Summary: We will not investigate Ms X’s complaint about the Care Home’s failure to take appropriate action when Mr Y had a medical emergency. This is because further investigation would not lead to a different outcome.

The complaint

1. Ms X complained on behalf of a relative, Mr Y who is now deceased. She said the Care Home where he lived, failed to take appropriate action when he experienced a medical emergency and was admitted to the hospital. She said the Care Home's response to her enquiries about the events of that day was inadequate.
2. As a result, she had to conduct her own investigation into Mr Y’s death, which was time-consuming and caused avoidable distress at a time when she should have been able to grieve.
3. Ms X wants answers about Mr Y’s hospital admission, believing the Care Home’s actions were inappropriate. She wants an independent review of its emergency procedures and policy updates to ensure the safety of other residents. She also wants the Care Home to reimburse her legal fees she incurred pursuing the matter.

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The Ombudsman’s role and powers

4. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
5. The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)
6. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide:

• we could not add to any previous investigation by the organisation, or
• cannot achieve the outcome someone wants, or
• further investigation would not lead to a different outcome, or
• there is another body better placed to consider this complaint.

(Local Government Act 1974, section 24A(6), as amended, section 34(B))

7. We normally name care homes and other care providers in our decision statements. However, we will not do so if we think someone could be identified from the name of the care home or care provider. (Local Government Act 1974, section 34H(8), as amended)

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How I considered this complaint

8. I considered information provided by the complainant and the Care Provider.
9. I considered the Ombudsman’s Assessment Code.

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My assessment

10. Mr Y was a resident at the Care Home, run by Keychange Charity, for many years when one morning he experienced a medical emergency leading to the Care Home calling an ambulance. Mr Y was admitted to hospital the same day where he died a week later.
11. Upon arrival in hospital the ambulance crew raised safeguarding concerns into timings when Mr Y’s medical emergency started and the time when the Care Home called the ambulance service.
12. Following Mr Y’s death Mrs X asked the coroner to prepare an inquest into Mr Y’s death and the local authority conducted safeguarding enquiries.
13. The matter of Ms X’s complaint has been reviewed by a local authority and the coroner in an independent investigation. The Care Home identified areas for improvement, including more accurate record-keeping and time-recording. It agreed to implement staff training on this as part of ongoing service improvements. Therefore we will not investigate Ms X’s complaint as further investigation would not lead to a different outcome.
14. In addition, Ms X wants the Care Home to reimburse legal fees she incurred as part of the inquest. We would not recommend the reimbursement of legal fees therefore this is not an outcome we could achieve. We also do not consider claims around personal injury or death. If Ms X believes the Care Home's actions on the day of Mr Y’s medical emergency contributed to his death, or wants to claim for her legal costs, this would be a matter for the court.

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Final decision

15. We will not investigate Ms X’s complaint because further investigation would not lead to a different outcome.

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Investigator's decision on behalf of the Ombudsman