Summary: We will not investigate Mr B’s complaint that his treatment provider failed to provide him with proper support and reasonable adjustments during his two day stay. This is because there is not enough evidence of fault having caused Mr B a significant enough injustice to warrant an ombudsman investigation.

The complaint

1. Mr B representative complained Mr B’s treatment provider failed to provide reasonable adjustments or enough support to enable him to access toilet facilities during the short period of time he was in the facility. Mr B’s representative says the provider lacked empathy and failed to investigate his concerns in a timely manner or provide one substantive response. Mr B ‘s representative says Mr B’s anxiety and stress levels have deteriorated since he left he facility and he is now under the Care of the Community Mental Health Team. Mr B’s representative says the provider should apologise and provide a partial refund of the fees paid for the unsuccessful rehabilitation outcome.

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The Ombudsman’s role and powers

2. We investigate complaints about adult social care providers. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• the action has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify our involvement, or
• it is unlikely we could add to any previous investigation by the care provider, or
• it is unlikely further investigation will lead to a different outcome

(Local Government Act 1974, sections 34B(8) and (9))

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How I considered this complaint

3. I discussed the concerns with Mr B’s representative and considered the information provided by him and the treatment provider. I sent Mr B’s representative a copy of my draft decision and considered his comments on it.

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What I found

4. Mr B’s representative’s complaint is regarding Mr B’s residential drug and alcohol detoxification and rehabilitation treatment provider. Complaints about drug and alcohol treatment are not within the Ombudsman’s jurisdiction. But, we can consider whether there is any fault with the accommodation and personal care element which is part of the programme,.
5. Mr B’s representative says the treatment provider’s failure to provide Mr B with a named key worker during his two day stay at a rehabilitation facility exacerbated Mr B’s anxiety and, because of the severe pain he was in, caused by dual hip fractures, resulted in him threatening suicide and self-medicating.
6. The provider says Mr B was seen by a medical practitioner prior to his admission and was diagnosed with a groin strain. The provider says Mr B was not allocated a key worker because he was undergoing a detox and the first few days are about getting comfortable and adjusting to the detox. The provider says key work usually starts about five days later after the detoxification is completed. In addition, there are no key work sessions during the weekend, and, as Mr B was admitted on a Friday afternoon key working would not have taken place in any event. Mr B’s representative say he was not informed about the keyworker allocation prior to his stay. We cannot investigate this element of the complaint as it is in relation to the provision of treatment.
7. The provider says Mr B was in a room directly next to a disabled friendly bathroom with full wet-room facilities. The provider says clients often find them easier to use than the facilities in their room when undergoing a medical detox. The provider says Mr B was not aware of his hip fractures during the time he was in the facility because he was under the influence of illicit substances and only became aware when he started to detox. Mr B was diagnosed with dual hip fractures when he was admitted to hospital two days later. Mr B’s representative say he was not aware there was a disabled bathroom nearby. However we will not investigate this point as we could not say what Mr B was told about bathroom facilities and the treatment provider has confirmed the bathroom was available.
8. I have not seen any evidence that Mr B requested or should have received 1:1 care and would not have had an allocated keyworker during the weekend he was admitted for his detox. We could not say the provider’s actions are fault.
9. The care provider disagrees with Mr B’s representative that staff did not provide care or empathy. The provider says staff always show empathy. It said when Mr B took a potentially fatal overdose in front of staff it telephoned an ambulance and waited with him and kept him safe until the ambulance arrived, despite the fact he threatened them with an illegal weapon which was on his person. Mr B disputes he threatened staff with a knife and says the drugs he took were found by the treatment provider and returned to him.
10. Mr B’s representative says Mr B should have a partial refund. The provider says:

‘Our refund policy is in line with all other treatment facilities. If you self-discharge from our service then you are either entitled to treatment credit or a partial refund. Because the minimum stay in our facility is currently 14 days (this is set by PHE because of Covid shielding), this is the minimum you would be charged. However, if you are discharged from the service for threatening and abusive behaviour or bringing illegal substances into the premises then you are discharged from our service and no refund is due. All of these details are contained within the payment and refund policy and also the terms and conditions of treatment, both of which were received and signed for by Mr B at the point of his admission to the service.

11. Mr B was discharged because he had taken illegal substances and was threatening staff with a weapon both of which should not have brought onto the premises under the terms and conditions of the treatment. We could not say the provider’s decision to discharge him from the service was fault or that it should have given Mr B a partial refund.
12. Mr B’s representative complained about the delay in the provider responding to his complaints. We will not investigate this point. Where the substantive matters themselves are not investigated we will not normally consider how a provider has responded to a complaint. That is the case here.

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Final decision

13. We will not investigate this complaint. This is because there is not enough evidence of fault having caused Mr B a significant enough injustice to warrant an ombudsman investigation.

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Investigator's decision on behalf of the Ombudsman