Summary: Mr G complained about the failure of the Council, the NHS Trust and the Integrated Care Board to meet his daughter’s health and social care needs when she was discharged from hospital in
July 2020. We decided to end our investigation to allow separate legal proceedings to conclude.

The complaint

1. The complainant, who I shall refer to as Mr G, complains about his daughter’s discharge from hospital in July 2020 following detention under the Mental Health Act 1983. He says Leicestershire Partnership NHS Trust (the Trust) discharged his daughter, Miss B, from hospital without notifying Leicestershire County Council (the Council) and the former Clinical Commissioning Group now NHS Leicester, Leicestershire and Rutland Integrated Care Board (the ICB) to ensure she was properly assessed for section 117 aftercare services. The complainant says the Council where Miss B was living, (the City Council), took six months to determine it was not the responsible authority to provide aftercare before notifying the Council. He says the Council and the ICB delayed meeting his daughter’s needs for about two years. Mr G complains his daughter’s health and wellbeing deteriorated as a result and he experienced increased carer’s strain and was unable to work and socialise with family and friends.
2. He would like the Council and the ICB to ensure Miss B receives the care and support she needs and therapy to deal with her trauma. He would also like recompense for the impact the alleged faults had on him.

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The Ombudsmen’s role and powers

3. The Ombudsmen 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)
4. The Ombudsmen may investigate complaints made on behalf of someone else if they have given their consent. The Ombudsmen may also investigate a complaint on behalf of someone who cannot authorise someone to act for them, if the Ombudsmen consider them to be a suitable representative. (Health Service Commissioners Act 1993, section 9(3) and Local Government Act 1974, section 26A(1) and 26A(2), as amended)
5. We can decide whether to start or discontinue an investigation into a complaint within our jurisdiction. (Local Government Act 1974, sections 24A(6) and 34B(8), as amended, Health Service Commissioners Act 1993, section 3 (2))

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How I considered this complaint

6. I have considered information provided by the complainant and the organisations complained about.
7. All parties had an opportunity to respond to a draft of this decision.

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What I found

Background

8. Miss B was detained in hospital under the terms of Section 3 of the Mental Health Act 1983. Section 3 is for the purpose of providing treatment. Before the person is discharged an assessment should be completed to see if they have any needs that should be met. This is known as section 117 aftercare.
9. Section 117 imposes a duty on councils and the relevant NHS health authority (the ICB) to provide or commission free aftercare services to patients who have been detained under certain sections of the Mental Health Act. These free aftercare services are limited to those arising from or related to the mental disorder, to reduce the risk of their mental condition worsening, and the need for another hospital admission again for their mental disorder.
10. The Trust arranged Miss B’s discharge from hospital in July 2020. When responding to Mr G’s complaint the Trust said its clinicians had considered Miss B did not need social services support when it discharged her. It said her s117 needs could be met by healthcare. It notified her general practitioner and sent a discharge letter.
11. Miss B also received informal care from Mr G and lived with him. Mr G has been registered as his daughter’s lasting power of attorney for health and personal welfare (LPA). An LPA is a legal document, which allows a person (‘the donor’) to choose one or more persons to make decisions for them, when they become unable to do so themselves. The 'attorney' or ‘donee’ is the person chosen to make a decision on the donor’s behalf. Any decision has to be in the donor’s best interests.
12. Mr G later complained to the Trust that it discharged Miss B without holding a Care Programme Approach (CPA) Meeting or considering her section 117 aftercare needs. The CPA is a framework used in mental health services to assess, plan, review and coordinate treatment, care and support for people with complex care needs. He also complained about issues relating to Miss B’s clinical care and the provision of suitable therapy. He said his daughter’s health deteriorated as a result.
13. Mr G contacted the City Council to request social care support but it later discovered it was not the responsible council for aftercare following its interaction with Miss B and Mr G. The City Council contacted the Council about six months later, and it became involved in December 2020.
14. The Council allocated a social worker in January 2021 and also contacted the former CCG around this time requesting support with case management. It also held a virtual meeting with Miss B, her advocate and Mr G to discuss her care needs.
15. The Council said it offered Miss B support from its Home Care Reablement Service so it could assess her care needs over a period of time. It said it did not receive a response from Miss B or Mr G about the offer. Mr G does not agree with what the Council said. He said the Council painted an inaccurate picture of his daughter’s care needs. He said this left Miss B without the care and support she needed and in a position where she had to rely on him and other family members to provide her health and social care support.
16. Mr G wrote several letters of complaint to the Council, the Trust and the CCG relating to his daughter’s care and support needs and the alleged failure of the organisations to meet her needs and follow the correct legislation and guidance. He said the organisations repeatedly failed to meet their statutory duties and responsibilities in regard to Miss B’s care needs and his own needs as a carer.
17. Mr G received several complaint responses from the Council and the Trust throughout 2021 and 2022 and replied to them to voice his continued concerns and disagreement with what they had said. He remained dissatisfied and so asked the Ombudsmen to consider his complaints.

Analysis

18. We have considered Mr G’s complaint about the City Council as a separate complaint under case reference 21 007 131.
19. After considering Mr G’s complaint about the other issues and his suitability as a representative we started an investigation in this complaint and made enquiries of the organisations complained about.
20. In response to our enquiries the Council provided information to confirm that there are ongoing separate legal proceedings involving all parties subject to this complaint. This includes Mr G, the ICB and the Trust.
21. We have considered all the information provided by Mr G and the organisations complained about and weighed this up against the practicalities of continuing with our investigation now. Following this consideration, we have decided to end our investigation to allow the ongoing legal proceedings to conclude.
22. Once the proceedings have concluded Mr G can ask us to reconsider his complaint.

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Final decision

23. We have decided to end our investigation to allow ongoing legal proceedings involving Mr G, the Council, the Trust and the ICB to conclude.

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Investigator's decision on behalf of the Ombudsman