Bristol becomes latest council to be attacked by LGO over elderly care

The Local Government Ombudsman has attacked Bristol City Council for failing to take sufficiently robust action in relation to an elderly woman’s care, despite receiving a large number of serious safeguarding alerts.

It is the second time in under a week that a local authority has been sharply criticised by the Ombudsman over the provision of a poor standard of adult care.

The LGO last week attacked the London Borough of Bromley for “extraordinary and inexcusable” delays in reviewing the care of an elderly man who had been living in a home outside the area.

In this latest report the Ombudsman said Bristol had failed over a four-year period to monitor whether a placement for the elderly woman in a residential care home was meeting her needs.

Dr Jane Martin, the LGO, said she was particularly troubled in view of the number of serious safeguarding alerts the council had received during the time the woman was a resident. “Had more robust action been taken by the council, then the poor standard of care and treatment she received may have been detected far sooner,” she suggested.

The case related to the care of Mrs J, an elderly lady with dementia who required 24-hour care. The cost of her placement in the residential care home in Bristol was partly met by the council and partly out of her own funds.

In 2008 the Care Quality Commission – or the Commission for Social Care Inspection, CSCI, as it then was – rated the care home as a zero. The complainant’s son, Mr J, said that the standard of care his mother received during this period of time was poor and of great concern to the family. However, Mr J was not informed of the zero rating by the local authority.

Mr J eventually felt it was necessary to move his mother to alternative accommodation – identified by the family – following a “particularly appalling” incident at the care home in December 2008.

The cost of the placement at the new care home was more than the council would usually expect to pay, and Mr J felt he had no other choice than to make a ‘third party contribution’ to the cost.

Mr J complained to Bristol about the poor standard of care at the initial care home, the lack of support and advice he had received from the council about moving his mother to another placement and the financial contribution he had made for the new placement.

Bristol launched an investigation, which found that Mrs J had not had her personal care needs met for a number of months and that this had impacted negatively on her health and wellbeing. But the report concluded that Bristol had taken appropriate action to safeguard Mrs J.

The local authority’s report recommended a number of improvements to procedures which included informing relevant individuals when care homes had been zero rated. The council also apologised for its shortcomings and provided Mr J with a copy of its action plan to improve services.

The LGO concluded that there was maladministration in the council’s reviewing and safeguarding strategy, and expressed concern about the poor communication between the council and the family. She also decided that Bristol had not properly considered the circumstances around Mrs J’s move to an alternative placement, which had led to Mr J contributing to the cost.

Although the authority’s investigations did reveal faults, it appeared that the responsibility for the poor standard of care had been attributed directly to the care home.

The LGO concluded that, as the commissioner of the service Mrs J received, Bristol was responsible for the poor service received. It had failed to carry out adequate reviews and had delayed undertaking a series of monitoring visits (despite having instigated a placement ban). Had various measures been in place, the incident in December 2008 might have been prevented.

The maladministration had led to both Mr and Mrs J being caused significant distress, she added.

The local authority has told the Ombudsman that it has implemented further procedural improvements to address the difficulties highlighted in the LGO’s investigation and has agreed to review its action plans in light of the report.

Bristol has also agreed to:

• provide an apology for the faults identified in the LGO’s report
• make a payment of £500 to Mr J in recognition of the distress he has suffered and his time and trouble in pursuing the complaint
• pay financial compensation to Mr J equivalent to any contributions that he made towards his mother’s care costs for the period February 2009 to October 2009 in recognition of the failings that led to the move to a new care home, and
• make a further financial award to Mrs J of £6,000 in recognition of the council’s failings in providing a suitable standard of care and in failing to protect her under its safeguarding procedures.

Philip Hoult