Summary: We will not investigate this complaint about adult social care in a nursing home. This is because we cannot achieve the outcome the complainant wants; a payment for loss of earnings. It is unlikely an Ombudsman investigation would lead to a different outcome than the Council has already provided.

The complaint

1. Ms B says that poor care for her father, Mr C, and a lack of training for the staff working in the care home led to her stepping in and caring for her father. Ms B says this caused a significant loss of earnings and expenses and had an impact on her mental health. The Care Provider has given Ms B a payment, but it does not cover all her losses. Ms B has been trying to resolve matters with the Care Provider for over a year. Ms B has found the complaint process repetitive and time consuming.

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The Ombudsman’s role and powers

2. We investigate complaints about councils and certain other bodies. Where an individual, organisation or private company is providing services on behalf of a council, we can investigate complaints about the actions of these providers. (Local Government Act 1974, section 25(7), as amended)
3. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service but must use public money carefully. We do not start or continue an investigation if we decide:

• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome, or
• we cannot achieve the outcome someone wants, or
• there is another body better placed to consider this complaint.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

4. The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)

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How I considered this complaint

5. I considered information provided by the complainant.
6. I considered the Ombudsman’s Assessment Code.
7. I considered the Ombudsman’s Guidance on Remedies.

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My assessment

8. Mr C lived at Monkscroft Care Centre (the Care Provider). The Council arranged this placement to meet Mr C’s adult social care needs.
9. The Care Provider has accepted some failures and paid £4000 to Ms B to recognise the impact on her, and the financial impact of replacing some of Mr C’s items.
10. Ms B wants a substantial extra payment to cover her loss of earnings.
11. The Ombudsman’s Guidance on Remedies explains we do not normally recommend remedies that reimburse loss of earnings. We cannot usually, on balance, prove a clear and causal link between the fault and the claimed injustice of lost earnings. There are frequently other factors, personal circumstances and choices involved. Such payments are therefore best resolved by the courts. If complainants are only seeking such reimbursement, we may decide to end our investigation because we cannot achieve the sought outcome.
12. It is unlikely an Ombudsman investigation would recommend any further financial remedy than the £4000 given as a symbolic payment to acknowledge the impact on Ms B and the direct financial loss of replacing items. Mr C has since died, and so we can provide no remedy for his personal injustice. The Care Provider has also apologised to Ms B and taken action to improve service.
13. Ms B is also unhappy with the way the Care Provider on behalf of the Council dealt with her complaint.  But it is not a good use of public resources to look at the Council’s complaints handling if we are not going to look at the substantive issue complained about.  We will not therefore investigate this issue separately.
14. The Care Quality Commission (CQC) is the independent regulator of health and social care in England and has fundamental standards below which care should never fall. The Care Provider has accepted some failings which might be a breach of the fundamental standards, such as inaccurate record keeping.

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Final decision

15. We will not investigate Ms B’s complaint because we cannot achieve the outcome she wants; a payment for loss of earnings. It is unlikely an Ombudsman investigation would achieve anything further than the Care Provider’s investigation.
16. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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Investigator's decision on behalf of the Ombudsman