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London Borough of Enfield (08 006 408)

Adult care services        Maladministration, no injustice

11 March 2010

This case involves complaints about the London Borough of Enfield; the Barnet, Enfield & Haringey Mental Health NHS Trust; and the Barnet and Chase Farm Hospitals NHS Trust, in a joint investigation carried out by the Local Government Ombudsman and the Health Service Ombudsman.

Mr I had schizophrenia and lived in sheltered accommodation managed by Enfield Council. In December 2006 after his medication was changed he said he experienced back pain and shortness of breath. An ambulance was called and he was taken to A&E. He was examined and discharged home where he died four days later of pulmonary embolus and deep-vein thrombosis.

Mr I’s sister complained that failings in her brother’s care and treatment at A&E, the changes to his psychiatric medication, and a lack of support at the sheltered housing all contributed to his death, and that sheltered housing staff should have informed her about what was happening.

Health Service Ombudsman, Ann Abraham, said:

“Our investigation into the Mental Health Trust and the Hospital Trust led us to conclude that their care and treatment of Mr I was reasonable. He received a reasonable standard of care in both A&E and in his discharge."

Tony Redmond, Local Government Ombudsman said:

“The service provided to Mr I by the Council’s staff fell below a reasonable standard and this amounted to maladministration. The Council failed to follow its internal policies: to record if a hospital form accompanied Mr I to A&E and update the tenant risk assessment.”

But he did not criticise Council staff for not informing Ms I of her brother’s illness, as he had specifically asked them not to do so.

The Local Government Ombudsman said: “I consider that it was appropriate for staff to respect Mr I’s autonomy by accepting his decision at that time.”

The Ombudsmen did not uphold the complaint as they could not conclude that maladministration led to the injustice that Ms I had claimed.

Date Updated: 16/03/10