Decision Date: 07th February 2020
Mrs X complained on behalf of her parents, Mr and Mrs Y.
Mrs and Mrs Y lived in their own home. The Council commissioned a carer to visit each day to help with things like personal hygiene and taking medication. The services included help to
- Get up in the morning, wash, dress and have breakfast;
- Settle them into their chair downstairs;
- Prepare lunch, use the toilet and settle again in their chairs;
- Prepare supper, use the toilet, wash, undress and get into bed;
- Take medication.
From May 2019 the Council commissioned a new provider as the old one gave notice. Soon after, the Council started receiving complaints from numerous people, including Mr and Mrs Y, about the care being received.
Mrs X complained that carers were late, left soiled sheets unchanged, failed to shower Mr and Mrs Y, and failed to help with other personal hygiene matters. One example Mrs X gave of late attendance was a carer showing up at 11am instead of 8am.
This was a list of the complaints:
- Late arrivals to deliver care, and at least one care session missed;
- The contractor had nobody available to take calls when Mrs X or Z tried to call them to find out what had happened with the carer;
- Beds not changed when wet. The care plan says carers should check the beds because Mr and Mrs Y suffer incontinence and if wet, put the bedding in the washing machine;
- The carers on occasion failed to shower Mr and Mrs Y, or shave Mr Y as set out in the care plan;
- Failure to help Mr and Mrs Y use equipment;
- Failure to dress Mr and Mrs Y suitably;
- Failure to help with personal hygiene and put teeth in;
- Putting eye drops in the wrong eye;
- Failure to apply skin creams at the right time.
Throughout June 2019 there were numerous meetings between the social worker, Mrs X and the contractor, resulting in the contractor and its branch manager agreeing to take action to improve punctuality and standard of care.
However, in July, Mrs X told the social worker that despite there being some improvements, they were still unhappy with the contractor.
The family insisted on ending the Council’s service on 25 August 2019 and with help from the social worker hired a different contractor and paid for the care privately from choice.
The contractor’s documentation advised service users to contact the Ombudsman. Mrs X complained direct to the Ombudsman, although the service was a council commissioned service, not a privately arranged service. The Council has changed the complaints procedure to encourage families to complain first to the Council in such cases.
What was found
The LGO concluded that the care contractor failed to provide the standard of care Mr and Mrs Y and Mrs X could reasonably expect. It highlighted that nobody should be left in soiled clothes or bedding, as it is not going to preserve their dignity.
The LGO said that the contractor failed significantly to provide the care at the right times and to the right standard. As the Council’s contractor, the Council was responsible for the poor care. “We expect councils to carefully oversee the care delivered and to swiftly take up any concerns raised by clients.”
Despite the social worker taking action throughout June, the LGO stated that the Council ‘did not do enough to ensure significant improvement leading to a service equal to the service previously enjoyed by Mr and Mrs Y’. The new service should have met the same standard as the previous care.
The failings in care amounted to fault, and resulted in significant distress for Mr and Mrs Y, and Mrs X. The LGO recommended the Council apologise and pay Mrs X £750.
Points for the public, families, service providers, councils, etc.
This report makes it clear that quality issues are not always just the fault of the provider. If a council owing Care Act duties to a person or a couple as here chooses to contract that service to a provider, the council cannot get out of the obligation inherent in the duty to meet needs, to meet needs adequately and appropriately and to a reasonable standard.
There was an era some years ago when directors of adult services went on record saying that they didn’t need contract monitoring staff because CQC was there to regulate providers. How naïve that must have seemed, and how unaware of the local government legal framework for securing best value.
Under the Care Act, if a council contracts with a provider for hands-on care, then it is the customer and the provider owes a duty of CARE through that contract to the service user.
If the person spends their own money, or has a council funded direct payment instead of a care package of services the system is that they contract privately with a provider, and are responsible for sorting out their own issues with the standards. But in either case they can go to the Ombudsman about a complaint if it is not properly dealt with to a person’s satisfaction.
That is perhaps the reason that the new provider, unused to be commissioned by the council, had apparently contractual documentation in place advising its clients to go direct to the Ombudsman.
This report underlines that if the care is council commissioned, the council is primarily liable for sorting out complaints of inadequacy after one has raised them with the provider, informally; if the council doesn’t do a good job there, one can take it further to the Ombudsman later.
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The full Local Government Ombudsman report of Wakefield City Council’s actions can be found here