Ombudsman cautions councils against allowing multiple care home contracts to run in tandem

The Local Government and Social Care Ombudsman has warned councils against allowing the care homes they work with to have subsidiary contracts with clients.

The warning follows an investigation which revealed that Leeds City Council had allowed a provider to have a second contract with a woman the local authority had placed in one of its homes.

The woman behind the complaint informed the Ombudsman about several issues regarding the care of her mother.  These included her mother looking unkempt during one visit, items of clothing and other possessions going missing, and only being allowed ‘window visits’ at certain times during the COVID-19 pandemic. She also said the payment and funding arrangements were confusing.

The Ombudsman’s investigation found that, between June and November 2020, the care home had a second contract in place with the family to make up the difference between what it charged the council for the woman’s care, and its private rate. This was contrary to statutory guidance.

The daughter’s complaints about the care home’s delay in registering her mother with a GP, and about her standard of appearance and missing possessions were upheld by the Ombudsman.

The report noted: “Access to GP services will be something essential for all users of residential care. So, we consider this oversight a fault. It also calls into question whether the Care Provider kept adequate records in line with the fundamental standards at that time.”

The complaint about visiting arrangements during the pandemic was not upheld.

Michael King, Local Government and Social Care Ombudsman, said: “The woman’s family were given no choice but to sign the second contract with the home as a condition of acceptance of the care home placement, with the council’s full knowledge this was taking place. At the time, it was the council’s responsibility – not the family’s – to arrange their mother’s care, so they should not have been asked to do this.

“This has caused unnecessary distress and confusion for the family at what was already a difficult time.

“I am pleased the council and care provider have both agreed to my recommendations to improve their contracting arrangements so in future other families are not caused the same frustration.”

In this case the council and care provider have agreed to apologise to the family.

The Ombudsman report revealed that the council and care home will each pay the family £300 in recognition of the distress and time and trouble caused and will pay £200 and £100 respectively to the mother’s estate for her lost clothing and possessions.

Leeds City Council will also refund the mother’s estate £173 per week for the time she entered the care home until 8 November 2020. The care home will refund £33 per week for the same period, offset against the outstanding invoice for charges.

A Leeds City Council spokesperson said: “We welcome and accept the Ombudsman’s findings and we are now looking at reviewing our processes to implement the Ombudsman’s recommendations. We are sorry for the confusion experienced by the family as a result of two contracts being in place at the same time.

"We hope the Ombudsman can see that the council has at all times tried to come up with a process which is fair to care providers, whilst also ensuring that service users’ needs are met without delays. We are committed to listening to service users and their families. Understanding their experiences helps us to spot problems and drive improvements.

"The lessons we have learned from Mrs B’s experience and the care her mother received will help us to improve services for others, and we are looking at implementing a number of improvements including having a single contract between three parties – the council, the person requiring the care and the care provider; reviewing our written guidance to care providers; redrafting our customer leaflets on care charging; explaining the updated contract arrangements and guidance to the customer and their family.”

The council has agreed to end the practice of allowing providers to enter contracts with clients or their families to make additional charges for care that run alongside the council’s own contracts.

It will also review its financial assessments practice to avoid delays in the process.

The care home will meanwhile review its contract’s standard terms and conditions around notice periods and remove or revise any clause that refers to shortfalls between the rate paid by the local authority and its ‘full amount charges’.