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Central and North West London NHS Foundation Trust (17 018 994a)

Category : Health > Hospital acute services

Decision : Closed after initial enquiries

Decision date : 08 Feb 2019

The Ombudsman's final decision:

Summary: The Ombudsmen will not investigate Mrs D’s complaint about the way the Trust and Council communicated with her when her brother, Mr E, was discharged from hospital into a care home. This is because although we recognise there may have been shortcomings in communication, it is unlikely that an investigation would achieve anything further for Mrs D.

The complaint

  1. Mrs D complains that her brother, Mr E, was discharged from hospital to a care home, without his family being informed. She told us the family only found out he had been moved when they went to visit him in hospital and he was not there.
  2. Mr E was moved to a care home about an hour’s drive away from where he had been living and from his family and friends. Many of them are now unable to visit him because of the travelling involved. Although Mrs D has no complaint about the standard of care at the home itself, she feels that the Trust and Council should have talked to her about the option of moving Mr E further away.
  3. As a result of her complaint to us, Mrs D would like the Trust and Council to acknowledge that they should have communicated better with her and to apologise for what happened.

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The Ombudsmen’s role and powers

  1. The Ombudsmen investigate complaints about ‘maladministration’ and ‘service failure’. I use the word ‘fault’ to refer to these. The Ombudsmen must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. 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 organisations
  • they cannot achieve the outcome someone wants.

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

  1. 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.

(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

  1. In considering this complaint, I have spoken to Mrs D and looked at the information she sent us. I have also looked at the complaint responses of the Council and the Trust, and considered the relevant legislation and statutory guidance.
  2. I also considered Mrs D’s comments on our draft decision.

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What I found

  1. Mr E was admitted to a psychiatric ward of the hospital on 10 November 2015, after his mental health deteriorated. He was in hospital for several months. In September 2016, Mr E was assessed as unable to return to the community. A Best Interest meeting was held to decide what should happen when he was discharged from hospital.
  2. Best Interest decisions are set out in the Mental Capacity Act 2005, which is the framework for acting and deciding for people who lack the mental capacity to make particular decisions for themselves. A key principle of the Mental Capacity Act 2005 is that any act done for, or any decision made on behalf of a person who lacks capacity, must be in that person’s best interests.
  3. In its response to Mrs D’s complaint, the Council, with input from the Trust, said that Mrs D had been present at the Best Interest meeting when the options for Mr E were discussed. However, Mrs D told us that at that time, she had been informed that Mr E would be discharged to a local care home. She said there was no mention of a care home further away being considered.
  4. The Council and Trust said that they contacted ‘many nursing homes’ about Mr E, and he was initially placed in a care home in the local area. However the care home decided that they could not meet Mr E’s needs and he returned to hospital. He became unwell and was moved to a different ward. The Trust said its records show that a nurse from that ward told Mrs D that her brother would be moved to a care home in another town, as they had offered him a place. However he would not be moved while he was ill and would only be discharged once he was physically better.
  5. The response states that Mr E’s social worker, Ms F’s “recollection is that she informed [Mrs D] that once the funding had been approved, [Mr E] would be moving to the other care home, and she provided [Mrs D] with details of the home on 26 January 2018.” The Trust said its records also show that the ward matron telephoned Mrs D on 31 January 2018, to tell her that Mr E would be discharged to the other care home. Mr E was discharged on 1 February 2018. The Trust and Council acknowledged that Mr E was discharged by clinical staff on the ward without informing Mr E’s social worker or the staff on the psychiatric ward where he had been a patient for a long time. They acknowledged that this may have caused some confusion.
  6. Mrs D disputes what the Council and Trust say about how the discharge decision was communicated with her. She says she was not told in advance that Mr E would be discharged to the other care home, and that she did not receive a telephone call from the matron. She told us Mr E’s family thought he was still in hospital, which is why they went to visit him there. However when they arrived, they were told he was not there and he was in the care home in another town.
  7. I accept that this is Mrs D’s version of events, and recognise that the situation must have been very distressing for her. It seems that even if the decision to discharge Mr E to the care home in another town had been planned, there was a lack of communication from the ward that ultimately discharged him, either with Mr E’s social worker or Mrs D. I recognise Mrs D’s view that she was not told about the move before Mr E was discharged. However, an investigation by the Ombudsmen is unlikely to establish anything further about how this decision was communicated at that time.

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Final decision

  1. The Ombudsmen will not investigate Mrs D’s complaint.

Investigator’s decision on behalf of the Ombudsmen

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Investigator's decision on behalf of the Ombudsman

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