South Yorkshire Integrated Care Board

3. Ms A complains about a South Yorkshire Integrated Care Board (the ICB) Continuing Healthcare (CHC) team case manager (CHC manager). She says between 16 December and 19 December 2022 the CHC manager did not carry out a thorough investigation into the safeguarding concerns for her son, Mr B.

4. Ms A says as a result it caused her months of stress, worry and it was traumatic for her.

5. Ms A wants service improvements and financial compensation.

6. On 19 December 2022 Mr B was picked up from organisation A by support staff at organisation B and they noticed he was unkept, had opened his bowels and his pad had not changed.

7. On 20 December 2022 the registered manager at organisation B (the manager) sent the local authority a safeguarding alert form. On 21 December 2022 the manager sent the CHC manager an email and attached the safeguarding alert form.

8. On 30 December 2022 the CHC manager sent the local authority an email detailing the safeguarding concerns. On the same day the CHC manager attended organisation A and reviewed its daily logs. The CHC manager provided details of her review and the steps taken to address the matter with staff.

9. On 6 January 2023 the local authority sent the CHC manager an email and requested Mr B’s full name. On the same day the CHC manager provided the information.

12. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong with the ICB CHC manager’s action when the safeguarding referral was made.

13. Ms A says complains the ICB CHC manager did not carry out a thorough investigation into the safeguarding concerns for her son, Mr B.

14. The ICB says the CHC manager is not responsible for her son’s clinical care but to ensure the appropriate care package was in place during the time. It says the CHC manager liaised with organisation A and the local authority safeguarding investigation appropriately. The CHC manager followed the appropriate process in relation to the safeguarding investigation.

15. The CHC manager reviewed the records and discussed the issues with organisation A. It said the local authority are responsible for safeguarding investigation as part of its statutory duties. It is not the CHC manager’s role to undertake the safeguarding investigation. The CHC manager’s role was to support this process and provide information requested by the safeguarding team and attend any multi-agency meeting directed by the local authority. It apologised if this had not been explained to her.

16. We understand how distressing and upsetting it would have been for Ms A when she was informed of her son’s condition and the safeguarding concerns. We can see the safeguarding form detailed concerns about Mr B’s care. The safeguarding form recorded Mr B had been collected from organisation A by a support worker. The support worker noticed Mr B looked unkept, he had opened his bowels and his pad had not been changed. She assisted him to the toilet and noticed his bottom was really sore and his skin was starting to break down. We understand this would have been a difficult and distressing time for the family.

17. The role of the CHC manager is to manage the CHC care package. It is not the role of the CHC manager to provide clinical care. The CHC manager carries out the administrative functions of managing the CHC care package. The ICB’s role in the management of the care package is set out in paragraphs 189 of the National Framework.

18. This includes ensuring a suitable care plan is in place, ensuring the care plan meets the individual needs, ensuring arrangements are in place for non-NHS services and they are working effectively, reviewing and monitoring the quality of the care and support arrangements and responding to difficulties/concerns in a timely manner. The CHC manager acts as a link to coordinate the services for the individual, ensuring any changes in a person’s needs are addressed. They also initiate and undertake any reviews.

19. Paragraph 190 of the National Framework says where an individual is subject to a safeguarding concerns the ICB’s are reminded to co-operate with local authority.

20. The records show the safeguarding form was raised by the manager at organisation B and copy was sent to the CHC manager. The CHC manager advised the manager that as long as the safeguarding form had been sent to the local authority and Ms A was aware the manager did not need to notify anybody else at this stage.

21. On 28 December 2023 when the CHC manager became aware the local authority had no record of the safeguarding concern being raised she checked the email address the safeguarding form had been sent to and realised it should have been sent to a different email address. The CHC manager contacted the manager and asked the safeguarding form was resent. On the same date the CHC manager sent Ms A an email and advised her of this. On 29 September the manager resent them safeguarding form to the local authority. The manager requested Ms A is updated and involved in the safeguarding process.

22. On 30 December 2022 the CHC manager sent the local authority an email. She said she had been advised to notify it that a safeguarding alert had been raised in relation to Mr B who attends organisation A for respite. She said the alert was raised by the manager at organisation B as he had a sore bottom when they picked him up on the morning of 19 December 2022. She detailed the reasons for the alert as listed on the safeguarding alert form.

23. The CHC manager also confirmed she had the same day visited organisation A’s offices and reviewed the daily log from his respite stay with the respite manager. The CHC manager said it was documented staff undertook personal care/showering each morning and evening. It was documented his bottom was pinkish on the morning of 19 December and cream was applied. He had loose stools.

24. The respite manager explained staff had not detailed that Mr B had a pinkish bottom in the communication book so this was not handed over to organisation B’s staff or Ms A. The respite manager said this had been addressed with staff and it was added to tasks in Mr B’s support plans. The CHC manager confirmed this was added to the support plans whilst she was there.

25. On 30 December 2022 the CHC manager sent Ms A an email. She confirmed she had reviewed the daily logs from organisation A from 16 December to 19 December. She confirmed the details of her visit to organisation A and the action taken to address the concerns with staff. She said an internal investigation is being undertaken and she had notified the local authority of her findings when she reviewed the daily logs.

26. On 6 January 2023 the local authority sent an email to the CHC manager and requested the full name of the person in order for it to check the safeguarding. On the same date the ICB manager provided it with Mr B’s name. On 17 January 2023 the manager sent an email to the local authority to chase a response to its safeguarding alert form. It copied in the CHC manager. On the same day the local authority confirming it would be making enquiries. The local authority officer confirmed there were no updates and would check again in a couple of weeks and provide an update.

27. We understand Ms A feels the CHC manager did not carry out a thorough investigation of the safeguarding concerns. The local authority is responsible for carrying out an investigation into safeguarding concerns. We can see the CHC manager acted in timely manner when it was notified of the safeguarding referral, it ensured the referral had been sent to the local authority who were responsible for carrying out the safeguarding investigations.

28. The CHC manager attended organisation A to view the daily logs and discuss the safeguarding concerns. She detailed the action that had been taken to prevent the mistakes from happening again. The CHC manager also contacted the local authority and provided a copy of the safeguarding form.

29. We can also see when the local authority contacted the CHC manager for information the CHC manager responded the same day. This is in line with its safeguarding policy for referring the matter to local authority, cooperating with requests in relation to the safeguarding and effectively managing and working with agencies in relation to the safeguarding concerns.

30. This is also in line with paragraph 190 of the National Framework which says when a safeguarding concern is raised the ICB should cooperate with the local authority. We cannot say there are indications of failing here for the CHC manager not carrying out a thorough investigation of the safeguarding concerns.

31. We understand how important Ms A’s complaint is to her. We hope she is reassured by the consideration we have given to her complaint.

1. We have carefully considered Ms A’s complaint about how a South Yorkshire Integrated Care Board (the ICB) CHC manager handled the safeguarding concerns for her son, Mr B. We are sorry to hear of Ms A’s concerns about the CHC manager. We understand how upsetting and distressing the events have been for Ms A and her family. We recognise how important the wellbeing of her son is.

2. We have decided to not consider the complaint further. This is because we have found no indication that anything went seriously wrong with the ICB CHC manager’s handling of the safeguarding concerns.