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Buckinghamshire Healthcare NHS Trust (19 018 653b)

Category : Health > Hospital acute services

Decision : Closed after initial enquiries

Decision date : 26 Mar 2020

The Ombudsman's final decision:

Summary: The Ombudsmen will not investigate Mr C’s complaint about events from May to July 2018. The complaints are late and there are insufficient grounds to accept them now.

The complaint

  1. Mrs C was admitted to an acute hospital in May 2018. Mr C complains about:
      1. Safeguarding referrals professionals raised in May and June 2018, about his ability to care for Mrs C at home. Mr C said the concerns were fabricated.
      2. A decision, based on the safeguarding referrals, to keep Mrs C in hospital until 27 June 2018. Mr C said this was against Mrs C’s wishes and appropriate authorisations were not in place.
      3. A decision to transfer Mrs C to a nursing home from hospital on 27 June 2018, rather than to allow her to come home. Mr C said this was against his and Mrs C’s wishes.
      4. The decision to authorise Deprivation of Liberty Safeguards (DoLS) (relating to the need for Mrs C to remain a resident of the nursing home) on 27 June and 27 July 2018. Mr C said he was not consulted about these assessments and authorisations.
      5. A refusal by the Council to appeal the DoLS when Mr C asked to do so.
  2. Mr C said that throughout these events professionals failed to put in place processes to protect Mrs C’s rights and wishes. Further, Mr C said professionals did not advise him of his rights, excluded him from communication and failed to respond to communication he sent.
  3. Mr C said that, as a result of these failings, Mrs C was held against her will: in hospital from 12 May to 27 June 2018; and, in an inappropriate nursing home from 27 June 2018 to 7 May 2019. Mr C said this caused Mrs C significant distress and led to a deterioration in her mental and physical health. Mr C said it also, in turn, led to drawn out Court of Protection hearings and caused him distress in trying to have Mrs C transferred. Further, Mr C said he was caused inconvenience by having to travel weekly 150-mile round trips to visit her. Mr C said he has been denied his right to be with his wife and Mrs C had been denied her right to be with him.

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The Ombudsmen’s role and powers

  1. The Ombudsmen cannot investigate late complaints unless they decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to the Ombudsmen about something an organisation has done. (Local Government Act 1974, sections 26B and 34D, as amended, and Health Service Commissioners Act 1993, section 9(4).)

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How I considered this complaint

  1. I considered Mr C’s written complaints and his response to my queries about the timing of his complaint. I contacted each of the organisations and asked for information about how they had handled Mr C’s complaints, and I considered the information they provided. I shared a confidential draft decision with Mr C and considered the comments he made during a telephone conversation along with the comments his representative provided in writing.

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What I found

Background

  1. Mrs C went into hospital in May 2018. Medics decided fairly quickly that she was medically stable enough to leave hospital. However, professionals raised concerns about whether Mrs C’s needs could be safely met at home. Mrs C remained in hospital against Mr C’s wishes. There were several Best Interest meetings and professionals decided it would be in Mrs C’s best interests to transfer from hospital to a nursing home around 75 miles from her home.
  2. Mrs C moved to the nursing home and the Council authorised DoLS stating this was appropriate.
  3. In June 2018 Mr C raised complaints with the Trust and Council about the decisions to keep Mrs C in hospital, to move her to a nursing home and to authorise DoLS to keep her there. The Trust replied toward the end of July 2018 and the Council replied in early September 2018. These complaints did not lead to any changes in Mrs C’s circumstances, or in any acknowledgements of notable failings in the way the situation had been handled.
  4. In September 2018 the Court of Protection began considering Mrs C’s case. This process finished in May 2019 with a decision that Mrs C should move to a different home.

Analysis

  1. We expect complaints to be made to us within 12 months of a person becoming aware of the issues they wish to complain about. If the complaints come to us outside of that time we consider them to be ‘late’. In some circumstances we may still be able to investigate even if a complaint is late.
  2. Mr C complained to the Ombudsmen in January 2020. This means that all of his concerns are late.
  3. I have carefully considered whether there are good reasons we should investigate Mr C’s complaints even though they are late.
  4. Mr C said that he did not obtain evidence to ‘further qualify’ his complaints until January 2019, when he got specific evidence of malpractice from the Court of Protection. He said that he had been writing to the Council and the CCG since May 2018 but received only dismissive responses. Mr C said the documents he got then shed light on the authorities’ behaviour the previous summer.
  5. From the evidence I have seen, Mr C knew the hospital would not discharge Mrs C home at the time. He has noted that his MP was involved in trying to ‘secure her release’. Further, Mr C said that he asked to appeal DoLS in June and August 2018.
  6. Mr C’s letter to the Council of 30 June 2018 shows his awareness of the DoLS procedures, and also an awareness of his concerns about the accuracy and appropriateness of the safeguarding concerns which had preceded them. He noted concerns about there having been ‘no mention that the Hospital’s Discharge Nurse used incorrect safeguarding information on which to implement safeguarding’. Mr C also said professionals should have ‘remove[d] the safeguarding restriction similarly therefore the DoLS’.
  7. The Trust also responded to Mr C’s concerns about a safeguarding referral in late July 2018, offering further evidence that Mr C knew of his concerns at that time.
  8. Therefore, while Mr C may have obtained more detailed information from the Court of Protection in January 2019, it remains that he knew of his concerns and had been able to raise them with the Council and Trust in June 2018.
  9. Mr C said that he could not pursue his complaints while the Court of Protection proceedings took place, from September 2018 to May 2019. Mr C said his priority throughout this time was to get his wife moved. Further, Mr C said he also understood it was not possible to raise complaints with the Ombudsmen while matters were at Court. Mr C said this was a lengthy, protracted process.
  10. Mr C could have approached the Ombudsmen after he received the local organisations’ responses to his complaints. Both the Trust – in July 2018 – and Council – in September 2018 – had provided information about how to escalate his concerns. It is understandable that Mr C’s primary aim at that point was to appeal against the DoLS and to see his wife transferred from the nursing home. Given the conflicting views of Mr C and professionals about this, the Court of Protection was the logical next step.
  11. I do not discount that the Court of Protection proceedings were lengthy, difficult and stressful. However, I do not consider they provide a compelling explanation for why Mr C could not also have raised a complaint with the Ombudsmen with a different objective than the Court proceedings. The Court was focused on the ongoing issue of where Mrs C should live, but the complaints process would have been able to consider historical events and consider different outcomes, aimed to addressing any potential injustice he and his wife had suffered to that point.
  12. If Mr C had approached the Ombudsmen between September 2018 and May 2019 there would have been an assessment of his complaint. This would have included considerations of whether there was an alternative legal remedy better placed to look at his concerns. This, in turn, would have involved considering all the outcomes Mr C wanted, and thinking about whether there were any outcomes that the Court could not achieve or any that the Ombudsmen could not achieve.
  13. I do not know what the result of this assessment would have been had Mr C approached the Ombudsmen shortly after he received the complaint responses from the Trust and the Council. It is possible there could have been a decision that the Court of Protection was best placed to serve as an appeal of the DoLS, and to consider if there was any merit in the decisions that had been made about Mrs C’s best interests and whether they needed to be overturned. However, these are considerations that could and should have been made at the time. It would have been appropriate to have approached the Ombudsmen soon after Mr C knew he was dissatisfied by the Trust’s and Council’s responses to his complaint.
  14. Mr C said that from May to December 2019 his wife was very unsettled at her new nursing home. He said his priority throughout this time was to help her to settle.
  15. It is understandable that Mr C wanted to spend time to help his wife settle into her new placement, and to ensure that she had the correct level of care and support. However, the process of complaining to the Health Service Ombudsman and the Local Government and Social Care Ombudsman is free, available to the public and can be initiated through a relatively straightforward form. It does not represent a considerable administrative, time-consuming burden. As such, I do not consider there is a persuasive explanation for why Mr C could not have attempted to escalate his outstanding concerns to the Ombudsmen over a period of around eight months, from May 2019 to January 2020. I consider Mr C could have pursued his concerns about historical events, which he knew the Court of Protection process had not resolved, sooner.

Conclusion

  1. Mr C raised complaints with the local organisations soon after the events, regardless of any ongoing disputes about Mrs C’s placement. The Trust replied at the end of July 2018 and the Council replied in early September 2018. Both provided fairly unequivocal responses which found no failings in their actions. The Trust provided a leaflet about options for complainants after its investigation. The Council’s response invited Mr C to contact the Council if he remained dissatisfied and signposted him to the Local Government and Social Care Ombudsman. Therefore, Mr C knew how he could escalate his concerns in September 2018.
  2. It is easy to appreciate that the circumstances of Mr C’s wife being placed in a distant nursing home, against his wishes, would have been upsetting. Further, the involvement of the Court of Protection is likely to have been stressful. In addition, it is understandable that Mr C had concerns about his wife settling in a new environment, after May 2019. However, I do not consider these factors fully explain why Mr C could not have come to the Ombudsmen sooner. Therefore, I do not consider there is a persuasive reason for the Ombudsmen to exercise discretion and set aside the time limit to consider this late complaint.

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Decision

  1. The Ombudsmen will not investigate Mr C’s complaints about events from May to July 2018. The complaints are late and there are insufficient grounds to accept them now.

Investigator’s decision on behalf of the Ombudsmen

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Investigator's decision on behalf of the Ombudsman

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