Summary: We will not investigate this complaint about adult social care in a residential care home. This is because we are satisfied with the actions the care provider has taken in response to the complaint. It has accepted fault, apologised, and will learn lessons to improve service. It is unlikely an Ombudsman investigation would achieve anything further.

The complaint

1. Ms C says the care provider acting for the Council neglected her relative, Ms D. Ms C also says the care provider failed to tell her when Ms D’s health was declining. This has been very distressing for Ms C, and she would like relevant staff suspended and properly investigated.

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The Ombudsman’s role and powers

2. We may investigate a complaint on behalf of someone who has died or who cannot authorise someone to act for them. The complaint may be made by:

• their personal representative (if they have one), or
• someone we consider to be suitable.

(Local Government Act 1974, section 26A(2), as amended)

3. Ms D has died; we have accepted Ms C as a suitable representative.
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 no worthwhile outcome achievable by our investigation.

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

5. We may decide not to start or continue with an investigation if we are satisfied with the actions an organisation has taken or proposes to take. (Local Government Act 1974, section 24A(7), as amended)

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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. The Council arranged Ms D’s placement in a care home to meet her adult social care needs. The care provider acts on behalf of the Council.
9. Ms C raised various concerns which the care provider has investigated and responded to.
10. One issue is about Ms D’s continence care. The care records show long gaps between Ms D’s continence care, implying she was wearing pads for a long time between them being changed. The care provider says it did change them regularly (if they were soiled and needed changing) but it has failed to always record when it checked or changed them. There is no way for the Ombudsman to know whether this is a failure in care or a failure in recording. We can provide no remedy to Ms D for the impact of any failures in her care.
11. The Care Quality Commission (CQC) is the independent regulator of health and social care in England. The CQC has fundamental standards below which a person’s care should never fall. The Care Provider should have provided Ms D with person-centred care meeting the needs and preferences detailed in her care plan and should provide care with dignity and respect. The Care Provider should also keep full and accurate records of the care it has provided. Its failures in these areas may be breaches of the fundamental standards.
12. The care provider has apologised to Ms C for her distress, and for its failures in communication with her when Ms D’s health was declining. The provider has reviewed its practices and spoken with relevant staff to improve service.

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Final decision

13. We will not investigate Ms C’s complaint because it is unlikely we would add to investigations already conducted or that an Ombudsman investigation would reach a different outcome. The care provider has apologised to Ms C for the impact of its failures and will learn lessons from the complaint. We are satisfied with this action in response to the complaint.
14. The Ombudsman has no powers to become involved in personnel matters so could not achieve the outcome Ms C wants about staff suspensions or any disciplinary action.
15. Under our information sharing agreement, we will share this decision with the Care Quality Commission (CQC).

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Investigator's decision on behalf of the Ombudsman