Summary: We will not investigate Ms X’s complaint. We most likely would not find fault with how Durham County Council responded to her safeguarding concerns. Also, we are unlikely to find fault with how her integrated care team supported her in response to those concerns.

The complaint

1. Ms X complains that Durham County Council (the Council) has not addressed several safeguarding referrals between May 2019 and February 2020.
2. The Council redirected the safeguarding concerns to her integrated care team (the Care Team), who she says were the cause of her concerns. Also, the Care Team’s support after the referrals was not suitable to meet her needs.
3. Ms X also says the Care Team should have made safeguarding referrals to the Council when her care stopped on 26 April 2019.
4. Ms X says she has been left hungry, unwashed, and uncared for. This impacted her physical and mental health.
5. Ms X would like the Council to act on future safeguarding referrals.

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The Ombudsmen’s role and powers

6. The Ombudsmen provide a free service, but must use public money carefully. They may decide not to start or continue with an investigation if they believe it is unlikely they would find fault or it is unlikely we could add to any previous investigation by the Council. (Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended).

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How I considered this complaint

7. I have considered information Ms X has provided in writing and spoke to her on the phone. Ms X had an opportunity to comment on my decision.

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What I found

Background

8. The Care Team is responsible for managing Ms X’s health and social care needs. The Care Team is an integrated team, which includes staff from the Council and Tees, Esk and Wear Valley NHS Foundation Trust.
9. In late April 2019, a care agency ended its care and support for Ms X’s needs.
10. On 16 May, Ms X called the Council’s Social Care Direct (SCD) and tried to raise concerns about the lack of care and support. Ms X said she had suffered neglect by her Care Team. SCD referred Ms X to the Care Team to address her concerns.
11. On 17 May, an advocate for Ms X made a safeguarding referral to SCD, because Ms X could not prepare food. The SCD asked the Care Team to address Ms X’s safeguarding concern.
12. A social worker offered Ms X a food parcel. Ms X declined the offer because the food would be from a food bank. Ms X said she had food at home but needed support to prepare it. The social worker offered to visit Ms X and prepare the food for the coming weekend. The social worker also offered Ms X a place in an all-female respite placement as a temporary measure to safeguard her. Ms X declined the offer because any male staff members would trigger her post-traumatic stress disorder (PTSD). The social worker later dropped off a food parcel, which did not need preparation. The social worker noted Ms X’s home to be safe.
13. Three days later, the SCD closed the safeguarding case. It said the Care Team was better placed to support Ms X’s concerns. However, Ms X was under the impression her case had met the threshold for a safeguarding investigation.
14. On 31 May, the North-East Ambulance Service told SCD it would be making a safeguarding referral about Ms X. The Council agreed to review Ms X after the weekend. It was satisfied Ms X had food to eat over the weekend.
15. On 24 June, Ms X called SCD and said she was suffering neglect and abuse from her Care Team. SCD tried to arrange short-term support that day, but its attempts were unsuccessful.
16. The next day, a social worker for SCD called Ms X. The social worker agreed to arrange feedback about the safeguarding referral on 17 May. The social worker also logged Ms X’s concerns on 24 June as a formal safeguarding referral.
17. On 4 July, the Council wrote to Ms X. It apologised for not explaining the result of the May and June safeguarding referrals. The Council decided her Care Team were best placed to address her concerns about care and support.
18. In December 2019 and January 2020 Ms X raised similar concerns about her care and support to SCD. SCD decided each time the Care Team were best placed to address her concerns.

Analysis

The safeguarding referrals

19. I do not consider an investigation by the Ombudsmen would likely find any fault or significant injustice.
20. County Durham’s Safeguarding Adult’s Policies and Procedures is the local safeguarding arrangement to prevent and respond to all safeguarding concerns. SCD is County Durham’s single point of contact for responding to adults at risk. SCD can decide to address safeguarding concerns through care management or care coordination.
21. The Ombudsmen cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. The Ombudsmen must consider whether there was fault in the way the decision was reached.
22. The Council considered the several safeguarding referrals between May 2019 and February 2020. It considered the concerns and decided the Care Team could address the lack of care and support, rather than carry out a safeguarding investigation. That was in line with the local safeguarding procedure.
23. The Council’s communication around the safeguarding referrals was poor, and I agree that was fault. The Council apologised for that fault, and I consider that remedies the confusion Ms X suffered in May and June 2019.

The Care Team’s support

24. I do not consider an investigation by the Ombudsmen would likely find any fault or significant injustice.
25. I have already decided in a previous investigation the Care Team’s support in May 2019 was appropriate.
26. I do not consider Ms X’s needs after May 2019 were significantly different to the period of care I have already considered. Therefore, it is unlikely I will make a finding of fault.

The lack of safeguarding referrals

27. Ms X raised this point nearly a year after sending her complaint to the Ombudsmen. It was not included in her original complaint to the Ombudsmen. Ms X should raise a formal complaint about her Care Team on this part of her complaint.

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Final decision

28. I do not consider an investigation would likely find fault with the Council’s response to, or the Care Team’s support after the safeguarding concerns.

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Investigator's decision on behalf of the Ombudsman