SPSO Individual Decisions

C's relative (A) required residential care in a care home. A's care was arranged and monitored by the partnership. C and their two siblings held joint power of attorney (POA) for A's financial affairs and welfare. Relations between the siblings broke down and C ultimately relinquished their POA status. C complained that the partnership subsequently failed to communicate with them reasonably, including failing to tell them when A was relocated to a new care home. C also raised a number of concerns regarding A's care home placement and the way that this was managed by the partnership. C contended that the new care home was not suitable for A's needs and complained that the partnership failed to ensure that A was not at risk. C submitted a complaint to the partnership regarding their experiences. C complained that there was an unreasonable delay to the complaint being confirmed and that there was also a delay to the partnership's final response. We found that, having been made aware of allegations from C of potential financial abuse and welfare issues affecting A, the partnership conducted full and thorough investigations and reached reasonable conclusions based on the evidence available to them. We did not uphold this aspect of the complaint. C officially remained as a POA for two months after verbally advising that they had relinquished their POA status. The partnership failed to communicate with C as a POA regarding A's transfer to a new care home. However, we were satisfied that the partnership had already acknowledged and apologised to C for this. We did not uphold this aspect of the complaint. We found that there was an initial delay assigning an investigating officer to deal with C's complaint and that this contributed to an overall unreasonable delay to confirming the complaint and issuing a decision. We upheld this aspect of C's complaint.

Mr C's mother (Mrs A) was in hospital for an extended period of time after a stroke. He complained that during that time the partnership failed properly to communicate with and include him in discussions about her care. He also said that the partnership unreasonably restricted the times when he could visit Mrs A. Mr C complained to the partnership that he had been treated poorly by staff who failed to include him in discussions about Mrs A's care. He said that he particularly wanted to discuss the appropriateness of the use of cannabidiol (CBD) in the management of Mrs A's pain but that staff reacted negatively to this and made assumptions about his intent. He said that they unreasonably imposed restrictions on him. In response, the partnership said that where a person had capacity to make their own decisions, like Mrs A, they were duty bound to allow them to make their own choices. Similarly, they had a legal duty to safeguard patients and to take necessary steps if there were concerns about their safety or wellbeing. With regard to the use of CBD oil, a number of meetings had been arranged with Mr C so that advice and guidance could be given about this but that he could not always attend, despite attempts being made to accommodate him. We found that CBD oil capsules had been found in Mrs A's bed and an Adult Support and Protection case conference had been convened as a consequence. While Mr C had been invited, he could not attend. A further meeting was held, after being rearranged to suit Mr C to discuss non-prescribed medication and there had been lengthy discussions about the potential harm that could be caused. At this meeting, it was agreed, amongst other things, that Mr C would not bring non-prescribed medication in to the ward, that he would visit at specific times and that his visits would be supervised. These agreed measures would apply for two weeks after which they would be reconsidered. Further meetings were held because Mr C was unhappy and

Miss C complained about the partnership's decision to move her father (Mr A) to sheltered accommodation. Miss C had Power of Attorney for her father and was of the view he required a care home setting to meet his needs. Mr A moved into his new tenancy but shortly after was involved in an incident which left him detained in hospital. Mr A was then discharged to a care home setting. Miss C complained that her views had not been considered and questioned the decision to move her father to sheltered accommodation. The partnership responded by explaining that there is no specific guidance on whether someone's care would be best met in supported housing or 24 hour care. They said that their normal practice would always be to use the least restrictive option that was suitable. They advised the decision to try housing with care was a multi-disciplinary decision which included Miss C and was approved by the housing committee. The partnership also advised that a social worker only became involved toward the end of the process when Mr A's needs increased and the assessment became more complex. Miss C was unhappy with this response and brought her complaint to us. We found that the quality of information provided by the partnership was poor and limited with no clear explanation about why the decision was made to move Mr A into sheltered accommodation rather than a care home. We noted that the partnership did not have any procedures which guide when it is appropriate for a social worker to become involved in the decision-making process. We took independent advice from a social worker who found that the council failed to involve a social worker at the appropriate time in the assessment process as they only became involved after Mr A was admitted to hospital. Given this and the poor quality of assessment, we upheld Miss C's complaint.

Miss C complained about the level of communication provided by the partnership regarding the care of her father (Mr A). Mr A was moved from a rehabilitation centre to another tenancy, however, this property did not suit his needs and Mr A returned to the centre. Miss C, who has financial power of attorney, complained that the partnership failed to reasonably involve Mr A's family members in decisions about his care. Miss C also complained that Mr A's care plan was not shared with his family, or made available to the rehabilitation centre, with no provisions implemented to ensure a smooth transition to his new tenancy. Miss C complained to the partnership who advised that they were attempting to balance promoting independence for Mr A, who did have capacity, against involving his family. They acknowledged that communication had been poor but were vague about what steps would be taken to avoid similar problems occurring in the future. Miss C was unhappy with this response and brought her complaint to us. The partnership responded to us and explained that on further review, they accepted many of the failings that Miss C identified in her complaint. We noted that communication had been poor between the partnership and Miss C and that relevant parties had not seen the content of the care plan. We upheld Miss C's complaints.