Summary: Mr A complained about the way his aunt, Mrs B, was cared for after she left hospital. The organisations wanted her to go into a nursing home and made it difficult for her to return home. There were problems with communication and equipment delivery. We will not investigate this complaint because the Trust accepted it made mistakes and apologised to Mr A and has improved its service. We consider this to be a suitable remedy.

The complaint

1. Mr A complains about the care his aunt, Mrs B, received from Croydon Local Borough Council and Croydon Health Services NHS Trust. Specifically, Mr A complains;
• Mrs B stayed in hospital for five weeks. He did not receive updates about her condition despite holding Lasting Power of Attorney for Health and Welfare.
• The planning for Mrs B to leave hospital was poorly organised.
• The Council wanted Mrs B to go into a care home, even though it knew she wanted to go home.
• When she went home, there were constant delays in delivering equipment to help her.
• The communication between the various agencies in her care was poor and this led to constant issues.
2. Mr A had his own health issues, and he struggled to cope with helping his aunt and manage his own needs. He felt pressured by the Council to move his aunt into a care home when he knew this was not what she wanted.
3. Mr A wants answers to his concerns and compensation for his experience.

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The Ombudsmen’s role and powers

4. We have the power to jointly consider complaints about health and social care. Since April 2015 a single team has considered these complaints acting for both Ombudsmen. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA)
5. 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).)
6. 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.

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How I considered this complaint

7. I considered all the information provided to us by Mr A.
8. I considered the Ombudsman’s Assessment Code.
9. I considered the LGSCO and PHSO guidance on remedies.

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What I found

Timeliness

10. Mr A’s complaint is out of time. The issues occurred from May – June 2020. Mr A did not make a complaint to the Trust until July 2021. Because of pressures on the NHS (COVID-19 pandemic), the Trust agreed to investigate his complaint. Mr A did not receive a final complaint response from the Trust until May 2024. The Trust said it did not deal with his complaint in a timely manner and there were delays in investigating.
11. I have considered the reasons Mr A has provided and I have decided to exercise discretion to assess Mr A’s complaint.

What happened

12. Mrs B went into hospital on two occasions, May and June 2020.
13. Mr A explained staff from the Trust, and the Council, were reluctant to let Mrs B go back to her own home and wanted her to go into a nursing home. Mr A explained this left him conflicted because he wanted his aunt to be safe, but she had told him she wanted to live out the end of her life at home.
14. The Trust did not contact Mr A while Mrs B was in hospital, he had to telephone for updates. He was also not told discharge planning had started and again had to contact the hospital. When she was ready to go home, there were problems with the delivery of equipment and this delayed her leaving hospital. Mr A thinks many of the issues were due to poor communications between the various agencies involved in her care.
15. Mr A complained to the Trust in July 2021. The Trust replied to this complaint in October 2022. It apologised for the delay and explained this was due to pressures from the COVID-19 pandemic. In this letter, the Trust accepted it got things wrong in its care of Mrs B. It accepted communication with him about discharge planning could have been better and recognised the distress this caused him, and apologised. It also apologised if Mr B felt he was not given updates about her medical condition, but it explained the medical team did not have the time to give updates when a patient was stable. The Trust admitted it should have discussed changes to Mrs B’s medication with Mr A, and apologised.
16. The Trust explained there was no case manager allocated to Mrs B’s discharge planning and this caused the issues Mr A was unhappy with. It explained since the events, its processes have changed and there have been improvements to ensure the Council and family are involved at every stage of the discharge process.
17. Mr A did not accept the explanations provided by the Trust and made a further complaint in July 2023. In March 2024 he contacted the Trust again as he had had no response.
18. The Trust wrote to Mr A in May 2024 with a final response. It apologised for the long delay in replying to him.
19. In this letter, it admitted further fault. It said staff should have contacted him and apologised. It explained due to the length of time since the events it could not confirm with individual staff, but it had reminded all staff of the importance of regular contact with the patient’s family. It also explained it understood how frustrating it must be to receive communication from several departments and agreed it had missed opportunities to reassure him. The letter also apologises again for the faults it admitted to previously and the difficulties Mr A and Mrs B faced. It recognised the unnecessary stress this added and provides assurances changes have since been made.
20. I asked the Council to comment on what happened and it explained at the time of the events, there was a small team in the hospital who followed what the Trust staff asked them to do. The Council said since 2024 it had a fully integrated team of staff in the hospital, including a discharge team.
21. The PHSO guidance ‘Principles for Remedy’ says “where maladministration or poor service has led to injustice or hardship, public bodies should try to offer a remedy that returns the complainant to the position they would have been in otherwise. If that is not possible, the remedy should compensate them appropriately. Remedies should also be offered, where appropriate, to others who have suffered injustice or hardship as a result of the same maladministration or poor service. There are no automatic or routine remedies for injustice or hardship resulting from maladministration or poor service. Remedies may be financial or non-financial.”
22. The guidance adds “An appropriate range of remedies will include:
• an apology, explanation, and acknowledgement of responsibility
• remedial action, which may include reviewing or changing a decision on the service given to an individual complainant; revising published material; revising procedures to prevent the same thing happening again; training or supervising staff; or any combination of these”
23. The Trust has admitted it got things wrong and apologised. It is unable to remedy the injustice to Mrs B as she had sadly died before Mr A made the complaint. However, it has recognised Mr A had an injustice in his own right, investigated his concerns, apologised, and taken steps to improve its service to ensure others do not encounter the same.
24. I consider this to be an appropriate remedy and an Ombudsmen investigation would be unlikely to achieve anymore.

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Decision

25. The Trust admitted it got things wrong, it apologised and made changes to improve its service. I consider this to be a suitable remedy for the identified fault. We will not investigate this complaint because it is unlikely an Ombudsmen investigation would achieve any more.

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Investigator's decision on behalf of the Ombudsman