Summary: The Ombudsmen cannot investigate a complaint about treatment and support provided to a family member by a Trust, a CCG and a Council for mental health and alcohol dependency services because it is late. We have seen no reason the complainant could not have brought the complaint to the Ombudsmen sooner.

The complaint

1. Mrs B complains about the lack of care and treatment her son, Mr A, received for his mental health and alcohol problems. The services were provided by Tees, Esk and Wear Valleys NHS Foundation Trust (the Trust), South Tees CCG (the CCG) and Middlesbrough County Council (the Council) who fund Middlesbrough Recovering Together (a drug and alcohol service). Mrs B says the lack of care and dual diagnosis process contributed to Mr A’s deterioration and his death in January 2017.
2. Mrs B wants improvements to the services provided to those with mental health issues and alcohol dependency. In particular she would like to see a better dual diagnosis process in place between the organisations.

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The Ombudsmen’s role and powers

3. The Ombudsmen investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, the Ombudsmen consider whether it has caused injustice or hardship (Health Service Commissioners Act 1993, section 3(1) and Local Government Act 1974, sections 26(1) and 26A(1), as amended).
4. 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

5. In reaching my decision, I took account of the information Mrs B provided to the Ombudsmen and her comments on a draft decision statement. I also reviewed the complaints correspondence and responses from the Trust, the CCG and the Council (MRT).

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What I found

Background

6. In 2015 Mr A sought help for depression and alcohol addiction. Despite having some talking therapy his mental health deteriorated and he was admitted to hospital under the Mental Health Act. Following his discharge from hospital Mr A was unable to stop drinking and continued to experience mental health problems.
7. In May 2016 Mr A and Mrs B were due to attend an appointment at the Trust to discuss Mr A’s treatment. However, because of his mental state at that time, Mrs B could not get him to the appointment. Mrs B says she still attended the meeting but discussions were limited because Mr A was not present. She asked questions about dual diagnosis and lack of support for Mr A, but says this was ‘not welcomed’.
8. The mental health team subsequently discharged Mr A from its service as it consider he was not engaging with the service.
9. On 28 December 2016 Mr A collapsed at home and was taken into hospital. Unfortunately he did not make a recovery and he died on 4 January 2017.
10. Mrs B wrote to the head of the mental health team in February 2017 detailing some concerns about the care her son had received.
11. Mrs B formally complained to the Trust in December 2017 about the lack of support and treatment with his mental health and alcohol dependency. The Trust responded to the complaint in March 2018. It advised Mrs B she could take her complaint to the Ombudsman if she remained unhappy. Mrs B then met with the Trust in May 2018.
12. In August 2018 Mrs B complained to the CCG. As the complaint concerned various aspects of the care provided to Mr A and a number of different organisations were responsible for these, the CCG coordinated a complaint response. This included the CCG, the Trust, Mr A’s GP and MRT. The CCG sent the joint response to Mrs B in March 2019. It said Mrs B should take her complaint to the Ombudsman if she was not satisfied with the responses to her complaint.
13. Following this, Mrs B contacted the Trust’s complaints department and said she was still unhappy with one of the issues she had raised. In July 2019 the Trust wrote to Mrs B and confirmed this outstanding issue was the responsibility of the Council and that she should complain to the Council if she wished to pursue this. It reminded Mrs B she could complain to the Ombudsman if she had any outstanding concerns.
14. Mrs B also contacted NHS England to escalate concerns about Mr A’s GP. However, NHS England considered the complaint out of time under the NHS complaints regulations and in September 2019 it advised Mrs B it would not investigate.
15. Mrs B complained to the Ombudsman in October 2019.

Analysis

16. The complaint to the Ombudsmen was not made within 12 months of the events or Mrs B becoming aware of the events being complained about. The complaint is therefore late. I have considered whether there is any reason for the Ombudsmen to exercise discretion and investigate this complaint.
17. There was a delay in Mrs B complaining to the Trust. However, she did write to the mental health team soon after Mr A died. It possibly should have treated this letter as a complaint and Mrs B therefore may have felt her concerns were being investigated. However this was not followed up until December 2017 with a complaint to the Trust.
18. The Trust and the CCG signposted Mrs B to the Ombudsmen at least three times between March 2018 and July 2019. However, she decided to pursue her complaint through other avenues until October 2019.
19. It is now over three years since the events complained about happened. Although Mrs B was not responsible for all the delay, it means the prospect of reaching a sound, fair and meaningful decision is considerably reduced. Mr A’s records are all likely to be available so it should be possible to establish what happened in terms of care and treatment. However, some of the concerns relate to discussions between Mr A, his family and the professionals responsible for his care, including that he was declining to engage with support services. Given the time that has passed, any recollections by individuals are unlikely to be reliable. It may therefore be difficult to reach findings about certain aspects of the complaint.
20. Having reviewed the complaint responses from the organisations, it is also evident they have accepted fault and made changes to the services provided in the locality. According to the responses, this includes closer links between organisations and the way they work together and a better ‘dual diagnosis’ process. This is an outcome Mrs B was seeking and the complaint responses say that her complaint was a factor in shaping these changes and improvements. Therefore, even if the Ombudsmen did exercise discretion with the time limit, an investigation is unlikely to achieve more than Mrs B has already accomplished through her complaints.
21. Having carefully considered the information available, I have seen no reason for the Ombudsmen to exercise discretion and investigate this complaint.

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Decision

22. The Ombudsmen should not investigate this complaint because it is late. I consider the complaint could have been brought to the Ombudsmen sooner and the time that has passed means the prospect of reaching a sound, fair and meaningful decision is limited.

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Investigator's decision on behalf of the Ombudsman