Summary: We will not investigate Mr B’s complaint about treatment and care provided to his late brother, Mr C, by the Trust and the Council. This is because it is unlikely an investigation would find fault.

The complaint

1. Mr B complains that Mid Yorkshire Teaching NHS Trust (the Trust) provided poor care to his late brother, Mr C, while he was in hospital on six separate occasions over a period of several months. He complains the Trust put a do not attempt cardiopulmonary resuscitation (DNACPR) in place. He also says the Trust did not provide physiotherapy to Mr C and that he developed pressure sores.
2. Mr B complains that Wakefield City Council (the Council) discharged Mr C to a care home that could not meet his needs and was far from his family. Mr B says the Council was going to carry out adaptations to Mr C’s home but this did not happen. Mr B says he tried to contact the social work team to discuss Mr C’s care but got no response. Mr B also says the Council is asking him to pay £1776.68 towards the care home fees.
3. Mr B says that he feels he has had no closure because the organisations are not taking responsibility for what happened to Mr C.
4. As an outcome of his complaint to the Ombudsman, Mr B said he seeks improvements to procedures and disciplinary action.

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The Ombudsmen’s role and powers

5. The Ombudsmen have the power to jointly consider complaints about health and social care. Since April 2015, these complaints have been considered by a single team acting on behalf of both Ombudsmen. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA)
6. The Ombudsmen investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, the Ombudsmen consider whether it has caused injustice or hardship. (Health Service Commissioners Act 1993, section 3(1) and Local Government Act 1974, sections 26(1) and 26A(1), as amended)
7. The Ombudsmen provide a free service, but must use public money carefully. They may decide not to start or continue with an investigation if they believe:

• it is unlikely they would find fault, or
• they cannot achieve the outcome someone wants. (Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

8. I considered information from Mr B, the Trust and the Council.
9. I considered the Ombudsman’s Assessment Code.
10. Mr B had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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My assessment

11. Mr C attended the Trust’s emergency department after he fell at home. He was diagnosed with a broken femur and had surgery. Mr C remained in hospital for physiotherapy. The Council’s adult social care team was involved in planning Mr C’s discharge from hospital.
12. Mr C had several more hospital admissions over the following months. He was initially discharged to the same care home. However, following his next hospital admissions, he was discharged to different care homes. The Council said this was because the previous homes could no longer meet Mr C’s needs. Sadly, Mr C died in June 2023.
13. Mr B complained to the Trust and Council about Mr C’s care.
14. Regarding Mr B’s complaint about DNACPR, the Trust said because Mr C had increased confusion, it tried multiple times to contact his next of kin about the DNACPR at the time, but was unable to make contact. The Trust said it contacted Mr B the next day and the medical staff discussed DNACPR with him then. The Trust apologised to Mr B for not discussing the DNACPR with him and Mr C at the time. The Trust’s explanation that it tried to contact Mr C’s next of kin at the time, and spoke to Mr B the next day, appears reasonable and in line with the General Medical Council guidance, Good Medical Practice. Therefore, my view is an investigation would be unlikely to find fault on this issue, or to add to the explanation Mr B has already received from the Trust.
15. Mr B raised concerns that the Trust did not provide Mr C with physiotherapy during his time in hospital, and said he developed pressure sores. The Trust said Mr C was referred for physiotherapy the day after his initial surgery, and that he had pressure ulcers when he first went into hospital. The response provided details from the records of physiotherapy provided to Mr C during his first three admissions to hospital. The Trust said sometimes Mr C would engage with this and sometimes he did not. The Trust said during his later hospital stays, it was documented that Mr C was unlikely to regain independent mobility because of his medical issues. An investigation would be unlikely to find fault with the Trust for not providing physiotherapy, as the response sets out details of the physiotherapy provided.
16. Regarding the choice of care home, Mr B said he did not want Mr C to go the care home chosen in March 2023, as it was too far away from his family. In responding to Mr B’s complaint, the Council said it had contacted 22 different care homes in the area when planning Mr C’s discharge from hospital, but none of them could meet Mr C’s needs. The Council said its hospital social work team explained this to Mr C and Mr B before he left hospital. It said any alternative home would be further away. The Council referred to its records of this discussion, which said Mr B was not fully happy with the choice of care home but that he understood there were no other suitable options at the time.
17. Mr B explained he recalls making it clear that he did not want Mr C to go to the care home. I recognise Mr B’s view that he was not happy with the choice of care home, and that he has a different recollection of this discussion. Given the different recollections, it is unlikely that an investigation would be able to determine exactly what was said during this discussion. This does not mean I dispute Mr B’s recollection, but my view is an investigation would be unlikely to find fault by the Council regarding the discussion about choice of care home.
18. Mr B complained he tried to contact the social work team to discuss Mr C’s care but got no response. The Council said that when Mr B contacted it with his concerns, the social worker telephoned Mr B to discuss this the next day. The Council also said the social worker visited Mr C that day to ask his views about the care home, and recorded that Mr C said wanted to move to another placement. The Council said the plan agreed between Mr C and the social worker, was that Mr C would stay at the care home while waiting for an assessment from the community therapy team and, once that was completed, the social worker would support him with finding a new placement. However, sadly Mr C became unwell and was admitted to hospital.
19. The Council’s response said it took steps to address Mr B’s concerns by speaking to him, visiting Mr C to discuss his care, referring Mr C for an assessment, and planning to support him with finding a new placement. The response quotes from the Council’s records of the discussion that took place during the visit. Mr B said his own records show he contacted the care home and there was no social care visit at this time. I recognise Mr B’s own record of what happened with the visit to Mr C is different from the Council's response. However, even if there were fault by the Council in relation to the visit, any injustice caused to Mr B by this issue alone would not be sufficient for us to investigate.
20. Mr B also complained that the Council is asking him to pay £1776.68 towards Mr C’s care home fees. The Council said it had discussed finances with Mr C before he left hospital in March 2023, and that Mr C had told the social work team Mr B was supporting him with his finances. The Council then discussed this with Mr B and later sent him an invoice. Mr B explained to the Council he did not have access to Mr C’s finances. It is unlikely an investigation would find fault with the Council on this point, because the Council said it contacted Mr B about finances following information from Mr C. After Mr B had explained he was not involved with his brother’s finances, the Council acted on this by telling the payments team and clarifying Mr B was not expected to pay the invoice himself. Therefore, it is unlikely an investigation would find fault with the Council on this point.

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Final decision

21. We will not investigate Mr B’s complaint about the Trust and Council for the reasons set out in the Assessment section, above.

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Investigator's decision on behalf of the Ombudsman