Summary: The Ombudsmen will not investigate Ms L’s complaint about her hospital admission and discharge arrangements. This is because it is unlikely the Ombudsmen would achieve anything further for her.

The complaint

1. The complainant, who I have called Ms L, complains about what happened when she was admitted to hospital following an overdose. Ms L said she was told she was not allowed to leave the ward and this should not have happened. She also complains that she was told she should be detained on a psychiatric unit, but that this should not have been considered, as a psychiatric assessment found she had no mental illness. Ms L says she has never received an explanation for this. She also complains about the actions of a social worker in relation to the support she received after she left hospital.

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The Ombudsmen’s role and powers

2. 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 they could add to any previous investigation by the bodies, or
• there is another body better placed to consider this complaint.

(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

3. I considered information provided by Ms L over the telephone and in writing, including written information from the Trust and Council. I have also considered comments from Ms L on a draft version of this decision.

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What I found

4. Ms L said that she was told she would be detained in hospital and not allowed to leave the ward, even though a psychiatric assessment showed she did not have a mental health condition.
5. The Trust’s response states that inpatient psychiatric admission was one of a range of options following Ms L’s assessment. It said that following the psychiatric assessment, a decision was made by the multi-disciplinary team (that is, staff from both health and social care) that Ms L could not return home. Therefore, she was to remain on the ward until a suitable placement had been found.
6. The Trust referred to the records, which said Ms L should “remain on [the ward] with 1-1 observations, remaining in eyesight at all times.” Although this does not specifically say Ms L could not leave the ward at all during her admission, the Trust accepted it could have been interpreted in that way. The Trust appropriately apologised for any confusion caused by this. The Trust also said that the staff they spoke to about the complaint, including the nurse Ms L referred to, could not recall telling Ms L or her family that she was not allowed to leave the ward at all, for example, to go out for lunch.
7. The Trust apologised for any confusion caused by the information Ms L was given about remaining on the ward. They said they had fed back to the staff involved regarding the clarity of the notes, asking them to ensure that “notes are as clear as possible to avoid any misunderstanding”. I accept that Ms L recalls being told she could not leave the ward. However, as the Trust has interviewed the staff involved, and they could not recall saying this, it is unlikely we would be able to establish what was said at this stage.
8. Regarding the complaint about the social worker, the Council told us it had not dealt with a complaint from Ms L about this. Although they had met her to discuss her concerns about the social worker, the Council said it understood this was because Ms L was referring the matter to the Health and Care Professions Council (HCPC).
9. However, the social worker was involved in the Trust’s response about Ms L’s discharge from hospital. The Trust spoke to her about the complaint and included her comments in its response.
10. The Trust recorded the social worker’s comments as she was “fully involved in the decision and planning process following [Ms L’s] assessment at the hospital. She confirmed that the agreement for [Ms L] not to return home was a multi‑agency decision” and not the social worker’s decision alone.
11. The Trust acknowledged that some of the communication with Ms L and her family, while Ms L was on the ward, was confusing. The response says this was because it was not clear initially whether Ms L would need support from mental health services or social care, and discussions between both services needed to take place, meaning she did receive different information. This response seems reasonable in that it explains the social worker’s role in the process and that the decision that Ms L should not return home was made by both health and social care. The Trust apologised for any confusion about the communication from both agencies.
12. However the Council has not dealt with a complaint about the social worker’s actions after Ms L was discharged. Ms L says that the social worker was supposed to meet with her every 10 days to review her progress, but she did not keep to this agreement. Ms L said that the social worker sometimes did not see her for more than a month and failed to communicate with her.
13. Ms L said she raised these concerns with the Council at the time, but there was a delay in the Council responding. Ms L said that during this period, the social worker left the Council. Ms L said and the Council then told her they were unable to ask the social worker about her decisions and actions in the follow-up period of care, because she was no longer working for them.
14. I appreciate that this is frustrating for Ms L, as she has not received a response to this part of her complaint. I understand that Ms L has already approached the HCPC about this part of the complaint. The HCPC are better‑placed than the Ombudsmen to handle complaints about the conduct of a specific social worker.
15. To summarise, the Trust has acknowledged some shortcomings in record‑keeping and communication, and has taken steps to address these. The Trust has also apologised for any confusion around the arrangements for Ms L’s future support and the social worker has explained her role in the decision. They have interviewed the staff involved who have said they could not recall telling Ms L she could not leave the ward. It is unlikely the Ombudsmen could now add to the explanations already provided. The complaint about the social worker’s actions after Ms L left hospital is best directed to the HCPC.

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Final decision

The Ombudsmen will not investigate Ms L’s complaint, as it is unlikely that an investigation would achieve anything further for her.

Investigator’s decision on behalf of the Ombudsmen

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Investigator's decision on behalf of the Ombudsman