The Local Government and Social Care Ombudsman has issued a good practice guide for care providers based on the complaints it received and, in a growing number of cases, has upheld.
The Local Government and Social Care Ombudsman investigates councils’ adult social care departments and the services they provide, working in tandem with the Care Quality Commission (CQC). While the CQC monitors, inspects and regulates services to ensure they meet standards of quality and safety, the ombudsman deals with complaints from individuals where something has gone wrong that personally affects them. Where its investigations have found fault, the ombudsman can make ‘recommendations’ to remedy that fault.
Ombudsman can only make recommendations for improvement
Those ‘recommended remedies’ could be in the form of an apology, a financial payment or a reassessment of services or ‘suggested’ wider improvements to training and procedures. These remain ‘suggestions’ and ‘recommendations’ however. The ombudsman lacks the authority to impose penalties or demand changes. It comments primarily on how well or fairly any given complaint has been handled and expresses the hope that providers will learn lessons from the complaints it receives.
Increase in number of complaints – and number upheld
Common complaints to the ombudsman include disputes about fees or problems with billing and invoices. Since 2010 - 2011, the ombudsman has investigated more than 2,000 complaints and reports a steady year-on-year increase in the number of enquiries it receives. This could be partly attributed to greater awareness of its function, but of more concern is the steady increase in the uphold rate of the complaints it investigates.
Last year (2018) 69% of investigations into complaints about care providers were upheld, compared with 62% in 2017. Equally worrying is the fact that a growing number of those complaints concerned basic care issues such as out-of-date care plans or a failure to complete a comprehensive assessment.
Out of date care plans and no assessments
One such complaint is highlighted in their good practice guide report – ‘caring about complaints: lessons from our independent care provider investigations’. An individual identified as ‘Jerome’ had dementia and terminal cancer. His daughter complained about a number of issues concerning the quality of care he received. The ombudsman’s investigation found the care provider did not keep comprehensive or up-to-date care plans nor was an adequate assessment of his mental capacity carried out.
That failure was mirrored in the case of Jane Olive Parker, who transferred to a care home in Tameside, Greater Manchester and choked to death after being given an inappropriate meal. There too staff did not assess her directly, no new care plan was put in place and crucially the existing care plan made no mention of her well documented choking risk and erroneously stated that Mrs Parker should be on a Stage 4 rather than a Stage 3 diet.
‘We can only hope that providers, whether delivering care in a residential context or in the person’s own home, are indeed encouraged to adopt best practice. Ensuring that care plans and assessments are up-to-date and accurate would seem to be the obvious first step to do just that, but our experience and that of the ombudsman itself suggests there is still some way to go before many of those providers take those lessons on board.’