The Local Government and Social Care Ombudsman says that councils and care providers need to learn urgent lessons about accountability and safeguarding.

The Local Government and Social Care Ombudsman is urging councils and care providers to learn urgent lessons about accountability and safeguarding, after an investigation found an elderly Portsmouth woman received months of substandard care – including being fed dog food – while a statutory safeguarding inquiry sat unresolved for six months.

The Ombudsman’s report into Portsmouth City Council, which commissioned the home care from Radis Community Care, found the woman was subjected to what the council itself described as “a catalogue of errors”.

Care workers visited the woman, who was cared for in bed following a fall, several times a day to provide food, fluids, personal care and to administer medication.

But the council’s own safeguarding enquiry found concerns about staff allegedly falsifying records and not carrying out some visits despite them being recorded as having been undertaken, ignoring or not being aware of the woman’s care plan, not positioning her properly and not supporting her with her mobility, and feeding the woman inappropriate food, including stale and inedible food.

The council’s inquiry also found CCTV footage allegedly showing a care worker feeding the woman in a way the family considered forceful, providing medication in a way the woman could not independently access it, and unintentionally feeding the woman microwaved dog food which was recorded in the daily log as a “lamb dinner”.

Abysmal failures

“This is a truly shocking case, with abysmal failures,” said Local Government and Social Care Ombudsman, Amerdeep Clarke.

“In this case, a vulnerable woman’s care deteriorated over many months while a statutory inquiry drifted without proper oversight. It is a stark reminder that a council’s safeguarding duty does not end when a contract is signed. Councils must actively scrutinise the care they commission – especially where concerns already exist about a provider,” she continued.

The Ombudsman’s report also highlights failures of oversight by Portsmouth City Council. When safeguarding concerns were first raised in April 2024, the council opened an enquiry. Its own local policy sets a 28-day completion target, but this was not completed until six months later in October 2024.

The Ombudsman found the council had treated Radis’ internal investigation as if it discharged its own statutory duty, without putting in place independent scrutiny, even though Radis was already being subject to a separate Large Scale Safeguarding Enquiry at the time.

The Ombudsman found the failings engaged the woman’s Human Rights under Articles 3 and 8, relating to degrading treatment, dignity and private life.

In this case, Portsmouth City Council has accepted the Ombudsman’s findings and has agreed to apologise to the family, refund the woman’s care fees for the period April to July 2024, and make symbolic payments totalling £1,000 to recognise the distress caused.

The council no longer commissions services from Radis.