Summary: Mrs B complained that the Care Provider unreasonably charged her for four weeks fees in lieu of notice when she moved her husband Mr B to a new home . She said she was not aware of the notice period and had not signed a contract. She was also unhappy with the standard of care Mr B received. We found the Care Provider did not make clear to Mrs B that it considered Mr B was a permanent resident. We have asked the Care Provider to make a symbolic payment of £200 to Mrs B for the distress caused.

The complaint

1. Mrs B complains that Silver Birch Care Home (the Care Provider) in respect of her husband Mr B:
• incorrectly charged Mr B over £4000 in lieu of notice when Mrs B moved him to another home on 23 May 2023;
• failed to inform her or her step-daughter (Ms D) that Mr B was considered a permanent resident from 8 March 2023;
• failed to provide a copy of any contract or paperwork confirming that Mr B was a permanent resident and subject to a four-week notice period; and
• failed to provide Mr B with an adequate standard of care while he was at the home.
2. This has caused Mr and Mrs B financial loss and distress.

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The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. If they have caused a significant injustice or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 34B, 34C and 34H(3 and 4) as amended)
4. 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

5. I have considered the complaint and the documents provided by the complainant, made enquiries of the Care Provider and considered the comments and documents the Care Provider sent. Mrs B and the Care Provider had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

6. Mr B has a progressive medical condition. Mrs B was his main carer at their home alongside a package of care from a care agency. He was paying for the cost of the care. In early 2023 Mrs B had a carer breakdown and Mr B went into the home initially for two weeks of respite care. This was arranged by a local carer support group and paid for privately by Mr and Mrs B.
7. On 23 February 2023 Mr B’s daughter Ms D asked the Care Provider if Mr B could stay there for another three weeks because Mrs B did not feel able to have Mr B back home. She asked the Care Provider to send invoices to Mrs B as Mrs B now wished to take care of the payments.
8. Ms D says she was pressured by the Home to sign a contract on 1 March 2023. This said the contract started on 6 March 2023 and could be ended by either party giving four weeks’ notice. She says she did not know what it said and she was not aware of the four week notice period. The Care Provider said it considered Mr B was a permanent resident from this point. It believed Ms D had confirmed this because she had cancelled a holiday on the basis Mr B was now staying at the Home.
9. In mid-March 2023 Mrs B raised several issues with the quality of Mr B’s care. She said he had fallen because the care staff put his call bell out of reach and he got up to go to the toilet. She also said his leg bandages were too tight and a friend had loosened them. She said his chair was unsuitable. She started to look for an alternative home for Mr B. She said the Care Provider was aware she wanted to move Mr B.
10. At the beginning of May 2023 Mrs B visited the Home and was concerned there were no staff on reception. She also said Mr B was in an unsuitable chair, there was a lack of care with his dressings, and he was not having regular movement to help heal his leg wounds. Mrs B had found an alternative home for Mr B and was having discussions with the local authority about the fees.
11. On 23 May 2023 Mrs B took Mr B to the new home. Ms D paid the fees up to the end of May 2023, but the Care Provider said fees of approximately £4000 were outstanding for the remainder of the notice period.
12. The Care Provider sent Ms D and Mrs B a reminder for the fees in November 2023. Mrs B paid them shortly afterwards but said she was going to make a complaint as she did not sign a contract, she was unhappy with the care and the staff were unprofessional.
13. In May 2024 she formally asked the Care Provider to waive the outstanding charge and complained about the care provided to Mr B. She said the delay in contacting them had been due to a delay by the local authority in completing the financial assessment.
14. The Care Provider replied saying that:
• Ms D told the Home by email in March 2023 that Mr B was going to be a permanent resident.
• On one occasion Mr B had slipped from his chair while a member of staff was present but did not injure himself.
• On another occasion a friend had removed Mr B’s bandages and applied a simple dressing. The out of hours nursing staff arrived but as Mr B was asleep it was agreed they would return during the day to dress his leg and there was no immediate risk to him.
• On another occasion he declined to be shaved but was assisted with other personal care.
• The chair had been assessed but the community physiotherapy team and he had a footstool to elevate his legs. He had been walking regularly with his frame.
15. Mrs B complained to us, and we decided to investigate this complaint in July 2024. In response to my enquiries the Care Provider has sent the daily care records which show that Mr B was attended to regularly, assisted with personal care tasks, monitored for fluid intake and his leg wounds were regularly checked and dressed. The records support the Care Provider’s complaint response detailed in paragraph 14 above.

Analysis

16. Mrs B removed Mr B from the Home with no notice. Regardless of whether Mrs B was aware of the notice period or whether Mr B was considered a permanent resident, she should have been aware that this would incur some extra charge in lieu of any notice.
17. However, I do not consider the Care Provider informed either Mrs B or Ms D that Mr B was a permanent resident from early March 2023. I agree Ms D signed a contract, but this did not explicitly refer to Mr B being a permanent resident and Ms D clearly signed it in a hurry and under pressure. I also do not think the email Ms D sent to the Home on 8 March 2023 was sufficient evidence for the Care Provider to conclude that Mr B was a permanent resident. It simply referred to Mr B being at the home now. I would expect the Care Provider to have confirmed the position in writing to Ms D and Mrs B when the contract was signed.
18. Mrs B did not sign a contract and was not aware Mr B was considered a permanent resident. So, there is no evidence she knew about the notice period and was caused distress when she received the invoice for the remainder of the notice period.
19. I accept there was some confusion between Ms D and Mrs B over who was responsible for the payments and the position changed during the period Mr B was there. However, this seems to add weight to my view that the Care Provider should have clarified in writing to Mrs B and Ms D, when Mr B became a permanent resident and the consequences of that change.
20. I have not found evidence to support Mrs B’s view that the care given to Mr B was inadequate. The care records are very detailed and indicate that Mr B was regularly attended to and cared for. Mrs B did not complain until she was asked to pay the outstanding fees.

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Agreed action

21. In recognition of the injustice caused to Mrs B I recommended the Care Provider, within one month of the date of my final decision pays Mrs B £200.
22. The Care Provider has agreed to my recommendation and should provide us with evidence it has complied with the above actions.

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Final decision

23. I consider this is a proportionate way of putting right the injustice caused to Mr and Mrs B and I have completed my investigation on this basis.

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Investigator's decision on behalf of the Ombudsman