Summary: Ms X complained the Care Provider, Sabrina Healthcare, asked her aunt Ms Y to leave its residential home because of comments she made on social media. She also complained the Care Provider refused to let her contact Ms Y and did not tell her important information about Ms Y’s health. Ms X said this situation caused her emotional distress. The Care Provider was at fault when it served notice on Ms Y and restricted her contact with Ms X without following its own complaints policy or contractual terms and conditions. This fault did not cause a significant injustice to Ms X or Ms Y, as it later said Ms Y could stay at the home. There was no other fault found in the Care Provider’s actions.

The complaint

1. Ms X complained the Care Provider did not give her aunt Ms Y, sufficient notice to leave its residential home during the COVID-19 pandemic. She asserts the Care Provider only asked Ms Y to leave because Ms X had complained about its service on social media. Ms X further complained the Care Provider prevented her from communicating with Ms Y. She said this situation caused her distress and upset.

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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 an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended
3. If we are satisfied with a care provider’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)
4. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC)

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How I considered this complaint

5. I contacted Mrs X and discussed her view of the complaint.
6. I made enquiries of the Care Provider and considered the information it provided. This included a draft residential contract, the Care Provider’s complaints policy and Mrs X’s complaint correspondence.
7. I wrote to Mrs X and the Care Provider with the draft decision and considered their responses before I made the final decision.

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What I found

Law

8. The Care Quality Commission (CQC) Registration Regulations 2009 issue guidance on how to meet the fundamental standards below which care must never fall. We use those fundamental standards as a benchmark in assessing injustice.
9. Regulation 19 requires care providers to provide a statement to service users clearly specifying the terms and conditions of the services to be provided.

10. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards those registered to provide care services must achieve.
11. Regulation 12 states care providers should assess the risks to service user’s health and safety during any care or treatment.

The Care Provider’s terms and conditions

12. The Care Provider’s contract terms state if the home is no longer able to meet the service user’s needs or the service user wishes to leave the home for any reason, either side must give four weeks’ notice in writing.

The Care Provider’s complaints policy

13. Service users should always be given the opportunity to make a formal complaint if they need to. Formal complaints may be made verbally to a senior person.
14. Every formal complaint will be investigated, and a response issued within 28 days.

What happened

15. Ms Y is elderly and suffers with dementia. Her niece Ms X oversees Ms Y’s care as she lacks the ability to make her own decisions.
16. Ms Y lived at the Care Provider’s residential home for several years until recently.
17. The Care Provider notified Ms X that its fees were increasing on 8 April 2020 with the increase due to take effect on 1 May 2020.
18. On 12 and 15 April 2020, Ms X contacted the Care Provider to complain that it had failed to give her the required 28-day notice about the increase. She said she wanted a breakdown of the new fees and a copy of Ms Y’s contract with the home. The Care Provider says Ms X used unacceptable language during their conversations.
19. Following this, Ms X made comments about the Care Provider on social media. Ms X says she did not say anything disparaging and shared information she had been given by other service users. The Care Provider says Ms X insulted its staff and indicated the Care Provider was mistreating Ms Y. The Care Provider says Ms X also said the home manager told her she could not move Ms X from the home due to the COVID-19 pandemic and this was not true.
20. The Care Provider recorded the following note on 15 April 2020, “Ms X has put things about the home on [social media], [The Care HomeOwner] is annoyed at this as people were putting negative/bad comments about us… the manager said that he would now be giving her notice due to what she had put on the internet for all to see.”
21. On 16 April 2020, the Care Provider wrote to Ms X and told her that because of her actions she had 28 days to remove Ms Y from the home. The Care Provider contacted the Care Quality Commission (CQC) and explained what had happened.
22. Ms X contacted the Care Provider on 17 April 2020 to discuss the situation. She told the Care Provider she was unhappy with the fee increase but she did not want to remove Ms Y from the home.
23. The Care Provider acknowledged Ms X would struggle to find an alternative placement, but it would not have further contact with her because her comments had upset staff at the home and the working relationship between them had broken down.
24. On 22 April 2020 the Care Provider wrote to Ms X and told her it would extend the notice period until the COVID-19 pandemic had passed. The Care Provider said this offer was conditional on Ms X agreeing to the fee increase and refraining from posting negative comments about the home on social media. The Care Provider told Ms X she could not directly contact the residential home and must only contact the head office. The Care Provider also said Ms X would need to provide an alternative contact for the Care Provider to communicate with and she could only contact Ms Y through skype or facetime.
25. In response to our enquiries the Care Provider has stated that government advice at the time required it to limit Ms X’s contact with Ms Y to window visits only. The Care Provider has also clarified that it suggested Ms X give Ms Y a mobile phone so she would be able to contact her directly without speaking to the care staff first.
26. Ms X decided to find a new Care Provider for Ms Y. Ms Y left the Care Provider’s home in June 2020.
27. On 5 August 2020 Ms X wrote to the Care Provider and requested a copy of Ms Y’s contract and a breakdown of fees requested. Ms X reiterated that the Care Provider failed to give appropriate notice of the fee increase. Ms X also complained the Care Provider failed to inform her Ms Y had been recently diagnosed with a serious health condition and told Ms Y’s new Care Provider that Ms Y could be aggressive, but this was not the case.
28. Ms X brought her complaint to the Ombudsman as she remained unhappy with the situation.
29. In response to the Ombudsman’s enquiries, the Care Provider confirmed it did not give Ms X the required notice of the fee increases but delayed the increase to ensure Ms X received the proper notice period. The Care Provider said it was not aware Ms Y was suffering with a serious health condition and provided notes showing it was in the early stages of investigating Ms Y’s health with Ms Y’s GP when she left its care. The Care Provider said it did not tell Ms Y’s new Care Provider that Ms Y was violent but has provided notes recorded by staff at the home which describe Ms Y as displaying aggression occasionally. The Care Provider has confirmed that it has waived £500 outstanding arrears on Ms Y’s account as an act of goodwill.

Findings

30. Ms X complains the Care Provider served notice on Ms Y because it was unhappy with the comments she had made about its service. The Care Provider has confirmed the comments led to a relationship breakdown between it and Ms X and it served notice on Ms Y for this reason. Having reviewed the terms and conditions of the Care Provider’s residential contract, I consider the Care Provider acted with fault when it took this action. I understand the relationship between the Care Provider and Ms X had deteriorated, but the Care Provider’s contract terms do not cite it can terminate a contract due to poor relations between it and the service user or the representative. Additionally, the Care Provider is required to consider the impact of its actions on the health and safety of its residents. I cannot see that the Care Provider considered how a move to another home might affect Ms Y or that it took action to ensure the move would not negatively impact her health. I do not consider this fault caused Ms Y or Ms X a significant injustice as the Care Provider later retracted its intention to serve notice.
31. Ms X has complained the Care Provider restricted her from visiting Ms Y following their disagreement. The Care Provider offered to extend the notice period on the condition Ms X limited her contact with Ms Y to phone and skype. The Care Provider also designated a single point of contact for Ms X. Neither the Care Provider’s complaints policy or contract terms and conditions make provision for the Care Provider to limit contact between representatives and their relatives in this manner. I cannot see in the correspondence provided that the Care Provider informed Ms X that these restrictions were due to COVID-19. I would also expect the Care Provider to confirm how long it intended to restrict Ms X’s communication with Ms Y in line with good administration practice. Further, I cannot see that the Care Provider considered the impact limiting Ms Y’s contact with Ms X would have on her mental health. This is fault. As Ms X opted to move Ms Y to another residential home shortly after this, I do not consider this fault caused Ms Y or Ms a substantial injustice.
    
    Ms X states the Care Provider did not tell her Ms Y was suffering from a serious health condition when she left its care. The care notes the Care Provider has provided show the Care Provider contacted Ms Y’s GP to investigate the cause of some health issues she was experiencing, but the GP had not determined what she was suffering with when she moved into another Care Provider’s care. I am satisfied the Care Provider acted in line with what I would expect on this complaint point.

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Final decision

32. There was some fault in the Care Provider’s actions, but this did not lead to an injustice on Ms X or Ms Y’s behalf. I have completed the investigation.

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Investigator's decision on behalf of the Ombudsman