information provided was not factual. He also disputed the substantiated outcome. Mr H also complained the Council had told Care Provider 2 not to allow Mrs J to work there and it would stop commissioning services if she continued to do so.
19. The Council did not uphold these parts of Mr H’s complaint.

Analysis

The Council failed to adequately investigate or review evidence about an allegation of abuse

20. Mr H complained that the Council failed to investigate the allegations made in 2022 and relied upon the evidence of Care Provider 1 to reach a substantiated outcome.
21. The Care and Support Statutory Guidance states that a Council would have to satisfy itself that an employer's response has been sufficient to deal with the safeguarding issue. If it is not satisfied, then it should start an enquiry of its own.
22. The Council attended the allegations management meeting in January 2023 where the allegations and evidence were discussed. The result of this meeting was that on the balance of probabilities, evidence indicated emotional, psychological, physical and organisational abuse. The allegations were substantiated and the document stated this meant there was sufficient identifiable evidence to prove the allegation and that relevant conduct had occurred.
23. Also, following Mr H’s complaint, the Council explored this matter. The Council reviewed the information provided about the steps taken by Care Provider 1 which included speaking to the service user, other staff members and with Mrs J. The Council stated it was satisfied that proper enquiries were made for Care Provider 1 to reach a conclusion. Therefore, the Council did not need to complete further enquiries as it was satisfied with the actions of Care Provider 1.
24. The Council evidenced that it considered the allegations in line with its procedures and the law. This was a decision the Council was entitled to make. There is no fault here.
25. It was the role of Care Provider 1 to investigate Mrs J’s actions and decide if the allegations were substantiated. However, Mr H has not complained about the actions of Care Provider 1 to us, he has complained about the actions of the Council, therefore we are unable to investigate Care Provider 1’s involvement in the matter.
26. Although we could investigate a separate complaint about a care provider, we only have the power to do so if the complaint is about the provision of care. This complaint is not about the provision of care and so, even if Mr H were to make a separate complaint about the Care Provider, we could not investigate it.

The Council wrongly substantiated the allegation despite the Disclosure and Barring Service deciding differently

27. As I have already discussed, the Council decided that Care Provider 1 had made proper enquiries to decide the allegations were substantiated.
28. While the DBS may have taken a different view on the allegations about Mrs J, the Council and Care Provider 1 were entitled to make their own decisions on the safeguarding allegation. Neither was obliged to follow the findings of a different agency in doing so. I am satisfied the Council had considered the matter properly and there is no evidence of fault here.

The Council told Care Provider 2 not to allow Mrs J to work at the care home

29. Mr H complains the Council told Care Provider 2 not to allow Mrs J to work at the care home. Mr H was also unhappy that the Council told Care Provider 2 these allegations were substantiated without completing its own investigation.
30. The minutes of the allegation management meeting held on 26 July 2023, show that Care Provider 2 was already aware of the first set of allegations. Care Provider 2 stated the Nursing and Midwifery Council had shared that Mrs J had working restrictions and had to work alongside another nurse due to its ongoing investigation. Care Provider 2 was advised to contact the Nursing and Midwifery Council for more information.
31. The minutes of the meeting show that Care Provider 2 decided to suspend Mrs J. This was after receiving information that she was being investigated as part of a wider enquiry following information heard by the coroner. The minutes were also clear that Care Provider 2 “need to decide on her [Mrs J’s] suitability to work with vulnerable service users at this time”. There is no evidence the Council told Care Provider 2 not to allow Mrs J to work at the care home within this meeting and it was clear the decision was for Care Provider 2 to make.
32. The Council also investigated Mr H’s complaint that it had told Care Provider 2 not to allow Mrs J to work for the provider and that it would not commission services if it did so. The Council concluded this was not the case. Apart from the minutes of the allegation management meeting there is no objective evidence about this part of the complaint and therefore there is no evidence of fault.

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Final decision

33. I have completed my investigation and I do not find fault with how the Council has investigated and responded to the safeguarding allegations.

Investigator’s final decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman