Decision Report 202101301

Summary

C's elderly parent (A) was admitted to a care home to recuperate following surgery. C complained to Aberdeen City HSCP (ACHSCP) that the care home discharged A to their family home without knowing the result of their COVID-19 test and that they were not wearing a mask. The family were informed that A had tested positive for COVID-19 the day after they returned home. C also complained that the care home failed to communicate reasonably with the family about A during their admission.

In their response to C's complaint, ACHSCP acknowledged that it was best practice to have the result of the COVID-19 test prior to discharge. They explained that there was no national guidance regarding COVID-19 testing of residents being transferred from a care home to their domestic home. However, Health Protection Scotland guidance was that the risks should be discussed with the resident's family, specifically when there is an ongoing outbreak as there is a risk that the service user may be incubating the virus and could transmit to other household members. ACHSCP acknowledged communication with the family could have been better and that A was not supported to communicate with the family.

We found that there was no national guidance regarding COVID-19 testing of residents being discharged from a care home to their domestic home. However, we also found that it was evident that there was some ambiguity about what the discharge procedures should be and that there was a missed opportunity for ACHSCP and the care home to firm up their policy on safe discharging residents to their domestic home. As a result, A was discharged home having unknowingly tested positive for COVID-19 and the family were prevented from having a discussion to consider the risks.

We noted that it was accepted by all parties that A was not wearing a mask when they were discharged and that this was in breaching of COVID-19 hygiene protocols. In addition to this, we found that the standard of communication with the family fell below the expected standard. Therefore, we upheld C's complaints.

Recommendations

What we asked the organisation to do in this case:

• ACHSCP should apologise to C for the failure to communicate with the family about A's COVID-19 test to allow the family to assess the risks and for discharging A without knowing the result of the COVID-19 test. ACHSCP should also apologise for the failure to communicate with the family about A's wellbeing during their admission. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.