Decision Date: 11th February 2020
Mrs X complained on behalf of her late mother, Mrs Y.
Mrs Y had been living in a care home since 2013.
In 2016 Mrs X first complained to the Council about the care Mrs Y was receiving. After numerous complaints, the Council held a safeguarding meeting in April 2017.
During the meeting it was agreed that the particular nurse in question should be reported to the relevant professional body. The CCG would follow up with the care home to ensure it had been done. The report did not clarify whether the nurse was part of an FNC package, or why the CCG were the body to follow up.
In May 2017, when Mrs X received the minutes from the meeting, she did not feel they were accurate and complained to the Council. She did not receive the amended minutes until January 2018.
Mrs Y the service user had passed away in 2017.
Mrs X never received confirmation from the Council that the actions agreed in the meeting were carried out. Mrs X contacted the professional body to check whether the nurse had been reported. She had not.
Mrs X had written 19 letters to the Council over the last two years, chasing up the safeguarding measure. She did not receive a response until 29th March 2019, in which the Council confirmed that a safeguarding investigation was completed. It said a social worker contacted the care home and was told the report of the nurse had been carried out, but it had since discovered it had not.
The Council apologised to Mrs X stating “the Local Authority does have an ultimate responsibility to ensure that the outcomes of the safeguarding proceedings were carried out, and should have been more proactive in confirming that the then manager of the nursing home had made the report and that the CCG were following up with NMC to confirm their actions”.
In this report there was no mention as to the accountability of the CCG, and why they did not follow up with the Nurse.
What was found
The Council failed to ensure the outcome of the safeguarding investigation was completed. This was fault.
It also failed to respond to Mrs X’s correspondence for over two years. This was fault.
Mrs X was put to significant time and trouble, having to contact the Council repeatedly.
The LGO recommended that the Council apologise and pay £500 to Mrs X for its failure to respond to her, and pay a further £250 for the time and trouble she was put to.
Nothing was paid to signify the failings of the home as employer of the nurse and the impact on Mrs Y.
Points for councils, families, service users, care homes etc
When a council pays for a care package in a nursing home, the responsibility to choose a good provider, monitor compliance with the care plan paid for through the contract, and ensure that the plan meets the needs, is the council’s. But even if the council has funded the whole package, and is repaid the FNC from the NHS (the funded nursing care element), the NHS is the purchaser of that part of the service. It is thus responsible for the adequacy or any problems with that part, in public law terms, management of complaints, etc.
Here, the home’s NURSE was the cause of the safeguarding issues, and that is what made it appropriate for the CCG to be tasked but the safeguarding outcomes plan to ensure that the nurse was reported. Anyone – including the LA, or Mrs X herself, could have reported the nurse, but the home undertook to but ultimately overlooked that or failed to follow the plan. The CCG failed to check. The Local Authority failed in its overall responsibility to attend to the outcomes of the safeguarding plan, and this is one of those examples where the outcome could have been implemented by the council directly, rather than a suggestion that an agency such as the CCG should do something or ought to do something. Those latter types of outcome, regarding for instance moving a client who is inadequately cared for by a hopeless care home, are not enforceable BY a council, because it is not able to make decisions that are given to the CCG by the law (provision of health care to meet needs).
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The full Local Government Ombudsman report of Coventry City Council’s actions can be found here