Council and NHS trust criticised over support for man with mental health needs

A joint report by two Ombudsmen has criticised a local authority and an NHS trust over their failure to provide proper care and support for a man with mental health needs to enable him to leave independently.

The investigation by the Local Government Ombudsman (LGO) and the Parliamentary and Health Service Ombudsman (PSHO) found that South Essex Partnership University Trust failed to carry out a proper capacity assessment about Mr X’s ability to make decisions about managing his food and looking after himself.

The trust failed to ensure that support workers visited Mr X regularly or encouraged him to attend to his oral health and adopt a healthy lifestyle.

Bedford Borough Council was also found to have failed to carry out a community care assessment of Mr X’s needs.

In addition, there was a delay in seeking appropriate supported living accommodation for Mr X, who is in his late 50s and has paranoid schizophrenia.

When he moved into supported accommodation in December 2011, his general condition improved.

The LGO and the PSHO recorded a finding of maladministration and service failure, saying that this led to injustice for Mr X and his family.

The report recommended that the trust and council should:

  • Write jointly to Mr X and Mrs A (his sister and the complainant) acknowledging their failings and apologising for them;
  • Make a joint payment of £2,000 to Mr X in recognition of the impact their failure properly to assess his capacity had on him;
  • Make a joint payment of £500 to Mrs A “to recognise the distress and inconvenience caused to her”; and
  • Develop a plan to address the identified failings.

Dr Jane Martin, Local Government Ombudsman, said: “While I have no doubt in this case that the care team was seeking to provide the best support, their presumption that the person affected had the mental capacity to make his own decisions resulted in him being malnourished. This was detrimental to his health and distressing for his family.

“Despite his family repeatedly raising concerns about the man’s welfare, the care team presumed that the man had the capacity, and therefore the right, to make decisions for himself, however unwise they were. Appropriate supported accommodation should have been considered much sooner for him.”

Parliamentary and Health Service Ombudsman Julie Mellor said: “Health and social care professionals were so fixated on the man’s wishes to live independently, that they failed to carry out a capacity assessment of his ability to look after himself, which would have revealed that he was unable to cope with everyday tasks like feeding himself and cleaning.

“As a result, he was two and a half stone underweight, his teeth were rotten and his bedclothes hadn’t been washed in months. At one point his family were so concerned for him that they brought him to live with them.”