LGO raps Bromley for "extraordinary" delays in reviewing care for elderly man

The Local Government Ombudsman has attacked the London Borough of Bromley for “extraordinary and inexcusable” delays in reviewing the care of an elderly man.

The Ombudsman, Dr Jane Martin, said the man – Mr B – was living in unsatisfactory conditions at a care home (D House) arranged by Bromley but situated outside its area. Mr B had been receiving an inadequate standard of care “for a considerable period of time, perhaps as long as 18 months”, she said.

The key conclusions in the LGO’s report were:

• There appeared to be no doubt that care standards at D House were unsatisfactory, even if they were not always so bad as to warrant a change of care placement. A series of poor inspection reports dating back to the time of Mr B’s first placement should have put Bromley on alert that closer monitoring of the contract might be required, but it appeared not to have had significant contact with the ‘host’ local authority for the area in which the home was situated, if at all.
• “If, as the council says, it did not have the resources to carry out reviews of care provision out of its own area, then it could have asked Kent County Council to assist with information or a visit at the appropriate time, and not leave the matter until over a year later,” the LGO said. “Failure to follow either of these courses of action amounts to maladministration. I do not believe that the council’s reliance on any absence of complaint from the family during this time excuses this lack of proper attention to its statutory responsibilities.”
• A review in December 2007 highlighted some concerns about Mr B’s care provision and in February 2008 Mr A began to complain formally that the standard of care being provided to his father was unsatisfactory and that his health was deteriorating as a result. It took until December 2008 before Mr B was moved to another placement. “During this time the council appears only to have dealt with Mr A’s correspondence as matters of fees and finance, and its responses generally do not properly address the care issues which were being raised.” This was maladministration, the LGO said. She added that the council’s failure to ensure that adequate care was being provided was confirmed in its own investigation report in July 2009.

The LGO also found that Bromley had delayed significantly in properly investigating Mr A’s complaints, which he first made in February 2008. An investigation officer was not appointed until March 2009, and the report concluded in July 2009. The council’s response accepted the findings but did not offer a satisfactory remedy for the injustice flowing from its faults, according to the Ombudsman.

“In fact, the council’s position remains that it is not directly responsible for the standard of care provided to Mr B, and it has suggested more than once that Mr A pursues that with D House direct,” the LGO said.

Dr Martin said that position was “significantly flawed” for a number of reasons:

• Neither Mr A nor Mr B had any contract for service with D House; the contract was made by Bromley, and so D House could not be liable to anyone but the council for the service it provides.
• The Department of Health’s Charging for Residential Accommodation Guidelines make it clear that the council retains legal responsibility for a contract it arranges with a care provider, even if the resident must make a contribution to care costs, and whether or not it is paid directly to the provider
• The law says that the council has a statutory duty to provide care services which meet the needs of those persons assessed as having care needs which are eligible for services provided by the council. “So the council cannot escape responsibility for ensuring that services are of a satisfactory standard simply by contracting them out to a third party provider.”

"Overall, the council's failure through the complaint process to accept responsibility for what has happened to Mr B amounts to further maladministration which compounds its earlier faults, and has added to the injustice Mr B and his family have been caused," the LGO said.

The Ombudsman recommended that Bromley pay £1,000 to Mr B in recognition of the fact that his care was likely, on balance, to have been less than adequate, in addition to its agreement to write off £2,000 owing to the council. It also called on the authority to pay £1,000 to Mr A “in recognition of his separate injustice of uncertainty, distress, time and trouble”.

The LGO called on Bromley to: review its procedures for reviewing and monitoring care home placements; review its accounting procedures; review its complaints procedures so that the extraordinary and inexcusable delays seen in this case are avoided in future; and report to the Ombudsman in six months the outcome of its procedures review.

Philip Hoult