A woman has received £100 and an apology from a London council after two care visits to her home were missed following her being discharged from hospital. The Local Government and Social Care Ombudsman also found Westminster City Council at fault for delays completing a mental capacity assessment for the woman.
A spokesperson for the council said the service has since been reviewed and that it has ensured ‘all parties involved with this case have learnt from this incident’. According to a recent decision published by the Ombudsman, the woman, named Ms C, was admitted to hospital with an infection in June 2022.
She was discharged later that same month with a care and support plan of three visits daily by provider Sagecare, before being admitted to hospital again the following month after feeling unwell. Westminster carried out a care review a few days later and opted to increase Ms C’s plan to four visits daily.
This was due to resume on July 25, the day she was discharged from hospital. However, at a visit on July 27, her carers realised no-one had stopped by over the previous two days. Sagecare subsequently raised a safeguarding concern with the council.
Ms C’s son, known as Mr D, made his first complaint to the council a day later raising concerns including the support and communication from Sagecare. The council apologised the following month and arranged a follow-up assessment.
Ms C was subsequently placed on a waiting list for the Extra Care service, a specialist form of housing for older people. She was assessed in August 2023, though said she did not wish to move from her flat.
In December that year, Ms C was visited by a social worker investigating concerns raised by Sagecare that she had refused support and her health may be declining. The social worker reported Ms C was able to remain at home with support, and the council reduced the number of visits to two daily after she said she did not need the four visits previously prescribed.
Sagecare again raised concerns about Ms C’s declining care in January 2024. Westminster then made a referral to the GP for a capacity assessment. Later that month Mr D filed a second complaint regarding the care the council was providing his mother.
The council responded by saying it was awaiting the GP assessment into Ms C’s mental state, that it cannot force her into supported housing, and that it had asked for a mental capacity assessment to be carried out as soon as possible. This was completed several months later.
Westminster City Council has apologised to Ms C and her son for the incidents raised in the Ombudsman’s report
(Image: LDRS)
‘Nothing to prevent’ earlier assessment
In their report, the Ombudsman found the council had regularly reviewed Ms C’s needs, though it should have questioned whether she was capable of declining support earlier than it did. According to the report: “Sage Care [sic] raised concerns with the council in early January 2024 that Ms C was refusing care and potentially putting herself at risk. So at this point, the council should have raised the question as to whether Ms C had the capacity to make the decision to refuse care. It made a referral to the GP several weeks after concerns were raised, but there was nothing to prevent it carrying out its own capacity assessment. It did not do this. This was fault.”
The Ombudsman however notes the ‘injustice’ caused to Ms C was limited, and that the completed assessment found she did have the capacity to make decisions about her care. There was also fault found in the visits Sagecare missed between July 25 and 27.
“[Westminster] said a charity took Ms C home when she was discharged from hospital, and Ms C had asked it to give her the keys to her home instead of it putting them back in the key safe,” the report reads. “The charity gave Ms C the keys and did not tell anyone about this. The council told me the care and support plan began again on 25 July 2022, and the carer carried out the scheduled care visits, but they could not gain entry to Ms C’s home.”
The Ombudsman adds the carer should have followed the council’s ‘no-reply’ policy, which would have escalated the case to Adult Social Care services, a welfare visit to Ms C and entry to her home. They wrote: “This fault meant Ms C went without care for two days, until access to her home was gained on 27 July 2022. It also caused distress to Mr D when he became aware of the situation.”
Agreed actions include the council apologising to Ms C and Mr D and paying Ms C £100, as well as briefing staff on the importance of the ‘no-reply’ policy and other issues within three months. A spokesperson for Westminster City Council said: “This incident occurred in 2022 involving one of our home care providers. The council acknowledges that the two visits were missed and has already sent its sincere apologies to Ms C and Mr D for the distress caused.
“The service has since reviewed and put systems in place to prevent this from happening again, in line with the Ombudsman’s recommendations. The council has ensured that all parties involved with this case have learnt from this incident.”
A spokesperson for City and County Healthcare Group, which owns Sagecare, said: “We acknowledge the Ombudsman’s decision and are sorry for what our service user and her family experienced. We have reviewed our procedures and training to ensure the right lessons have been learned. The wellbeing of our service users is always our top priority.”
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