05.01.17
LGO: Councils cannot ‘contract out accountability’ for care home services
The Local Government Ombudsman (LGO) has urged councils to hold social care providers accountable after complaints that an elderly woman lost one-third of her body weight in a care home run by Wokingham Borough Council.
The woman, Mrs X, who is in her nineties and suffers from aphasia, arthritis and osteoporosis, was admitted to Murdoch House, run by Four Seasons Healthcare on behalf of the council, in 2010.
By the time she was discharged in December 2013, her weight had fallen from 61.9kg to 41.4kg and her BMI was at 15, meeting the medical standard for malnourishment.
Mrs X’s daughter, Mrs A, complained about a number of issues, including her mother’s weight, a lack of activities for her to take part in and a lack of support from staff to help her walk, which led to her falling and breaking her hip.
In response to an investigation from the LGO, Wokingham council found that it had failed to carry out any reviews of Mrs X’s care because of an administrative error. Mrs X’s care plan was not updated to reflect concerns about her weight and Murdoch House had no activities co-ordinator or regular activities for residents.
The LGO also said that the care home didn’t keep a full record of falls. This was partly because it was operated by Southern Cross Healthcare until the provider failed and sold the home to Four Seasons in 2012, and some records were lost in the process.
The regulator concluded that Wokingham had failed to properly assess Mrs X’s care and had missed an opportunity to take action when Mrs A first raised concerns in 2012. It ordered the council to pay £3,500 to Mrs X and £500 to Mrs A.
To ensure that outsourced services were meeting the required standards for elderly people’s care, the LGO also recommended that the council’s future contract monitoring included specific checks of nutrition, activities and falls monitoring.
Dr Jane Martin, the LGO, said: “This case highlights the need to remind councils that when contracting out services to third parties, they cannot contract out the accountability for those services. Sadly, this is an example where a vulnerable woman and her family have suffered because their council has neglected its duty to them.
“I now urge Wokingham council to consider seriously my recommendations and take on board the changes it needs to make to ensure other people do not suffer in this way.”
The Centre for Health and Public Interest (CHPI) warned recently that standards in adult social care homes have declined significantly in the past 20 years as budget cuts make it harder for councils to control outsourced services.
The CQC has also predicted that care homes could collapse because of a lack of financial sustainability in the market.
Cllr Julian McGhee-Sumner, Wokingham Borough Council's executive member for health and wellbeing, said: “We are profoundly sorry for the poor care provided in this case, and for the distress this caused our care client and her family. The care she received was below the standard we expect from our care providers and we apologise that we did not identify these problems."
He added that the council was now "confident" that it had "fully addressed" the LGO's concerns.
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