Summary: The Ombudsmen will not investigate Miss B’s complaint that her mother, Mrs C, was taken into hospital against her wishes, that there was a delay in finding a care provider, and that records do not reflect what really happened. This is because it is unlikely an investigation would add to the responses Miss B has already received from the Council and the Trust.

The complaint

1. Miss B complains that Southampton City Council (the Council) failed to provide a suitable care package for her mother, Mrs C. Miss B said she cancelled the care package because the provider was not caring for her mother safely, and that this left her caring for her mother alone. Miss B complains that Mrs C was taken into hospital, against her and Mrs C’s wishes. Miss B complains that the records made by Southern Health NHS Foundation Trust (the Trust) and Council do not reflect what really happened. She also says Mrs C wanted to be discharged home from hospital, but there were delays in putting a care package in place which meant this was not possible.
2. Miss B would like the Trust and the Council to acknowledge their mistakes in the care and support provided. She would also like them to acknowledge their records are not accurate, and seeks disciplinary action for staff.

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The Ombudsmen’s role and powers

3. 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, 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

4. In reaching this decision, I spoke to Miss B and considered the information she sent us. I also reviewed the complaint responses and documents from the Council and Trust. I also considered Miss B’s comments on a draft version of this decision.

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My assessment

5. Mrs C had a diagnosis of vascular dementia. She lived at home with her daughter, Miss B, and had a package of care partly funded by the Council and partly by herself. Mrs C also received care from district nurses. In September 2020, Miss B cancelled the care package as she was concerned the current provider was not caring for her mother safely. Miss B said the Council was supposed to call her back about an alternative provider, but that this did not happen. Miss B was then caring for her mother by herself.
6. A safeguarding referral was made, and a social worker and mental health nurse visited Mrs C at home. Discussions were held with Miss B and Mrs C, but they could not reach an agreement about how to manage Mrs C’s care. The Council said the social worker tried to arrange respite care overnight, but this was not possible. It was arranged for Mrs C to be transported to hospital. Mrs C remained in hospital for several weeks. Sadly, Mrs C died in hospital.
7. Miss B complained to the Trust and the Council about what happened the day Mrs C went into hospital, the Council failing to return calls to arrange a new care package, and delays in arranging care preventing Mrs C from being discharged from hospital.
8. The Council’s response to Miss B accepted lack of communication after the care package was cancelled, both with Miss B and between teams within the Council. It also accepted delays in its handling of the complaint. It said that on the day Mrs C went into hospital, it acted in line with the Care Act and Mrs C’s best interests. It explained the steps taken after Mrs C was admitted to hospital, and found no delay in planning care while Mrs C was in hospital. The Council also said Miss B and her brother were involved in a discharge planning meeting at the hospital.
9. The Council partly upheld Miss B’s complaint. It said it would change processes to improve communication between teams, and with service users. It also apologised to Miss B and offered her a payment of £600. Miss B says she has not accepted this payment.
10. The Trust responded that the help Mrs C required had increased over time, and was linked to both her physical and mental health needs. The Trust said the day Mrs C went into hospital, it had used the Mental Capacity Act 2005 “which allows, in emergency circumstances for urgent decisions to be made in the person’s best interests”. It said its actions on the day Mrs C went into hospital had been in line with good practice. The Trust said it would take steps to improve how it processed referrals.
11. Miss B was dissatisfied with these responses and complained to the Ombudsmen.
12. Having considered the available information, my view is that an investigation by the Ombudsmen would be unlikely to add to the responses Miss B has already received. The Council and Trust accepted shortcomings in terms of communication, complaint handling, and referrals, and took steps to prevent recurrence.
13. The Trust and Council explained they used the Mental Capacity Act to admit Mrs C to hospital. I recognise that Miss B considers the records relating to Mrs C’s capacity are inaccurate. Miss B would also like the Trust and Council to acknowledge their records are inaccurate. Were we to investigate Miss B’s complaint, it is unlikely we would be able to say whether the records are inaccurate. In investigating the complaint, the Council and Trust considered the records made at the time and interviewed relevant staff. It is unlikely an investigation could add to this. Miss B also seeks disciplinary action, which is not something the Ombudsmen could achieve.

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Final decision

14. The Ombudsmen will not investigate Miss B’s complaint because it is unlikely we could add to the responses Miss B has already received.

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Investigator's decision on behalf of the Ombudsman