Summary: Mrs T complains about a failure to assess her late mother’s social care needs before she left hospital. The Ombudsman will not investigate this complaint as it is unlikely to find fault by the Council.

The complaint

1. Mrs T complains East Sussex County Council (the Council) did not assess Mrs R before she left hospital in December 2018.
2. Mrs T said Mrs R would have been eligible for assistance from the Council had she been assessed at the time, and so has been financially disadvantaged. In addition, Mrs T said the failings caused Mrs R considerable stress and anxiety. Mrs T feels this, in turn, delayed her overall recovery. Further, Mrs T said the events caused her stress and anxiety.

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The Ombudsman’s role and powers

3. 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 would find fault, or
• it is unlikely further investigation will lead to a different outcome.

(Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

4. I have read Mrs T’s written complaint to the Parliamentary and Health Service Ombudsman (PHSO) and read a PHSO caseworker’s notes of their conversation with her. I have read Mrs T’s complaints to a hospital trust and its responses. I have also considered relevant legislation and guidance.
5. I shared a confidential copy of this draft statement and invited her comments on it.

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What I found

6. Mrs R lived in sheltered accommodation with a care package. There were considerable gaps between care visits, particularly during the night.
7. In early December 2018 Mrs R went into hospital due to an obstructed bowel. Surgeons did not want to operate due to Mrs R’s age but the hospital kept her in for several days.
8. During Mrs R’s admission Mrs T told a nurse that Mrs R would need respite when she left hospital. Mrs R had not walked for a week and was nervous about going home, particularly about a lack of support overnight. The nurse advised Mrs T the hospital would request a social care assessment before it discharged Mrs R.
9. On 10 December 2018 doctors determined that Mrs R no longer needed to be in hospital for medical care. The hospital referred Mrs R for a social care assessment. Mrs T wanted Mrs R to go to a particular nursing home. She arranged for someone from the home to visit the ward and assess Mrs R. The hospital discharged Mrs R to the nursing home later the same day.
10. In the middle of January 2019 the nursing home told Mrs T the Council had refused to fund Mrs R’s placement as it had not assessed her before she left hospital.

My view

11. As part of the discharge process hospitals need to think about whether it might be unsafe to discharge a patient without measures in place to meet their care and support needs. If it thinks it might be unsafe it must tell the relevant council of that patient, and it should talk to the patient about this. Once it has given this notice hospital must consult the council before deciding what it will do to make sure discharge is safe. (Schedule 3, Care Act 2014; and The Care and Support (Discharge of Hospital Patients) Regulations 2014))
12. When it receives an assessment notice a council must carry out a needs assessment of the patient. Councils have a minimum of two days to do this after they receive the notice. (Schedule 3, Care Act 2014; The Care and Support (Discharge of Hospital Patients) Regulations 2014; and, Paragraphs 17 to 20 of Annex G of the Care and Support Statutory Guidance)
13. As well as issuing an assessment notice hospitals must also give councils written notice of when it intends to discharge the patient. The minimum discharge notification allowed is at least one day before the proposed discharge date. Where the discharge notice is issued after 2pm it will not be treated as having been served until the next day. (Schedule 3, Care Act 2014; The Care and Support (Discharge of Hospital Patients) Regulations 2014; and, Paragraphs 26 to 29 of Annex G of the Care and Support Statutory Guidance)
14. Legislation and guidance are clear about the relevant responsibilities of the NHS and council when someone leaves this hospital. This includes the relevant timescales.
15. In this instance the Council was not allowed the minimum time to respond to an assessment notice and conduct an assessment. As such, there is no realistic prospect that an investigation of the Council would find fault on its part for failing to assess Mrs R before she left hospital.

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Decision

16. The Ombudsman will not investigate the Council’s actions as it is unlikely there was any fault on its part.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman