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A West London council has been found at fault by the local government watchdog after a vulnerable woman was found "on the floor, disorientated and injured" after council appointed care workers failed to intervene when she did not answer the door.
The woman, referred to as Mrs Y in the report, was known to have "cognitive decline" and faced "particular risks associated with poor nutrition and unsafe door locks". Despite this, Hillingdon Council's contracted care staff left the woman without ascertaining her condition when she did not open the door.
On the first day, February 9, Mrs Y opened the door and told the carer that she "did not need any support". On February 10 and 11, she did not answer the door, and in both instances the carer's office advised the carer to move on.
This violated the council's no reply policy and procedure. The policy states that if a service user does not respond, "under no circumstances will the attempt to establish the service user's safety be discontinued until the exact circumstances are known, or the matter has been placed in the hands of emergency services".
The policy also mandates that a manager should attempt to contact the service user's emergency contact (Mr X, her son) and social worker. This was not followed.
After Mr X, who lives in Ireland, was unable to reach his mother by phone for a few days, he asked a neighbour to check in on her. The neighbour found Mrs Y "on the floor, disorientated and injured," requiring paramedics and hospital admission.
When the neighbour found Mrs Y, the house was extremely cold as the heating had been turned off for days. There was also evidence that Mrs Y had fallen in the kitchen.
Mr X noted that the front door was unlocked. This contradicted the social worker's claim that carers had been unable to gain access.
One month before the incident, a social worker carried out a home visit after Mr X requested a residential placement due to the risks Mrs Y faced. The council decided this was not the "least restrictive option" because Mrs Y was independent and reluctant to engage with help.
The council decided to commission a short-term community-based package of care (four visits a day) to further assess her needs without doing it on her terms. It also noted it would consider conducting a mental capacity assessment due to Mrs Y's lack of engagement, in order to establish if she had the mental capacity to make decisions about her care needs.
The Local Government and Social Care Ombudsman found that the failure to follow the no reply procedure amounted to fault on the council's part. She added: "The care provider left the situation on two days running not knowing Mrs Y's circumstances and whether she was safe.
"No contact was made by the care provider with either the social worker or Mr X."
Hillingdon Council was ordered to apologise to Mr X and Mrs Y and make a payment of £500 to recognise the distress caused. The council must also provide details of the actions taken by the Quality Assurance Team to specifically address the issues that are highlighted by this case and to prevent similar situations.
A Hillingdon Council spokesperson said: "We accept the decision of the Local Government and Social Care Ombudsman and the recommendations to improve our services. We have apologised to and compensated the complainant (the cost has been recouped from the care provider), and the council’s quality assurance team is working closely with the care provider to improve their practices, monitor their performance and ensure this does not happen again."
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