Summary: The Ombudsmen have decided not to investigate Mrs A’s complaint about her mother’s care and support between 2003 and 2018. There is insufficient evidence of serious or continuing injustice and given the time that has passed, investigation is unlikely to achieve more. The Ombudsmen will not investigate more recent complaints because these have not yet been through the complaints procedures with the relevant organisations.

The complaint

1. Mrs A complains about London Borough of Camden (the Council) and Camden and Islington NHS Foundation Trust (the Trust). She complains about the care and treatment of her mother, Mrs B. Mrs A has concerns about events from 2003 including, in broad terms, complaints about:
• the mental health diagnosis and treatment of Mrs B between 2003 and 2011;
• a lack of support for Mrs B at home from 2011 to 2014;
• inadequate support during Mrs B’s placement in a care home (Home 1) from 2015 to 2017;
• inadequate support for a move to an extra care placement (Home 2) in 2017;
• the care and support at Home 2 from mid-2017 to March 2018;
• inadequate care and support at a care home (Home 3) from 2020; and
• the Council’s failure to complete a safeguarding investigation in October 2020.
2. Mrs A says she wants to see evidence of service improvements and to receive compensation for the distress caused to her and her mother.

Back to top

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 provide a free service, but must use public money carefully. They may decide not to start or continue with an investigation if they believe:

• it is unlikely they would find fault, or
• the fault has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify their involvement, or
• it is unlikely they could add to any previous investigation by the bodies, or
• they cannot achieve the outcome someone wants.

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

5. The Ombudsmen will not generally investigate a complaint unless they are satisfied the matter has been brought to the relevant organisation’s attention and that organisation has had a reasonable opportunity to investigate and reply to the complaint. (Local Government Act 1974 section 26(5), as amended, and Health Service Commissioners Act 1993, section 9(5))
6. The Ombudsmen cannot investigate late complaints unless they decide there are good reasons. Late complaints are when someone takes more than 12 months after being aware of an issue 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).)

Back to top

How I considered this complaint

7. I considered correspondence Mrs A and her advocate sent to the Ombudsmen. I also considered information from the Council and the Trust, including complaint responses sent to Mrs A. I considered relevant legislation and guidance.

Back to top

My Assessment

8. Mrs A complained to the Council in 2018 about the issues from 2003 to 2018. The Council shared this with the Trust because they were jointly responsible for Mrs B’s care package. The Trust and the Council agreed with Mrs A they would only consider events complained about that happened between 2017 and 2018. It considered complaints about events before this were out of time under The Local Authority and NHS Complaints Regulations 2009 (the complaints regulations).
9. The Council and the Trust investigated the complaint jointly. The Trust responded to the complaint on behalf of both organisations in July 2018.
10. Mrs A complained to the Ombudsmen in 2020, but she could not continue with her complaint because of health problems. We agreed to place the complaint on hold until she could arrange suitable support with her complaint. Mrs A, with the support of her advocate, complained to the Ombudsmen again in January 2022.
11. I do not consider the complaint to be late because Mrs B lacks mental capacity. I accept it is reasonable to assume she lacked awareness of the issues Mrs A has since raised on her behalf.

Events from 2003 to 2017

12. These issues happened a long time ago and there has been no local investigation. The Trust and Council declined to investigate on the basis the complaints were out of time under the complaint regulations. It does not appear Mrs A challenged this at the time or raised these issues with the Ombudsmen until 2020.
13. Given the passage of time, any recollections by individuals are unlikely to be reliable and policies, guidance and legislation has changed. Mrs B’s care has also moved on. I do not consider there would be a realistic prospect of reaching a meaningful decision about these issues now. I therefore do not consider we should investigate this part of the complaint.

Events from 2017 to 2018

14. When Mrs A first raised concerns about the appropriateness of Mrs B’s placement at Home 2 with the Council, it agreed to arrange a new placement that would suit Mrs B’s needs better. She moved to another care home shortly after.
15. The Trust and the Council have accepted that, with hindsight, the placement at Home 2 was not suitable and apologised to Mrs A. They also discussed the complaint with staff to ensure they fully consider the risks and benefits when looking at lower support settings in future. I do not consider investigating this issue would add anything to the outcome already provided by the Council and the Trust.
16. Mrs A said the Council did not provide enough information about care home choices when it agreed to find a new placement for Mrs B. From the evidence available to me, it appears the process of finding a new placement took around 12 weeks after the Council had agreed Home 2 was an unsuitable long-term placement. However, the Council had offered other placements before this but Mrs A did not consider these were suitable. I therefore do not consider the delay was unreasonable and there are no indications Mrs B did not receive care or support during this time. When Mrs B moved this effectively resolved this issue so there is no ongoing injustice.
17. Mrs A’s complaints about the care and support Mrs B received at Home 2 included that:
• the Council did not change Mrs B’s GP as agreed;
• the Council involved a staff member from Home 2 in a meeting, which was against Mrs A’s wishes;
• a removal van was not arranged when Mrs B moved;
• the home was not clean;
• there were no activities for residents; and
• Home 2 did not ensure Mrs B had enough food; and
• staff spoke to family impolitely.
18. The Council explained changing someone’s GP was not something its staff could do but apologised if staff had given the family the wrong impression. Based on the information available, there is no clear and definable impact linked to this complaint which would amount to an injustice.
19. The Trust and the Council said it was appropriate and justified to involve the staff member in the meeting about its service. However, the Trust accepted this went against Mrs A’s objections and apologised for any distress the staff member’s presence caused her. I consider this is a reasonable and proportionate outcome to this part of the complaint and it is unlikely we could achieve more by investigating.
20. The Trust and the Council apologised for the inconvenience not arranging a removal van caused. They also said they would reimburse the costs Mrs A incurred and ensure staff were familiar with the correct process. This was clearly a source of stress for Mrs A, however I consider the apology alongside repayment was a proportionate remedy. We are unlikely to achieve more by investigating.
21. The Trust and the Council said there were two unannounced visits to Home 2 while Mrs B was a resident. These found Home 2 to be clean and tidy and there was evidence of regular activities with events displayed on the noticeboard. I do not consider investigation into these events is likely to achieve more given the time that has elapsed.
22. With regards to the food available, Mrs B was at the placement for several months. A review of food charts would not be proportionate and is unlikely to establish if appropriate food was offered. There is no evidence Mrs B suffered harm and she has long since moved to another placement. This issue has effectively been remedied and investigation is unlikely to achieve more.
23. The Trust and the Council accepted fault with the way a staff member spoke to Mrs B’s family. The complaint response included an apology for the upset the situation caused. It also explained a manager had spoken to the staff member in depth about her behaviour and about how to conduct herself professionally. I do not consider an investigation would be likely to lead to anything more.

Events post-2018

24. Mrs A has not complained to the Trust or the Council about these issues. They are distinct issues and the organisations should have an opportunity to consider and respond to these concerns. These complaints have therefore been brought to the Ombudsmen too soon for us to consider.

Back to top

Decision

25. For the issues up to 2018, there is not enough evidence of serious or ongoing injustice and given the time elapsed since the events, we are unlikely to achieve much more than has been done by the organisations already. It would therefore not be proportionate for the Ombudsmen to investigate.
26. The complaints about events after 2018 have not been raised with or considered by the relevant organisations. It is therefore too soon for the Ombudsmen to consider these issues.

Back to top

Investigator's decision on behalf of the Ombudsman