Summary: Mr X complained the NHS Trust and the Council moved his father from hospital into a care home that could not meet his needs. Mr X says the failings led to his father suffering an injury which hastened his death. Mr X also complained the Council missed carer’s assessments, which meant he missed payments. We will not investigate these complaints because there is not enough evidence of fault with the discharge planning or with how the Council dealt with a carer’s assessment request. Other complaints about earlier carer’s assessments were late.

The complaint

1. Mr X complains about Sandwell Metropolitan Borough Council (the Council) and The Dudley Group NHS Foundation Trust (the Trust). He complains about hospital discharge arrangements for his father Mr Y. In particular Mr X says:
• the care home Mr Y moved to was unsuitable and he should have had 1:1 care;
• he was not allowed to visit the care home before his father moved there; and
• the Council have not paid him for carer assessments that he says he is entitled to.
2. As a result of the fault, Mr X says his father suffered a life changing injury which “accelerated his death”. Mr X also says he has missed carer payments of £1200.
3. Mr X is seeking apologies and compensation to recognise the time the family lost to spend time with Mr Y. He also seeks a payment of £1200 for missed carer payments.

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The Ombudsmen’s role and powers

4. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
5. 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
• the fault has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify our involvement.

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

6. We cannot decide what level of care is appropriate and adequate for any individual. This is a matter of professional judgement and a decision that the relevant responsible body has to make.
7. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us 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

8. I considered evidence provided by Mr X, the Council and the Trust as well as relevant law, policy and guidance.
9. Mr X had an opportunity to comment on my draft decision.

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What I found

Brief background

10. Mr Y lived at home. His son, Mr X, was his carer. In 2022 Mr X asked the Council for a carer’s assessment. The Council completed this and Mr X received a payment of £400.
11. Mr Y went into hospital in early 2024. When he was medically ready to leave hospital (did not need treatment in a hospital setting), a trusted assessor (an employee of the Trust trained to complete assessments for the Council to support a discharge from hospital) completed an assessment of Mr Y’s needs. The Trust considered Mr Y should move to a care home with 24-hour care, where assessment of his longer-term needs could take place.
12. Mr Y moved to the care home in February 2024. The care home completed a falls risk assessment for Mr Y. It put measures in place to manage this and reduce the risk of harm. This included lowering Mr Y’s bed, a motion sensor, a crash mat placed next to the bed, regular repositioning and observations.
13. Twelve days after Mr Y moved to the care home he had a fall and needed to return to hospital. The Council completed a safeguarding enquiry following Mr Y’s fall. This looked at the hospital discharge arrangements. The outcome of the safeguarding enquiry was “inconclusive”.
14. In Mr X’s complaint to the Council in February 2024 he noted he had not had a carer’s assessment since 2022. The Council referred Mr X for a carer’s assessment, but as Mr Y was in hospital, this could not be completed.
15. Mr Y died in March 2024.

My assessment

Carer’s assessments

16. Mr X’s complaint about historical carer’s assessments is late. These relate to his carer role from 2018-2024. He asked the Council for a carer’s assessment in 2022 so was aware of the process. Mr X did not complain to the Council about this until 2024. I have seen no reason he could not have complained sooner. We therefore cannot consider this part of Mr X’s complaint.
17. Mr X’s request for a carer’s assessment in 2024 is not late, so we can consider this. The Council noted Mr X’s request for a carer’s assessment in his complaint correspondence and forwarded this to the appropriate team. However, Mr Y was in hospital then, so it could not progress this. The Council appears to have considered the request in line with the Care Act. I have seen no indication of fault by the Council.

Hospital discharge

18. The Trust’s trusted assessor completed the discharge paperwork and noted Mr Y needed 24-hour care. The records show Mr Y’s relevant medical information and needs were shared with the care home. The Council explained that a social worker also noted the family’s concerns about Mr Y’s night-time needs. The social worker contacted the Trust to discuss this and ensure the care home could meet Mr Y’s needs.
19. The care home also completed its own assessment to ensure it could provide appropriate care based on the information in the records. While Mr X and his family considered Mr Y needed 1:1 care through the night, this ultimately would be professional judgement by the care home staff. The safeguarding records note the care home completed an appropriate falls risk assessment. I have seen no indication of fault with the information shared or the decision by the Council to place Mr Y at the care home.
20. Mr Y’s fall was 12 days after he moved. The care home had not raised any concerns in this time about being able to manage Mr Y’s needs. Had it done, it could have asked for extra support or funding from the Council. There is therefore no clear link between Mr Y’s fall and the Trust’s or the Council’s decision­ making about Mr Y’s discharge to the care home.
21. Mr X also says he was not told he should have been able to visit the care home before his father moved there. Mr X said the care home later told him he had a right to visit. The Council explained that for this type of hospital discharge, there was a “no choice policy” with the care home. It also said there was no record of any discussions between Council or Trust staff and Mr X about visiting the care home prior to Mr Y’s hospital discharge. The Council acted in line with its policy by explaining there was no choice with this type of placement. I have seen no evidence the Council or the Trust refused any requests to arrange a visit to the care home for Mr X. There are no indications of fault by the Council or the Trust.

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Decision

22. We will not investigate this complaint. Part of Mr X’s complaint is late and there are no indications of fault by the Council or the Trust for the other parts.

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Investigator's decision on behalf of the Ombudsman