Summary: Mrs B complained that the organisations failed to provide a specialist chair for her father, Mr C, which he needed as part of his Section 117 aftercare, which is jointly funded by the Council and ICB. We have upheld Mrs B’s complaint about the Council, as the Council has proposed actions which resolve the outstanding issues.

The complaint

1. Mrs B complains on behalf of her father, Mr C, that Hertfordshire County Council (the Council) and NHS Central East ICB (the ICB) failed to provide him with a specialist chair that he needed as part of his Section 117 aftercare, on leaving hospital in June 2025.
2. Mrs B complains that after a chair loaned by the hospital had to be returned, the organisations involved in Mr C’s care failed to arrange a suitable replacement. Mrs B says that when she raised concerns about this, she got no response, meaning she decided to buy the chair for Mr C using his funds.
3. Mrs B says that failure to provide the specialist chair Mr C needed meant he spent three months unable to sit out of bed. She said this was distressing for her to witness, and trying to resolve the issue for her father was difficult and upsetting for her. Mrs B said there has also been a financial impact, as the chair was paid for using Mr C’s own funds.
4. As an outcome of her complaint, Mrs B would like the organisations to apologise, to demonstrate they have made improvements to Section 117 aftercare services, and to reimburse Mr C for the cost of the chair.

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The Ombudsmen’s role and powers

5. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
6. We investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, we 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. If it has, they may suggest a remedy. Our recommendations might include asking the organisation to apologise or to pay a financial remedy, for example, for inconvenience or worry caused. We might also recommend the organisation takes action to stop the same mistakes happening again.
8. If we are satisfied with the actions or proposed actions of the organisations that are the subject of the complaint, we can complete our investigation and issue a decision statement. (Health Service Commissioners Act 1993, section 18ZA and Local Government Act 1974, section 30(1B) and 34H(1), as amended)

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How I considered this complaint

9. I considered evidence provided by Mrs B, the Council, and the ICB as well as relevant law, policy and guidance.
10. Mrs B and the organisations 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

Section 117 aftercare

11. Anyone who may have a need for community care services is entitled to a social care assessment when they are discharged from hospital to establish what services they might need. Section 117 of the Mental Health Act imposes a duty on health and social services to meet the health/social care needs arising from or related to the person’s mental disorder for patients who have been detained under specific sections of the Mental Health Act (e.g. Section 3). Aftercare services provided in relation to the person’s mental disorder under S117 cannot be charged for. This is known as section 117 aftercare.
12. Mrs B’s original complaint related to NHS Hertfordshire and West Essex ICB as a joint commissioner of Mr C’s Section 117 aftercare, alongside the Council. This is now part of NHS Central East ICB.

Background

13. While he was in hospital, Mr C’s needs were assessed prior to him being discharged to a nursing home. The assessment found that Mr C needed a specialist adjustable chair, to enable him to sit out of bed. Mr C used this type of chair while in hospital. The assessment says a similar chair would need to be provided at the nursing home.
14. Mr C’s placement at the nursing home was jointly funded by the Council and ICB under Section 117 aftercare, and arranged by the Council.
15. When Mr C first moved to the nursing home, the hospital loaned him a chair until his own chair could be ordered. Mr C then had a further assessment, which again found he needed an adjustable chair.
16. After Mr C had been in the nursing home for approximately two months, the hospital chair needed to be returned. However, at this stage, a replacement chair had not been arranged. Mrs B said this meant Mr C was unable to sit out of bed at all for three months.
17. During this time, Mrs B contacted the Council on several occasions, requesting the Council arrange a chair for Mr C as part of his Section 117 aftercare. The Council said it would need to carry out a further assessment of Mr C’s needs. However, Mrs B said she did not hear anything further about this, and so she raised a formal complaint.
18. The Council responded to Mrs B’s complaint, agreeing to fund the chair to meet Mr C’s needs. However, by the time Mrs B received the response, she explained she had already purchased a chair on Mr C’s behalf.
19. Mrs B then complained to the Ombudsmen.

My analysis

20. As noted above, Mr C was entitled to Section 117 aftercare during the period of care complained of. While there is a Section 117 aftercare policy in place, equipment funding and provision is covered by a joint Council and ICB equipment policy. This sets out the framework for providing equipment to people with an assessed health and/or social care need.
21. Mr C’s hospital assessment records detailed the type of chair he would need at the nursing home. Subsequent assessments and reviews also said Mr C required the chair. Mr C had the hospital chair for two months at the nursing home, but no other chair was arranged for Mr C during this time, as had been indicated in the hospital assessment.
22. The records indicate that while there were discussions between the Council and Mrs B about the chair during this time, there does not appear to be clear communication about how the chair would be provided. This was fault by the Council, causing frustration to Mrs B. The Council acknowledged delays in how it communicated with Mrs B about this. The Council said that in response, it had agreed to provide the chair for Mr C, but as noted above, by this stage Mrs B had already purchased the chair directly. We found no fault by the ICB on this point, as the communication involved Mrs B and the Council.
23. The Council said that following Mrs B’s complaint, it developed improved guidance on equipment provision in care homes, to ensure consistency and clarity for health, social care and care providers.
24. Regarding Section 117 aftercare, the Council said it would take action to improve integrated working in this area, by producing new guidance for health and social care professionals. These actions should help prevent recurrence of the communication issues identified in this complaint.
25. During my investigation, the Council also proposed to take the following actions:

• to apologise to Mrs B and Mr C;
• to refund Mr C for the cost of the chair, on provision of a receipt confirming the amount; and
• to make a symbolic payment of £250 to Mrs B, to acknowledge the distress she experienced in trying to ensure Mr C had the correct equipment for his needs.

26. Based on the information provided, I consider the above actions would be a suitable remedy to Mrs B’s complaint.

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Action

27. Within four weeks of the final decision on this complaint, the Council has agreed to complete the actions it proposed during my investigation of this complaint, as set out in paragraph 25, above.
28. Within 12 weeks of the final decision on this complaint, the Council has agreed to provide us with evidence of the service improvements it proposed in paragraphs 23 and 24.
29. The Council should provide us with evidence it has complied with the above actions.

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Decision

30. I uphold Mrs B’s complaint about the Council, as the Council has proposed actions which resolve the outstanding issues.

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Investigator's decision on behalf of the Ombudsman