Local Authority Ombudsman

Discussion in 'Legal and financial issues' started by Cornishman, Jun 6, 2014.

  1. Cornishman

    Cornishman Registered User

    May 27, 2013
    As mentioned on here previously, my mother was deemed CHC eligible (after waiting 6 years for it) from 2009 until it was taken away again by the NHS in 2013, as she was again deemed ineligible.

    Apart from all the whys and wherefores of the DST (best work of fiction since Shakespeare), the assessment was undertaken in August 2012 and the Joint Decision Panel sat in August 2013 (no misprint).

    The NHS Framework Document for CHC explicitly states, and states it more than once, this process should not normally exceed 28 days. It also explains why this timescale is so important - it is so that the decision panel has reliable and up-to-date information on which to base their decision. Seems reasonable.

    The CCG have bullied, lied and cajoled their way through this when we complained including at the appeal panel, saying quite staggeringly, when cornered, that the rules "don't apply" to my mum. Needless to say we're pursuing all that through other channels.

    But it occurred to me too - what on earth was the LA rep on the decision panel doing, in actually agreeing to sign off the recommendation of the DST? Common sense and / or professional integrity should have rung alarm bells, and that individual should have, in the family's view, declined to make a decision based on this completely farcical situation and unreliable evidence.

    I doubt anyone on here will be overly surprised when I say it was more a case of "Where do I sign?" The LA rep said in the decision letter my mum was "within the scope of the care the LA could lawfully provide". How did she know, having never set eyes on my mum, and using CH records dating back 15 months and not less than a year old? For example, the DST says my mum was attending social functions, whereas by the time of the decision panel, and a long time before, she was totally immobile and her general health condition was continuing to deteriorate.

    So I took the case to the LA (not Health) Ombudsman stating this was a serious case of maladministration.

    Today the LA Ombudsman wrote to say, because it's a "NHS decision", the matter will not be investigated. Note: Not that our case "isn't upheld", but it won't even be investigated.

    So why do the LA even turn up at a decision panel, if they have no powers, no influence and clearly haven't the wherewithal to "whistle blow" when the CHC assessment process is being so conspicuously disregarded? And where there's a clearly defined framework, surely such a serious and conscious deviation from the guidelines is a dereliction of duty in public office. And they're failing to provide my mum with the consideration she deserves and is entitled to under statute.

    But the LA Ombudsman then thinks there's no case to answer. Again, if the LA Ombudsman will not investigate such an obvious case of maladministration, what they do all day? (Worry about parking tickets and unemptied bins, presumably).

    So the stonewalling continues - almost 2 years of this now, and 11 years since my mum went into the CH.

    Has anyone else approached the LA Ombudsman, and anyone know if there's any hope of redress other than legal action?

    Is there an Ombudsman Ombudsman LOL?

    Thanks for reading: Just helps to share.

  2. vernumamy

    vernumamy Registered User

    Jan 25, 2014
    I'm sorry Cornishman, I can't offer you any help, but I would like to wish you good luck.

    I have followed your case, and I know how draining and demoralising this can be.

    All the best.:)
  3. Cornishman

    Cornishman Registered User

    May 27, 2013
    Thanks V.

    As you say, it is draining and demoralising, and invariably at a time when in parallel we are caring and thinking about our loved ones.

    I'm sure we'll succeed, even if it means legal challenges.

    The authorities, whoever that may be, whether NHS, LA and sometimes even the CH, seem to act with ungoverned and unchecked impunity.

    It's a disgraceful state of affairs, and anyone who thinks this isn't all about the money is frankly deluded in my opinion and experience.
  4. nmintueo

    nmintueo Registered User

    Jun 28, 2011
    #4 nmintueo, Jun 6, 2014
    Last edited: Jul 30, 2014
    Since the Local Government Ombudsman takes the position is that it was an NHS decision and not an LA one (LA reps on panel notwithstanding), take it to the Parliamentary and Health Service Ombudsman instead.

    The NHS complaints procedure

    Parliamentary and Health Service Ombudsman

    Whether this offers any hope of redress is another matter. I've never had to deal with the LA Ombudsman, but found PHSO to be - oh, how to put this politely? - solely interested in getting rid of the complainant, and not concerned with tedious old facts and rules.

  5. Cornishman

    Cornishman Registered User

    May 27, 2013
    #5 Cornishman, Jun 6, 2014
    Last edited: Jun 6, 2014
    Thanks N.

    We put a case to the Parliamentary and Health Ombudsman in January, who have just written to say they "hope to start their investigations within 50 working days" - so that's 7 months just to even look at it. Doesn't inspire confidence that they're "working for us" does it? :(

    With regard to the LA Ombudsman - my thinking was that the LA rep is working in a public office (just like the CCG), but as they clearly demonstrated at face value they think guidelines and rules are only for "the little people", she should be accountable. Clearly not though.

    Despite a massive and obvious failure to apply due process, the LA Ombudsman can't even be bothered to ask for the LA's version of events, let alone hold them to account.

    Thanks for thoughts and input.
  6. FifiMo

    FifiMo Registered User

    Feb 10, 2010
    Hiya Cornishman,

    Just by way of reassurance, yes, one of our TP members did take her concerns and problems to the LGO - and she won the case. (She is no longer able to post here on TP, but I do remember most of the details.) It was not connected with CHC at the time, although that may have followed later (I'm not sure), but it was hugely connected with Social Services, Social Workers, Local Authority standards and rules and, far more importantly, the provision of and standards of care.

    The LA was found to have failed to follow correct procedures, to have failed to provide that which the LA was required to provide, to have failed to keep to an acceptable timescale, and so on. Lots of other issues too, including inappropriate record-keeping and a lack of attention to detail.

    She received financial compensation from the LA, which went to her chosen charity, but that compensation wasn’t what she was looking for. Unfortunately, as far as I am aware, the very thing she was looking for was the thing she never received - an apology! Nor did she get a full explanation of the ‘whys and wherefores’.

    One thing you may not have been told by the LGO - it is possible for the LGO and the PHSO (Parliamentary and Health Service Ombudsman) to conduct a joint investigation, especially where the nature of the complaint covers both Local Authority involvement in care, and also health care.

    This link may be of help for you: http://www.ombudsman.org.uk/about-u...mentary-and-health-service-ombudsman-welcomes

    Whew! That took me a trip down memory lane and through my emails from the time! LOL

  7. Cornishman

    Cornishman Registered User

    May 27, 2013
    Thanks Fiona and for the links and researching for your old stuff on this subject.

    Unfortunately the LGO has already stated my complaint won't even be investigated further, which in itself I think is quite outrageous. I've checked various sources, and seems the LGO is answerable to just about no one.

    Here is a clear case of a Council representative in a responsible position being party to a serious failure of process that has a detrimental and long term impact to an individual, but isn't even troubled by an enquiry from the LGO, let alone admonishment. That same person could well be doing the same next week with impunity and without any checks or balances.

    To reiterate, this person said my mother was within the scope of what the LA could provide, thus colluding with the NHS to discontinue CHC for my mum. They used DST evidence at least a year old, when the guidance clearly tells them they should use data up to 28 days old. Public servants should be more accountable than that.

    The LGO said this:

    "While the Council had a part to play in providing evidence for the continuing healthcare funding decision-making process, the decision to withdraw funding is solely the responsibility of the NHS team. So the Ombudsman could not find the Council to be at fault in the way the funding decision was reached."

    This response shows either a total lack of understanding of how Joint Decision Panels work (clue is in the word "Joint"), or it reveals an accidental insight into how Joint Decision Panels really work. In other words, LAs just do what they're told, and have no "voting rights" over the CCG bullies.

    Either way, it is another example of how everything is summarily dismissed because they know it leaves individuals and their families almost powerless.

    If these decisions were correct, lawful and backed up by integrity and proper process, there would be no need for this nonsense.

    But just as these decisions are frequently based on malpractice and questionable tactics, the governance process seems to be similarly drawn into the same mirky world.

    I just wish we could see an end to this, but we'll keep on fighting.

    Thanks as ever for your kind input and thoughts.
  8. FifiMo

    FifiMo Registered User

    Feb 10, 2010
  9. Cornishman

    Cornishman Registered User

    May 27, 2013
    Thanks again Fiona - that's great and very helpful.

    I'm not there yet - I'm politely writing back to say they've actually misinterpreted my original complaint. They seem to think I'm saying mum is not within the scope of the LA (actually, she isn't), but my complaint was wholly about the fact the LA rep signed off a totally non-compliant CHC decision based on a completely obsolete year-old DST. Surely they should be answerable / accountable for doing that.

    Complaining about how a complaint (to the LA) about a complaint (to the LGO) has been handled!!! Ever get the idea there's a few barriers being thrown up? ....Perish the thought :)

    Best regards and appreciate your interest and efforts.
  10. fr0d0

    fr0d0 Registered User

    Dec 23, 2009
    Mid Wales
    Well done Cornishman and keep at it! There are records in law of several cases (for CHC funding) that were won on the grounds that the LA couldn't provide for a need that was outside of their remit, so I think you're on the right track.
  11. cliveo

    cliveo Registered User

    Sep 11, 2011

    Hi Cornishman,

    I have followed your posts with interest as I have similar on going problems with processes not being followed after 18 months of bashing my head on the wall trying to deal with this. Have you applied to have your case reviewed by the Independent Review Panel as I believe you were not successful at Local level.

    I have had good and bad dealings with Solicitors, Ombudsman and recently a advocacy service endorsed by Age UK.(They charge so I cannot promote the service and I more than appreciate this is not an option open to everybody). Their website does offer the best free information available by download I have come across on the subject of Continuous Care. I know how frustrating this must be for you and you must know a great deal about the subject by now. I would be happy to supply details off forum if interested.

  12. Cornishman

    Cornishman Registered User

    May 27, 2013
    #12 Cornishman, Jun 10, 2014
    Last edited: Jun 10, 2014
    Hi again everyone.

    Well it took less than a week to firmly hit the buffers with The Local Government Ombudsman.

    In short they (well, actually a she if you're talking about the actual person) don't want to know about CHC cases*. I was forewarned of this on here, but I thought it was such an obvious case of maladministration by both the NHS and the LA at the Joint Decision Panel (who you might remember were using a YEAR OLD DST to decide my mum no longer met CHC criteria) so thought I'd try my luck complaining to the LA and then the LGO. This to run in parallel with IRP etc with the NHS.

    Both the LA and now the LGO consider that CHC decisions are "wholly a NHS matter". Which seems completely inconsistent with the fact that there were only 2 people on the err.. "Joint" Decision Panel, one from the NHS and one from the LA.

    So when the LA rep, who has never set on eyes on my mother, used the DST which used CH records written as much as 15 months prior to the panel, which said she wasn't immobile (she was totally bed bound by the time they got round to making the CHC decision a year later), she said my mother was "within the limits of what the LA could provide". The framework document strongly suggests the information the decision panel uses should be no more than 28 days from assessment, to ensure it's "current".

    But now I'm being told that actually wasn't a decision. Indeed, the LA rep doesn't make any decisions. It's wholly a NHS decision.

    Which if nothing else goes to show what a charade all of the assessment process is.

    The NHS call the shots. The LA (certainly in this case) do what they're told.

    I've put a FOI request in today (my first ever FOI request!) to the LA asking for their definition of "the limits of what the LA could provide". I'm guessing they won't be able to provide one, which will make their reply interesting, even if it doesn't get us very far.

    * As a measure of "don't want to know" - I worked all weekend on my submission to the LGO which, because this matter has dragged on for almost 2 years now, amounted to 5 pages plus annexes of "evidence". I sent this first-class post on Monday evening to the LGO office in Coventry and had their email reply by lunchtime the following day (today) saying it wouldn't be investigated and case closed!
  13. crazyfish

    crazyfish Registered User

    Oct 12, 2012
    Hi Cornishman,
    Hope things are not getting you down too much but reading through some of your recent posts it looks like you are having a real tough time.
    I don't recall if you have consulted a specialist solicitor regarding your ongoing problems.
    But I think the time has now come when this option should be considered seriously .
    As mentioned by another member it is highly unlikely that the NHS are seeking any court action the onus will be upon you to get them into court and let a judge decide.
    This forum is a great place to throw a few ideas around but there are very few specialist lawyers amongst us although some people seem to think they know it all.
    Perhaps a very strong solicitors letter telling your local CCG that as far as you are concerned they are not abiding by the NHS doctrine and guidelines or the law and you intend to take legal action against them to obtain your mothers statutory rights.
    As you are probably aware the ombudsman is a waste of time the only person the CCG or LA will take notice of is a judge.
    You could seek advice from a legal advisor in your area or someone here may give you a name of someone who helped them .
    There is of course the Hugh James who have good and bad results .
    Failing that PM and I will give you the name of the solicitor who helped me.
    But I do think that you are dealing with a totally intransigent CCG who will completely ignore any evidence you put in front of them.
    They have made their mind up and as far as they are concerned you are just small fry who they can afford to ignore in the hope that you will go away.
    Maybe it's time to get someone to help and take some weight of your shoulders.
    So far you have done more than could be expected of anyone to protect your mothers interests but I know from experience that this process is physically draining and can affect your own health .
  14. Norfolkgirl

    Norfolkgirl Account Closed

    Jul 18, 2012
    That's right. In my (mum's) situation SS ignored my warnings of likely further incidents and guess what, they then happened again. I have now taken legal advice against mum's abusers and the specialist private prosecutors have flagged up serious potential criminality which SS ignored when I reported to them. If I take this further I will sue SS for wasting my time with them and for distressing me over their ignorance, as well as many other "professionals" in the care sector.
  15. crazyfish

    crazyfish Registered User

    Oct 12, 2012
    Good for you Norfolkgirl,
    To many people are bullied and cajoled by the so called professionals into agreeing to things which are not in the best interests of themselves or their family.
    The SS and the NHS both ignore the law when it suits them but try and impose the law as they see it on the rest of us.
    It takes a few people like yourself to stand up to them then maybe things may change.
    But unfortunately I don't think that is going to happen unless the law and the NHS constitution changes.
    And no political party is likely to volunteer to change anything to do with the basic right of every citizen to receive free NHS care at the point of need.

    It would be a massive vote loser.
    So we should all fight for what is our relatives statutory rights for however long it takes before the NHS sees that the games up and people now realize that they are being duped when they are passed over to the SS so that they can be asset stripped.
    The old and sick are a very vulnerable and easy target.
    However this ridiculous system of assessments and criteria can't go on for ever as there are now more and more people realizing that this process produces results that are illegal and so they are questioning those results.
    This is tying up a great deal of NHS resources one person can tie up a whole department for months if they keep questioning procedures and asking for everything in writing.
    The more people who do this the more likely something may change.
    If people just sit back and let things take there course then that is just what the NHS want .
    Nobody rocking the boat.
    Good luck Norfolkgirl keep going.
  16. Cornishman

    Cornishman Registered User

    May 27, 2013
    Hi Mick

    Thank you very much for your supportive message and for all your help in the past.

    As you say, we're getting to the end of the avenues open to us to get a resolution. I had limited hope that we'd get some sort of proper treatment, but have been staggered by the stonewalling, lies and tricks by all the agencies, who seem to instinctively know there's mutual advantage in colluding with each other. It's all so un-British! LOL

    I did think maybe we should have adopted an "Ian Perkin" approach when my mother's CHC eligibility was withdrawn quite scandalously by the CCG last year, who carelessly left stuff lying around the Internet showing this was all part of a massive CHC "review" (aka - CHC withdrawal programme, which even had stated reduction targets of around 40% I recall), and let the NHS to take us to court. But without specialist advice, I was in danger of getting out of my legal depth because we were under contract with the CH 2003 to 2009 (the latter when NHS finally awarded CHC), so I'd think the CH might in theory come after me, waving that old contract.

    So as you suggest, it's time for legal action. My mother should have had free care since a specialist NHS doctor said in 2003 when she was discharged from hospital straight to the CH that "she would not survive outside the sheltered environment an EMI care home would provide", but it took until 2009 to get CHC, and to take that away again, using a year-old DST which was reverse-engineered from the decision backwards, just 4 years later from a lady in her 80s and after 15 years of Alzheimer's is shameful. Especially the manner it was done with CCG visits taking place without the family's knowledge, denial certain documents were held by the mental health partnership (which we later managed to obtain direct), being told no one involved in the case would be at the appeal panel, only to arrive to find the nurse assessor sitting there who then proceeded to undermine all our evidence and belittled their own procedural failings, the Chair being her boss, the LA rep on the decision panel now saying "she didn't take any decisions" (apart from the one saying mum was now within the limits of what the LA could lawfully provide!), the LGO saying there's no case to answer, the LA changing the wording of our complaint in order to minimise it and make it easier for them to avoid criticism; the list goes on...

    It really is draining, and it's great to have support on here as there's not much of it around from those whose job it really is to help, but who spend all their time doing the opposite.

    I'll send you a PM over the next day or so to enquire more about your experiences on the legal stuff.

    Many thanks as ever and I appreciate all that you do on here.
    Best regards
  17. fr0d0

    fr0d0 Registered User

    Dec 23, 2009
    Mid Wales
    My solicitor is in Wales so I think no use to you cornishman. She has been brilliant without us even engaging h her professionally. I'd thoroughly recommend it and can assure you from my experience that it can be an extremely positive step. I was recommended her by Nicola Mackintosh. Just someone working representing vulnerable people. Good luck my friend.

    Sent from my Nexus 4 using Talking Point mobile app
  18. Cornishman

    Cornishman Registered User

    May 27, 2013
    Hi again fr0d0 - Thank you very much for that. I'll message you separately to find out more.

    As you suggest, to hand this over to a professional will be somewhat of a relief I'm sure.

    We've always thought we should be seen to go through all the proper processes (oh the irony in that phrase!!!) before taking legal action. But it's becoming increasingly clear that until we get to that stage, the CCG, and to a lesser extent the LA, will continue to give us the "runaround".

    Grateful for your input as ever.
    Best regards
  19. geum123

    geum123 Registered User

    May 20, 2009
    The main solicitor in Wales who specializes in NHSCC claims, also handles cases in England cornishman. They are well versed in both the English and the Welsh version of the DST tool framework.

    They saved me an awful lot of angst and high blood pressure, because the more I read the more I realized that sometimes, justice is not seen to be done.
    I wanted to ensure that it was.......They won my Dads case retrospectively....... and I was able to give more attention to my Dad.:)

    I have pm'd you their details.

    Incidentally, I have read of a couple of people who followed (unqualified) advice not to pay care home fees. They came a cropper big time.
    It is a few years ago now and I forget the exact details..........:(
  20. witchpig

    witchpig Registered User

    Dec 31, 2011
    Maidstone Kent
    Have you thought about contacting one of the national newspapers as they are interested in stories like this.

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