Summary: Mrs D complained about the care and support provided to her daughter, Miss E, in a supported living placement run by Priory Care Group and jointly funded by Hampshire County Council and a clinical commissioning group. Mrs D said the response from the provider was inadequate and she wanted disciplinary action taken against those individuals she held responsible for decline in her daughter’s wellbeing. The Ombudsmen cannot add to the previous investigation completed by the authorities and cannot achieve the outcome Mrs D wants. For these reasons the Ombudsmen should not investigate the complaint.

The complaint

1. The complainant, who I shall refer to as Mrs D, complains about her daughter’s placement in a support living placement that was jointly funded by Hampshire County Council (the Council) and a Clinical Commissioning Group (CCG). Mrs D said the Priory Group (the Provider) that was commissioned by both authorities failed to provide adequate care and support to her daughter, Miss E, who was resident in the placement between August 2016 and January 2019. Mrs D said he response from the provider was inadequate and as an outcome for her complaint she would like disciplinary action taken against the individuals she feels are responsible for a decline in her daughter’s development.

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The Ombudsmen’s role and powers

2. The Ombudsmen have the power to jointly consider complaints about health and social care. Since April 2015, these complaints have been considered by a single team acting on behalf of both Ombudsmen. (Local Government Act 1974, section 33ZA, and Health Service Commissioners Act 1993, section 18ZA)
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)).
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 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)

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How I considered this complaint

5. I have considered information provided by the complainant, the Council and the Provider. I have also considered the law and guidance relevant to this complaint.

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What I found

6. Miss E has learning difficulties and lived in a supported living placement which was jointly funded by the Council and a CCG but run by the Provider. The placement was a shared house and Mrs D says Miss E was lived there since August 2016.
7. Mrs D is Miss E’s lasting power of attorney (LPA) for health and care decisions and so can make decisions on Miss E’s behalf. Mrs D’s husband is LPA for
   Miss E’s property and financial affairs.
8. In February 2018 Mrs D wrote to the Provider to raise complain about the care and support being provided to Miss E. In summary, Mrs D said the following:
• staff in the placement did not provide enough support and time to allow Miss E to regain her life skills around areas such as feeding herself at mealtimes, improving life skills and being creative;
• the Provider allowed physical barriers in the placement such as restricting access to the kitchen;
• staff did not give Miss E the attention she needed or responded to her requests for assistance, for example, when asking for a drink;
• the Provider did not use the hours allocated to Miss E to meet her needs when at home or in the community. For example, she was not being encouraged to feed herself;
• staff did not understand the court of protection documents that Mrs D asked them to place on Miss E’s file; and
• a service manager had asked Mrs D not to visit Miss E as often and not to bring family and friends.
9. The Provider acknowledged the letter of complaint and responded in May. In summary, it said:
• Miss E had a planner in place which detailed all the activities she participated in at the placement. The Provider also had care and support plans in place although it acknowledged that these were not shared with Mrs D until after she had complained;
• there had been a notable decline in Miss E’s willingness to feed herself. Further work was needed with a speech and language therapist to ensure a clear plan was put in place;
• there was one occasion when no members of staff were available to support Miss E in the community. There was no contingency plan in place and going forward a plan would be put in place;
• access to the kitchen was prevented as part of depravation of liberty safeguards application to safeguard Miss E’s health and wellbeing;
• family visits were not restricted but two visits weekly had been suggested by a team working with Miss E to see if it impacted on her behaviour; and
• there was no evidence a staff member had restricted Miss E’s movements, but staff needed to use clear communication with Miss E in line with her communication diary.
10. The Provider partially upheld Mrs D’s complaint in specific areas, apologised and detailed what improvements it had made in the letter. It also said it would arrange a meeting with the Council to ensure decision making by professionals when considering Miss E’s needs would be shared with staff in the placement. It also said it would record formal meetings and allow time for informal chats after meetings. It improved the staff rota to include cover for the lounge area in the house.
11. The Provider wrote a final letter to Mrs D which acknowledged there had been further correspondence and telephone calls to discuss Mrs D’s concerns. The Provider said it had been difficult to draw a definitive conclusion on matters because of the difference of opinion between it and Mrs D. The letter referred
    Mrs D to the Ombudsman.
12. The Council corresponded with a Member of Parliament in late 2018 following concerns raised by Mrs D. It said the relevant safeguarding authority had investigated Mrs D’s concerns and the investigation identified the placement was not suitable for Mrs E’s needs. The letter confirmed Mrs E was safe in the placement but confirmed the Council agreed Miss E needed to move and it was focusing on sourcing alternative accommodation for her.
13. Mrs D confirmed that Miss E moved to a new placement in January 2019. She said she is happy in the new placement and Mrs D has not had cause to complain.

Findings

14. The Provider responded to Mrs D’s concerns and partially upheld some of her complaints. The Provider acknowledged there had been fault and apologised to Mrs D. It identified areas of improvement and confirmed what improvements it had either made or had planned to make. This has remedied any injustice caused by the faults accepted by the Provider.
15. The issues raised by Mrs D would be difficult to say what happened, on balance, as it is one person’s word against another. Documentary evidence available would not answer specific questions. For example, we are unlikely to find documentary evidence to determine whether staff failed to respond to Miss E’s requests such as when she asked for a drink. Further investigation by the Ombudsmen would not achieve more than the investigation completed by the Provider.
16. The Council also considered issues under its safeguarding procedures but did not deal with a formal complaint. Ultimately it determined Miss E needed to use and this happened. Miss E has been happy and settled in her new placement since January 2019.
17. One of the outcomes Mrs D wanted the Ombudsmen to achieve was disciplinary action taken against the individuals she feels were responsible for the faults. The Ombudsmen could not achieve this outcome. For these reasons the Ombudsmen should not investigate this complaint.

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Final decision

18. I have considered comments from Mrs D and have closed the complaint for the reasons set out in this statement.

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Investigator's decision on behalf of the Ombudsman