Summary: We will not investigate Mrs B’s complaint about care provided to her late husband Mr B. This is because further investigation by us could not add to the Care Provider’s response or make a different finding of the kind Mrs B wants.

The complaint

1. Mrs B complained about the care her late husband Mr B received from his Care Provider between 2018 up until his death in January 2022. Mrs B says she did not complain before now because of the threat of him being evicted. Mrs B complained:

• Food provided to Mr B was not satisfactory, the Care Provider on occasions said it had run out of food, food was not nutritionally balanced, and she felt at times food was withheld as a punishment. Mrs B says she has photographic evidence of the poor food offered to Mr B.
• Mr B received poor personal care. Mrs B had to request he was showered, have his hair washed and shaved. Mr B was left wet, smelled of urine and was not showered daily.
• Mr B’s Care Provider refused to call a GP until the following week. It was only after Mrs B called the Out of hours GP and complained they attended. Mr B was diagnosed with sepsis and would have died before Tuesday.
• Residents answered the telephone and Mrs B could not get through to discuss Mr B’s wellbeing.
• Mrs B complained about the way she was treated and spoken to by staff. Mrs B says staff were aggressive and cold towards her. She says she was slandered, and false accusations were made against her. Mrs B says she felt intimidated during a meeting.

2. Mrs B wants the Care Provider to train staff better, provide adequate food and refund the money Mr B paid for his care.

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The Ombudsman’s role and powers

3. We investigate complaints about adult social care providers and decide whether their actions have caused an injustice, or could have caused injustice, to the person making the complaint. I have used the term fault to describe such actions. (Local Government Act 1974, sections 34B and 34C)

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How I considered this complaint

4. I considered information provided by the complainant.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

6. The Care Provider responded to Mrs B’s complaints. It assured her there had never been an occasion when food had run out and found no evidence that Mrs B had raised concerns or complained about Mr B’s food during the period he lived in the home. It found no evidence of a complaint or suggestion that Mr B had been refused food as a punishment. It noted in December 2021 Mrs B agreed to attend the home to try to support Mr B with nutrition as he was refusing meals. It said the home has a constant supply of food outside of the menu provided and sandwiches, snack soups and tinned foods are always in stock. The Care Provider says Mr B’s nutritional intake record show he was well fed, his nutritional state was good, he maintained weight and his needs were met.
7. Mrs B says she did not complain at the time because she was fearful of Mr B being evicted. Whilst Mrs B may have photographs of food she was unhappy with these were not brought to the attention of the Care Provider at the time. The Care Provider’s records show Mr B was well fed and his nutritional intake was good. Although Mrs B disagrees, we could not say Mr B was denied food, his food was not adequate or make a different finding to that given to Mrs B by Mr B’s Care Provider.
8. Mrs B complained the Care Provider did not give appropriate information to the Out of Hours GP and she had to follow up the call. Mrs B says the Out of Hours GP initially refused to attend because the Care Provider said Mr B could wait until the following week. The NHS contacted the Care Provider to investigate this matter further as it felt the staff member had not provided adequate information about Mr B’s condition. While the NHS was concerned it did not receive appropriate information from the carer who made initial contact with it, we cannot comment on the actions of health care professionals or intervene in a complaint between the Health Service and the Care Provider. We cannot comment on personnel matters or investigate what action the Care Provider has taken against the individual staff member complained about by the Health Service.
9. Fortunately, Mrs B’s persistence resulted in the NHS taking action to treat Mr B so no injustice was caused to him from the actions of or lack of actions from his Care Provider.
10. The Care Provider acknowledged Mrs B’s preference for Mr B to have a daily shower. It explained consent can be problematic for people with dementia and although Mr B had a shower once or twice a week, it confirmed he had a full wash daily. The Care Provider says on occasions Mr B refused to be shaved and explained it cannot force residents with dementia but says it ensured Mr B was shaved when he was compliant. The Care Provider says it undertook regular checks of Mr B’s pads which were recorded as ‘dry’ or ‘’changed’ and confirmed records show Mr B was recorded as being incontinent of urine between two and four times a day and checks in between showed his pads were dry. The Care Provider said Mr B was always more comfortable when Mrs B visited and acknowledged the difficulties for relatives coping with dementia. The Care Provider has explained the reasons for the lack of showers/shaves, explained how often Mr B’s pads were checked and changed, and further investigation by us could not add to this or make a different finding.
11. The Care Provider explained there was an issue with the telephone lines, but this is now resolved. We could not add to this point.
12. The Care Provider apologised if Mrs B felt staff were aggressive and cold and explained staff often felt intimidated by Mrs B’s approach and like Mrs B, staff felt on edge and uncomfortable. It explained it initially gave Mr B notice to leave because of the breakdown in the relationship between Mrs B and staff, not because of any concerns about Mr B’s care. However, it decided to withdraw the notice following an agreement with Mrs B to hold weekly meetings where she could raise complaints directly with management not staff members. It acknowledged from the minutes, discussion with staff and Mrs B’s complaint the meeting was difficult and advised Mrs B it will reiterate to staff how meeting should be conducted. We were not present at the meetings or times of communications when both parties perceived things differently and could not add to the Care Provider’s response or make a different finding even if we investigated.

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Final decision

13. We will not investigate Mrs B’s complaint because further investigation could not add to the Care Provider’s response of make a different finding of the kind Mrs B wants.

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Investigator's decision on behalf of the Ombudsman