Summary: The Ombudsmen will not investigate Mr X’s complaint about a best interest decision to discharge his wife to a residential home. The Ombudsmen are unlikely to be able to add to previous investigations by Nottinghamshire County Council and Nottinghamshire Healthcare NHS Foundation Trust.

The complaint

1. Mr X complains that Nottinghamshire County Council (the Council) and Nottinghamshire Healthcare NHS Foundation Trust (the Trust) wrongly decided it was in his wife’s (Mrs X) best interests to discharge her from hospital to a residential home in February 2017. Mr X said this caused him significant distress, and he would like to make sure similar fault does not happen to others.

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The Ombudsmen’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. 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 could achieve a different outcome.

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

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How I considered this complaint

3. I considered information Mr X provided in writing and by telephone. This includes documents by the organisations complained about. I have also written to Mr X with my draft decision and considered their comments.

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What I found

4. Mrs X suffered with vascular dementia and Mr X cared for her.
5. During an admission at the Trust in February 2017, a social worker completed a mental capacity assessment of Mrs X. The social worker determined Mrs X lacked capacity to decide what care and support she received. The Council and Trust later jointly decided it was in Mrs X’s best interests to move to a residential home. Mr X disagreed with the decision, and said she needed one to one care, 24 hours a day, because she was prone to falls.
6. In March 2017, Mrs X moved to the residential home.
7. In May 2017, Mr X agreed with the social worker his wife should stay at the residential home.
8. In August 2017, Mrs X fell and broke her hip. She also later had a seizure.
9. Mrs X died in July 2018.
10. In response to Mr X’s complaints:
• The Council said it considered many options for Mrs X during the best interest decision making process and considered Mr X’s views. However, it should also have completed a risk assessment to see if Mrs X could have coped at home. The social worker would learn from this. The Council also agreed Mrs X needed one to one care, 24 hours a day, which the residential home provided.
• The Trust said it supported the social worker to make the best interest decision for Mrs X.
11. Mr X said the decision to discharge his wife to the residential home in her best interests was distressing for him. That decision, if it was taken with or without fault, would have always been distressing for Mr X.
12. I do not believe further investigation could add to anything to address Mr X’s distress. The social worker has demonstrated learning from not carrying out a risk assessment to see if Mrs X could have coped at home.
13. The Ombudsmen must consider what material difference we can achieve by using public money to investigate. In this case it is unlikely further investigation would achieve more for Mr X.

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Final decision

14. I consider the Ombudsmen should not investigate this complaint. I do not consider further investigation of these issues by the Ombudsmen would achieve more for Mr X.

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Investigator's decision on behalf of the Ombudsman