Summary: We will not investigate this complaint about adult social care in a care home, and when to seek medical advice. This is because there is not enough evidence of fault to justify investigating. The care provider acting for the council sought medical advice and acted on it.

The complaint

1. Ms F says the care provider acting for the Council failed to seek appropriate medical attention when her relative, Ms G, was clearly unwell. Ms F says this caused a decline in Ms G’s health and wellbeing. Ms F wants the care provider to improve procedures and prevent this happening to any other residents.

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The Ombudsman’s role and powers

2. 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
• we could not add to any previous investigation by the organisation, or
• further investigation would not lead to a different outcome.

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

3. We consider whether there was fault in the way an organisation made its decision. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), 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. Ms G lived at a care home arranged by the Council. The actions of the care provider (who run the care home) are on behalf of the Council to meet Ms G’s adult social care needs.
7. The care provider noted Ms G was unwell and sought medical advice from the Community Matron. The care provider acted on the advice it received. When there was a further decline in Ms G’s health, the care provider sought medical advice from the NHS advice line and Ms G went to hospital.
8. The Ombudsman is not an appeal body. We cannot challenge the care provider’s decision unless there is fault in its decision making. In this case, I am satisfied the care provider has taken the right steps to seek medical advice and act on it. The care provider was entitled to rely on the advice it received. I understand Ms F disagrees and thinks the care provider should have done more. However, this is not evidence of fault in the care provider’s decision and professional judgement.

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Final decision

9. We will not investigate Ms F’s complaint because there is not enough evidence of fault, and it is unlikely investigation would lead to a different outcome.

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Investigator's decision on behalf of the Ombudsman