An elderly woman with dementia did not receive adequate in-house care from Worcestershire County Council.

An elderly woman with dementia did not receive adequate in-house care from Worcestershire County Council, finds Local Government Ombudsman, Dr Jane Martin. In her report, issued today, she says the lack of monitoring of the woman’s care plan led to her home being allowed to deteriorate to an very unclean condition.

She says “the Council had no comprehensive strategy in place to manage the risks posed by her lack of capacity. While some risks were identified and addressed in [the woman’s] care plan, more might have been done to address further aspects of her behaviour that placed her at risk. In particular, her habit of overdressing in hot weather.”

The Ombudsman welcomes the Council’s agreement to follow her recommendations to remedy the injustice to the woman and her daughter, by apologising and paying £2,000 compensation. It has also introduced changes to its procedures to try to prevent any repetition of the faults identified.

The woman’s stepdaughter complained about the care provided for her stepmother, who has dementia and was at that time living in her own home, by an in-house care agency of the Council. She complained that her stepmother was often left in a dirty house with bed linen and clothing left unwashed; that her personal hygiene, dress and food intake were not adequately monitored; and that the Council failed to carry out an assessment of need after she had been admitted to a residential home for such an assessment to be undertaken. She also says that no subsequent assessment of need or revision of the care package was undertaken during the following month when, during a spell of hot weather, her stepmother over-exercised and overdressed unaware of the risks posed by this behaviour. This resulted in her health deteriorating and a prolonged admission to hospital, after which she was unable to return home and moved into residential care.

The Ombudsman found evidence to support all of the complaints and criticises the Council for not learning lessons sooner. The Council failed to carry out adequate risk assessment or care planning; failed to communicate to care workers the limits of the woman’s capacity; and care workers in turn failed to bring repeated instances of the woman placing herself at risk in hot weather to the attention of Council managers. The Ombudsman also finds that the woman should not have been left unattended on a day she was later admitted to hospital.

As a result of these failings the Ombudsman considers the stepdaughter has a justified sense of outrage that her stepmother was left in an unclean and unhygienic home at times and that more might have been done to prevent her posing a risk to herself through over-exercising in hot weather. The Ombudsman cannot say the Council’s failings led to the prolonged hospital stay and subsequent admission to residential care, but there is uncertainty about whether this might have been avoided. 

Report ref no 09 013 172

Article date: 14 July 2011