The Ombudsman's final decision
Summary: Ms X complained that the Care Provider gave notice to Mr Y without waiting for advice. She says this caused immense stress and inconvenience to Ms X and the family and they would like the Care Provider to review its policies and procedures. We found no fault.
The complaint
The complainant, whom I shall refer to as Ms X, complains on behalf of her uncle, Mr Y. Ms X says Guysfield Residential Home (the Care Provider) could not meet Mr Y’s needs despite advertising that it deals with challenging behaviour and specialist dementia needs. It gave Mr Y notice without waiting for advice from the Council.
This caused Ms X and the family “immense stress and inconvenience”. They would like the Care Provider’s policies and procedures to be reviewed as they are concerned others could be affected by the same issues in future.
The Ombudsman’s role and powers
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. (Local Government Act 1974, sections 34B and 34C) 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) We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), as amended)
How I considered this complaint
I considered information from the Complainant and from the Council.
I sent both parties a copy of my draft decision for comment and took account of the comments I received in response.
Background
Fundamental Standards of Care The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards that registered care providers must achieve. The Care Quality Commission (CQC) has guidance on how to meet the fundamental standards.
CQC The Care Quality Commission (CQC) is the statutory regulator of care services. It keeps a register of care providers which meet the fundamental standards of care, inspects care services, and reports its findings. It can also enforce against breaches of fundamental care standards and prosecute offences.
Regulation 9 is about person centred care. The guidance says: “Providers must do everything reasonably practicable to make sure that people who use the service receive person-centred care and treatment that is appropriate, meets their needs and reflects their personal preferences, whatever they might be.”.
“When planning how to meet a person's preferences, providers should take into account, and make provision for, any impact this may have on other people using the service.”.
Regulation 12 is about safe care and treatment. The guidance says: “Providers must provide care and treatment in a safe way.”.
“Providers must do all that is reasonably practicable to mitigate risks.”.
“Only relevant regulated professionals or suitably skilled and competent staff must deliver care and treatment.”.
What happened Mr Y was admitted to Guysfield Residential Home in September 2021 following pre admission assessments which noted some confusion and hallucinations. The Care Provider decided admission was appropriate but soon after admission, Mr Y displayed verbal and physical aggression towards staff and residents.
In late November 2021, the Care Provider alleged that Mr Y assaulted another resident who sustained significant injuries. Those present at the time of the assault were not able to give a reliable account of the events. Ms X disputes that Mr Y was responsible and says the Care Provider was discriminatory in blaming Mr Y because he was the only male present at the incident. She suggests this was the reason the Care Provider assumed he was responsible.
The Care Provider gave notice to the Council a few days later and notified Ms X the same day by phone. It confirmed this in writing almost two weeks later. Mr Y moved in mid December. Ms X complained and the Care Provider responded. It noted that in the last two and a half months, it had noted nine incidents of verbal or physical aggression towards staff or residents.
A member of the family stated that prior to admission Mr Y had not shown any signs of aggression or using foul language.
Was there fault which led to injustice?
It is regrettable when someone with dementia is forced to move home, however, a care provider cannot ignore risks of violence to other residents and staff. In this case, it was a particularly serious incident involving significant injuries to another resident that triggered the Care Provider’s decision to give notice. It is required to do this if it cannot meet someone’s needs and the level of aggression attributed to Mr Y was significant.
It is not my role to decide whether the Care Provider was able to meet Mr Y’s needs, but to decide if it dealt with the decision to give notice properly. I am satisfied that it had good reason to decide it could not meet Mr Y’s needs adequately and protect the other residents at the home. The family had not seen any sign of aggression so it is unsurprising that the Care Provider did not recognise the extent of this when it decided it could meet his needs. I find no fault.
Final decision
I have completed my investigation and found no fault.
Investigator's decision on behalf of the Ombudsman