Summary: Mrs X complained about the quality of care provided to her late mother Mrs Y at a care home. We have ended our investigation as there is no worthwhile outcome we could achieve by further investigating this complaint.

The complaint

1. Mrs X complained about the quality of care provided to her late mother Mrs Y at a care home. In particular, Mrs X complained about a fall at the care home, following which Mrs Y subsequently died. Mrs X wants the care provider to refund Mrs Y’s care fees.

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The Ombudsman’s role and powers

2. 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)
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:

• 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))

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How I considered this complaint

4. I considered evidence provided by Mrs X and the care provider as well as relevant law, policy and guidance.
5. I gave Mrs X and the care provider an opportunity to comment on a draft of this decision. I considered any comments I received before making a final decision.

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What I found

What happened

6. Mrs Y moved into the care home in the Summer of 2022.
7. Mrs Y had a fall at the care home during Spring 2023. Mrs Y died shortly afterwards from the injury she sustained. In late 2023, following an inquest, the coroner’s conclusion was ‘accident’.
8. Mrs X complained to the care provider in February 2024. She raised concerns including:
• a care worker not changing Mrs Y’s bedding when it was wet in late 2022;
• the boiler at the care home not working;
• the care provider lost Mrs Y’s spare hearing aids;
• the care provider did not involve her in Mrs Y’s care planning;
• concerns around staffing levels; and
• concerns around Mrs Y’s fall.
9. The care provider responded in May 2024. Mrs X remained unhappy and complained to us.

Analysis

10. Mrs X’s concerns related to events from 2022 and early 2023. We would not normally investigate events from more than 12 months before the complaint was made 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.
11. If Mrs X had concerns about the quality of care, it was open to her to raise these issues with the care provider and us sooner. There are no good reasons to investigate these events now and this part of Mrs X’s complaint is therefore late.
12. Although the care provider’s records are available, our role is to remedy injustice caused by fault and it is unlikely further investigation would lead to a worthwhile outcome for the following reasons.
13. We 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 improvement recommendations due to likely changes in staffing and procedures within the care home since the time of the events. In addition, the Care Quality Commission (who are the statutory regulator of care services) inspected the care home in August 2023 and identified areas for improvement. It is for the CQC to identify and address any breaches in the fundamental standards of care those registered to provide care services must achieve.
14. In addition, 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. The coroner has already investigated the fall which led to Mrs Y’s death and it was for them to decide if the care provider’s actions or inactions contributed to this and, if so, what consequential actions the provider needed to take to prevent reoccurrence.
15. There is therefore nothing I could likely add to the coroner’s investigation, nor should I re-examine events that a coroner has already had the opportunity to consider.
16. Mrs X would like Mrs Y’s care fees refunded. This is not something I could achieve. We cannot award compensation in the same way the courts can. We remedy individual injustice that results from fault and recommend service improvements to prevent recurrence.
17. For the reasons I have already explained there is no worthwhile outcome I can achieve by further investigating this late complaint.

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Decision

18. I have ended my investigation as there is no worthwhile outcome I could achieve by further investigating this late complaint.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman