Summary: We will not investigate Mr B’s complaint about care provided to his late sister, Miss C. This is because we could not add to the Care Provider’s response or make a different finding.

The complaint

1. Mr B complained about care provided to his sister Miss C. Mr B says

• Miss C was sexually assaulted in the home when she was first placed there;
• Miss C’s care and treatment was poor- a night nurse tore her ileostomy bag off her;
• The Care Provider lied to the police which meant he was not allowed to visit Miss C before she was admitted to hospital.
• Miss C died due to infusion of a PEG feed;
• Staff did not listen to him about how best to support Miss C.

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The Ombudsman’s role and powers

2. The Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or may decide not to continue with an investigation if we decide:

• we could not add to any previous investigation by the organisation.

(Local Government Act 1974, section 24A(6))

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How I considered this complaint

3. I considered information provided by the complainant and the Council.
4. I considered the Ombudsman’s Assessment Code.
5. I considered Mr B’s comments before making a final decision.

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My assessment

6. The Care Provider investigated Mr B’s complaints. It says it was not aware of the allegation of a sexual assault. It advised Mr B if he provided the date on which the alleged assault took place it will look into it further. It also advised Mr B to report such a serious incident to the police. Mr B says he did report this incident immediately it had happened and, although he was unable to follow the complaint up directly with the Care Provider, he reported it to the CQC and NMC. We could not add to this or make a different finding even if we investigated. Allegations of sexual assault are criminal matters and are for the police to consider.
7. Mr B says a night nurse tore Miss C’s ileostomy bag from her in February 2020 causing her pain. The Care Provider says when questioned the same evening the nurse said he had hardly touched Miss C when Mr B became verbally aggressive and said he did not know what he was doing. Prior to his incident Mr B had been observed stopping Miss C’s PEG feed and flushing the tube despite discussions with him that he was not to undertake these tasks. Mr B called the police. Mr B disputes the Care Provider’s version of events, however further investigation could not say what happened when we were not party to the incidents.
8. The Care Provider says the following day Mr B was observed again disconnecting Miss C’s PEG line. The manager asked him to stop and given the interventions of the previous evening regarding the PEG feed, asked Mr B to leave the building. It says records show Mr B became threatening, raising his voice saying he would do the task. The Care Provider says the manager called the police as Mr B would not leave the building when asked. The police attended and escorted Mr B from the premises. He was advised he could not return, and Miss C’s social worker would keep him updated on Ms C’s condition.
9. The Care Provider acknowledged Mr B was angry, upset and was concerned for Miss C. Prior to being admitted to the home, Mr B had cared for Miss C. However, it also explained it had to have consideration for staff and other residents in the home. Sadly, Miss C was taken to hospital and died of Covid-19 on 28 March 2020. It acknowledged how difficult it would have been for Mr B not to visit or see Miss C prior to her being admitted to hospital. We could not add to this or make a different finding even if we investigated.
10. The care provider acknowledged there were lessons to learn from Mr B’s complaint. It said:

• Complaints procedures will be displayed in the home for easy access.
• Not all staff statement relating to the incident in February 2020 could be located so in future statements will be archived together and included in the Home Development Plan.

11. Mr B emailed the CQC with his version of events, however, we could not say what happened in February 2020 when we were not there, or be critical of the Care Provider for saying Mr B could not enter the home for the reason given even though Mr B disputes them. Care Provider’s should review incidences where it has banned relatives from seeing loved ones. The Care Provider says there was an active safeguarding investigation going on at the time about Mr B’s involvement in Miss C’s care but sadly Miss C passed away before the review could take place.

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Final decision

12. We will not investigate this complaint. This is because further investigation could not add to the care provider’s response or make a different finding.

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Investigator's decision on behalf of the Ombudsman