Summary: Mrs X complains about a care home’s actions when her mother in law was admitted to hospital and after her death. We consider there was fault by the care provider which caused injustice to the family. The care provider has agreed a remedy.

The complaint

1. Mrs X, Mrs B’s daughter in law, complains about the care provider’s actions including
• not informing next of kin when Mrs B was admitted to hospital.
• not providing Mrs B the basic toiletries included in the contract she signed.
• dumping her belongings in bin bags after Mr B’s death.
• delay in refunding fees to the family.
2. Mrs X says that Mrs B died in the hospital and the family were only able to say goodbye via video call. The events caused the family distress. Mrs X wants an apology, and for the care home to pay a financial penalty.

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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. If they have caused an injustice we may suggest a remedy. (Local Government Act 1974, sections 34 B, 34C and 34 H(3 and 4) as amended).
4. If we are satisfied with an organisation’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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What I have and have not investigated

5. I have investigated the complaints in paragraphs 1 and 2 above.
6. I do not intend to continue my investigation into Mrs X’s complaints that:
• The care home should have involved the family when Mrs B completed a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT form) with the GP who attended Mrs B at the care home. This form was about her wishes regarding emergency treatment.
• The hospital had recorded in its notes that Mrs B had dementia, but the care home denied she had dementia.
7. These complaints concern records made by the health service and therefore a complaint about the reasons for that information should be made to the health service. It appears that Mrs B had mental capacity to make decisions about her care and treatment. I have not seen sufficient evidence to show that the care home lied when it said Mrs B did not have dementia, as it its records did not indicate she had dementia. I do not consider there is sufficient evidence the home was at fault regarding Mrs B’s decision to complete the ReSPECT form with the GP and to not to advise the family about it.

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How I considered this complaint

8. I have discussed the complaint with Mrs X and considered the information she provided. I have made enquiries of the care provider and considered the comments and documents it provided. Mrs X and the care provider had an opportunity to comment on my draft decision. I considered the comments I received before making a final decision.

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What I found

9. In 2022 Mrs B was living in a residential care home. She was self funding and paid the fees herself.
10. In June 2022 Mrs B became ill at night and the care home called an ambulance. Mrs B was admitted to hospital. The care home did not advise Mr and Mrs X or any other family members about this.
11. The family found out the next day when Mrs B’s grandson visited her at the home, and the home advised she was in hospital.
12. Mr X complained to the home that it did not tell him about his mother’s admission to hospital. He said the home should have let him know.
13. Mrs B’s condition worsened after a couple of days, and she sadly passed away in the hospital. Mrs B’s granddaughter was with her when she died.
14. Mr X called the care home to advise Mrs B had died. He said the family would come and collect her belongings within the seven day notice period as required. However, when Mr X came to collect her possessions five days later, the home had cleared her room and all her belongings were dumped in bin bags. Mr X says that he met the care home’s manager, but he did not show any compassion.
15. The care home replied to Mr X’s complaint that it should have advised the family about Mrs B’s admission to hospital. It said that Mrs B told staff she did not want the home to contact Mr and Mrs X about going into hospital in the night because they were on holiday. But it said it gave Mr X’s number to the paramedics so that they could call him.
16. Mr X asked the care home for a refund of fees in mid July because a direct debit had been taken after her death.
17. As he had not received the refund by mid October, Mr X emailed the home. He emailed again 10 days later. The care home arranged a refund of over £1800 by the end of October.
18. In January 2023 Mr X complained to the care home that it
• Did not call the family when Mrs B was taken into hospital. He said his mother would have insisted they were informed.
• Cleared the room and put Mrs B’s possessions in bin bags before the seven day notice period
• Charged for basic toiletries such as soap and denture tablets when these were included in the contract. Mrs B had to practically beg for these items when she should not have had to do this.
• Took several months to refund overpaid fees.
19. The care home replied to Mr X’s complaint in February. It said Mrs B did not want the home to inform Mr X as he was on holiday. It attached a copy of the care notes which showed that the home’s care workers tried to inform Mr X, but Mrs B was upset and did not accept that the home should contact Mr X. The notes showed that the paramedics took Mr X’s number and advised they would call him. The care home said it regretted it did not inform him of Mrs B’s admission to hospital and it apologised for this.
20. The care home said it deeply regretted that staff put Mrs B’s belongings into bin bags and said this was not normal practice. It assumed this was due to a breakdown in communication and it apologised for this.
21. The care home apologised that there was confusion regarding toiletries. It said it had now changed its contract terms and conditions. It said that staff members would regularly buy items for Mrs B.
22. Finally, the care home apologised for its delay in refunding the overpaid fees. The care home did not advise whether the response was its final response, or give details about complaining to the Ombudsman.
23. Following Mrs X’s complaint to the Ombudsman, I asked the care home what actions it had taken to remind staff about informing families and representatives about residents being admitted to hospital. It confirmed that it had discussed with staff about informing families as soon as it is practical to do so. However, when residents ask staff not to inform their families, the care home advised staff to escalate the issue to management.
24. I asked the care home for its comments regarding basic toiletries being included in the contract Mrs B signed, but she had had to pay for these when they should have been provided free of charge. The care home replied that it was not aware Mrs B purchased her own toiletries. It said that the home manager would purchase items when Mrs B asked for these.

Analysis

25. I consider there was fault by the care provider which caused injustice as follows:
• It did not ensure that the family were advised about Mrs B’s admission to hospital. I note that Mrs B did not want the family to be contacted at night time as they were on holiday. As the home noted Mrs B insisted on this and became upset, I do not consider there is fault here. However, it appears the care home then passed the responsibility for advising the family on to paramedics without checking that this had been done the next day at a more reasonable hour. I note the family became aware of the situation within 12 hours of Mrs B’s admission, but it was distressing for them to hear about this late. After this, members of the family were able to visit Mrs B in hospital. And Mrs B’s granddaughter was with her when she died.
• I consider there is sufficient evidence the care home charged Mrs B for basic unbranded toiletries, when its contract stated these were included. The extent of this is not clear as it appears that some staff did not ask her to pay for unbranded toiletries, while others did. The contract may have now changed, but Mrs B should not have had to pay. It appears that staff were unclear about the specific terms in Mrs B’s contract and assumed that she should pay. This is likely to have caused frustration and distress for Mrs B. However, we cannot remedy the injustice this caused Mrs B as she has passed away. I have recommended a remedy for Mrs X in view of the distress caused to the family.
• There was fault by the care provider as its cleared Mrs B’s room early and put her belongings in bin bags. This caused distress to Mr and Mrs X.
• There was significant delay in it refunding fees to Mr X. As he was arranging matters regarding Mrs B’s estate this caused him inconvenience and time and trouble chasing this up.
26. The care provider has already apologised to Mr X for these faults. It has also taken appropriate steps to prevent these faults occurring again.
27. However, I have recommended a symbolic financial remedy in view of the distress caused to the family and Mr and Mrs X’s time and trouble.

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Agreed action

28. I recommended that within one month of my decision
• The care provider pays Mrs X £150 as a remedy for the injustice caused by its faults when Mrs B went into hospital, and following her death.
• The care provider reminds managers their complaint responses should confirm when they are at the final stage and should signpost complainants to the Ombudsman if they remain dissatisfied.
29. The care provider should provide us with evidence it has complied with the above actions.

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Final decision

30. There was fault by the care provider causing injustice to Mr and Mrs X. The care provider has agreed my recommendations to remedy the injustice. I have ended my investigation and closed the complaint.

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Investigator's decision on behalf of the Ombudsman