Bedford authorities did not assess man with mental health needs properly leaving him without appropriate support
12 Jun 2014 03:56 PM
Bedford care
professionals focused on keeping a man with mental health problems in his own
home at a cost to his health and welfare, an investigation has
found.
The joint investigation by the
Local Government Ombudsman (LGO) and Parliamentary and Health Services
Ombudsman into Bedford Borough Council and South Essex Partnership University
Trust found that the man suffered from malnutrition and poor dental health
because professionals did not properly assess whether he had the capacity to
make decisions for
himself.
The man, who is in his late 50s
and who has paranoid schizophrenia, had been living independently in a flat and
was visited regularly by social workers and health care professionals. His
sister and their parents started to raise concerns about his health and
well-being in 2008.
Over the next three years, the
area’s support team reviewed his situation, but the family still had
concerns about the level of care. The authorities assessed the man as having
the capacity to make decisions about where he lived and how he spent his money,
but no assessment was made about his ability to manage his food, personal care
or oral health.
A support package was put
together but there was confusion between the council and the trust over the
amount of care the man was receiving. The man finally moved into supported
accommodation in December 2011 and his general condition has
improved.
The joint investigation found
that the council and trust failed to provide proper care and support for the
man and did not carry out proper capacity assessments. Support workers did not
visit regularly enough, did not encourage him to attend to his oral health or
adopt a healthy lifestyle. There was also a delay in seeking appropriate
supported living accommodation.
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:
“This vulnerable man
was left living in squalor because he did not receive the care he was entitled
to.
“His sister repeatedly
raised concerns about her brother’s ability to make decisions for
himself, especially about his health and money. She resorted to taking food
parcels to her brother’s home to ensure he didn’t go
hungry.
“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.’"
The ombudsmen have recommended
that the council and trust should develop action plans to address the failings
identified and write jointly to the man and his sister to acknowledge the
failings and apologise for their impact. The authorities should jointly pay the
man £2,000 in recognition of the impact that their failure to assess his
capacity properly had on him.
The authorities should also
jointly pay the man’s sister £500 for the inconvenience and
distress caused by the service failures
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