Summary: Mrs G complains the Council did not deal properly with her father, Mr X’s, about his care placement. The Council was at fault because it delayed telling Mrs G that Mr X could not return to his residential home, its communication afterwards was poor, it didn’t record a decision properly and it didn’t fully respond to her complaint. The Council should apologise to Mrs G and pay Mrs G £250 for the distress caused. The Council has already reviewed its working practices in relation to Mrs G’s complaint.

The complaint

1. The complainant, whom I shall refer to as Mrs G, complains the Council did not deal properly with events when her father, Mr X was in hospital, because it:
• took too long to tell her that Mr X could not go back to Home Z, his residential home;
• did not readmit him to his residential home;
• delayed arranging his discharge from hospital to another placement; and
• did not let her collect Mr X’s belongings from Home Z after he had been discharged.
2. Mrs G says Mr X remained in hospital unnecessarily for around seven weeks after he was fit for discharge, which caused Mr X and herself distress and inconvenience.

Back to top

The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word ‘fault’ to refer to these. We cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
5. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

Back to top

How I considered this complaint

6. I have spoken to Mrs G about her complaint and considered the information she has provided to the Ombudsman. I have also considered the Council’s response to her complaint and its response to my enquiries.
7. Mrs G and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

What happened

8. Mr X had dementia and had lived in a Council-run residential care home, Home Z, for some years. He was admitted to hospital. After spending seven weeks in hospital, he moved not back to Home Z but to a nursing home. Sadly, Mr X has since died. Mrs G argues that, while Mr X was in hospital, the Council mishandled communications with the family and did not deal properly with matters concerning where Mr X should live. In particular, she considers the Council was wrong not to take Mr X back to Home Z and it took too long to arrange an alternative.

Analysis

9. Mr X was assessed for NHS continuing health in March 2019. He did not qualify for fully funded care but was eligible for Funded Nursing Care (FNC). Mr X’s family unsuccessfully challenged that decision, arguing that he should have received fully funded care.
10. I have seen a needs and wellbeing assessment which shows the Council considered Mr X had nursing care needs in late 2018. He received FNC in 2019. I have seen further assessments undertaken since Mr X was admitted to hospital which are supportive of these conclusions. Mr X required some degree of nursing care, which Home Z was unable to provide. The Council is not at fault regarding Mr X not returning to Home Z.
11. Mr X’s family were told that he could not return to the Home Z four days after the decision was made. The Council accepts that Mrs G was not initially advised of the recommendation of the Manager at Home Z directly which caused some distress. This is fault by the Council. Mrs G suffered distress as a result of the delay.
12. After Mr X was admitted to hospital, care notes show that he was transferred to the care of the hospital social work team. It was intended that Mr X be discharged to a nursing home where his needs could be fully assessed. This process was known as Discharge to Assess (D2A). Care notes show the Clinical Commissioning Group (CCG) agreed to this and later changed its decision.
13. The delay before Mr X was discharged to a nursing home was caused by:
• Two periods where he was ill and considered not medically fit for discharge;
• Information and relevant documents having to be sent between the Council and the Hospital, as a result of him not being medically fit for discharge;
• The decision of the CCG not to proceed with the D2A in relation to Mr X.
• Finding a nursing home for Mr X that his family were happy with.
14. Once the CCG had decided not to discharge Mr X through D2A, the Council consulted with Mr X’s family very quickly. Mr X’s family held a preference for one particular nursing home and waited for a place to become available there. Mr X was discharged to his family’s preferred nursing home. This is not fault by the Council.
15. The Council has already accepted in its complaint response to Mrs G that a misunderstanding led to confusion about Mrs G being able to collect Mr X’s possessions from Home Z. The Council says the manager was not aware that Mr X was moving to a nursing home. This is fault by the Council. Mrs G was caused distress when she tried to collect Mr X’s possessions from Home Z.
16. The Council said in its complaint response that, “communication could have been better with the family and between the health professionals to ensure a professional response to each turn of events to allay any fears that the family had about [Mr X] not being wanted or welcome at the home. Hospital staff and Social care staff need to work closer together to give an accurate and consistent message back to family members to keep them abreast of the situation about their loved one. I recommend that senior managers’ always use this case as an opportunity to learn lessons about close professional relationships and ensure consistent communication with all levels of staff in both social care and hospital settings.” I agree with the Council.
17. As a result of the Ombudsman’s investigation, the Council:
• agrees it did not respond to Mrs G’s complaint about delays in the hospital. This is fault by the Council. Mrs G did not have her complaint fully responded to.
• agrees there was no written record of the best interest decision taken about Mr X’s discharge to his family’s preferred nursing home. This is fault by the Council. However, there is evidence of the Council discussing with Mr X’s family where he should be discharged to. Mr X was discharged to the preferred nursing home. Mrs G did not suffer any significant injustice as a result. I also note the Council says it has already been brought to the attention of relevant staff to prevent it happening again.
• says it has identified the need to consider practice in relation to communication and work is already underway to address this.

Agreed action

18. To remedy the injustice caused by the fault I have identified, the Council has agreed to take the following action within four weeks of this decision:
• apologise to Mrs G;
• pay Mrs G £250 for the distress caused;
• provide evidence to the Ombudsman about the outcomes of work underway to address working practices relating to communication.

Back to top

Final decision

19. I have found fault by the Council, which caused injustice to Mrs G. I have now completed my investigation.

Back to top

Investigator's decision on behalf of the Ombudsman