In Knowsley MBC (9 June 2014), the Local Government Ombudsman found the Council to be at fault for failing to have a support plan for a man with autism and severe learning disability requiring 24 hour care and for not carrying out annual and other timely reviews. It also failed to formally assess his capacity to make specific  decisions and had not followed the correct procedures for determining his best interests. As a result, he was required to live with a co-resident in supported accommodation which led to a deterioration in his challenging behaviour and significant avoidable distress. The recommendations included the payment of £500 to be spent on Mr X and £500 to his mother for the uncertainty caused.

In South Essex Partnership University Trust and Bedford Borough Council (May 2014), Mr X was a 58 year old man with paranoid schizophrenia who was living in a flat in squalor. His family were concerned about his poor self-care and inadequate diet. He was 2.5 stone underweight, his teeth were rotten and bedclothes had not been washed in months. So concerned were his family at one point that his parents took him to live with them. The Local Government Ombudsman and Parliamentary and Health Service Ombudsman found that the Trust’s failure to carry out a proper capacity assessment of his ability to make decisions about managing food and looking after himself was a service failure. There was sufficient evidence to challenge the assumption of capacity, with occupational therapy reports noting he was underweight and that there was no food in his flat. Thus, the presumption of mental capacity resulted in him being malnourished. The Trust failed to ensure that support workers visited him regularly or encouraged him to attend to his oral health and adopt a healthy lifestyle. The Council had failed to carry out a community care assessment of his needs and there was a delay in seeking appropriate accommodation for him. A joint payment of £2000 for the impact of failing to properly assess his capacity and £500 to his sister for distress and inconvenience was recommended.