Summary: A man complained that he was evicted because the Council and NHS Trust did not provide him with enough support around his housing needs. The Ombudsmen find no fault with the Council’s and Trust’s actions.

The complaint

1. A man I will call Mr P complained about Royal Borough of Kensington and Chelsea (the Council) and Central and North West London NHS Foundation Trust (the Trust). He said:
1. A social worker did not support him in 2014 – 2015;
2. From October 2017 to March 2018, mental health and social care services failed to provide adequate support with his housing needs. This led to him becoming very unwell and facing eviction;
3. From March 2018, social services did not take all the relevant factors into account when assessing his social care needs;
4. Social services and mental health services kept disputing his earlier diagnosis of post traumatic stress disorder (PTSD);
5. They ignored that he had plantar fasciitis and peripheral neuropathy in his feet and would not give him pain relief for about nine weeks starting June 2018;
6. They did not believe that he has dyslexia and ignored the effect this has on his ability to participate in interview situations;
7. A member of staff at St Charles hospital made homophobic remarks to him;
8. The Trust and Council handled his complaint poorly. Mr P said he complained to both the Council and the Trust in December 2017. The Trust responded in March but ignored two thirds of his complaint.

Back to top

What I have investigated

2. I have investigated Mr P’s complaint about a lack of support with his housing needs, which was his main concern. At the end of this statement I have explained why I have not investigated the remaining parts of the complaint.

Back to top

The Ombudsmen’s role and powers

3. The Ombudsmen investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, the Ombudsmen consider whether it has caused injustice or hardship (Health Service Commissioners Act 1993, section 3(1) and Local Government Act 1974, sections 26(1) and 26A(1)). If it has, they may suggest a remedy. Recommendations might include asking the organisation to apologise or to pay a financial remedy, for example, for inconvenience or worry caused.  We might also recommend the organisation takes action to stop the same mistakes happening again.
4. The Ombudsmen cannot question whether an organisation’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended, and Health Service Commissioners Act 1993, sections 3(4)- 3(7))
5. If the Ombudsmen are satisfied with the actions or proposed actions of the bodies that are the subject of the complaint, they can complete their investigation and issue a decision statement. (Health Service Commissioners Act 1993, section 18ZA and Local Government Act 1974, section 30(1B) and 34H(i), as amended).

Back to top

How I considered this complaint

6. I considered information provided by the parties to the complaint, including relevant health and social care records.
7. I shared a draft of this decision with the parties to the complaint and invited their comments.

Back to top

What I found

8. Mr P is diagnosed with bipolar disorder, in addition to other health conditions. The records indicate that the professionals involved with his care consider that when Mr P is mentally well he functions at a high level and can manage his own affairs. When he is unwell, he hears voices, becomes paranoid, is mistrustful of professionals, and often declines support. Mr P lived in accommodation owned by a registered provider of social housing (the landlord).
9. Mr P said the period in which he did not receive adequate support was October 2017 to March 2018. However, the events he complained about extended into April 2018, so I have considered those too. Mr P’s primary concern about his housing during this period was that his neighbours were saying abusive things about him. He said his care coordinator did not believe him, and said he was hearing voices. Mr P told me his care team did not try to contact his landlord about the problems until March 2018. He said he felt that if the problems had been addressed sooner, he would not have become as unwell as he did. He also complained that his care coordinator decided he should have a mutual exchange (swapping homes with another social housing tenant) without consulting him.
10. At the start of this period, Mr P’s care coordinator was a Community Psychiatric Nurse (the CPN). I could not see evidence in the records of October or November 2017 that Mr P sought assistance with housing needs. There are notes on two dates which say he was frustrated that there was no progress with his plan to swap homes. However, I have seen no reason to believe that this was due to fault on the part of the Trust or Council.
11. There is a record in October that Mr P reported hearing voices more frequently, and no longer just in his flat. There is a record in November that Mr P complained about hearing the voices of his neighbours, but found it difficult to know which were real and which were not.
12. In early December, Mr P told the Trust there was a sound proofing problem with his flat. He was concerned about his neighbours saying abusive things about him. Later in December, the Trust noted that Mr P had paranoid ideas, but did not believe that he had bipolar disorder. There were clear signs that his mental health was relapsing.
13. Taking these records into account, it is understandable that the professionals felt the abusive comments Mr P reported may have been auditory hallucinations rather than abuse from his neighbours. I note that there are later entries in the Trust’s records which refer to Mr P appearing to respond to auditory hallucinations on the ward. A doctor brought to Mr P’s attention that he had previously experienced similar problems in other places, and that the start of the current problems coincided with a reduction in his medication.
14. On 18 December, Mr P went to the Trust’s offices and saw his CPN. Mr P said he wanted to speak to a social worker about his housing problems. The CPN said she could help with this at their appointment the following day. Mr P left. Later, he cancelled the appointment and said he did not want contact with the mental health team. This is evidence that the Trust made support available to Mr P, but he did not accept it.
15. On 2 January Mr P told the CPN he wanted a new care coordinator, who was a social worker. He said he had issues with his landlord, and wanted to move to another area. He refused permission for his CPN to contact his landlord. As Mr P did not wish to work with the CPN and did not allow her to contact his landlord, it is difficult to see how she could have supported him with his housing concerns.
16. Later in January, Mr P was detained under the Mental Health Act, in another part of the UK. Records of March, when he was back home, say he reported that his neighbours were talking about him and felt the Trust was not acknowledging his housing problems. He was allocated a new care coordinator, a social worker (Officer B).
17. Officer B visited Mr P on 13 March, but Mr P did not answer the door. Officer B left Mr P a note asking him to contact him as soon as possible. In the early hours of 14 March, Mr P left Officer B seven voicemails, in which he said Officer B was not welcome to visit him. Mr P called Officer B again during the day, and said he wanted help with his complaint to his landlord about anti-social behaviour. He agreed to meet Officer B later that day. At the meeting, Officer B observed signs that Mr P was unwell. Mr P told Officer B he had rent arrears, and Officer B offered to support him with this at a further meeting.
18. On 20 March, Mr P cancelled a meeting with Officer B. Again, this is evidence that support was available to Mr P, but he did not accept it.
19. In late March, Mr P was detained under the Mental Health Act again, after damaging his neighbour’s property.
20. The Trust’s records of April include that Mr P was not willing to work with Officer B. Mr P’s landlord investigated a complaint from him about verbal abuse from his neighbours, but did not find enough evidence to support his complaint. The landlord offered him supported accommodation in the area to which he wanted to move, but he declined. He also said he did not want to return to his home, and he did not want a home swap.
21. Records of 18 April say there was a meeting about Mr P’s housing, which Mr P organised. Officer B did not attend. Those present agreed that Mr P would not return to his home. He said he wanted to move to another part of the UK. Officers from his landlord agreed to find accommodation for Mr P following his discharge from hospital.
22. A record of 24 April says Mr P reported that he was waiting to hear from his landlord about accommodation. Officer B asked for contact details for the landlord. Mr P said he did not want any information shared with his landlord without his written permission. Officer B agreed to phone and email the landlord if it did not respond by the end of the day. He did this, but the landlord did not reply.
23. A record of 25 April said Mr P reported that Officer B suggested that Mr P organised a home swap. Though a home swap was discussed, there is nothing in the records to indicate Officer B suggested this. Rather, the records indicate that Officer B believed they were waiting for the landlord to organise alternative accommodation.
24. On 8 May, the Council responded to a complaint Mr P made in April. The Council said Officer B contacted Mr P’s landlord in March and April. It understood Mr P had met with his landlord on the ward, and while Officer B did not attend it was not clear he was invited. It apologised that Mr P was unhappy with the service he had received and offered Mr P a meeting.
25. In August, the Trust responded to complaints Mr P made in June about various matters including lack of support with his housing. It said its community team had liaised with the safeguarding lead to make sure Mr P was safe and liaised with police and neighbourhood watch to look into Mr P’s concerns about discrimination. The Trust said while Mr P was in hospital its discharge coordinator worked with him around his housing, and the plan was to facilitate a house swap. Mr P was not happy with this plan and said he could “conduct this” himself. The discharge coordinator intended to work further with Mr P and arrange a professionals meeting with his landlord, but before this happened Mr P discharged himself. Mr P did not agree to the community team contacting his landlord without him present, which prevented them providing support.

Conclusion

26. I have seen that Mr P was offered support with his housing concerns, but he was unwilling to accept support from his care team and did not allow them to liaise with his landlord without him. Therefore, there was little his care team could do.
27. Mr P said he was evicted because of lack of support with his difficulties with his neighbours. The Trust’s records of later in 2018 show that his landlord decided to evict him because it was concerned about the risk he posed to other residents, following various incidents.
28. I have not found evidence that Mr P’s eviction may have resulted from the Trust and the Council failing to provide adequate support with his housing needs. Rather, the evidence suggests that they tried to support Mr P, but he found himself unable to accept the support.

Back to top

Decision

29. I find that the Trust and the Council were not at fault.

Back to top

Parts of the complaint that I did not investigate

30. I did not investigate the complaint that a social worker did not support Mr P from 2014-2015 because this is a late complaint.
31. I did not investigate the complaint that a member of staff made homophobic remarks to Mr P because it is unlikely we could find strong enough evidence to make a finding of fault.
32. I did not investigate the complaint that the Council did not take all the relevant factors into account when assessing Mr P’s social care needs because Mr P could have raised any other needs he considered he had, so it is unlikely we would find fault.
33. I did not investigate the complaint that social services and mental health services disputed Mr P’s diagnosis of PTSD because I have not seen evidence that they disputed it. There are records that Mr P told the Trust he did not believe he had bipolar disorder and that he had PTSD. But the Trust telling Mr P it considered he has bipolar disorder is not the same as the Trust saying he did not have PTSD.
34. I did not investigate the complaint that social services and mental health services ignored that he has dyslexia and that this affects his ability to participate in interviews because Mr P has not provided sufficient detail of this complaint.
35. I did not investigate the complaint that the Trust’s staff refused to give pain relief to Mr P for pain in his feet, because there is evidence that he was given pain relief when he reported pain in his feet so it is unlikely we would find fault.
36. I did not investigate the Council’s involvement in the complaint handling because the Trust delivers the social care service for people with mental health needs on the Council’s behalf, so it is not fault for the Council to direct Mr P to the Trust rather than responding directly. I did not investigate the Trust’s involvement in the complaint handling because the Trust produced a further response to Mr P’s complaints after he brought his complaint to us.

Back to top

Investigator's decision on behalf of the Ombudsman