Summary: We will not investigate this complaint about the quality of care in a care home. There is insufficient evidence of fault in some areas of complaint, and insufficient evidence of injustice in others, to warrant investigation by the Ombudsman.

The complaint

1. Miss X complained the Council-commissioned Care Provider neglected her grandfather, Mr Y, who has since died. She said:
• Mr Y was often unclean and unpresentable;
• he had recurring pressure sores which caused him significant discomfort;
• staff dismissed Miss X’s concerns, saying pressure sores were scratches and saying “he always looks like that” when she mentioned he looked unwell; and
• Mr Y’s room was unclean and his bathroom bin was not emptied frequently enough.
2. Miss X said the matter caused distress. She wanted the concerns taken seriously and for service improvements to be made so others do not experience the same issues.

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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:

• there is not enough evidence of fault to justify investigating, or
• any fault has not caused injustice to the person who complained, or
• any injustice is not significant enough to justify our involvement.

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

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How I considered this complaint

4. I considered information provided by the complainant and the Council.
5. I considered the Ombudsman’s Assessment Code.

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My assessment

Insufficient evidence of fault to warrant investigation

6. Part of Miss X’s complaint related to Mr Y often having food on his face and down his clothes some time after a meal.
7. The Care Provider explained in its complaint response that Mr Y sometimes had food left on his face and clothes due to the care staff using the ‘retreat and return’ method when Mr Y did not accept assistance to be cleaned after a meal. It also said at times it waited for Mr Y’s wife to be present before providing care. There is insufficient evidence of fault by the Care Provider.
8. Part of Miss X’s complaint related to comments of staff when she raised concerns, which she felt were dismissive. We could not say what verbal conversations occurred between Miss X and care staff. The accounts of both parties differ. There is insufficient evidence of fault by the Care Provider.
9. Parts of Miss X’s complaint related to the Care Provider’s management of Mr Y’s health. The Care Provider has explained the steps it took in relation to a pressure sore that became evident on Mr Y’s return from hospital. The Council considered the Care Provider’s management of Mr Y’s skin and found no evidence of fault by the Care Provider. The Council found the pressure sore to be consistent with a long wait in A&E.
10. The GP assessed Mr Y on the day Miss X says she raised concerns about him looking unwell, and all observations were within normal parameters. Upon Mr Y deteriorating in health two days later, the Care Provider asked the GP to visit again, at which time they prescribed antibiotics for Mr Y for a chest infection. There is insufficient evidence of fault in the Care Provider’s actions.

Insufficient injustice to warrant investigation

11. We will normally only investigate a complaint where:
• the complainant has suffered serious loss, harm, or distress as a direct result of faults or failures by the service provider, or
• there are continuous and ongoing instances of a lower-level injustice that remain unresolved over a long period of time.
12. There is insufficient evidence of a significant personal injustice in relation to
    Miss X’s complaints about Mr Y’s bin not being emptied and cleanliness of his room. The Care Provider did not deny issues in these areas, and invited further evidence from Miss X. However, given the lack of injustice related to these parts of the complaint, we will not investigate these matters in any event.

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Final decision

13. We will not investigate Miss X’s complaint because there is insufficient evidence of fault in some areas of complaint, and insufficient evidence of injustice in others, to warrant investigation by the Ombudsman.

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Investigator's decision on behalf of the Ombudsman