Summary: There is no evidence of fault by the Council. The Council arranged respite care when Mr X was discharged from hospital and there is no evidence the Council told the family it would be free reablement care. There is also no evidence of inadequate care in the care home or of delay in organising home care.

The complaint

1. The complainant, Mr X, is represented by his daughter Miss A. They complain the Council charged Mr X for care on discharge from hospital which they thought would be free rehabilitation care. Miss A complains the charge for the respite stay has caused Mr X a financial injustice as he should not have had to pay.
2. Miss A says Mr X’s family had to help him three times to shower in the care home as help with personal care was inadequate and he did not get a footstool recommended by the GP. The family also say Mr X’s mattress was not inflated on some nights and his family had to tell care staff of this.
3. Miss A also complains there was a delay by the Council in arranging a care package so Mr X could return home.

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The Ombudsman’s role and powers

4. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
5. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

6. I read the papers put in by Miss A and discussed the complaint with her.
7. I considered the Council’s comments about the complaint and any supporting documents it provided.
8. Miss A and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Care home after hospital discharge

9. Mr X was in hospital, after a fall at home. Miss A says the hospital consultant told her Mr X would transfer to 'a care facility for rehabilitation with physiotherapy and occupational health support'. Miss A said that Mr X went to a care home with no extra support and the Council said Mr X should pay for this care. Miss A says the social worker emailed the family a handout about the cost of care which pointed out the 6 week free reablement care so they did not expect to get an invoice for the care (£1369).
10. In its response to Miss A's complaint, the hospital said that ' the decision to discharge Mr X to respite care was made ultimately by Hull Social Services. This decision was reached following consultation with the hospital Therapy team (Physiotherapy and Occupational Therapists) who decided that Mr X was not appropriate for a rehabilitation bed or a reablement bed due to confusion/disorientation'.
11. The NHS complaint report notes that initially the physiotherapist documented that Mr X was suitable for rehabilitation. However, on two further occasions a physiotherapist documented that Mr X was not suitable for rehabilitation because of confusion and his cognition was the main limiting factor of his mobility. The report said the Occupational Therapist decided that as Mr X was not orientated and was not retaining information about his current surroundings, he would be at significant risk of falls if left alone between care calls so may need respite care.
12. I can see there is evidence that both the Physiotherapist and the Occupational Therapist decided Mr X was not orientated to date and place and therefore, not able to engage in an active rehabilitation programme in a rehabilitation bed.
13. The social workers notes have no mention of a reablement bed. The notes record that she advised Miss A about the online calculator and that the finance department would be in touch for Mr X’s financial information. The social worker emailed Miss A’s sister the booklet about paying for care.
14. The social workers note of 20 December said that Mr X moved to respite care but Miss A was unhappy as the social worker told her that her dad would have reablement care, not respite care.
15. I have looked at all the written evidence available. It is clear the hospital staff were of the view that reablement care was not suitable for Mr X and so the social worker arranged respite care. It is also clear from the social workers notes that Miss A and they told the family about the need to pay for care. I cannot see any fault by the Council.

Standard of care

16. Miss A has made several complaints about the standard of care in the care home. The family complain that Mr X’s mattress was not inflated on a number of nights and Mr X did not get a footstool. The care home says that an alarm would sound if the mattress became deflated and they have no record of a request for a footstool. Miss A says that family had to help Mr X three times to shower in the care home as help with personal care was inadequate. The care home has said that care providers helped Mr X to wash daily, apart from one morning when family were visiting.
17. Miss A also complains the care home did not organise physiotherapy for her father. The care home has said that as Mr X could sit, stand and mobilise independently there was no reason to refer him. The care home has also included details of its contact with Mr X’s GP.
18. There is no evidence from the social workers file notes that Miss A complained about Mr X’s care at the care home at the time. I can see that Mr X’s family were very concerned about him, visited frequently and did ensure that he received the care he needed. But, I cannot see evidence of lack of care at the care home that would amount to fault or that the Council failed to investigate allegations made at the time.

Delay in arranging care package

19. On 14 January the Council agreed to arrange a package of 4 care calls a day for Mr X when he returned home. No providers said they could provide the care package so on 29 January Mr X’s family offered support so only 2 calls per day were needed. The Council found a care provider on 5 February and a start date was agreed for 17 February.
20. Mr X went home on 5 February, supported by his family and they cancelled the care package as they did not need it.
21. I can see that it took several weeks to arrange the home care package. But there is no evidence of delay or fault by the Council. The Council was chasing up providers and managed to secure a care package. Mr X’s family, clearly worried about Mr X remaining in the care home organised to support him themselves and did not need the carers. While I can see that this was a stressful time for the family, I am not convinced there was fault by the Council on this point as the social worker was clearly trying to arrange the care but it took longer than ideal due to a lack of care providers.

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Final decision

22. I have completed my investigation of this complaint. This complaint is not upheld as I have found no evidence of fault.

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Investigator's decision on behalf of the Ombudsman