Summary: We will not investigate Mr X’s complaint about poor care by his late mother’s care provider. He says they ignored medication instructions which led to medication being administered incorrectly. This is because an investigation would not lead to any further findings or outcomes. In addition, there is insufficient evidence of fault.

The complaint

1. Mr X complains about poor care by his late mother’s care provider. He says medication instructions were ignored, leading to medication being administered incorrectly. He also complains about the Council chasing him for his mother’s outstanding care charges.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

3. I considered information provided by the complainant and the Council.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. Mr X’s mother, Mrs Z, received care and support from a care provider. Mr X said the care provider failed to administer medication appropriately, which put his mother at risk. Mr X said he has refused to the pay the care provider’s invoice for charges because of the poor care.
6. In response to his complaint, the care provider said:
• it had administered Mrs Z’s medications in line with the instructions given as per the prescription labels. It explained it could not amend this unless instructions were given directly from the doctor or pharmacist.
• It could not force Mrs Z to take medication if she refused it.
• There was one occasion where medication was not administered with the appropriate gap between doses. It apologised for this.
• There was one occasion where a certain medication was not administered correctly. It apologised for this.
• It asked Mr X to provide any evidence of alternative written medication instructions from either the doctor or pharmacist.
7. The Council reviewed the care provider’s response and was satisfied with the investigation and findings made. It also noted Mr X provided a letter from a consultant who suggested use of one medication more frequently, up to 21 days a month, giving 10 days free to prevent tolerance. However, the Council was satisfied this was not a direct instruction for Mrs Z’s medication to be administered two days on, one day off.
8. It is clear there is some dispute over what the medication instructions were. I note Mr X said he provided verbal instructions to the care provider about how to administer his mother’s medications, but the care provider said it had followed the instructions as per the prescription labels on the medicines.
9. We would not find fault with the care provider for administering medications in line with the instructions given by the doctor, pharmacist, or prescription label given it had no other written instructions from a doctor or pharmacist advising otherwise. There is no evidence to suggest Mr X provided the care provider with alternative administration instructions from a doctor or pharmacist. Therefore, an investigation is not justified as further investigation is not likely to lead to any further findings or outcomes.
10. The Council sent Mr X the invoices for the outstanding balance still owed by his mother for the care and support services she received. Mrs Z has been assessed as having to pay a contribution towards the care and support services she receives. The Council is entitled to charge, and Mrs Z is responsible for paying her contribution.
11. Mr X is the responsible person for managing his mother’s estate following her death. Therefore, it is appropriate for the Council to send him the invoices for the outstanding charges and to contact him to arrange payment. An investigation is therefore not justified as we are not likely to find fault.

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Final decision

12. We will not investigate Mr X’s complaint because an investigation would not lead to any further findings or outcomes. In addition, there is insufficient evidence of fault.

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Investigator's decision on behalf of the Ombudsman