With thanks to Lucy Series for bringing this to our attention, we note a recent joint finding of maladministration by the Local Government and Health Service Ombudsmen by Kirklees Metropolitan Borough Council and the South West Yorkshire Partnership NHS Foundation Trust. The finding is of particular relevance given the conclusions relating to the use of the DOLS regime.
A couple suffered from dementia. In April 2009, the husband was admitted to hospital with acute glaucoma. The couple’s son - himself a doctor - told the authorities that he believed the injury had been caused by a blow from his mother, who was beginning to show signs of dementia. This report was not followed up, and a safeguarding plan was never implemented. Instead the father’s discharge from hospital was hastily arranged and he returned home without any protection.
The wife’s needs increased and in April 2009, she was admitted to hospital whilst her husband went into respite care. The woman stayed in hospital for six weeks whilst her son arranged a care package, employing a RGN to provide care when her husband came home. However, both the local authority and the Trust considered that this was inadequate, and instead instituted a care package requiring the father to stay in the respite placement. A DOLS authorisation was sought and granted, the authorities recognising that the result gave rise to a deprivation of the husband’s liberty. The son was not involved in the decision. In addition, when the Trust wrote to the son recommending that his parents be placed in separate care homes, they sent a copy to his mother – causing her a great deal of distress.
The investigation also found that the Trust failed to reassess the father’s prescription for dementia drug, Aricept, in line with NICE guidance.Dr Jane Martin, Local Government Ombudsman, said:
“As a result of actions by both the council and the Trust, the couple were denied the chance of living at home together in a settled lifestyle for longer than they did. The couple suffered a needless loss of dignity, while their son felt ignored, undermined and excluded from any decision about their care.
I am pleased that both the council and the Trust have agreed to our recommendations and hope they go some way to remedy the poor treatment and upset the family has endured.”
Julie Mellor, Health Service Ombudsman, said:
“Involving their son could have led to better outcomes for the couple. Families and carers can have the key to understanding the needs of their loved ones. sThat’s why public services must, in law, involve families and carers in making life changing decisions for vulnerable people.”
Both the council and the Trust agreed to apologise to the man and his parents, and to review the way they involve relatives in assessing and planning care for family members with dementia and review their joint arrangements for responding to complaints.
The Trust also agreed to review the way it reassesses prescriptions for Aricept in line with guidance. Both the council and Trust agreed to make a payment of £1,000 to the couple to acknowledge their distress. The Trust will also give the woman an additional payment of £250 in recognition of the distress caused from reading the report about her future care. The authorities have also agreed to make a payment of £500 to the son to acknowledge his distress.
As Lucy notes, the Ombudsmen provide a useful route by which the inappropriate use of DOLS can be reviewed by bodies which have jurisdiction to consider past conduct; they provide a useful alternative to the Court of Protection whose primary focus is forward-looking.