Summary: Mr X complained about the quality of care provided to his late mother Mrs Y in a care home. We have ended our investigation as the complaint relates to events from 2020 and 2021. Mr X could have complained to us sooner and an investigation now is unlikely to achieve a worthwhile outcome.

The complaint

1. Mr X complained about the quality of care provided to his late mother Mrs Y at a care home. In particular he complained:
1. it changed her GP without her consent,
2. failed to apply COVID rules consistently,
3. failed to provide a contract,
4. missed appointments and ignored pain management requests,
5. provided inadequate nutrition, and
6. failed to initiate end of life procedures.
2. Mr X says this led to a decline in Mrs Y’s condition and meant the family needed to provide significant support to Mrs Y.

Back to top

The Ombudsman’s role and powers

3. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something a care provider has done. (Local Government Act 1974, sections 26B and 34D, as amended)
4. 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 another body better placed to consider this complaint, or
• there is no worthwhile outcome achievable by our investigation.

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

Back to top

How I considered this complaint

5. I have considered the information provided by Mr X and have discussed the complaint with him on the telephone. I have considered some initial information provided by the care provider and the relevant law and guidance.
6. I gave Mr X and the care provider the opportunity to comment on a draft of this decision. I considered any comments I received in reaching a final decision.

Back to top

What I have found

What happened

7. Mrs Y had a terminal illness. She was admitted to hospital in 2020 after a fall in which she broke her hip. Mrs Y’s family found a care home which Mrs Y moved into in November 2020. Mrs Y died at the care home in July 2021.
8. In September 2021 Mr X raised a concern with the care home about the care bill. He also raised some issues about the quality of care. The care home responded to his concerns in October 2021. It also agreed to review the bill and reissued the invoice.
9. Mr X raised further concerns with the care home in October 2021. It responded in late October 2021 and gave details of how Mr X could complain to us.
10. Mr X remained unhappy and in early December 2021 the care provider agreed to put the bill on hold until Mr X had a chance to review the documentation and provide his full comments.
11. The care provider contacted Mr X in March 2022. It referred to its correspondence from December 2021 when Mr X said he needed more time. It said it could call if he felt that would be beneficial. As it heard nothing further, in December 2022 the care home wrote to Mr X to remind him of the debt and said if it did not hear anything by the end of the month it would contact its credit control.
12. Mr X responded in mid December 2022 again setting out his concerns. The care provider responded in February 2023. Mr X requested 21 days to respond as he considered the response was inaccurate.
13. The care provider heard nothing further and wrote to Mr X in the autumn seeking payment of Mrs Y’s care bill. In November 2023 Mr X responded with some further concerns. The care provider responded to these in January 2024. It again provided Mr X with our details.

Analysis

14. Mr X is complaining about events that occurred between November 2020 and July 2021. We would not usually investigate events from more than 12 months before the complaint to us unless:
• we decide there are good reasons for the person not making the complaint sooner; and
• we are satisfied there will be sufficient information available to reach robust, fair conclusions and meaningful recommendations; and
• we consider we will be able to achieve a worthwhile outcome.
15. Mr X was aware he had cause for complaint in 2021 and was made aware of us by the care home in late 2021. There were also significant gaps when he did not progress the complaint with the care provider. There are no good reasons why he could not have complained to us sooner in 2021 or 2022. In addition, although the care provider’s records are available, our role is to remedy injustice caused by fault and I do not consider further investigation would lead to a worthwhile outcome. We look to put people back in the position they would have been in if not for the fault. Mrs Y has died so any injustice caused to her by potential fault cannot now be remedied.
16. We also look to make recommendations for service improvements to prevent a recurrence of the fault. Given the passage of time it would be difficult to make relevant service improvements due to likely changes in staffing and procedures within the care home since the time of the events.
17. In addition, the Care Quality Commission (who are the statutory regulator of care services) inspected this care home in January 2022. It would be for the CQC to identify and address any breaches in the fundamental standards of care those registered to provide care services must achieve.
18. Any concerns about Mrs Y’s pain management are matters for the GP not the care home. We cannot look at the actions of GPs.
19. Mr X was not satisfied with the quality of care provided. However, Mrs Y received care in the care home for which she was aware of the cost when she moved in and which she was required to pay for. Mr X has not paid Mrs Y’s care bill and a cancellation of the care charges is not something we could achieve. If Mr X believes the care home acted in breach of contract or did not have a valid contract with Mrs Y, then that is a matter most appropriately dealt with in court.

Back to top

Final decision

20. I have ended my investigation as the complaint is late and there is no worthwhile outcome I could achieve by investigating it now.

Investigator’s decision on behalf of the Ombudsman

Back to top

Investigator's decision on behalf of the Ombudsman