Summary: Mrs X complained the Council failed to properly investigate her concerns about the Council commissioned care delivered to her mother in-law, Mrs Y. There was some fault with the care however, the Care Provider took appropriate action to prevent a recurrence of fault. There was no fault with how the Council responded to Mrs X’s concerns.

The complaint

1. Mrs X complained the Council failed to properly investigate her concerns about the Council commissioned care delivered to her mother in-law, Mrs Y. Mrs X said the care workers:
• did not correctly prepare meals for Mrs Y; and
• made an error with Mrs Y’s medication.
2. Mrs X said it caused her and her husband distress and frustration. She wants the Council to acknowledge it was at fault.

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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. 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 significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, sections 24A(1)(A) and 25(7), as amended).
5. 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

6. I considered information provided by Mrs X.
7. I considered information provided by the Council.
8. Mrs X and the Council had the opportunity to comment on the draft version of this decision.

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What I found

Safeguarding adults

9. 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)

What happened

10. Mrs Y lives in her own home with her son, Mr X and her daughter in-law, Mrs X. Mrs Y has physical health problems. In June 2023, the Council commissioned a domiciliary care provider to support Mrs Y at home. This included support with meal preparation, medication, personal care and transfers.
11. In May 2024, Mrs X complained to the Care Provider because:
• she was unhappy with how care workers were preparing meals for Mrs Y. For example, she said care workers were serving meals overly cold, overheating meals or incorrectly mixing up different types of food. Mrs X said as a result, Mrs Y had been physically sick or had not eaten her meal; and
• a care worker had administered medication to Mrs Y when Mrs Y’s records instructed staff not to administer this specific medication. Mrs X said the Care Worker in question then falsified the records to show they did not administer the medication to Mrs Y.
12. The Council’s records show the Care Provider contacted the Council and spoke to it about Mrs X’s concerns. The Care Provider informed the Council Mrs X had complained about its care on several occasions and her approach to the matter was causing further issues. In response, the Council:
• spoke with Mrs Y’s son, Mr X and informed him Mrs X was falling out with the care workers which was causing further issues. Mr X said he would discuss the matter with Mrs X;
• reiterated Mrs X’s concerns to the Care Provider. The Care Provider said it would investigate the concerns; and
• visited Mrs Y, Mr and Mrs X in their home to discuss the issues. It noted Mrs Y said she was happy with the care workers. Mr and Mrs X reiterated their concerns about the care. They said they felt the Care Provider did not listen to their concerns and was subsequently not addressing the issues. The Council informed Mrs X the Care Provider was considering terminating its contract for Mrs Y’s care due to Mrs X’s approach towards it and the care workers. Mrs Y said she was happy with the care workers and was not aware of any issues with them. Towards the end of the visit the Council noted, overall Mr and Mrs X as well as Mrs Y said the care package was working for Mrs Y and they were willing to work to resolve the current issues.
13. The Care Provider responded to Mrs X’s complaint and said:
• it upheld her concerns about food preparation. It had trained its care workers in food preparation. It had also arranged for care workers to shadow more experienced care workers to gain a better understanding of food preparation;
• the care worker said they did not administer the medication to Mrs Y earlier in May 2024 and this was documented on the system. However, the Care Provider had arranged a medication competency check with the care worker; and
• several concerns she raised were not addressed in line with its complaints policy. It said it had reminded relevant staff of its processes and policies when responding to concerns raised about the care.
14. The Council’s records show Mrs X remained unhappy with the care workers who visited Mrs Y. Towards the end of June 2024, the Care Provider issued a notice to the Council to end its contract of care to Mrs Y. The Care Provider stopped providing its services to Mrs Y later in July 2024.
15. Mrs X was unhappy with how the Council had responded to her concerns about the Care Provider, in particular her concerns about the care worker administering medication when they were advised not to. She said the Council should have referred the matter to its safeguarding team. Subsequently, she complained to the Council and reported her concerns she had with the Care Provider as a safeguarding matter.
16. The Council responded to Mrs X and said it had referred her concern regarding medication to its safeguarding team. However, it noted Mrs Y was not at immediate risk of abuse as the Care Provider had stopped providing care and since then, Mr and Mrs X had been providing the care.
17. As part of its safeguarding investigation, the Council wanted to make further enquiries which included speaking with Mrs Y to obtain her views on the matter. The Council’s records show it attempted to contact Mrs X on several occasions to arrange a visit however, Mr and Mrs X did not want Mrs Y to be upset and so would not agree to a visit. The Council reached out to Mrs Y’s General Practitioner (GP) to check on Mrs Y’s health and wellbeing. The GP had no concerns with Mrs Y. Based on this, the Council wrote to Mrs X and informed her it was closing the case.
18. Mrs X remained unhappy and complained to us.

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Findings

19. The Care Provider investigated Mrs X’s concerns and found there was some fault with its care. It made changes to its service to prevent a recurrence of fault. This was appropriate.
20. Mrs X said the Council should have conducted a safeguarding investigation about the suspected medication error at the time she had complained. The Council made reasonable efforts to resolve the matter through care management. It discussed the issues with the Care Provider and visited Mrs X and the family to obtain their views. During the meeting, there were no obvious concerns raised about Mrs Y’s health and wellbeing and the notes record Mrs Y was happy with the care workers. The Council was not at fault for how it responded to Mrs X’s concerns at the time.
21. In response to a further complaint from Mrs X, the Council agreed to investigate the suspected medication error under its safeguarding procedures. The Council later closed the investigation as it had no concerns with Mrs Y’s health and wellbeing, Mr and Mrs X did not want Mrs Y contacted about it and the Care Provider had stopped providing care to her in July 2024 and so she was no longer at risk of abuse. This was appropriate and the Council was not at fault.

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Final Decision

22. I have now completed my investigation. There was some fault with the Council commissioned care however, the Care Provider took appropriate action to prevent a recurrence of fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman