Summary: We will not investigate Mrs X’s complaint about decisions made by Dorset Council and Cross Road Practice in relation to her mother’s mental capacity. The Council has accepted there was fault with the way it communicated and apologised. We are unlikely to achieve more.

The complaint

1. Mrs X complains about actions taken in relation to her late mother, Mrs Y. Mrs X complains about a decision by Cross Road Practice (the Practice) to approve Mrs Y’s request for her medical information not to be shared with Mrs X. Mrs X says the Practice did not properly consider whether Mrs Y had mental capacity to make this decision and whether she had been coerced by another family member. Mrs X says the Practice relied on inaccurate information from Dorset Council (the Council). She complains the Practice and the Council failed to safeguard Mrs Y, incorrectly dismissing events as a family dispute. She is also unhappy with the way the Council handled her safeguarding concerns.
2. Mrs X says the organisations’ failure to act properly on her concerns left Mrs Y at risk.

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The Ombudsmen’s role and powers

3. The Ombudsmen have the power to jointly consider complaints about health and social care. Since April 2015, these complaints have been considered by a single team acting on behalf of both Ombudsmen. (Local Government Act 1974, section 33ZA, and Health Service Commissioners Act 1993, section 18ZA).
4. 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
• any injustice is not significant enough to justify our involvement; or
• further investigation would not lead to a different outcome.
  (Local Government Act 1974, section 24A(6), as amended, section 34(B))

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How I considered this complaint

5. I considered evidence provided by Mrs X, the Council and the Practice as well as relevant law, policy and guidance.
6. Mrs X had an opportunity to comment on my draft decision. I did not receive any comments.

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What I found

Key legislation and guidance

Mental Capacity Act 2005 and Code of Practice

7. The Mental Capacity Act 2005 (the MCA) applies to people who may lack mental capacity to make certain decisions. The Code of Practice (the Code) sets out steps organisations should take when considering whether someone lacks mental capacity.
8. A ‘person who lacks capacity’ means a person who does not have the ability to make a particular decision or take a particular action for themselves at the time the decision or action needs to be taken. A person may lack capacity to make some decisions for themselves but will have capacity to make other decisions.
9. Both the MCA and the Code start by presuming individuals have capacity unless it can be proved otherwise. A person should be assessed on their ability to make a specific decision, at the time it needs to be made.
10. The Code says all practicable steps should be taken to support individuals to make their own decisions before concluding someone lacks capacity. The Code says people who make unwise decisions should not automatically be treated as not being able to make decisions. Someone can have capacity and still make unwise decisions.

What happened

11. Mrs Y was an elderly woman. Mrs Y’s daughters, Mrs X and Mrs Z, previously held joint Lasting Power of Attorney (LPA) for Mrs Y’s finances and health. A ‘Lasting Power of Attorney’ (LPA) is a legal document which allows people to choose one person (or several) to make decisions about their health and welfare and/or their finances and property, for when they become unable to do so for themselves. The 'attorney' is the person chosen to make a decision on their behalf.
12. Mrs Y lived with Mrs Z. Mrs Y had previously said she wanted her medical information shared with both her daughters.
13. Around 2023, Mrs X and Mrs Z’s relationship broke down. In 2024, the Office of the Public Guardian revoked Mrs Y’s LPAs, and the Court of Protection (the Court) became involved.
14. The Court deals with decision-making for adults who may lack mental capacity to make specific decisions for themselves. The Court may need to become involved in particularly difficult cases or cases where there are disagreements that cannot be resolved in any other way. The Court may decide to appoint a Deputy to make certain decisions on behalf of someone who lacks the mental capacity to do so themselves.
15. In 2024, the Court appointed a professional Deputy to manage Mrs Y’s property and financial affairs. A Court appointed assessor found Mrs Y had mental capacity at the time to make her own health and welfare decisions. Therefore the Court did not put any formal arrangements in place for decisions relating to this.
16. Later that year, Mrs Y was diagnosed with dementia. Mrs X and Mrs Z had limited direct contact. Mrs X would contact the Practice for updates about her mother’s health.
17. In July 2025, Mrs Y visited the Practice, accompanied by Mrs Z. Mrs Y told a locum GP she did not want her medical information shared with Mrs X. When Mrs X next called the Practice, it told her it was unable to share her mother’s medical information with her as Mrs Y had withdrawn consent.
18. Mrs X raised concerns with the Practice about this decision. Mrs X said her mother had previously given consent for information to be shared with her. She questioned if her mother had the mental capacity to make this decision and felt she may have been coerced by Mrs Z.
19. Mrs Y’s regular GP reviewed matters and felt she had mental capacity to make decisions around sharing her information, so the Practice did not formally assess her capacity. The Practice had no concerns about Mrs Y’s care by Mrs Z. The Practice requested for any further information to go via Mrs Y’s appointed Deputy.
20. Mrs X raised safeguarding concerns with the Council. The Council carried out safeguarding enquiries but did not take further action.
21. In January 2026, Mrs Y sadly died.

Analysis

The Practice

22. Mrs X complains the Practice failed to properly assess Mrs Y’s mental capacity around consent to share her medical information. She says the locum GP was unfamiliar with Mrs Y and the family and accepted Mrs Y’s statement at face value without considering her mental capacity or whether she had been coerced by Mrs Z.
23. The locum GP felt Mrs Y had capacity at the time to decide who she wanted to have access to her medical information. When Mrs X raised concerns, the Practice spoke with the locum GP and asked Mrs Y’s regular GP to review the matter. The Practice also spoke with the Council’s safeguarding lead. The locum GP maintained their view Mrs Y was able to decide and there was nothing to suggest she had been coerced. Mrs Y’s regular GP, who knew her well and was aware of the family dynamics, reviewed the matter and also decided Mrs Y had capacity to withdraw consent.
24. When Mrs X raised concerns, the Practice initially asked Mrs Y to come in for a formal mental capacity assessment. However, after further consideration as outlined above, the Practice decided this was not necessary. I appreciate this was frustrating for Mrs X. However, the Practice was satisfied Mrs Y had mental capacity, therefore there was no obligation to carry out a formal mental capacity assessment. The Practice appears to have acted in line with the MCA, which states that a person must be presumed to have capacity unless it is proven otherwise. As such, we would be unlikely to find fault on this point.
25. Mrs X complains the Practice failed to raise safeguarding concerns with the Council. The Practice considered Mrs X’s concerns and spoke with the Council. The Practice did not have concerns about Mrs Y’s wellbeing and therefore had no obligation to raise safeguarding concerns on behalf of Mrs X. Mrs X was able, and did, raise her safeguarding concerns directly with the Council. Any further investigation by us would be unlikely to find fault.

Safeguarding

26. Mrs X complains the Council failed to take sufficient safeguarding action to protect Mrs Y.
27. Historically, the Council has responded to several safeguarding concerns raised by Mrs X in relation to Mrs Z’s actions towards Mrs Y. The Council generally found no concerns about Mrs Y’s wellbeing.
28. In 2025, Mrs X raised concerns with the Council about difficulties contacting and visiting Mrs Y and her decision to withdraw consent for Mrs X to have access to her medical information. Mrs X felt Mrs Z was isolating Mrs Y and influencing her decisions.
29. Mrs Y’s social worker carried out several unannounced visits to Mrs Y, during which she spoke with Mrs Y alone. The Council found Mrs Y was able to clearly express her views and these were being followed. The Council decided Mrs Y could make her own decisions around contact with her family and access to her medical information.
30. The Council investigated Mrs X’s concerns and satisfied itself there was no evidence of abuse or neglect. The Council noted Mrs Y had changed her opinion on multiple occasions about consent to share her information, however there was no evidence she was being influenced to do so. The Council appear to have acted in line with the MCA and further investigation is unlikely to find fault.

Mrs Y’s mental capacity

31. The Council and the Court previously assessed Mrs Y as unable to make some decisions about her care. It appears her mental capacity fluctuated at times. However, even if a person has been deemed unable to make some decisions, there are other decisions about their lives they will be able to make. A person with dementia may still be able to make certain decisions. A person should be assessed on their ability to make a specific decision, at the time it needs to be made.
32. Mrs Y changed her mind several times about who could have access to her medical information, both before and after she was diagnosed with dementia. Mrs Y was entitled to change her mind and this is not necessarily evidence of coercion or lacking capacity. The MCA states that a person must be assumed to have capacity unless it can be proved otherwise. Further, the MCA states that a person should not be automatically deemed to lack capacity to make a decision, even where another person may find the decision unwise.
33. Multiple professionals considered Mrs Y was able to make decisions about family contact and who could access her medical information. Therefore, the professionals were the obliged to follow Mrs Y’s wishes. While Mrs X was concerned about these decisions, which were sometimes contrary to previous decisions, Mrs Y was entitled to change her mind. We are unlikely to find fault by the Practice or the Council.
34. Mrs X is unhappy a formal mental capacity assessment was not completed. The Council completed several informal reviews of Mrs Y’s capacity, which did not indicate a formal assessment was necessary. We would not be able to determine whether a formal assessment would have reached a different decision to the informal reviews, as all relevant information appears to have been available at the time.
35. The Practice and the Council used their professional judgment to make decisions about Mrs Y’s capacity, based on her presentation at the time. The social worker and regular GP both knew Mrs Y well and spoke with her face to face. Any further investigation by the Ombudsman would not have the benefit of this insight.
36. Mrs X disputes Mrs Y’s capacity to make these decisions. However, any investigation by the Ombudsmen would not be able to determine Mrs Y’s mental capacity at the time. It then follows that we would also not be able to say whether Mrs Y was placed at risk. We are unlikely to find the injustice Mrs X claims.
37. If there is a conflict about whether a person has capacity to make a decision, and all efforts to resolve this have failed, the Court of Protection might need to decide if a person has capacity to make the decision. Mrs X asked the Council to apply to the Court. However, the Council did not consider this necessary because it deemed Mrs Y to have mental capacity. Mrs X was able to apply to the Court herself regarding her ongoing concerns around Mrs Y’s capacity. While Mrs X has explained her concerns about the costs involved, this may have been the appropriate route where the disagreement between Mrs X and the Council could not be resolved.

Communication with the Council

38. Mrs X complains the Council failed to call her back about safeguarding concerns. The Council records show action was taken on Mrs X’s concerns. The Council has apologised for not always returning Mrs X’s calls promptly. Further investigation by us is unlikely to achieve more.

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Decision

39. The Ombudsmen will not investigate this complaint. We are unlikely to find fault by the Practice and the Council in relation to Mrs Y’s mental capacity and safeguarding. The Council has already accepted fault around its communication with Mrs X and apologised to her. Further investigation by the Ombudsmen is unlikely to achieve more.

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Investigator's decision on behalf of the Ombudsman