Ombudsman warns councils over care home contracts

Good guidance practice issued care providers
Michael King, Local Government and Social Care Ombudsman

Local authorities have been told not to allow care homes they work with to have subsidiary contracts with clients.

The warning comes from the Local Government and Social Care Ombudsman after Leeds City Council allowed Indigo Care Services Ltd, which trades under the name Orchard Care Homes, to have a second contract with a woman it had placed in the provider’s Paisley Lodge care home in the city.

The woman’s family complained to the ombudsman about several issues. These included their 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 pandemic. Payment and funding arrangements were also confusing, the family said.

An investigation by the ombudsman found, 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 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,’ said Michael King, Local Government and Social Care Ombudsman.

Complaints about the care home’s delay in registering the mother with a GP, and about her standard of appearance and missing possessions were all upheld. However, it did not uphold the complaint about visiting arrangements during the pandemic.

Both the council and care provider have agreed to improve their contracting arrangements.

They will each pay the family £300 for the distress and time and trouble caused. The council and care home will pay £200 and £100 respectively to the mother’s estate for her lost clothing and possessions. The authority 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.

The ombudsman said it published the report because it considered it in the public interest ‘given the injustice caused to the complainants and the wider systemic problems around charging the complaint has revealed.’

Leeds City Council 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 its own agreements.

Accepting recommendations, a council spokesperson, said: ‘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.’

It added it was looking at implementing improvements including having a single contract between three parties – the council, the person requiring the care and the care provider; reviewing written guidance to providers; redrafting customer leaflets on care charging; and explaining updated contract arrangements and guidance to customers and their family.

Indigo Care Services agreed to 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’.

Indigo Care Services did not wish to comment when contacted by CMuk.