Summary: The Ombudsman should not investigate Mr B’s complaint about the Council’s actions relating to his late mother’s care and support arrangements when she was discharged from hospital in 2016. The complaint is late and there are no good reasons to investigate it now.

The complaint

1. The complainant, whom I shall call Mr B, complains about London Borough of Watham’s (the Council) actions relating to his late mother’s, Mrs C’s, discharge from hospital in 2016. Specifically, Mr B says following his mother’s hip operation:
• the Council and a NHS Hospital Trust discharged his mother too soon with a proper care and support plan in place;
• the Council’s reablement service/home care was insufficient and did not meet Mrs C’s needs; and
• the care home commissioned by the Council failed to act to deal with Mrs C’s leg infection and this resulted in hospital admission where she later died.
2. Mr B says the alleged faults caused him and his sister avoidable distress as they had to care for their mother who had substantial needs.

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The Ombudsman’s role and powers

3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a council has done. (Local Government Act 1974, sections 26B and 34D, as amended)

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How I considered this complaint

4. I have considered information provided by Mr B in writing and the Council’s response to his complaint. Mr B has had an opportunity to respond to a draft of this decision.

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What I found

Legal and administration context

5. The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 sets out the arrangements for which responsible health and social care bodies must make for dealing with complaints. The regulations state a complaint must be made not later than 12 months after the matter subject to the complaint occurred or if later, the date the matter subject to the complaint came to the attention of the complainant.

Background

6. Mrs C suffered with dementia and lived at home receiving informal care from her daughter and Mr B. She also received visits from the local dementia team.
7. In July 2016 Mrs C had a fall at home and was taken to hospital. An initial x-ray did not show a hip fracture, but this was diagnosed a few days later. She stayed in hospital for 14 days until she was discharged home.
8. The Council provided a reablement care package to Mrs C at home following assessments completed by a social worker while she was in hospital. Mr B said the reablement team provided support with eating, washing and dressing. However, he said her medication and night-time needs were overlooked.
9. Mr B said he told the social worker his mother would need 24-hour care as both he and his sister could not manage her care needs at home. He said when
   Mrs C’s needs became apparent the Council arranged a nursing home placement but then at the last minute changed the placement to a residential care home placement.
10. Mrs C moved to the placement in August. Mr B said his mother settled in well initially but developed a sore on her left foot which the family were told about.
    Mr B said the home did not discuss or mention the seriousness of his mother’s foot infection. He said the family remained concerned, but it was difficult to get information from the home and the doctor who visited. He was dissatisfied with the wound care provided.
11. Following a visit from a district nurse Mrs C was transferred to hospital in early September because she needed urgent medical attention for her foot infection.
    Mr B said he was told by the hospital medical team that vascular surgery or amputation was not appropriate due to Mrs C’s age.
12. Following further discussion between Mrs C’s family and the medical team a decision was made to withdraw antibiotics and provide palliative care. Mr B said his mother received good care while on the ward but at times his mother’s foot was ‘left sitting on the floor’.
13. Mrs C died in October 2016 from septicaemia and ischemic gangrene of the left leg.

Mr B’s complaint to the Council

14. Mr B said he complained to the authorities about the issues relating to his mother’s care in July 2016 but did not receive a response. A complaint response from the NHS Hospital Trust acknowledges Mr B’s complaint made in July 2018 but does not refer to an earlier date.
15. The Council responded to Mr B’s complaint in October. It said it had considered whether it could make an exception to investigate Mr B’s complaint because the events happened over 12 months ago. The Council said events involving Mrs C while in the home happened between July and September 2016. It said Mr B could have complained sooner, and it would not make an exception to the
    12-month rule.

Findings

16. Mr B said he complained to the NHS about the issues in July 2016. have not seen documentary evidence to confirm he made a complaint then. The issues
    Mr B complains about occurred between July and September 2016. Therefore, it is unlikely he could have complained to the Council about the issues which occurred in August and September 2016 in any complaint made earlier.
17. Mr B said he was waiting for the NHS to respond to his complaint made in 2016. He recalls dictating his complaint to an officer working for the NHS. He said he did not hear anything for at least 12 months. There is no evidence to show
    Mr B contacted the NHS within the alleged period of delay.
18. There is no evidence to show Mr B complained to the Council directly at the time he said he complained to the NHS or during the period of the alleged delay. This means the Council was not aware of the complaint until after July 2018.
19. The law inserts a time limit for a complainant to bring their complaint to the attention of the Ombudsman. This intends to provide the Ombudsman with the best opportunity to arrive at a robust and evidence-based decision. It also ensures fairness by enabling us to decline an investigation which could and should have been made sooner.
20. The issues Mr B complains about are serious and is likely to have caused him distress. While this is understandable it would also have been reasonable for him to have complained to the Ombudsman sooner.
21. The events happened so long ago that it would not now be fair or robust for the Ombudsman to rely on people’s memories of events. For these reasons, we will not investigate this late complaint now.
22. The Parliamentary and Health Service Ombudsman can consider Mr B’s complaint which relates to the NHS Hospital Trust.

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Final decision

23. Mr B’s complaint about the Council’s action when providing care and support to his mother is late. There are no good reasons to investigate it now.

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Investigator's decision on behalf of the Ombudsman