Summary: The Council acknowledged failings in the domiciliary care provided to Mrs Y during this investigation, but it failed to offer a remedy for the injustice caused. We have made recommendations to address this.

The complaint

1. Mr X complains about the quality of domiciliary care provided to his mother, Mrs Y.

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 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

What I found

Relevant legislation

4. 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

5. Mrs Y is a senior citizen and lives in her own home. She received domiciliary care from St Gregory’s Homecare between 6 February 2024 – 31 July 2024. The care was commissioned by the Council.
6. Mr X had concerns about the quality of the care shortly after the service commenced. He contacted the care agency directly on 15 February 2024 saying a carer had not read Mrs Y’s care plan, and consequently had attempted to access Mrs Y’s home using the wrong entrance. In March 2024, he submitted further complaints about cleanliness. He said carers had left faeces on the bathroom floor, had not properly disposed of incontinence pads, left dirty tissues on the floor, not left a light on, putting Mrs Y at risk, curtains were left unopened and Mrs Y’s bed left unmade.
7. Mr X contacted the care agency again in May, June & July 2023 to report issues relating to duration of visits, shower schedules, medication issues, Mrs Y not wearing her alarm pendant and leaving the property untidy.
8. The care agency acknowledged Mr X’s emails and assured him it would investigate. In turn, it responded to some of the issues raised, and later wrote to him on 3 July 2024 responding to all the concerns raised. The author of the letter acknowledged failings in the standard of care provided and set out the action taken, which included, disciplinary action against one carer, further training of others, and procedural changes. The author assured Mr X of improvements to care delivery, and that Mrs Y visit schedule would be ‘more predictable’.
9. Mr X says the quality of care did not improve so he requested a change of care agency, which he says was a stressful process in itself, impacting on him and his wife. The care agency ceased providing care to Mrs Y on 31 July 2024. Mr X says carers did not turn up on the last day, which he says is a ‘perfect metaphor for their efforts’
10. Mr X submitted a complaint to this office. On reviewing the complaint, it appeared not to have gone through the Council’s formal complaint procedure, so we suspended the investigation for a short period to allow the Council to investigate. Mr X says he did raise his concerns with numerous officers at the Council and understood he had followed the correct process for doing so.
11. The Council contacted Mr X to discuss his concerns and subsequently responded to this office. It acknowledged the quality-of-service Mrs Y received fell below the standard that is expected and required and expressed its regret.
12. The Council says it had concerns about the quality of the service provided by the care agency before Mr X’s complaint and it had initiated a quality improvement process, which the Council says the care agency positively engaged with. A recent telephone survey showed improvements to service delivery have been made and the majority of service users are satisfied with the service.
13. The Council is satisfied with the progress made to date, and it will continue to monitor the improvement plan.

Analysis

14. When Council’s commission care services for a person they remain liable for the failures of the care provider. So even though Mr X complains about the care agency the Council is liable for the faults of the care agency.
15. People have a right to expect safe, effective, and appropriate care that meets their needs. This is not what happened here.
16. The Council acknowledges the service provided to Mrs Y was below an acceptable standard. Whilst it may not have had sight of a formal complaint from Mr X, it was aware of quality-of-care issues on a wider scale. It appears to have overlooked informal complaints from Mr X about this.
17. When alerted by this office, the Council had the opportunity to review the complaint and consider a remedy for the injustice caused. Although it acknowledges fault, it appears not have considered a remedy.
18. Mrs Y was subject to poor care, for which a remedy is required.
19. Mr X also suffered injustice, he was witness to the poor care Mrs Y experienced, and he was put to significant time and trouble pursing the matters with the care agency, the Council, and this office. For this a remedy is required.
20. In respect of the wider systemic issues, I am satisfied with the steps taken by both the Council and the care agency to address the failings, and improve service delivery. No further intervention is required by the office.

Back to top

Agreed action

21. The Council should, within four weeks of the final decision:

• provide Mrs Y with a written apology for the acknowledged failings by the care agecy, and pay her £500;
• pay Mr X £250 to acknowledge his time & trouble pursuing the complaint with care agency, and this office;
• provide us with evidence it has complied with the above actions.

Back to top

Final decision

22. The Council acknowledged failings in the domiciliary care provided to Mrs Y during this investigation, but it failed to offer a remedy for the injustice caused.
23. The recommendations above are a suitable way to settle the complaint.
24. It is on this basis; the complaint will be closed.

Investigator’s final decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman