Ombudsman criticises 15-minute care calls after investigation reveals three-minute care calls to woman with dementia

AN investigation into Warrington Borough Council by the Local Government and Social Care Ombudsman revealed an elderly woman with dementia was on occasions only receiving three-minute care calls, instead of the allocated 15 minutes.

Now Warrington Borough Council has been told to apologise, pay £500 compensation and review other cases, following an investigation by the Local Government and Social Care Ombudsman, regarding a complaint about care workers not staying for the allocated time and inaccurate invoicing.

Following the investigation, the Local Government and Social Care Ombudsman says Councils need to ensure any care visits they arrange give enough time for care workers to do their job properly.

The warning comes after Warrington Borough Council was found to have allocated 15-minute care calls to more than 300 people in the borough, despite national guidance stressing these were ‘not usually appropriate’.
In one case, which led to the Ombudsman’s wider investigation, care workers had sometimes stayed for just three minutes, despite the family paying for the full visit.
Michael King, the Local Government and Social Care Ombudsman, said: “At the heart of this investigation are people, often vulnerable, who rely on care visits to give them the dignity and quality of life they rightly deserve.
“We are increasingly looking at complaints from a human rights perspective – and councils need to consider the rights of service users to have a private life when commissioning or delivering care.
“Councils also need to make sure that the care they arrange is sufficient to meet people’s needs. When looking at visits which may require care workers to dress, wash or feed a person, 15-minutes is rarely enough.”

In the case investigated by the Ombudsman, a family initially complained about the care workers from an agency commissioned by the council, D H Homecare Limited, also known as Direct Health UK Limited, which provided care and support, not staying for the allocated time when visiting a relative with dementia, and about inaccurate invoices provided to them. During the investigation into that complaint, the Ombudsman became concerned about the 15-minute care calls the relative was receiving.
The Ombudsman used its powers to widen an investigation when it appears other people may be affected by similar issues. This led to the Ombudsman finding 313 other people in Warrington had also been receiving these short calls.
The Local Government and Social Care Ombudsman remedies injustice and shares learning from investigations to help improve public, and adult social care, services. In this case the council has apologised and agreed to pay the family £500 for the distress it has been put through.
The Ombudsman has the power to make recommendations to improve processes for the wider public.
In this case the council has been instructed to investigate a 10 per cent sample of the people currently receiving 15-minute care calls to see if this is enough to meet their needs. Should this sample review identify anyone who should not be receiving such calls, the council will carry out a full review of all 313 cases.

The issue came to light after Mr X complained about the Council and the Agency which provided care to his late mother Mrs Y who suffered from dementia. He said care workers did not stay for the allocated time and invoices were inaccurate. He also complained the response to his complaint was inadequate.
The care and support plan devised by the Council in March 2019 said Mrs Y needed help with personal care, toileting, eating and drinking, dressing, maintaining her home, moving about safely and maintaining relationships.
The Council commissioned three visits a day from the Agency: a thirty-minute call in the morning, and two fifteen-minute calls at lunch and tea. Mrs Y had two care workers for each visit because she needed two people to move and lift her.
Care workers logged their arrival and departure times on an electronic call monitoring (ECM) system using their mobile phone. The ECM system recorded the start and finish time so administrators could check timeliness and length of calls.
The ECM records for September to November 2019 showed:
On many occasions where care workers did not stay the full fifteen minutes for the lunch and tea calls: call times of as short as three minutes were recorded. Ten and eleven minutes also featured on the records; and several occasions where care workers stayed less than thirty minutes for the morning call.
The Council’s invoices charged Mrs Y for fifteen minutes and thirty minutes in line with the agreed schedule.
The report also found that the Council’s complaint response was inadequate. There was a failure to identify Mr X’s concerns about short times as a potential quality issue. Instead, the Council focused on Mr X’s complaint as one about billing. This was a missed opportunity to identify and take steps to rectify poor practice and was a further fault.

A Warrington Borough Council spokesperson said: “We currently contract around 10,500 hours of home-care per week in the community to help people remain independent in their own homes. Around 11% of all home-care packages delivered to people in Warrington are by 15 minute visits, which are usually for safe and well checks and activities that help people to regain and maintain their independence.
“We are confident that our approach is in line with legal requirements and is person-centred, reflecting the feelings and wishes of the person receiving support.
“Nevertheless, we accept the view of the Local Government and Social Care Ombudsman in their public interest report and are complying with the recommendations they have set out. We have already undertaken reviews of people in receipt of 15 minute calls to ensure they are appropriate, and we are planning further work in the next two months which will include independent assessment of our work. We will use the findings from the report and our own assessments to assure current and future service provision meets the required standards.
“We will continue to seek feedback and listen to the views of service users, their families and care providers to ensure high standards of care are delivered.”