Summary: We will not investigate this complaint about Mrs C’s care provider. This is because we are satisfied the actions taken by the Care Provider remedies the injustice.

The complaint

1. Mr D complained his mother’s, Mrs C’s, care provider, refused to call for healthcare professionals to attend in November 2022 when Mrs C was showing signs of distress despite her family’s request they do so. Mr D says this has had an extreme effect on Mrs C, who was forced to spend an additional day in severe pain more than was necessary. Mr D says a family member called the out of hours GP the following day who immediately called an ambulance. Mrs C was transported to hospital and was hospitalised for a month. Mr D says Mrs C has never fully recovered from this and wants her care provider to acknowledge its failure to refuse emergency care. Mr D says the Care Provider should return money spent on care and compensate Mrs C for her suffering.

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The Ombudsman’s role and powers

2. 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)
3. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse effect 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 the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)

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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. Mr D says Mrs C’s family’s request for medical intervention was refused and they had to call the out of hours GP the following day. Although there are discrepancies around this point we will not investigate it further. Mrs C’s family member/s could have called the GP the previous day if they felt their concerns and requests were not being listened to. We could not make the causal link between Mrs C’s ongoing decline in health and her not receiving medical treatment a day earlier in November 2022.
7. The Care Provider has detailed what action it took over the two days in November 2022 when Mrs C became unwell. It disputed Mr D’s assertion that had family members not been present, Mrs C’s condition would have gone unnoticed. It said the nurse called 111 who requested an ambulance come to the home resulting in Mrs C being taken and admitted to hospital. Further investigation by us could not add to this.
8. The Care Provider acknowledged some areas where it could have done better. It apologised Mr D felt he was not listened to and explained it had arranged for nurses to attend ‘Active Kindness’ training. It said documentation, communication and record keeping could have been better but did not agree Mrs C had not been properly cared for and supported during this time. As a good will gesture it agreed to waive the outstanding amount of £285.21 but refused to reimburse care fees. We are satisfied with the remedy provided and could achieve no more than this even if we investigated.

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Final decision

9. We will not investigate Mr D’s complaint because we are satisfied with the Care Provider’s actions, and we could achieve no more than that even if we investigated.

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Investigator's decision on behalf of the Ombudsman