Summary: We will not investigate this complaint about the planning and care arrangements for a child when they left hospital following surgery. We are unlikely to reach a different outcome or achieve more than the organisations have already done through local and statutory complaints procedures.

The complaint

1. Miss X complains on behalf of herself and her daughter, Z, about Worcestershire County Council (the Council), University Hospital Bristol NHS Foundation Trust (the Trust) and NHS Herefordshire & Worcestershire ICB (the ICB). Miss X complains about faults in planning Z’s discharge from hospital and providing support after she had surgery in February 2024. Miss X’s complaints include:
• poor communication between the organisations and with her;
• the planning before the surgery;
• care and support for Z after she left hospital;
• facilities which were not suitable for her needs;
• being ignored and “gaslit” through the whole process; and
• flawed complaint handling.
2. Miss X says because of the fault Z felt isolated and suffered distress. Miss X says she also suffered avoidable time, trouble, uncertainty and distress at an already difficult time for her, leading to a serious negative impact on her mental health. She says this was upsetting for her children to witness.
3. Miss X says she wants the organisations to be accountable for the fault, provide meaningful apologies and an appropriate financial remedy. She also wants the organisations to improve services to prevent similar problems for her family and others in the future.

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The Ombudsmen’s role and powers

4. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
5. We investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, we consider whether it has caused injustice or hardship. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe it is unlikely we would find fault or it is unlikely we could add to any previous investigation by the bodies. (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

6. I considered evidence provided by Miss X and the organisations complained about, as well as relevant law, policy and guidance.
7. I considered the Ombudsman’s Assessment Code.

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What I found

8. Z receives care under Children and Young People’s Continuing Care (support for children with complex needs). The Council and the ICB provide this jointly. In February 2024 Z had planned surgery. Z could not return home to recover because planned building work to adapt their home was taking place. The ICB, the Trust and the Council arranged for Z to move into alternative accommodation for a few weeks when leaving hospital. Miss X was unhappy with how this was planned and the appropriateness of the care locations.
9. Miss X complained to the ICB and the Trust before bringing the complaint to the Ombudsmen. At this stage the Council had not been involved with the complaint. As the issues were about a joint care package, we asked the Council to consider this under the children’s statutory complaints procedure (a three-stage procedure set out in law for councils to follow when looking at complaints about some children’s social care services). We also asked the organisations to consider responding jointly to the complaint.
10. The Council considered Miss X’s complaints under all three stages of the children’s statutory complaint procedure. This included a stage two independent investigation. This also considered how joint health and social care decisions were made. A stage three review panel found the investigation at stage two was fairly and thoroughly carried out, and the findings were consistent with the available information. The Council and ICB also issued a joint complaint response apologising for the fault and injustice identified in the investigation and setting out actions to address this.
11. Our consideration of complaints dealt with under the children’s statutory complaints procedure focuses on how the Council handled the procedure. This is because stage two and three of the procedure involve independent people who should ensure the council’s consideration of the complaint is thorough, fair and transparent.  If a council has investigated something under the statutory children’s complaint process the Ombudsmen would not normally reinvestigate it.
12. The case documents show the independent investigation looked at the relevant health and social care records and interviewed professionals involved in Z’s care. They considered what happened in line with relevant professional guidance and standards. I have seen no evidence to suggest the investigation or findings were flawed or factually inaccurate. The independent investigator supported their explanations in the report with clear reasons.
13. The investigation found the planning and arrangements for Z leaving hospital were complex and complicated further because Z could not return home. However, it found the organisations managed these circumstances and agreed a plan to use alternative accommodation while Z recovered. The Council also explored other choices that would have allowed the family to stay together, but this turned out not to be suitable. I acknowledge the arrangements were not Miss X’s preferred choice, but the independent investigator showed the organisations properly considered this and decided the plan based on Z’s needs.
14. The independent investigation also found the organisations largely communicated well with Miss X and between each other. I note the ICB’s complaint response also set out a chronology of the communication with Miss X when planning Z’s post-surgery care.
15. The independent investigator upheld part of the complaint about the way a social worker worded some correspondence. They did however comment they did not consider this meant the social worker lacked empathy with Miss X’s situation. The investigation recommended the Council should apologise and provide reflective feedback to the social worker. The Council accepted this recommendation.
16. I have seen no indication of fault with the way the Council handled the statutory investigation. While the investigation did not uphold all Miss X’s complaints, it did uphold some parts and recommended actions to the Council. It accepted and implemented these. While consideration under this complaint procedure is not a statutory requirement for the ICB or the Trust, Miss X’s complaints about how the organisations worked together were considered independently and robustly. We are unlikely to reach a different outcome by investigating.
17. The independent investigation also considered the overall handling of this complaint. It appears the Ombudsmen’s role may have been misunderstood by the investigator, so I consider this part of the independent complaint report is potentially flawed. However, the report did note the lack of a joined-up approach to the complaint handling and that having no single point of contact for Miss X may have caused her distress.
18. The joint letter from the Council and the ICB to Miss X accepted there was fault with their complaint handing. In particular it noted there was no joint approach when it was clear the complaint involved multiple organisations. They apologised to Miss X for the fault and the distress this caused to her. They also set out actions to learn from this and address the issues identified. The ICB and the Council committed to ensure complaints spanning more than one organisation would be managed collaboratively in future. The actions taken appear reasonable and proportionate, and we are unlikely to achieve more by investigating.

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Decision

19. We will not investigate Miss X’s complaint because we are unlikely to achieve a significantly different outcome to the independent investigation carried out under the Children Act statutory complaint procedure.

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Investigator's decision on behalf of the Ombudsman