The Local Government and Social Care Ombudsman (the Ombudsman) has issued a report on the impact of COVID-19 on local authorities and care providers, dealing with the significant increase in pressure on these services caused by COVID-19. The report covers the period 1 April 2020-30 November 2021, reflects on complaints made by service users and members of the public and identifies common issues arising from such complaints.
Adult social care made up 20% of all COVID-related complaints investigated by the Ombudsman during the period covered by the report. The report also deals with complaints relating to the other issues (including benefits and tax and education and children’s services) which make up the remaining 80% of COVID-related investigations. However, the key findings in the report arising specifically from upheld care complaints are as follows:
- Care plans were not properly developed and/or reviewed as circumstances changed.
- Inadequate record keeping of care provided during lockdown meant uncertainty about how users were supported.
- Pre-existing delays and backlogs in service delivery were exacerbated and compounded by COVID-19, which meant that important further actions were delayed.
- There were significant delays in carrying out Care Act assessments, sometimes preventing or delaying moves out of hospital or between providers.
- The needs of people receiving care were not put at the centre of decisions.
- Rules governing the use of PPE were not adhered to and/or fast-changing rules and procedures were not always adopted throughout an organisation’s practice.
- There was a failure to adapt promptly to the opportunity to reopen services as restrictions relaxed, including relaxing visiting rules as lockdowns ended.
- There were difficulties with prioritising key decisions about longer term care.
- There was inflexibility about the creative use of direct payments to secure appropriate care when normal provision was affected by lockdown.
- Relatives were given unclear advice about visiting people in care homes at the end of life stage.
- There were confusing changes and fluctuations in care, sometimes without the consultation required by the Care Act.
- There were various problems with transfers between hospital and care, and between different care providers, particularly involving reablement.
- Some changes to practice involved consultations which did not appropriately consider whether it was reasonable to make adjustments for people with disabilities.
- Complaints were handled poorly, exacerbating the impact of the faults in the care itself.
It is worth pointing out that these findings relate only to those complaints which were upheld, and that there were of course numerous complaints made during the relevant period which the Ombudsman did not uphold. Furthermore, the report strikes a more positive note when it confirms that organisations commonly incorporated the Ombudsman’s decisions in fundamental reviews of practice, to learn from their experiences of COVID-19. It therefore appears that lessons have been learned across the board and that hopefully the same mistakes are unlikely to be made again.
Nonetheless, the report states that COVID-19 exposed fault lines in council and care provider systems which were already present, and added pressure to pre-existing weaknesses caused by Government cuts. Dealing with complaints was stated to be a “casualty of the crisis”, with complaints teams struggling to cope due to being overstretched and under-resourced. It is therefore possible that the impact of COVID-19 may continue whilst a backlog of issues remains, and that more COVID-related complaints may be forthcoming. Whether that leads to claims is once again a wait and see…