Clinical treatment in hospital : Betsi Cadwaladr University Health Board

Mrs N complained about aspects of her mother, Mrs V’s, care at, and discharge from, Ysbyty Penrhos Stanley Hospital between November 2019 and May 2020. The investigation considered whether there was a delay in discharging Mrs V to a nursing home, whether there was a failure to support Mrs V in challenging a Deprivation of Liberty Safeguards (“DoLS”) authorisation, whether the Health Board relied on a health and welfare Lasting Power of Attorney (“LPA”) to justify a lack of communication with Mrs N and her brother, Mr B, whether it was appropriate to discharge Mrs V to a nursing home without consultation with Mrs N and Mr B or informing them of her new address, whether there was a failure to ensure the nursing home could meet Mrs V’s needs and whether the ending of the health funding arrangements took place without appropriate review. The Ombudsman found that there were good reasons for Mrs V’s discharge being delayed. The Health Board had acted reasonably in dealing with Mr A as the holder of the LPA with regard to the choice of a nursing home; it had ensured that the nursing home could meet Mrs V’s needs and reviewed the placement some 2 months later. The placement had been funded by a Welsh Government scheme to facilitate discharge of patients from hospital during the COVID-19 pandemic and this funding arrangement had remained in place. The Ombudsman did not uphold these parts of the complaint. However, the Ombudsman found there had been delays in the Health Board applying for urgent and standard DoLS authorisations, which meant the Relevant Person’s Representative was not appointed promptly. Mrs V was therefore deprived for a time of the opportunity of challenging the standard authorisation, which was an injustice to her and engaged her human rights. The Ombudsman upheld that element of the complaint. The Health Board agreed to apologise for these failings, ensure that staff were reminded of their legal obligations in ensuring DoLS applications were made without delay, and undertake an audit of its DoLS applications and their compliance with regulations and guidance.