Summary: We will not investigate this complaint about Mrs X’s mother’s care in the lead up to her death. We could not add to the investigations that have already taken place, and we could not achieve a meaningful outcome for Mrs X.

The complaint

1. Mrs X complained about the circumstances leading up to her mother’s (Mrs Y’s) death. Her concerns include care home staff failing to seek medical attention and not informing the family there had been an incident.
2. Mrs X says the care provider’s actions caused her mother’s death and the matter has caused her significant distress. She wants answers and apologies, as well as compensation and a refund of all care fees Mrs Y paid, which she says is around £5,000 - £6,000.

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The Ombudsman’s role and powers

3. 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 or continue an investigation if we decide:

• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome, or
• we cannot achieve the outcome someone wants, or
• there is no worthwhile outcome achievable by our investigation.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

4. The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)
5. We have the power to start or end an investigation into a complaint about actions the law allows us to investigate. We may decide not to start or continue with an investigation if we think the issues could reasonably be, or have been mentioned as part of the legal proceedings regarding a closely related matter. (Local Government Act 1974, sections 24A(6) and 34B(8), as amended, section 34(B))

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How I considered this complaint

6. I considered information provided by the complainant.
7. I considered the Ombudsman’s Assessment Code.

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My assessment

8. Mrs X’s complaint relates to the care her mother, Mrs Y, received and the alleged failure of the care provider to seek the appropriate medical attention when they found Mrs Y unresponsive.
9. The events have been subject to scrutiny via several processes since then, including a safeguarding investigation by the Local Authority and court processes. We will generally not investigate a complaint where further investigation by the Ombudsman would be unlikely to achieve a worthwhile outcome. In this case, we could not obtain the answers Mrs X seeks, and we could not override the decisions that have been made by the courts, including that of the coroner about the cause of Mrs Y’s death.
10. Mrs X seeks a refund of care fees and compensation which are over and above what we would likely be able to achieve, even if we could investigate what happened. We cannot award compensation in the same way the courts can, and we direct complainants to the courts where that is their primary goal. We may make recommendations a care provider refunds some care fees in some circumstances, however given that we could not come to different conclusions than the courts, we could not recommend this in this case. It is open to Mrs X to consider pursuing legal proceedings in this respect.
11. Mrs X says she raised some of her concerns as part of the court processes. We will usually decide not to investigate a matter where the issues have been raised, or could have been raised, during court proceedings. All issues raised in the complaint could have been raised as part of the court proceedings that took place. We would not investigate the complaint in any event, for this reason.

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Final decision

12. We will not investigate Mrs X’s complaint because we could not achieve a meaningful outcome by investigating.

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Investigator's decision on behalf of the Ombudsman