Summary: Mr X complains about his wife Mrs Y’s adult social care. There was a delay to Mrs Y’s return home. Mr X had to pay higher care charges. The Council has amended its charges to reflect the care that Mrs Y would have received had she returned to home earlier. This is an appropriate remedy.

The complaint

1. The complainant, whom I shall refer to as Mr X, complains the Council has not dealt properly with his wife’s adult social care because:
• her care was neglected leading to her having her toe removed because of an infection that wasn't treated; and
• her move back home from the Care Provider was delayed.
2. Mr X says charges for care should not be made.

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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 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. When considering complaints, if there is a conflict of evidence, we make findings based on the balance of probabilities. This means that we will weigh up the available relevant evidence and base our findings on what we think was more likely to have happened.
6. Part 3 and Part 3A of the Local Government Act 1974 give us our powers to investigate adult social care complaints. Part 3 is for complaints where local councils provide services themselves. It also applies where a council arranges or commissions care services from a provider, even if the council charges the person receiving the care. In these cases, we treat the provider’s actions as if they were council actions. Part 3A is for complaints about care bought directly from a care provider by the person who needs it or their representative, and includes care funded privately or with direct payments using a personal budget. (Part 3 and Part 3A Local Government Act 1974; section 25(6) & (7) of the Act)
7. 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

8. I spoke to Mr X about his complaint. I made enquiries of the Council and considered its response and the supporting documents it provided.
9. Mr X and the Council/Care Provider 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

What happened?

10. This is a brief chronology of key events. It does not contain everything I reviewed during my investigation.
11. Mrs Y was cared for at home by her husband, Mr X. She suffered from vascular dementia, which had a significant impact on her cognition and subsequently her ability to independently manage daily living tasks, maintain her safety and assess risk.
12. Mrs Y was admitted to hospital in August 2021 for social reasons when looking after her became too much for Mr X.
13. She was discharged to a care home, Rivermead, at the end of August.
14. In mid-September 2021, Mrs Y was again admitted to hospital for evaluation of seizure episodes.
15. Mr X and Mrs Y wanted to go home. Professionals agreed that Mrs Y should be discharged home with a package of care.
16. Mrs Y was discharged back to Rivermead for one month while the Council completed a care assessment for her.
17. In mid-October 2021 Mrs Y was admitted to hospital for a third time with an infection and had to have a toe amputated.
18. Mr X complained the care provided at Rivermead was not good enough, because her toe infection should have been identified and she should have been treated earlier than she was.

Analysis

Mrs Y’s care

19. I have reviewed evidence from a variety of documents provided by the Council and the Care Provider, Rivermead. These include Mrs Y’s care assessment, care notes, medication records and healthcare professional notes.
20. There is no evidence to directly link Mrs Y’s toe infection and subsequent amputation with the quality of care provided.
21. The first identification of a problem with Mrs Y’s toe was in October 2021 during a NHS continuing healthcare decision support tool meeting. This stated that Mrs Y was being treated by a podiatrist weekly for a wound beneath her toe. Healthcare professional notes show that this was correct.
22. There is no evidence to show that Mrs Y’s care was neglected. I do not consider this to be fault by the Council.

Delay returning home

23. The Council accepts that there was a delay in arranging a package of care to enable Mrs Y to return home following her discharge from hospital. This is fault by the Council. Mrs Y could have returned home earlier.

What the Council has done

24. The Council has agreed to reduce the cost of charges for Mrs Y’s care to reflect the costs Mrs Y would have incurred had she returned home earlier. This is an appropriate remedy.

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Final decision

25. I have found fault by the Council, that has already been remedied. I have now completed my investigation.

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Investigator's decision on behalf of the Ombudsman