Summary: We will not investigate Mr J’s complaint about his mother’s discharge from hospital in November 2017. This is because a significant amount of time has passed since the events Mr J is complaining about occurred and there is nothing to suggest he was unable to raise his concerns sooner.

The complaint

1. Mr J complains on behalf of his mother, Mrs K, about her discharge home from hospital in November 2017 by London Borough of Redbridge (the Council) and Barts Health NHS Trust (the Trust). Mr J says that his mother should have been discharged to specialist stroke rehabilitation centre, but the family was told no such centres exist.
2. Mr J says Mrs K was discharged without any care in place and when the home care package was arranged, it was insufficient to meet her needs.
3. He complains that Mrs K has been billed £6,500 for her home care package. He feels this care was unnecessary and the family should have been advised to go directly to an inpatient stroke rehabilitation facility.
4. Mr J is also unhappy with how his complaint has been handled.
5. Mr J would like service improvements where the option of private inpatient stroke rehabilitation treatment is discussed upfront with patients, allowing them to make an informed decision prior to discharge.

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The Ombudsmen’s role and powers

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 cannot investigate late complaints unless they decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to the Ombudsmen about something an organisation has done. (Local Government Act 1974, sections 26B and 34D, as amended, and Health Service Commissioners Act 1993, section 9(4).)

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How I considered this complaint

8. I have considered the information provided by Mr J, the Trust and the Council. I shared my draft decision with Mrs K and Mr J and they had an opportunity to comment. I have carefully considered the comments I received.

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What I found

What happened

9. In October 2017, Mrs K suffered a stroke and was admitted to the Acute Stroke Unit at Whipps Cross Hospital.
10. In November 2017, Mrs K was assessed as medically fit for discharge and recommended for a reablement care package. She returned home where she received daily care visits, four times a day with two care workers.
11. In December 2017, the Council visited Mrs K at home to discuss Mr J’s concerns about his mother’s care. The care package was changed to long term care at the same level of care. Mrs K was financially assessed as being liable for the full cost of her care.
12. In January 2018, Mrs K’s friend complained to the Trust on her behalf about her discharge planning. The Trust replied that Mrs K’s care had been appropriate.
13. In April 2018, unhappy with her care, Mrs K decided to privately fund a placement at an inpatient stroke rehabilitation facility. The home care package ended.
14. In June 2018, Mr J complained to the Council. The Council spoke with Mr J and explained that the complaint was about hospital discharge, and therefore a matter for the Trust. The Council reminded him about the outstanding charges for his mother’s care. The Council also sent an undated email with the same information, however it seems Mr J did not receive this letter as it was sent to an incorrect email address.
15. In April 2019, Mr J complained to the Ombudsmen.
16. In July 2019, the Ombudsmen passed the complaint back to the Council and Trust for further work. The Trust wrote to Mr J asking for consent from Mrs K for him to represent her. The Trust did not receive a reply and says it therefore could not proceed with the complaint.
17. In August 2019, the Council replied to Mr J. The Council repeated that the complaint was not in its remit, that the NHS had responded to the complaint and signposted to the Ombudsmen. The Council again reminded Mr J about outstanding care charges.
18. In January 2021, Mr J contacted the Ombudsmen again to say he hadn’t received full responses from the organisations and had now received a debt collection letter from the Council regarding the outstanding care fees.
19. We established that the Trust had not responded as it had not received consent. This issue was resolved and the Trust replied to Mr J in July 2022.
20. In October 2022, Mr J asked us to look at his complaint again.

Analysis

21. The Ombudsmen usually will not investigate late complaints unless they decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to the Ombudsmen about something an organisation has done.
22. Mrs K suffered her stroke in October 2017, over five years ago. Mr J did not contact the Ombudsmen until April 2019, around sixteen months after becoming aware of the matters complained about. Therefore, this complaint is significantly late.
23. Mrs K and Mr J were aware that they were unhappy with the discharge arrangements and home care package in late 2017 and throughout early 2018. Mr J was raising complaints with the Council and Trust in 2018. This demonstrates an ability to complain earlier. I am not persuaded that Mr J was unable to escalate his complaint to the Ombudsmen before now.
24. Mrs K’s friend, acting on Mrs K’s behalf, was signposted to the Ombudsman in the Trust’s 2018 complaint response. The Council letters also referenced the Ombudsmen. Therefore, I am satisfied that Mrs K was aware of the option to escalate the complaint to the Ombudsman in 2018.
25. There is also evidence of ongoing delay by Mr J in pursuing his complaint. After the Ombudsmen passed the complaint back to the Trust and the Council in July 2019, Mr J did not contact the Ombudsman again until January 2021, despite having been advised of possible time issues. Mr J also took three months to return to us in October 2022, after the Trust responded to him.
26. Our letter of 31 July 2019 advised Mr J ‘The Ombudsman usually allows 12 weeks for organisations to complete the complaints process. Once you receive a response from the Trust and the Council, you can come back to us if you still wish to pursue your complaint. You should do so as soon as possible. This is because the law says we should not normally look at complaints that are made more than one year after the person became aware of the events they complain about, unless there is a good reason for us to set the time limit aside.’ Therefore, Mr J was aware of the expected response timeframe and the need to return to us promptly. Had Mr J advised us earlier that he had not received a response from the Trust, we could have taken steps far sooner to resolve the issue.
27. I am not persuaded that Mr J has taken reasonable steps to actively pursue his complaint in a timely manner. Mr J has not explained why it took him sixteen months to initially bring his complaint to the Ombudsmen. Nor why it took a further sixteen months for him to return to us in 2021, when he had not received a response from the Trust due to the lack of consent.
28. Mr J has expressed his view that the organisations may have been causing deliberate delay to prevent him bringing his complaint to us by causing time issues. I have seen nothing to suggest deliberate delay. I acknowledge Mr J did not always receive timely responses from the organisations and that there was some confusion and miscommunication during the complaint process which would have created some difficulty in Mr J pursuing his complaint. However, I am not persuaded this adequately explains the whole delay through from December 2017 to April 2019 or further delay after July 2019.
29. The Ombudsmen provide a free service but must use public money carefully. They may decide not to start an investigation if the prospect of conducting an effective investigation is reduced. In this case, it has been five years since the matters complained about occurred. As I will explain below, the significant amount of time passed impacts on our ability to consider the complaint now.
30. When a lengthy period of time passed, it can directly affect any attempts to gather information at a much later stage. For example, people’s memories and recollections fade and it can be much harder to obtain accurate accounts of an incident which occurred years before. This could impact on both the organisations’ and the Ombudsmen’s ability to consider this complaint now.

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Final decision

31. We will not investigation Mr J’s complaint. Over five years have passed since the events that are the subject of this complaint occurred. In my view, it would have been reasonable to expect Mrs K (via Mr J or her friend) or Mr J to approach us sooner than they did. This complaint is very late and I can see no good reason to consider it now.

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Investigator's decision on behalf of the Ombudsman