Summary: We will not investigate Mr B’s complaint about the Council’s safeguarding investigation into his concerns about his late mother’s, Mrs C’s care prior to her death. This is because there is not enough evidence of fault with the actions taken by the Council to warrant an Ombudsman investigation.

The complaint

1. Mr B complained about the care his late mother, Mrs C, received prior to her passing away in December 2020. Mr B says Mrs C was segregated, left on her own for long periods of time and says he was not told Mrs C was showing signs of dementia. Mr B says Mrs C would have needed support with her diet and eating and drinking. Mr B says he wants to see the records of what happened to Mrs C during the days and minutes prior to her death. Mr B says he does not know the actual cause of Mrs C’s death as there was no coroner inquest due to the Covid-19 pandemic. Although Mrs C’s death certificate records her death as old age Mr B is not sure if this was the cause. Mr B says he is devastated he could not spend the last few minutes of Mrs C life with her, and only knew of her death after she had passed away. Mr B alleges the Nurse who was with Mrs C at the end of her life injected her with something.

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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 effect on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We may decide not to start an investigation if the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

3. I considered information provided by the complainant’s representative.
4. I considered the Ombudsman’s Assessment Code.

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My assessment

5. The Council considered Mr B’s allegations and his concerns about Mrs C’s care under its responsibility for safeguarding vulnerable adults. It found no evidence to substantiate any of the allegations Mr B raised. It said Mrs C had capacity at the time and the death certificate recorded she passed away from old age and breast cancer. Mrs C had suffered with breast cancer since 2019, had undergone surgery and treatment but had refused ongoing cancer treatment. There was an end-of-life plan and DNAR in place which Mrs C’s daughter and named point of contact was aware of. Records show the care provider contacted Mrs C’s daughter and offered support for the family to visit before Mrs C passed away. When Mrs C died the care provider was unable to contact Mrs C’s daughter, so it contacted Mr B and informed him of her passing.
6. While it is understandable that Mr B would have wanted to spend time with Mrs C prior to her passing, the Council’s safeguarding investigation confirmed it had seen clear record keeping regarding the care provider’s and health professionals actions and everything had been done in line with procedures. There was no evidence of Mrs C being injected with anything. Documentation evidenced appropriate interaction with the family’s ‘point of contact’ and visits were offered. We could not add to this or make a different finding even if we investigated. The Council acknowledged the difficulties around visiting relatives in care homes due to Covid restrictions in place at the time.
7. The Council considered Mr B’s concerns under its role as lead safeguarding authority and found no evidence that Mrs C was not properly cared for. There is not enough evidence of fault with the Council’s actions to warrant an Ombudsman investigation.
8. Mr B has unanswered questions about the care Mrs C received in the last few days of her life. However, the Ombudsman cannot provide these answers. Mr B says he wants to see Mrs C’s health and care records. Information about how to access records can be found on the website below:

How to access information from a public body | ICO

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Final decision

9. We will not investigate Mr B’s complaint because there is not enough evidence of fault with the actions taken by the Council to warrant an Ombudsman investigation. Further investigation could not add to the Council’s response or make a different finding of the kind Mr B wants.

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Investigator's decision on behalf of the Ombudsman