Birmingham and Solihull Integrated Care Board

4. Miss A has complained to us about the organisations’ failure to act on safeguarding concerns she raised about her mother, Ms H. Miss A says the organisations had a duty of care to her mother and failed to fulfil this.

5. Miss A also complains about aspects of care and treatment the Trust provided to Ms H. Miss A says: • her mother was discharged without appropriate clinical investigations • the care plan was not appropriate for her mother’s needs • the Trust did not communicate the results of Ms H’s CT scan • the Trust did not consider Ms H’s family in its best interest meeting • the Trust did not consider a suitable care home for Ms H.

6. Miss A also complains about aspects of the care and treatment the ICB provided to Ms H, including when she resided in the care home. Miss A says it did not properly address Ms H’s medical needs, including prescribing required medication.

7. Miss A says her mother suffered abuse because of the organisations’ failure to protect her. Miss A also told us because of the Trust and ICB actions, her mother was left without the care and treatment she needed.

8. To resolve her complaint, Miss A would like an explanation from the organisations. She also seeks financial compensation.

11. The law says a person needs to make their complaint to us within a year of becoming aware of the problem. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason to do so. We have discussed this with Miss A to understand the reasons why she did not bring this complaint to us sooner. We have also considered the time the organisations took to respond to Miss A.

12. Miss A says she became aware of her concerns about the care provided to her mother in December 2019, when Ms H was discharged from the Trust and became unwell. Miss A thought more should have been done for her. For her complaint to be in time, Miss A would have needed to approach our office by December 2020. As she brought her complaint to us in September 2024, 3 years 9 months outside our time limit, we considered the reasons for the delay.

13. Miss A raised her complaints with the care home and ICB in February 2020. The care home provided its final response to Miss A in December 2020. This process took 10 months to complete. The ICB provided its response to Miss A in December 2021. This took 1 year and 10 months to complete.

14. Miss A raised her complaint with the Trust in March 2020. The Trust responded to Miss A in August 2020. This process took 5 months to complete.

15. We would not disadvantage Miss A for the time the organisations took to investigate her complaint. That said, there were periods Miss A did not pursue her complaint in a timely way, we have considered these periods below.

16. We can see by December 2021 Miss A had completed local complaints processes. Miss A sent us information about her concerns in July 2024 but did not send us a completed complaint form until September 2024. This means Miss A took 2 years and 9 months to fully submit her complaint after local resolution was concluded. This was 3 years and 9 months outside of our time limit.

17.  We have discussed this with Miss A to understand the reasons why she could not bring her complaint to us sooner. Miss A said she was pursuing her concerns during COVID-19 and this impacted her ability to pursue her complaint quickly. She explained she wanted her concerns about each organisation to be considered together and was not aware of our time limit. Miss A said she did not receive the Trust’s response until November 2022. She also explained she had to be careful about pursuing her concerns as she did not want her mother to suffer as a result when she was still under the care of the organisations.

18. From the evidence we have seen, in December 2020 Miss A wrote to the ICB with details of her concerns about the care and treatment Ms H had received. She also included her concerns about the care home. In December 2021, the ICB provided its response to Miss A and provided information about the Ombudsman and the steps open to her if she remained unhappy. This information was also provided to Miss A by the Trust when it sent her its final response in August 2020.

19. Miss A wrote back to the ICB in October 2022 chasing its response, in this correspondence we can see Miss A said she would have to take her concerns to the Ombudsman due to the ICB’s lack of communication. We understand Miss A said she did not receive the ICB’s response in December 2021. We think it would have been reasonable for her to follow up with the ICB sooner than October 2022. In November 2022, the ICB resent Miss A a copy of its December 2021 response.

20. We can see Miss A returned to the ICB in January 2023 stating she was unhappy with the complaint responses she had received. From the evidence we have seen it appears she was dissatisfied with the responses, not that she was raising new issues. The letter from the ICB resent to Miss A in November 2022, explains that if she was dissatisfied with the outcome of the ICB investigation she had the right to approach the Ombudsman.

21. Miss A continued to approach the ICB until May 2024 when the ICB again explained it had addressed all her issues in the December 2021 response. It made clear local resolution was concluded. We can see Miss A took a further 4 months to bring her complaint in writing to us.

22. We have considered the information helpfully provided by Miss A and are of the view that the threshold for setting aside the time limit is not met. We appreciate there may have been some periods, particularly during a pandemic, where Miss A’s ability to progress her complaint may have been impacted.

23. We do not see evidence these barriers prevented her from pursuing her issues with the organisations so can see no evidence why she could not bring her complaint to us sooner. When we have considered the reasons Miss A gave us for the periods of delay, we do not think these represented exceptional reasons to allow us to set the delay aside.

24. In August 2020 the Trust sent Miss A information about our Office which directed her to our website which contains all relevant information about when a complaint is ready for us, along with information about our time limit and details about advocacy services that can help support people with their complaints. We think it would have been reasonable for Miss A to have independently reviewed this information at that time.

25. Miss A’s complaint has come to us significantly out of time. We have identified periods where we think it would have been reasonable for Miss A to have submitted her formal complaint to us before September 2024.

26. We are sorry for any disappointment caused by our decision. We are grateful to Miss A for bringing her complaint to us and for speaking with us so openly about what happened. We understand this period was difficult for Miss A and we know how important her complaint is. We must apply our time limit fairly. For the reasons explained, we do not see good reason to set aside our time limit. We hope this statement clearly explains the reasons why we will not be considering this complaint further.

1. We have carefully considered Miss A’s complaint about the care and treatment the organisations gave her mother in 2019 and 2020. We know how difficult this time has been for her and how much she has been affected by the sad death of her mother. We extend our sincere condolences for her considerable loss.

2. We have decided not to consider the complaint further because Miss A brought her concerns to us outside our time limit.

3. We are grateful to Miss A for taking the time to speak to us about her concerns and all the information she provided. We recognise this decision may be disappointing and regret any distress this may cause. We will explain in this statement the reasons for our decision.