Summary: Mrs X complained that the care provider restricted her visiting hours to her mother-in-law. Based on current evidence the complaint will not be upheld. The care provider was entitled to limit the times for Mrs X’s visits.

The complaint

1. Mrs X (the complainant) says the care provider unreasonably restricted her visits to her mother-in-law (Mrs B) after she made some complaints. As a result, she says she has rarely been able to see Mrs B.

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The Ombudsman’s role and powers

2. We investigate complaints about adult social care providers and decide whether their actions have caused injustice, or could have caused injustice, to the person complaining. I have used the term fault to describe this. (Local Government Act 1974, sections 34B and 34C)

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How I considered this complaint

3. I considered evidence provided by Mrs X and by the care provider as well as relevant law, policy and guidance. I have not included in this statement all the evidence I have seen.
4. Both parties had an opportunity to comment on my draft decision. I considered their comments before making a final decision.

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What I found

Relevant law and guidance

5. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out the fundamental standards that registered care providers must achieve. The Care Quality Commission (CQC) has guidance on how to meet the fundamental standards.
6. Regulation 9A says “Everyone should work on the assumption that in-person visiting and accompaniment to appointments are possible. Providers must put in place any measures or precautions necessary and proportionate to ensure that visiting and accompaniment can continue to happen safely. These must be the least restrictive options and must be decided with the person using the service, and their family, friends or advocates where appropriate.”
7. The guidance continues, “there may be exceptional circumstances where, despite any precautions put in place, a visit or accompaniment may still pose a significant risk to the health, safety or welfare of a person using the service or on the premises. This risk will mean that, despite considering all possible actions and precautions, an in-person visit or accompaniment cannot be safely facilitated and there is no alternative but to restrict visiting or accompaniment at that time. If this is the case, the provider should put in place the necessary restriction and review arrangements regularly”.
8. The Mental Capacity Act 2005 introduced the “Lasting Power of Attorney (LPA)”. This replaced the Enduring Power of Attorney (EPA). An LPA is a legal document, which allows a person (‘the donor’) to choose one or more persons to make decisions for them, when they become unable to do so themselves. The 'attorney' or ‘donee’ is the person chosen to make a decision on the donor’s behalf. Any decision has to be in the donor’s best interests.

What happened

9. Mrs B has dementia. She has been resident in Kingswood Court Nursing Home for some time. She has an extended family, and one of her sons (who chose Kingswood Court) has enduring power of attorney (EPA) for her health and welfare. Mrs X is married to another of Mrs B’s sons.
10. Following a visit in May 2022, when the care provider says Mrs X was disruptive and acted in such a way that was very upsetting to some staff members, the care provider restricted Mrs X’s visits to weekday working hours. The care provider says this is so managers are available immediately in case Mrs X or staff raise any issues of concern.
11. Mrs X complained to the care provider about the ongoing restrictions in October 2024. She said the restriction severely limited her ability to visit. She said she believed the restriction was preventing Mrs B from receiving visits from a close family member.
12. The care provider’s director responded. He said Mrs B received regular and frequent visits from immediate family members. He said the impact of Mrs X not visiting Mrs B, who he says has advanced dementia, was assessed as negligible, but if she was indeed unable to visit during working hours, then they would consider a visit outside those hours if she was accompanied by Mrs B’s son, who has EPA.
13. Mrs X complained to us. She said the ongoing nature of the restrictions was disproportionate to the incident which prompted them.
14. The care provider says that Mrs B’s immediate family members are supportive of the restrictions and have no concerns that there is an effect on Mrs B.
15. Evidence from the care provider shows the restrictions have been considered subsequently but it was decided they should remain in place.

Analysis

16. The care provider was entitled to restrict Mrs X’s visits in line with the guidance which states that safe visiting “must be decided with the person using the service, and their family, friends or advocates where appropriate”.
17. The care provider’s duty is towards Mrs B, who is its resident, and to its staff. Mrs X can continue to visit during working hours and an offer was also made to extend that to an accompanied visit outside those hours.

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Decision

18. I have completed this investigation as I find no fault on the part of the care provider.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman