Summary: The Ombudsmen will not investigate a complaint about the way a care home requested a repeat prescription or prevented access to the home for a planned advocacy visit. This is because there is no evidence of significant injustice to the resident, and the injustice to their family has already been remedied.

The complaint

1. Mr X complains about Lancashire County Council (the Council) and Stocks Hall Nursing Home (the Home). He says the Home failed to ensure his mother, Mrs Y, had her prescribed medication for Alzheimer’s disease in May 2021. He says this meant she was without the medication for around three weeks and considers this had a detrimental effect on her health.
2. Mr X also complains the Home did not allow his wife or Mrs Y’s Deprovision of Liberty Safeguards (DoLS) advocate into the Home when they had arranged a visit in July 2021.

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The Ombudsmen’s role and powers

3. 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
• the fault has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify their involvement.

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

4. 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,as amended, and Health Service Commissioners Act 1993, section 18ZA)

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How I considered this complaint

5. I have considered information provided by Mr X and the organisations complained about, including complaint responses. Mr X has provided comments on a draft of this decision statement and I considered these comments.
6. Mrs Y’s placement at the Home was initially Council funded. In June 2021 she was awarded continuing healthcare funding (CHC). This was applied retrospectively to November 2020, however, we still consider the Council to be responsible for the Home’s actions until the CHC decision was made in June 2021 and complaints fall under the LGSCO’s remit. After June 2021, the Home became responsible as a health provider and complaints fall under the PHSO’s remit.

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My assessment

Prescription

7. In May 2021the Rapid Intervention and Treatment Team (RITT - a specialist Older Adult Mental Health community based service) prescribed medication for Mrs Y to trial for her dementia. When this was due to run out the Home contacted Mrs Y’s GP for a repeat prescription. However, as the RITT had prescribed the medication and were monitoring its effects, it was the community mental health team that were responsible for prescribing this. There was a delay in Mrs Y getting a repeat prescription of around three weeks, which meant the trial had to be restarted.
8. However, the delays were not all caused by the Home. Its actions in requesting a prescription from the GP instead of the mental health team may have been an error, but it has explained it also subsequently contacted the mental health team. The mental health team, as part of a separate complaint, has acknowledged fault in not issuing a repeat prescription sooner because a transfer of responsibilities between RITT and the community mental health team the prescription was not renewed.
9. The mental health team should have monitored Mrs Y’s medication and issued repeat prescriptions when needed. The Home possibly could have done more to chase the prescription, but ultimately it was the Mental Health Trust’s responsibility. Mr X does not wish to complain about the Mental Health Trust because it has taken responsibility for its faults and apologised.
10. While the delays with the prescription clearly caused inconvenience, fortunately it does not appear Mrs Y suffered any serious harm. Even if we found there was some decline in her health, I do not consider we could link this to fault by the Home.

Access to Home

11. A DoLS advocate went to the Home to review Mrs Y in July 2021. Mr X’s wife also attended. Mr X says the Home refused to let his wife or the advocate into the Home. He says the Home’s staff member spoke in a condescending manner and broke the trust the family had with the Home.
12. In correspondence with Mr X, the Home accepted fault in the way its staff spoke to Mr X’s wife and the DoLS advocate and apologised. It also said it has addressed this directly with the staff member.
13. The Home has also explained that its intention was not to refuse entry, but to explain that it did not have staff available to go through records with the advocate in detail. This was partly because the Home had spent time the previous day going through records with Mr X and a solicitor.
14. The Home explained the advocate said they were happy to arrange another time to go through the records in detail, but they still wanted to see Mrs Y that day. It seems the communication by the Home was poor and this caused some tension with Mrs Y’s family in particular. However, the Home did allow the advocate visit to go ahead the same day.
15. The Home accepted it did not handle this meeting well and has taken action to address this with its member of staff. The Ombudsmen cannot comment on disciplinary matters with staff, but I consider this, along with the apologies, provides a reasonable and proportionate outcome to remedy this complaint.

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Decision

16. The Ombudsmen will not investigate this complaint because we are unlikely to find the claimed injustice to Mrs Y from the medication delays could be directly linked to fault by the Home. Additionally the injustice caused by the Home’s initial refusal to allow Mr X’s wife or a DoLS advocate to visit Mrs Y has been resolved by actions the Home has already taken.

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Investigator's decision on behalf of the Ombudsman