The Ombudsman's final decision
Summary: We will not investigate a complaint about the Trust not being clear with Mrs N about Mrs O’s diagnosis and the refusal by the Council to pay for care fees. Mrs N wants compensation, and it is reasonable for her to pursue this by making a legal claim against the organisations.
The complaint
Mrs N complains about Birmingham City Council (the Council) and Birmingham Community Healthcare NHS Foundation Trust (Trust). Specifically, she complains; the Trust were not honest with her about her mother in law’s, Mrs O’s, dementia diagnosis which led them to make the wrong decisions about where she should live.
the Council have not provided suitable financial support to her and her husband to support Mrs O and have refused to pay back costs accrued in her care.
Due to the miscommunication, Mrs N and her husband accrued care charges they and Mrs O had no means of affording. They have been left with a large amount of debt they are unable to clear. Mrs N has panic attacks and caused notable distress because of the constant financial problems.
Mrs N wants compensation.
The Ombudsmen’s role and powers The Ombudsmen have the power to jointly consider complaints about health and social care. Since April 2015 a single team has considered these complaints acting on behalf of both Ombudsmen. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA) 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 and Health Service Commissioners Act 1993, section 4(1b))
How I considered this complaint
I considered information provided by Mrs N and the complaint responses from the Council and the Trust.
Mrs N had an opportunity to comment on my draft decision. I considered her comments before making a final decision.
What I found
The Council took over the fees for Mrs O’s care in February 2017. In April 2019 Mrs O moved into a nursing home and the Council started to pay all her care fees. Between February 2017 and April 2019 Mrs N paid top up fees of £100 a month. Mrs N made a complaint to the Council in December 2019 and asked it to pay back the top up fees. The Council found delays in appointing a new social worker which resulted in financial hardship. It offered to repay Mrs N 25 weeks of top up payment at £22.15. Mrs N says this is not enough as she paid more.
After receiving the Council’s response, Mrs N made a complaint to the Trust. In its final response, the Trust admitted the doctor did not tell Mrs N about the possibility Mrs O may have vascular dementia. The Trust apologised and explained it made service improvements but could not offer compensation. Mrs N says this is not enough because the choices they made, and the fees they accrued, were made based on the wrong information the Trust gave them.
Mrs N wants compensation which she has not been able to achieve through the complaints process. She can pursue a legal claim and has explained she is willing to explore this first. It is reasonable for Mrs N to pursue this option as it could lead to the outcome she wants to achieve. Because of this, the Ombudsmen will not consider this complaint.
Final decision
We will not investigate this complaint as Mrs N can make a legal claim.
Investigator's decision on behalf of the Ombudsman