Summary: We will not investigate Ms X’s complaint about the care home failing to provide adequate care to her mother and about poor standards of cleanliness of her mother’s room. This is because an investigation would not lead to any different findings or outcomes.

The complaint

1. Ms X complains the care home failed to provide adequate care to her mother as it failed to notice her mother had a kidney stone. She also complains about poor standard of cleanliness of her mother’s room.

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The Ombudsman’s role and powers

2. We investigate 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 an investigation if we decide investigation would not lead to a different outcome. (Local Government Act 1974, section 24A(6), as amended, section 34(B))

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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.

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My assessment

5. Ms X’s mother, Mrs B, was in a care home situated in another council’s (Council 2) area. In July 2023, Mrs B was taken to hospital as an emergency. At hospital, it was identified Mrs B had a kidney stone and sepsis.
6. Ms X complained the care home neglected her mother and that it should have identified she had a kidney stone earlier.
7. The care home responded to Ms X’s complaint and noted that no specific issues had been reported prior to Mrs B’s admission to hospital regarding pain or urine output. The care home noted Mrs B’s fluid output was not being monitored as there was no risk evident regarding fluid output. The care home also said that when staff were alerted to Mrs B being in pain, due to her screaming, they immediately contacted emergency services. It accepted that based on the photos provided by Ms B, it agreed that the room was not to the standard expected. The care home apologised for this.
8. The Council noted in its complaint response that Council 2 had completed safeguarding enquiries to consider whether there was evidence of neglect by the care home, and that the outcome was inconclusive.
9. Council 2’s safeguarding report noted that if an individual had kidney stones, they may present with certain symptoms. However, the evidence showed none of these symptoms had been spotted by staff. The report concluded this was reasonably due to staff not looking out for these signs, especially as Mrs B would not have been able to articulate any pain or concerns due to her diagnosis of dementia. Therefore, staff could not have known Mrs B had a kidney stone any earlier as none of the usual symptoms had been spotted. The outcome of the enquiries was that the concerns of neglect were inconclusive, due to lack of evidence.
10. An investigation is not proportionate as we are unlikely to reach any different findings in terms of whether it was possible for the care home to have identified Mrs B had a kidney stone earlier. An investigation would not lead to further evidence being uncovered and I am satisfied that, based on the evidence available, Council 2’s safeguarding enquiries led to a reasoned conclusion as to why staff were not looking out for the usual symptoms of kidney stones. Therefore, the evidence available does suggest staff acted as soon as possible once Mrs B presented as being in pain.
11. With regards to the poor cleanliness of Mrs B’s room, the care home has accepted this was not up to standard and apologised for this. An investigation would lead to any further outcomes for this matter.

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Final decision

12. We will not investigate Ms X’s complaint because an investigation would not lead to any different findings or outcomes.

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Investigator's decision on behalf of the Ombudsman