Summary: Mrs X complained about the treatment and care provided to her late grandmother, Mrs Y while she was living in a nursing home. We will not investigate Mrs X’s complaint because it is unlikely we could add to the responses she has already received from the organisations she complains about.

The complaint

1. Mrs X complains about the treatment and care provided to her late grandmother, Mrs Y, while she was in a nursing home managed by Maria Mallaband Care Group Ltd (the Care Provider). Mrs Y’s placement was arranged by Oxfordshire County Council (the Council) and jointly funded by the Council and NHS.
2. Specifically, Mrs X complains:

• Mrs Y did not get the care she should have had because of a lack of staff at the nursing home;
• During Mrs Y’s final days, other residents of the nursing home were wandering into Mrs Y’s room. Mrs X said there were not enough staff available to manage this. Mrs X said this meant she and Mrs Y’s family were trying to help other residents when they should have been able to spend this time with Mrs Y; and
• There was a delay in providing medication to manage symptoms of secretions, meaning Mrs Y experienced these symptoms for longer than she should have done, causing distress to Mrs Y and her family.

3. In bringing her complaint to the Ombudsmen, Mrs X would like to see the Care Provider improve its services through management training and increasing the number of care staff, so that others are not affected in a similar way.

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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. The Local Government and Social Care Ombudsman investigates complaints about adult social care providers. (Local Government Act 1974, sections 34B, and 34C, as amended). The Health Service Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’ in the delivery of health services (Health Service Commissioners Act 1993, section 3(1)).
6. 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 could add to any previous investigation by the bodies. (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

7. I considered information from Mrs X, the Care Provider and the Council.
8. I considered the Ombudsman’s Assessment Code.
9. Mrs X had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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My assessment

10. Mrs Y was living at the nursing home in a placement arranged by the Council, and jointly funded by the Council and NHS. Mrs Y’s family visited her regularly at the nursing home.
11. Sadly, Mrs Y’s health declined, and during this time her family stayed overnight with her at the nursing home. Mrs X explained Mrs Y was disturbed by other residents coming into her room. Mrs X said there were not enough staff available to provide support. She said because of this, she and her family often had to help other residents, when they should have been able to spend this time with Mrs Y in her final days.
12. The Care Provider apologised to Mrs X for the upset and disruption caused by other residents going into Mrs Y’s room. The Care Provider said there were enough staff, but accepted they were not effectively managed at that time.
13. The Council reviewed the staff rotas, daily records and care plan for the period of care complained of, and found there were sufficient staff on duty. It said Mrs Y received funding for one-to-one care for 10 hours a day, which it said was delivered based on the documents seen by the Council. The Council said one‑to‑one care was not provided at night as this was not required by Mrs Y’s care plan, but said staff carried out regular checks at night.
14. Both the Council and Care Provider responses give details of steps taken to improve services following Mrs X’s complaint. These included improving handovers, ensuring agency staff were included in this, and improved support and orientation for agency staff from the senior nurse in charge. The Council also said care staff would receive further training on end of life care. The Care Provider also discussed the actions taken at a meeting of the night care team.
15. My view is the Care Provider and Council have appropriately apologised to Mrs X for the distress caused, and have taken reasonable steps to improve services in relation to Mrs X’s complaint about staffing levels and support for residents. Therefore, it is unlikely an investigation would add any further to these responses for Mrs X.
16. Mrs X said anticipatory medication (hyoscine) to ease Mrs Y’s symptoms and keep her comfortable was not available when needed, even though Mrs X had been told the nursing home already had the medication. Mrs X said this meant Mrs Y experienced distressing symptoms which caused great upset to Mrs Y and her family.
17. In response to Mrs X’s complaint, the Care Provider apologised for the delay in obtaining the medication on the day it was needed. The Care Provider said this was caused by being on hold to the out of hours telephone service, and having to go to a pharmacy outside the local area to obtain the prescription. Mrs X said these issues should not have arisen, as the medication should already have been in stock at the nursing home. To address this, the Care Provider and Council said the nursing home would now keep a small amount of this medication in stock for similar situations in future.
18. I recognise the delay in obtaining the medication must have been distressing for Mrs Y and her family. The Care Provider and Council have appropriately apologised to Mrs X for the delay. The Care Provider and Council have taken reasonable steps to prevent similar delays in future. Therefore, an investigation would be unlikely to add to this response for Mrs X.

Summary

19. I recognise Mrs X said that what happened caused her a great deal of distress. The Care Provider and Council have given appropriate apologies to Mrs X for the distress caused, and have taken reasonable steps to improve services. Because of this, we will not investigate Mrs X’s complaint as we would be unlikely to add to the responses Mrs X has already received from the organisations.

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Final decision

20. We will not investigate Mrs X’s complaint, as it is unlikely we could add to the responses Mrs X has already received from the organisations she complains about.

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Investigator's decision on behalf of the Ombudsman