Summary: There was no fault in the way a council responded to safeguarding concerns Mrs X raised about her mother Mrs Y’s care in a care home.

The complaint

1. Mrs X complained for her mother Mrs Y that Northamptonshire County Council (the Council) failed to properly investigate concerns about Mrs Y’s care in a care home. Mrs X complained about over-use of sedatives and unexplained bruising. She said the Council’s safeguarding investigation into her concerns was inadequate.
2. Mrs X told us the Council’s fault caused her avoidable anxiety and distress and affected Mrs Y’s wellbeing.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word ‘fault’ to refer to these. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

4. I considered Mrs X’s complaint to us, the Council’s response to her complaint and documents described later in this statement.
5. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance

6. A council must make enquiries or ensure others do so, if it believes an adult in need of care and support is experiencing or is at risk of abuse or neglect. (Care Act 2014, section 42)
7. Care and Support Statutory Guidance sets out the purpose of a safeguarding enquiry, which includes establishing facts and deciding whether action needs to be taken to prevent abuse or neglect. The enquiry must include seeking the views of the person who may have been abused/neglected.

What happened

8. Mrs Y lived in the care home for three months in 2019 and then moved to another care home in September. Mrs X has power of attorney for Mrs Y which means she can manage Mrs Y’s finances for her. Mrs X arranged and paid for Mrs Y’s care on her behalf. The Council did not commission or fund the placement.
9. Mrs X raised concerns about the care home by contacting the Council after Mrs Y moved. The Council started a safeguarding enquiry into concerns about unexplained bruises and overuse of sedatives. The safeguarding enquiry involved two social workers who liaised with Mrs X, visited the care home, looked at Mrs Y’s care records and spoke to senior staff. The social workers sought Mrs Y’s views through staff at her new care home. I have summarised the main parts of the enquiry report below:
• Social workers examined Mrs Y’s care records including medication charts, records of visits and contact by the GP, family liaison records and care plans
• Staff at the care home said Mrs Y came from hospital with bruising and that she sometimes bruised herself by scratching and crossing her legs.
• Mrs Y’s care plans said she had bruises on her arms and legs and needed to be monitored
• The sedative was on Mrs Y’s medication chart, a copy was retained for the enquiry. Mrs Y asked for the sedative when she wanted it.
• Based on the information available, there was not enough to substantiate a safeguarding concern.
10. Mrs X complained to the Council about the issues she has raised with us and about other issues she has not pursued with us. The Council’s response explained the conclusions of its safeguarding investigation:
• Mrs Y sometimes refused medication, her sedative was prescribed ‘as and when required’ and so if she said she did not want it, the tablet would stay in the packaging until she asked for it. The GP made some changes to Mrs Y’s medicines
• The home noticed bruising when Mrs Y returned from hospital and Mrs Y also bruised herself when sitting in certain positions. Without witnesses to an incident or event, it was difficult to determine the cause. The Council’s role was to investigate the concerns raised and the officers involved followed the correct process
• The first social worker was a duty worker and did not have time to read all the documentation when she visited the care home and so the case was passed to a second social worker who did read everything
• The Care Quality Commission was responsible for enforcement action and not the Council. The Councils does quality monitoring visits for all care homes it commissions
• The safeguarding team acted promptly
• Officers assumed that records were accurate unless there was evidence of tampering.
11. The Council kept a copy of the care home’s medicine chart. This showed Mrs Y often refused the sedative and the care home noted this on the chart. I see no evidence staff at the care home gave Mrs Y more than the GP prescribed, often she received only one dose a day when the prescription said she could have up to three each day. I also see no evidence the drug records were tampered with.

Was there fault?

12. There was no fault. I am satisfied the Council acted in line with section 42 of the Care Act 2014 by making necessary enquiries into the safeguarding concerns Mrs X raised. The Council acted in line with Care and Support Statutory Guidance by interviewing key staff, speaking to Mrs X and Mrs Y, examining care records and recording findings in an enquiry report. The Council also retained key records from the care home that it used as evidence in the safeguarding enquiry. It is not our role to say whether abuse has taken place or not, it is for the Council to decide whether action needed to be taken to prevent abuse or neglect. I am satisfied the Council followed the correct procedures and so there was no fault in the conclusions which were based on the evidence found. I am also satisfied the Council’s complaint response explained the action officers took and that the evidence considered did not support a finding of neglect.

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Final decision

13. The Council made appropriate safeguarding enquiries in line with its duty under section 42 of the Care Act and so there was no fault.
14. I have completed the investigation.

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Parts of the complaint that I did not investigate

15. Mrs X also complained about the care home not giving her a copy of its resident guide or a written contract. I did not investigate this complaint as Mrs X needs to complain to the care home directly about this issue, which is not a safeguarding concern and therefore not something the Council had to look into.

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Investigator's decision on behalf of the Ombudsman