Summary: Miss E complains about the role of the Council in her mother’s care. She also complains her mother did not receive good care at a Care Home before she died. We will not investigate Miss E’s complaint because we can see no indications of unremedied fault by the organisations and are unlikely to be able to reach different conclusions than those already shared with Miss E by the organisations.

The complaint

1. Miss E complains about the care and treatment her mother, Mrs F, received before her death. Specifically, she complains;
• Oxfordshire County Council failed to allocate a social worker; Miss E raised a safeguarding concern which was not acted on; the Council delayed in accepting funding responsibility for Mrs F’s care placement when her Continuing Healthcare (CHC) funding was withdrawn.
• Mrs F went to a Care Home operated by Care UK in early December 2021. Miss E complains staff failed to provide Mrs F with appropriate care. When Miss E visited on 18 December 2021, her call bell was out of reach and staff had not helped her take medication.
2. Miss E explains the Council placed pressure on her to sell her mother’s house when CHC funding was withdrawn and this placed pressure on the family at a difficult time. Miss E worried her mother was not being cared for well at the Care Home. She has been left with many questions about the quality of her care after her death and has been unable to move on.
3. Miss E wants the Ombudsmen to investigate her complaints and look at whether the care provided was enough. She would like to better understand the circumstances leading up to her mothers death and for the organisations involved to take action to prevent similar problems occurring for other people.

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The Ombudsmen’s role and powers

4. The Ombudsmen have the power to jointly consider complaints about health and social care. Since April 2015 a single team has considered these complaints acting for both Ombudsmen. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA)
5. 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 could add to any previous investigation by the bodies, or
• there is not enough evidence of fault to justify investigating, or
• any fault has not caused injustice to the person who complained, or
• any injustice is not significant enough to justify our involvement, or
• they cannot achieve the outcome someone wants.

(Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

6. The Ombudsmen cannot question whether a decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the organisation reached the decision. (Local Government Act 1974, section 34(3), as amended, and Health Service Commissioners Act 1993, sections 3(4)- 3(7))
7. If the Ombudsmen are satisfied with the actions or proposed actions of the bodies that are the subject of the complaint, they can complete their investigation and issue a decision statement. (Health Service Commissioners Act 1993, section 18ZA and Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

8. I considered written information provided to us by Miss E, including her complaints to the Council and Care UK.
9. I considered the Ombudsman’s Assessment Code.
10. I asked Miss E for her comments before I made a final decision.

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What I found

Complaint against the Council

11. Miss E complains the Council failed to allocate a social worker to Mrs F, did not respond quickly to a safeguarding concern she raised and there were delays in it accepting funding responsibility for Mrs F’s care placement when her CHC funding was withdrawn. She felt pressured by the Council to sell Mrs F’s house.
12. The Council responded to Miss E’s complaints in its letter 13 March 2023. It explained it could not find reference to the Council insisting Miss E sell Mrs F’s house and could not comment on any refusal to accept funding responsibility. While I do not question Miss E’s recollection of events, the Ombudsmen could only review the same evidence and it would be unlikely we would come to a different conclusion.
13. The Council accepts there was a two-week delay in allocating a social worker and apologised for this. While it would have been preferable for Mrs F to have an allocated social worker, Miss E worked with duty social workers who understood Mrs F’s situation and wanted to help Miss E find a care placement for her. There is no lasting injustice to Miss E because she was talking to and working with the Council and it has apologised, which is what we would expect.
14. Miss E sent her safeguarding concern via email to an individual staff member’s inbox on 18 November 2021. The staff member was not available to read the email until 23 November 2021. When the staff member read the email, they noted it was about a Care Home in a different Council area and sent it to that Council the same day. The staff member contacted Miss E to explain what they had done. I can understand why Miss E would have been concerned when she did not receive a response, but the Council could not have done more in the circumstances.
15. I can find no indications of unremedied fault with the actions of the Council.

Complaint against Care UK

16. Miss E complains when she visited Mrs F on 18 December 2021 staff had placed her call bell out of her reach and did not help her take her medication.
17. In its complaint response of 7 February 2022, Care UK has explained Mrs F’s care notes show she became too unwell to use her call bell from 17 December. Because of this, staff placed her on hourly observations which is in line with their policy. I have reviewed Mrs F’s care records and can see hourly observations are recorded. Miss E disputes these observations took place.
18. Miss E also complains Mrs F was not given her lunchtime medication the same day. The National Institute of Clinical Excellence provides guidance to staff on managing medicines in care homes, it says “sometimes a person refuses to take a medicine. If this happens, staff in the care home should record what has happened and why (if the person will give a reason) in the person's care record and in the record of their medicines.” Mrs F’s medication administration chart shows she refused her medication when offered by staff. Miss E disputes this as she believes her mother could not speak at that time.
19. While I can understand Miss E would have been concerned to see Mrs F’s call bell out of her reach and to find out she had not had her medication, I can see no indication of fault with the actions of the staff at the Care Home.

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Final decision

20. The Ombudsmen will not further investigate Miss E’s complaints further, there are no indications of unremedied fault in the actions of the Council and it is unlikely I would find evidence of fault with the actions of staff at the Care Home.

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Investigator's decision on behalf of the Ombudsman