Summary: Mr B complained about the care and support provided to his mother when she was a patient of the Leeds Teaching Hospitals NHS Trust between October 2017 and January 2018. He also complained about the way Leeds City Council dealt with his mother’s discharge arrangements when she moved to care home from hospital in January 2018. We will not start an investigation into this complaint as we cannot add to the previous investigations completed by the Trust and the Council.

The complaint

1. The complainant, who I shall refer to as Mr B, complained about the clinical care his mother received when she was a patient of the Leeds Teaching Hospitals NHS Trust (the Trust) from October 2017 to January 2018. He also complained about the way a social worker employed by Leeds City Council (the Council) communicated with him and dealt with his mother’s discharge arrangements from hospital to a care home in January 2018. Mr B said he was not provided with adequate information about the discharge process and the multi-disciplinary team dealing with the discharge did not consider his or his mother’s views. Mr B said the Council and the Trust failed to answer his questions when he complained, did not take responsibility for any shortcomings, and they did not apologise.
2. Mr B claims the faults led to his mother losing her independence sooner than she should have done.

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The Ombudsmen’s role and powers

3. 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, and Health Service Commissioners Act 1993, section 18ZA)
4. 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 could add to any previous investigation by the bodies.

(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

5. I have considered information provided by Mr B in writing and by telephone. I have also considered information provided by the Council and the Trust.

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What I found

Background

6. Mrs C lived in her own home in the community. She was found collapsed at home and was taken to the Trust’s hospital emergency department on 1 October 2017.
7. On the same date Mrs C had a fall while she was in the emergency department and sustained a fractured neck of left femur (hip). She was transferred to a different hospital and underwent an operation on the same date.
8. Mr B said he started visiting his mother in the hospital from 2 October after she was transferred to a ward. He said he continued his visits on an almost daily basis.
9. Mr B said the Trust’s clinical team did not ensure his mother had enough exercise to aid her rehabilitation. Overall, he felt his mother spent too much time in bed and that the attention nursing staff paid to patients was inadequate. He also learnt that his mother had fallen again on 25 October.
10. The Council’s social worker formed part of the multidisciplinary team which started to discuss the plan for Mrs C’s discharge from hospital from November.
11. The social worker met with Mr B in mid-November to discuss Mrs C’s discharge arrangements. Mr B wanted his mother to be discharged home with a care package. However, the clinical team felt it would not be safe for Mrs C to return home even with a care package.
12. The Council assessed Mrs C’s mental capacity to make decisions about the discharge destination. The assessment continued over two visits due to Mrs C’s noted fluctuating capacity. The Council assessed that Mrs C had capacity to decide about a temporary move to a residential care placement.
13. Following further discussion and the completion of several social care and health assessments, health and social care professionals felt a move to 24-hour residential care was in Mrs C’s best interests. The Council said it provided Mr B with the details of residential homes that had rooms available.
14. Mrs C was discharged from hospital to a transitional residential placement in January 2018. A reviewing social worker visited her after she had settled in the placement and changed the status of the placement to temporary. Following further discussion with Mr B and Mrs C the social worker submitted a new care and support plan for the placement to become permanent.

Mr B’s complaint to the Trust

15. Mr B complained to the Trust in July 2018. His complaint listed concerns regarding Mrs C’s fall, the clinical care and treatment provided by the Trust and the way the clinical team communicated with him.
16. The Trust responded in February 2019. It apologised for the delay in dealing with the complaint and said it had reviewed it complaints process to ensure a timely response in future. The Trust replied to Mr B’s concerns in detail covering the concerns he had raised about Mrs C’s daily exercise, communication with him after Mrs C had fallen and staff communicating with Mrs C about her hearing aids. He also complained about what he felt was the Trust’s policy of allowing staff to choose Mrs C’s care home.
17. The Trust accepted there was a delay in ward staff contacting Mr B after his mother had fallen near her bed on 25 October. It said prior to the fall it had completed a falls risk assessment and Mrs C received enhanced observation. Following the fall, it reassessed Mrs C and increased the observation to one-to-one. It apologised for its delay in contacting Mr B to tell him his mother had fallen.
18. The Trust said it had considered Mrs C’s hearing and had made an Audiology referral to assess the effectiveness of her hearing aids. It also told Mr B it did not have a policy in place which allowed its staff to choose care homes for patients. It said it had made a referral to social services when requested to facilitate a safe discharge to a residential placement. The Trust directed Mr B to complain to the Parliamentary and Health Service Ombudsman (PHSO) if he was dissatisfied with the response.
19. Mr B made two further complaints which raised similar issues to the first complaint made. Mr B felt the Trust was not answering his questions or taking responsibility for what he felt had gone wrong. The Trust responded to his complaints in June 2020 and February 2021.
20. The Trust also confirmed it settled a legal claim brought by Mrs C. This fell outside the complaints process. Mr B then complained to the PHSO.

Mr B’s complaint to the Council

21. Mr B made a complaint to the Council in December 2018. His complaint included his concerns about the communication from the social worker, his view the Council had a policy which authorised social workers to choose care homes and his disagreement when the social worker spoke to Mrs C on her own without Mr B present.
22. The Council replied to the complaint in February 2019. It confirmed it did not have a policy which allowed social workers to automatically choose care homes for individuals. The Council said the social worker had offered the appropriate care home options to facilitate Mrs C’s discharge from hospital. It apologised to Mr B if he felt the social worker had dismissed his and his mother’s wishes. However, it said all the health and social care assessments completed led to the view Mrs C was at greater risk of harm if she returned home with a care package. Although it had considered the family’s views the care home placement was the least restrictive option.
23. The Council said the social worker had spoken to Mrs C on her own to assess her mental capacity to make specific decisions. It had not coerced Mrs C into accepting a residential care home placement. The Council said Mr B could escalate the complaint to the next stage if he remained dissatisfied.
24. Mr B responded to the complaint response and spoke further with the Council in March as he wanted to escalate the complaint to the next stage. The Council sent Mr B a further written response in April. In summary, the Council did not uphold Mr B’s complaint. It said it could not offer financial compensation as it had not found any failings. It directed Mr B to complain to the Local Government and Social Care Ombudsman (LGSCO).
25. Mr B did not complain to the LGSCO straightaway. Instead, he raised a further complaint to the Council in July 2019 with support from an advocacy agency. It again directed Mr B to complain to the LGSCO.

Findings

26. Mr B made several points when he complained to the Council and the Trust which related to the care and support his mother received. He also complained about how matters affected him when he acted as his mother’s representative.
27. Both the Council and the Trust provided responses which Mr B remained dissatisfied with. Mr B could have complained to the us earlier after he received the first response from the Trust and after he received the second response from the Council.
28. The complaint responses from the Council and the Trust go into some detail and confirm the evidence considered during each authority’s complaints investigation. Both authorities apologised to Mr B where necessary. Although Mr B feels dissatisfied with the responses he received. However, considering the information and detail already provided by the Council and the Trust there is nothing more the Ombudsmen could add by investigating this complaint.

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Decision

29. We have not investigated this complaint. There is nothing else we could add to the investigations previously completed by the Council and the Trust. I have closed the complaint.

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Investigator's decision on behalf of the Ombudsman