Summary: We will not investigate Mrs A and Mrs B’s complaint about the Council’s assessment of their cousin’s (Mrs D) needs before it decided she could return home. That is because we cannot achieve the outcomes they seek.

The complaint

1. Mrs A and Mrs B complain on behalf of their cousin, Mrs D. They say Nottinghamshire County Council (the Council) and Sherwood Forest Hospitals NHS Foundation Trust (the Trust) wrongly decided Mrs D should return home on discharge from hospital.
2. Mrs D had to pay around £1,500 to secure a loan from the care home to pay for the fees (until she sold her house). If the Council decided Mrs D should move to a care home initially, she would not have needed to pay that money.
3. Mrs A and B would like the Council to backdate the 12-week property disregard (which they later agreed) to the date of discharge. They would also like the Council and Trust to reimburse the costs Mrs D paid to the care home.

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The Ombudsmen’s role and powers

4. 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 would find fault, or we 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 considered information provided by the complainant and the organisations.
6. I considered the Ombudsman’s Assessment Code.
7. Mrs A and B had an opportunity to comment on my draft decision. I have considered their comments before making a final decision.

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What I found

Background

8. Since 2019, Mrs D lived in her home with a care package from the Council and was admitted to the Trust many times. The Trust admitted her twice in December 2023 and January 2024 with swollen legs and a chest infection.
9. In early April 2024, the Trust admitted Mrs D with the same issues. A week later, Mrs A and B explored moving Mrs D to care home (before speaking to Mrs D about it) and asked a care home to assess Mrs D.
10. In mid-May 2024, the Trust asked a Social Worker to assess Mrs D’s need for discharge. Because Mrs D’s needs had recently changed, the Social Worker asked the Trust for an update about those needs. It needed to review those needs before it decided where Mrs D should move on discharge. The Social Worker noted Mrs A wanted to move Mrs D into a care home and had reserved a room there. The Social Worker advised Mrs A to wait for the outcome of her assessment before arranging a place privately.
11. On 22 May 2024, Mrs A emailed the Social Worker to raise concerns about Mrs D’s equipment at home, her personal hygiene needs, and hot meals. The Social Worker responded to each point and asked if Mrs A was open to returning Mrs D home. Mrs A said Mrs D had agreed to move to a care home because the Council could not safely support her. Mrs A also said Mrs D needed financial help selling her home to pay for the care home fees.
12. The next day, the Social Worker assessed Mrs D and decided she could return home with a care package. She was not eligible for 24-hour support in a care home. The Discharge Team told the Social Worker Mrs D only wanted to move to a care home, and that was agreed before the Trust admitted her. The Discharge Team also told the Social Worker Mrs A wanted the Social Worker to apply for the 12-week property disregard. The Social Woker had already told Mrs A she can only apply for that if Mrs D was eligible for 24-hour care, which she was not.
13. The same day, the Social Worker spoke to Mrs D. Mrs D said she does not want to return home, will be moving to a care home and understood she needed to sell her house to pay the fees privately. The Social Worker said: “at no point I doubted her capacity to make this particular decision regarding her discharge destination”.
14. On 30 May 2024, Mrs D moved to the care home.
15. Mrs A and B complained to the Council in mid-June 2024.
16. In early-July 2024, the Social Worker assessed Mrs D at the care home. The Social Worker decided Mrs D had 24-hour care needs which should be met at the care home. It agreed to apply the 12-week property disregard from then.
17. In mid-July 2024, the Council responded to Mrs D’s complaint. It said it changed its mind about the 12-week property disregard, because the care home said Mrs D had additional needs, compared with the Social Worker’s assessment in late May. Mrs A and B were unhappy they had to take the decision out of the Council’s hands, and they did not consider Mrs D’s history of hospital admissions from home. Mrs D also had to pay around £1,500 for a loan from the care home to pay fees until she could sell her house.
18. In response, the Council said the Social Worker assessed Mrs D in May 2024 in line with its policy. It said Mrs A and B had decided Mrs D should move to the care home before the Council completed its assessment. Mrs A and B disagreed with the Council’s view, so approached the Ombudsmen in September 2024.

My assessment

19. I do not consider we should investigate Mrs A and B’s complaint. I could not achieve the outcomes Mrs A and B seek. They would like the organisations to reimburse Mrs D’s cost of securing the loan to the care home, and to backdate the date of the 12‑week property disregard.
20. If we decided the Council and Trust acted with fault in May 2024, on the balance of probabilities, we could not say what the outcome of that assessment would have been. We cannot say the Council and Trust would have decided Mrs D should have moved into the care home, if not for the fault. Therefore, we would not be able to recommend the Council backdate the 12-week property disregard and to reimburse Mrs D’s costs.

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Final decision

21. We will not investigate Mrs A and B’s complaint about the Social Worker’s decision to move Mrs D back home with support, in May 2024. We are unlikely able to achieve the outcomes Mrs A and B seek.

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Investigator's decision on behalf of the Ombudsman