Council criticised for moving man from care home against own advice
The Local Government Ombudsman has sought to remind local authorities that “while they can contract out care for the elderly to private homes, they cannot contract out the responsibility”.
Dr Jane Martin’s comments came on the publication of a report into a case where an elderly man’s health deteriorated significantly after social workers at Worcestershire County Council moved him from a nursing home to a less suitable care placement.
The move occurred despite the authority's own assessment which found that it would be detrimental to his health and well-being.
The elderly man had a range of issues such as diabetes and epilepsy. He also had a history of stroke and heart problems, had limited mobility and was doubly incontinent. The man needed help to get around and support with his medication, eating and drinking.
He had limited communication and, because of his dementia, often displayed challenging behaviour. The first home provided the man with a quiet space to calm him when he became agitated, the LGO said.
When the area’s NHS trust removed the man’s funding, the county council sought an alternative, cheaper placement. The man’s family was unable to pay the top-up to keep him at the original home.
According to the Ombudsman, officers at Worcestershire failed to give the family correct information on ‘top ups’. Nor did they consider if the council should continue to fund his care at the original home even though it could have done so.
The LGO report said the alternative accommodation was not suitable, and within ten days of the move in early November 2011, the man’s condition had deteriorated.
A month after the move, the man’s son complained to social workers that he had developed pressure sores, was being fed pureed food and had been found in bed fully clothed and covered in sweat with two pillows nearly covering his face.
The son also told social workers that his father may not have been having skincare checks and bed changes, and that notes were missing from his records. Additionally, his father was being returned to his room regularly because he was ‘shouting out’.
The Ombudsman’s report said a safeguarding investigation was never completed.
Less than two months after the man moved to the new care home, he was admitted to hospital for pneumonia and dehydration. He died there in January 2012.
The son complained to the council about his father’s situation, but it failed to investigate under the statutory complaints process. According to the LGO, officers did undertake some investigations under the adult safeguarding process but that investigation was found to be inadequate. “The second care provider did undertake some investigation work, but this too was found to be incomplete. ”
Following the investigation, Worcestershire has agreed to:
- conduct a review of the understanding among relevant officers of the Choice of Accommodation Directions 1992 and arrange for any training required;
- introduce a procedure to manage cases where residents of residential care become eligible for council funding of placements;
- conduct a review to check all social care staff have basic awareness on how to identify a complaint, the social care complaint procedure and its interaction with adult safeguarding procedures, and arrange any training required;
- review standard contract arrangements with care providers with regard to complaint handling;
- apologise to the complainant; and
- pay him £1,500 in recognition of the distress caused to him and his mother and the time and trouble in pursuing the complaint.
The Ombudsman said it had also sent a copy of the report to the Care Quality Commission.
Dr Jane Martin, Local Government Ombudsman, said: “Worcestershire County Council’s social workers ignored their own recommendations which stated that any move would have a detrimental effect on the man’s health and well-being and should have considered if any move should take place in these circumstances.
“While I cannot say that the new home and carers themselves caused the man’s condition to deteriorate, it is significant that the his condition did worsen once he was moved. The council should have done more to check that the placement at the second home was suitable, and officers should have done more to follow up the son’s concerns."
Dr Martin added: “I would like to remind councils that while they can contract out care for the elderly to private homes such as this, they cannot contract out the responsibility. In cases such as these, the actions of the care provider in carrying out these arrangements shall be treated as actions of or on behalf of the council.
"While you cannot put a price on the loss of a loved one, I have recommended a financial payment to the family in recognition of the stress and strain this situation must have placed them under."