Summary: Mr X complained about the actions of Scio Healthcare Limited, Highfield House Nursing Home, whilst his mother, Mrs Y, resided there. There was no fault in the way the Care Provider sought to meet Mrs Y’s medical needs. However, there were faults in the way the Care Provider communicated with Mr X. The Care Provider has agreed to apologise to Mr X for the frustration and uncertainty this caused him. It will also review with staff the importance of communicating effectively, to prevent a recurrence of fault.

The complaint

1. Mr X complained about the actions of Scio Healthcare Limited, Highfield House Nursing Home, whilst his mother, Mrs Y, resided there. He said the Nursing Home:
• did not respond to several emails he had sent to the Nursing Home;
• failed to inform him and his family when Mrs Y’s health had declined;
• did not seek medical advice when Mrs Y was unwell;
• did not tell him or Mrs Y when Mrs Y was eligible for NHS funded nursing care and how it had applied the funding to Mrs Y’s account; and
• did not tell him Mrs Y’s garden ornament had been damaged.
2. Mr X said this caused Mrs Y and the family distress and frustration and as a result, Mrs Y moved out of the Nursing Home. He wants the Nursing Home to provide a financial remedy to Mrs Y and to review its practices to prevent a recurrence of faults.

Back to top

The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused injustice, or could have caused injustice, to the person complaining. I have used the term fault to describe this. (Local Government Act 1974, sections 34B and 34C)
4. If an adult social care provider’s actions have caused injustice, we may suggest a remedy. (Local Government Act 1974, section 34H(4))
5. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
6. If we are satisfied with a care provider’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

7. I spoke with Mr X and considered the information he provided.
8. I considered the information the Care Provider, Scio Healthcare Limited provided.
9. Mr X and the Care Provider had the opportunity to comment on the draft version of this decision. I considered their comments before making a final decision.
10. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

Back to top

What I found

What happened

11. Mrs Y has complex health needs and resides in a nursing home. Mrs Y privately pays for her care. Between 2018 and 2022, Mrs Y was a resident at Highfield House Nursing Home.
12. In August 2021, staff noted Mrs Y was unwell. She appeared to be excessively sweating and looked faint. A nurse at the Nursing Home took Mrs Y to bed, monitored her blood pressure, heart rate and oxygen levels. Mrs Y later appeared well and so staff had no further concerns with her health. The Nursing Home did not inform Mr X of this.
13. Between October 2021 and December 2021, an assessor from the NHS completed an assessment with Mrs Y, Mr X and the Nursing Home to determine if Mrs Y was eligible for NHS funded nursing care (funding from the NHS to residential care homes that provide care by registered nurses). During this time, Mr X found out Mrs Y had been unwell in August 2021. In November 2021, Mr X emailed the Nursing Home and asked it to provide him with a full report of when his mother had presented as unwell. The Nursing Home did not respond to Mr X’s request.
14. Following the assessment, the NHS asked the Nursing Home to complete a blood test with Mrs Y and to monitor her for a week, due to her being unwell previously. The Nursing Home did this and communicated the results with Mrs Y’s General Practitioner (GP).
15. Later in December 2021, the NHS wrote to Mrs Y and told her she was eligible for NHS funded nursing care. It told Mrs Y the amount of funding she was eligible for and that it had backdated the funding to May 2021. It also told Mrs Y it would make the payment directly to the Nursing Home. The letter was sent to the Nursing Home. The Care Provider’s records show in March 2022, the Care Provider made Mr X aware of how the funding had been awarded. Mr X emailed the Nursing Home in May 2022 as he had further concerns about how the funding was being applied to Mrs Y’s account. The Nursing Home did not respond to Mr X’s email.
16. Towards the end of December 2021, Mrs Y became unwell. A nurse at the Nursing Home assisted Mrs Y to bed and took observations. Mrs Y later appeared well. The Nursing Home informed Mr X of this.
17. In May 2022, Mrs Y moved into another nursing home.
18. In June 2022, Mr X contacted the Nursing Home about a missing garden ornament which belonged to his mother. He wanted to know what had happened to it. The Nursing Home responded to Mr X and told him about a year ago, it had been damaged by high winds when it was outside in the garden. Staff had intended on fixing it however they were unable to locate all of the pieces.
19. In September 2022, Mr X complained to the Care Provider about the matters outlined in paragraph one. Mrs Y had an outstanding balance of care charges. Mr X wanted the Care Provider to apply a discount to the outstanding charges. The Care Provider responded and:
• recognised it should have responded to Mr X’s request in relation to wanting a report on his mother’s health and so apologised to him;
• explained it had informed him when Mrs Y became unwell in December 2021;
• provided Mr X with the Nursing Home’s records between December 2021 and January 2022 which showed how the staff responded when Mrs Y became unwell and any advice they sought from Mrs Y’s GP;
• told Mr X it had explained to him via email in March 2022 how it considered Mrs Y’s NHS funded nursing care; and
• said it was not clear if the Nursing Home had informed Mr X about the broken garden ornament at the time it had happened and so apologised for this.
20. The Care Provider did not reduce the amount of outstanding care fees. Mr X remained unhappy and complained to us.

Back to top

Findings

The Nursing Home’s communication with Mr X

21. Mr X asked the Nursing Home to provide him with a full report of his mother’s health when he found she had been unwell in the past. The Nursing Home did not respond and this was fault. However, the Care Provider recognised this in its complaint response and that it should have responded to his request. It therefore apologised to Mr X. This was appropriate.
22. Mr X required further clarity on how the NHS-funded nursing care was going to be applied to his mother’s account. The Care Provider’s records show it informed Mr X of this in March 2022. However, Mr X sent another email in May 2022 requesting further clarity. There is no evidence the Care Provider responded to Mr X. This was fault and caused Mr X frustration.
23. Mr X said the Nursing Home did not inform him when his mother was unwell. The Care Provider’s records show it failed to inform him his mother was unwell in August 2021. This was fault and caused Mr X uncertainty. It did notify him when she was unwell again in December 2021.

The Nursing Home’s response to Mrs Y being unwell

24. Mr X said the Nursing Home did not seek medical advice when Mrs Y was unwell. I have reviewed the Nursing Home’s records which show when Mrs Y was unwell in August 2021, a nurse assisted and observed her. Staff did not call a GP for advice however, there was no evidence which showed Mrs Y continued to present as unwell and was at the risk of harm. There was no fault with the Care Provider’s decision not to seek advise from a GP.

NHS funded nursing care

25. Mr X said the Care Provider did not inform him or Mrs Y when she became eligible for funded nursing care. In December 2021, the NHS wrote to Mrs Y and informed her she was eligible for funding. The letter was sent to the Nursing Home. It is unclear if the letter was shared with Mrs Y or Mr X. However, later, the Care Provider contacted Mr X and confirmed Mrs Y was eligible for the funding and explained how it would be applied to her account. The Care Provider was not at fault.

Mrs Y’s garden ornament

26. I decided not to investigate this further as I would not be able to achieve anything more. This is because there is no evidence Mrs Y was significantly upset by the matter. Furthermore, the Nursing Home explained to Mr X what had happened and how the ornament was broken and apologised it had not informed Mr X at the time.

Back to top

Agreed action

27. Within one month of the final decision, the Care Provider will apologise to Mr X for the frustration it caused him by not responding to his emails and not telling him when his mother was unwell.
28. Within one month of the final decision, the Care Provider will review with staff at the Nursing Home, the importance of communicating effectively with relatives of people who use the service. This is to ensure staff respond to concerns relatives may have and that staff keep relatives informed of any changes to their relative’s health.
29. The Care Provider will provide us with evidence it has complied with the above actions.

Back to top

Final decision

30. I have now completed my investigation. The Care Provider was at fault. It has agreed to our recommendations to remedy the injustice caused and prevent a recurrence of fault.

Back to top

Investigator's decision on behalf of the Ombudsman