Summary: Mr X complains about the Council’s failure to ensure domiciliary care was in place to help his wife while he was in hospital having surgery. The Council was at fault for the delay in call and complaint handling and arranging support for Mr X’s wife. This caused avoidable distress to Mr X and his wife at an already stressful time. The Council has agreed to apologise and make payments to Mr X and his wife for this injustice. The Council will also review and revise its published policy for handling Adult Social Care complaints.

The complaint

1. Mr X complains on his and his wife, Mrs Y’s, behalf about the Council’s failure to ensure domiciliary care and support was in place to help his wife while he was in hospital having surgery. Mr X and Mrs Y’s daughter had to travel from Australia to provide care and support to Mrs Y in the absence of Council arranged care. Mr X is unhappy the Council has refused to consider his request for a contribution to the cost of his daughter’s flight. Mr X feels the Council has downplayed the difficulties he experienced when trying to contact the Council for help. He is also concerned his wife was left without care due to an issue with paperwork. Mr X says the Council’s poor handling caused unnecessary additional distress to him and his family following surgery, which he would like the Council to properly remedy.

Back to top

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. 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)
3. 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)

Back to top

How I considered this complaint

4. I have spoken to Mr X and considered the information he and the Council have provided.
5. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

Relevant guidance

6. Intermediate care and reablement support services are for people usually after they have left hospital or when they are at risk of having to go into hospital. They are time-limited and aim to help a person to preserve or regain the ability to live independently. The National Audit of Intermediate Care lists four types of intermediate care:

• crisis response – services providing short-term care (up to 48 hours);
• home-based intermediate care – services provided to people in their own homes by a team with different specialties but mainly health professionals such as nurses and therapists;
• bed-based intermediate care – services delivered away from home, for example in a community hospital; and
• reablement – services to help people live independently which are provided in the person’s own home by a team of mainly care and support professionals.

7. Regulations require intermediate care and reablement to be provided without charge for up to six weeks. This is for all adults, whether or not they have eligible needs for ongoing care and support. Councils may charge where services are provided beyond the first six weeks but should consider continuing providing them without charge because of the preventive benefits. (Reg 4, Care and Support (Preventing Needs for Care and Support) Regulations 2014)

What happened

8. Mrs Y is sight impaired and her husband, Mr X, is her main carer who supports her in their own home.
9. On 8 February 2023, Mr X contacted the Council to ask for some help with caring for Mrs Y. Mr X was scheduled to attend hospital for surgery in late February and would struggle with supporting his wife when he returned home. Mr X says he made several attempts to speak to someone at the Council before he got through to its Customer Service team.
10. Mr X’s request for help was referred to the Council’s Reablement Team. A worker from that team made a home visit to Mr X and Mrs Y on 14 February 2023 to assess their needs. The Worker drew up a reablement plan for Mrs Y to receive two daily visits from carers to support her while Mr X was in hospital and then during his recovery at home.
11. Mr X attended hospital for surgery as planned on 20 February 2023. As he had heard nothing further from the Council about support for his wife, he arranged for neighbours to visit his home to help.
12. As no Council-arranged carers had attended by 24 February 2023, Mr X and Mrs Y’s daughter (Ms Z) travelled from Australia to help support her parents. Ms Z contacted the Council about the lack of support and crisis care was arranged while the Council organised reablement care. Crisis care was provided from 28 February to 2 March 2023.
13. Council-arranged reablement care for Mr X and Mrs Y started on 3 March 2023 and ceased on 31 March 2023.
14. On 16 May 2023. Mr X complained to the Council about the lack of support for his wife while he was in hospital. Mr X said he had really struggled with contacting the Council for help and the lack of help for his wife had added to the significant worry he had about having surgery. He felt the Council should reimburse some of the expense Ms Z had incurred in travelling from Australia to help her parents. He asked the Council to consider making a payment of £500 towards the cost of his daughter’s flight and a further £29 so he could purchase thank you gifts for his neighbours who supported Mrs Y before his daughter arrived.
15. The Council responded to Mr X’s complaint on 7 July 2023. It apologised for the difficulties he had experienced in contacting the Council for help and said it had since recruited more staff to help reduce call waiting times. The Council also apologised that an error with the paperwork had meant reablement care had not started as planned on 20 February 2023. The Council said it was unable to agree to the payment Mr X had suggested to partly reimburse his daughter’s travel expenses or thank you gifts for Mr X’s neighbours.
16. Mr X brought his complaint to us as he remained dissatisfied with the Council’s response.

Analysis

17. The Council has already acknowledged its call waiting times and handling of Mr X’s case could have been better. It upheld his complaints about this.
18. An error in the completion of paperwork meant the reablement plan drawn up for Mr X and Mrs Y was not referred to the relevant team to arrange carer visits in time for Mr X’s operation. Mr X and Mrs Y were understandably already experiencing significant worry at this time, which was disappointingly exacerbated by the Council’s error.
19. As a result, Mrs X was left without any formal care and support for four days. Thankfully, she did not come to any significant harm during this period. Further risk of harm was avoided by Ms Z’s attendance and intervention from 24 February 2023.
20. The Council has already told Mr X about the steps it has taken to improve its handling of incoming telephone calls. As a result, I do not consider there is any further recommendations I can make now in respect of this element of Mr X’s complaint. There is however no doubt Mr X experienced significant difficulties getting through to the Council, which added to his existing anxiety about his surgery. Having read the Council’s complaint response to Mr X, I do not consider the Council has sought to downplay the difficulties he experienced.
21. The Council’s failure to ensure the reablement plan for Mr X and Mrs Y was actioned correctly appears to have been a one-off incident, which was fault. In response to my enquiries, the Council has explained the steps it has taken to address this oversight with the individual worker and the rest of the Reablement Team.
22. The Council says it declined Mr X’s request for financial redress because it was not reasonable or appropriate. While it may not think the amount Mr X requested was appropriate, the Council should have considered whether a symbolic payment in recognition of the injustice experienced in line with our Guidance on Remedies was required in these circumstances. I have made a recommendation based on this below to address the injustice Mr X and Mrs Y experienced as a result of the Council’s faults. Since issuing my draft decision, the Council has shared its internal staff guidance for complaint handling, which includes provision for financial redress where appropriate.
23. In terms of complaint handling, it appears to have taken the Council 37 working days to respond to Mr X’s complaint. This seems excessive given the nature of the concerns being raised. The Council’s complaint policy for Adult Social Care does not include specific timescales for complaint responses, save for the statutory requirement to ensure complaint investigations and responses take no longer than six months to complete. Instead, the Council’s policy says it will inform the complainant of the timescale for response at acknowledgement of their complaint.
24. Since issuing my draft decision, the Council has provided further information about its handling of Mr Y’s complaint. This shows it advised Mr X it would respond by 22 June 2023. As the Council did not provide its substantive response to Mr Y’s complaint until 7 July 2023, my finding of fault in respect of complaint handling delay still stands. The Council has confirmed it did not inform Mr X its response would be late which will no doubt have added to his frustration. I have made a recommendation on how the Council might address the issues in its complaints process highlighted by this case through a wider service improvement.

Back to top

Agreed action

25. Within one month of my final decision, the Council agrees to:

• apologise to Mr X and Mrs Y for the significant distress caused by the delays in call and complaint handling and then arranging support for Mrs Y while Mr Y was in hospital; and,
• make a payment of £200 (£100 each) to Mr X and Mrs Y in recognition of the distress caused by the lack of support Mrs Y received when Mr X first went into hospital.

26. Within three months of my final decision, the Council has agreed to review and revise its published Adult Social Care Complaints Policy with a view to better defining the timescales for its responses and including consideration of financial redress in certain circumstances for service users. The Council should consider our Guidance on Remedies and our new Complaint Handling Code as part of its review.
27. The Council should provide us with evidence it has complied with the above actions.

Back to top

Final decision

28. I have completed my investigation and uphold Mr X’s complaint. Mr X and Mrs Y were caused injustice by the actions of the Council. The Council has agreed to take action to remedy that injustice.

Back to top

Investigator's decision on behalf of the Ombudsman