Summary: The Council acknowledged it failed to properly deal with Mr X’s complaint about his wife’s care properly before a complaint was made to this office. It apologised and offered a satisfactory remedy. There is no outstanding injustice that requires intervention from this office.

The complaint

1. Mr X is dissatisfied with the financial remedy offered by the Council in acknowledgement of his complaint about the care provided to his wife, Mrs X by care agency. The care was arranged by the Council.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• we could not add to any previous investigation by the organisation; or
• further investigation would not lead to a different outcome.

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What I have and have not investigated

3. As the events occurred 18 months ago, the complaint is late and out of time. However, as Mr X only became aware of insurance information relating to the number of carers allocated, I have exercised discretion to deal with this aspect of the complaint. Issues relating to the quality of the care will not be considered.

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How I considered this complaint

4. I have:

• considered the complaint and the information Mr X provided;
• considered correspondence between Mr X and the Council, including the Council’s responses to the complaint;
• made enquiries of the Council and considered the responses;
• considered relevant legislation;
• offered Mr X and the Council an opportunity to comment on a draft of this document, and considered the comments made.

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What I found

Relevant legislation

5. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards those registered to provide care services must achieve. The Care Quality Commission (CQC) has issued guidance on how to meet the fundamental standards below which care must never fall.

Key facts

6. Mrs X has dementia along with other health issues and requires full assistance in all areas of daily living. She lives at home with Mr X. Mr X has been Mrs X’s main carer for many years, along with some support from other family members.
7. Mr X contacted the Council’s social services in early 2023 asking for support to care for Mrs X. The Council completed a Care Act assessment in February 2023 I have had sight of this document, part of which records Mrs X to be unable to fully weight bear. The assessor deemed Mrs X to require two carers.
8. The support plan sets out the assistance Mrs X required, and that she required two carers.

Mrs X received domiciliary care from a care agency commissioned by the Council for a period of three weeks. She is a full cost payer; this means she does not receive any funding towards her care from the Council. However, as the care was arranged by the Council, it is the Council that holds responsibility for the actions of the care agency, and any failings by it.

9. Mr X says the care agency allocated two carers to Mrs X, when only one was needed. He requested only one carer, but he was informed by the care agency that its insurance policy would not allow this. Mr X later obtained a copy of the care agency’s insurance policy via a freedom of information request, which did not concur with the claims made by the care agency.
10. Mr X submitted a formal complaint to the Council in May 2023. He asked the Council to reimburse the fees for the second carer. The Council responded in September 2023. The author of the letter said such issues were a ‘care agency basis’, which social services had little influence over. The Council refused to reimburse any care fees.
11. Mr X corresponded with the Council further and received a second complaint response in December 2023. In this response the author explained two carers had been provided because Mrs X’s support plan, completed by the Council, identified this as a need. Therefore, the Council had requested the care agency provide two carers. The Council maintained its position on the reimbursement of fees for the second carer.
12. Mr X corresponded with the Council further setting out his disagreement with the Council’s position. The Council provided a final complaint response in May 2024. The author of the letter maintained the earlier position on the allocation of two carers, but did identify shortfalls in the way the Council dealt with Mr X’s complaints about this. The author acknowledged delays in responding to Mr X and confirmed not all the points raised by Mr X had been responded to. The Council offered Mr X £300 in acknowledgement of this, and for his time and trouble pursuing the matter.
13. Mr X does not believe this to be sufficient and is seeking an additional £1020 as reimbursement for a second carer he believes was unnecessary.

Analysis

14. It is not the role of this office to determine how many carers a person’s needs, that is the Council’s role. In this case the Council deemed Mrs X to need two carers. There is no fault in the way Council assessed Mrs X so I cannot comment on the decisions made.
15. The Council requested the care agency provide two carers for Mrs X. It was not wrong to do so. This was in accordance with the assessment and support plan. I realise Mr X requested one carer, but it was the role of a professional assessor to determine Mrs X’s needs in respect of formal care. There is no fault by the Council here. It is not at fault for refusing to reimburse the fees for the second carer.
16. The care agency had a duty to provide two carers. Whilst I cannot comment on the details of the care agency’s insurance policy, it is probable that it stipulates it must adhere to the requests from its commissioner, in this case, the Council. The care agency was not at fault.
17. Had the Council been clearer about the need for a second carer, and who had made this decision, then the confusion may have been avoided. The Council acknowledged it failed to respond to Mr X’s complaints properly, before the complaint came to this office. Its written apology and offer of a £300 remedy payment is satisfactory.
18. There is no outstanding injustice that requires intervention from this office.

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Final decision

19. The Council acknowledged it failed to properly deal with Mr X’s complaint about his wife’s care properly before a complaint was made to this office. It apologised and offered a satisfactory remedy. There is no outstanding injustice that requires intervention from this office.
20. It is on this basis; the complaint will be closed.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman