Summary: The Council failed to provide full information to Mrs C and her mother about the possibility of 24-hour care at home before she was discharged from hospital. An apology and payment to Mrs C, along with procedural changes, is satisfactory remedy.

The complaint

1. The complainant, whom I shall refer to as Mrs C, complained the Council failed to discuss with her the possibility of her mother having 24-hour live in care and instead only gave her the option of a care home when her mother was discharged from hospital. Mrs C says this caused her significant upset and distress as she had promised her mother she would never put her in a care home.

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The Ombudsman’s role and powers

2. 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)
3. 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)

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How I considered this complaint

4. As part of the investigation, I have:
• considered the complaint and Mrs C's comments;
• made enquiries of the Council and considered the comments and documents the Council provided.
5. Mrs C and the Council 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

Background

6. Mrs C's mother was living in her own home and receiving a package of care from December 2018. Mrs C’s mother was funding her own care.
7. Mrs C's mother experienced several falls and hospital admissions in 2019. In May 2019 while in hospital a mental capacity assessment was carried out. That decided Mrs C’s mother had capacity to decide where she wanted to live. Mrs C's mother had made clear she wanted to remain in her own home. At a multidisciplinary team meeting though the physiotherapist raised concerns about whether it was safe for Mrs C’s mother to return home due to the number of falls. The physiotherapist’s view was that Mrs C’s mother needed 24-hour care in a care home.
8. A discharge meeting took place at the hospital in July 2019. Mrs C attended the meeting but Mrs C's mother did not attend, at Mrs C’s request. The social worker attending the meeting recommended a placement in a care home for 24-hour care and Mrs C agreed to consider it. Mrs C later visited two care homes and identified a suitable placement. Mrs C's mother moved into the care home on 22 August. Mrs C's mother was readmitted to hospital on 3 September. While in hospital Mrs C made clear her preference was for her mother to return home with 24-hour care. The Council says the possibility of 24-hour care at home was being discussed at that point but sadly Mrs C's mother passed away later in September 2019.
9. The Council accepts it failed to provide full information to Mrs C and her mother about the possibility of 24-hour care at home before she was discharged in August 2019. The Council has apologised and has undertaken the following in response to the complaint:
• developed guidance for social work teams about care and support options, to include the option of 24-hour care within a person's own home;
• reviewed its guidance on options for people who are self funding their own care and support; and
• has committed to ensure service users and families wishes are fully explored throughout the assessment process.

Analysis

10. Mrs C says the Council failed to discuss the option of her mother having 24-hour live-in care when she was discharged from hospital in August 2019. Mrs C says her mother had always said she wanted to remain at home and Mrs C had promised her she would not have to go into a care home. Mrs C is therefore concerned the Council failed to discuss the possibility of 24-hour care at home with her, particularly as her mother was funding her own care.
11. The Council accepts it failed to include Mrs C’s mother in the discharge planning meeting which took place at the hospital in July 2019. I agree the Council should have included Mrs C’s mother in the meeting given there had been no mental capacity assessment to suggest she did not have capacity to make her own decisions. Failure to include Mrs C’s mother in the meeting is therefore fault.
12. I am also concerned during the meeting the only option considered was for Mrs C’s mother to go into a care home. At that point the only information the Council had about Mrs C’s mother’s wishes were that she wanted to return to her own home. Given that, plus the fact Mrs C’s mother was funding her own care, I would have expected the discharge planning meeting to discuss alternatives other than a 24-hour care home placement. Failure to do that is fault. Failing to discuss that meant Mrs C could not consider an alternative to her mother going into a care home. Mrs C is therefore understandably frustrated the Council did not discuss all options for her mother’s care with her. She is therefore left not knowing whether it would have been possible to arrange a 24 hour live in carer for her mother to remain in her own home.
13. I could not say though if the Council had discussed other options with Mrs C at the discharge planning meeting in July 2019 her mother would have been discharged home with 24-hour care rather than moving into a care home. That is because I cannot speculate about how long it would have taken the Council to arrange 24-hour care at home. Nevertheless, I consider Mrs C has suffered an injustice as she is understandably concerned about the Council’s failure to discuss all options with her.
14. I welcome the Council’s willingness to admit there was fault in this case and I welcome the procedural changes the Council has introduced to address those. I consider though a personal remedy is appropriate for Mrs C given her distress at having to place her mother in a care home without having had any other options discussed with her. I therefore recommended the Council apologise to Mrs C and pay her £250 to reflect her distress and the time and trouble she has had to go to pursuing the complaint. The Council has agreed to my recommendation.

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Agreed action

15. Within one month of my decision the Council should:
• apologise to Mrs C;
• pay Mrs C £250; and
• provide evidence of the procedural changes the Council has introduced to reflect the learning from this complaint, as referred to in paragraph 9 of this statement. That should include evidence that officers in social care have been reminded of the need to include service users in discussions about future care options, where the service user has capacity to take part.

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Final decision

16. I have completed my investigation and uphold the complaint.

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Investigator's decision on behalf of the Ombudsman