Decision : Not upheld
Decision date : 08 Jun 2021
The Ombudsman's final decision:
Summary: there is no evidence of fault in the way the Council decided to discharge Ms X from its social care service. Support from the mental health team remains available.
- Ms X (as I shall call the complainant) complains that the Council discharged her without notifying her and without an appropriate assessment. She says as a result she lost the opportunity to be considered for supported housing.
The Ombudsman’s role and powers
- We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
- If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)
How I considered this complaint
- I considered the information provided by Ms X and by the Council. Both Ms X and the Council had opportunity to comment on an earlier draft of this statement before I reached a final decision.
What I found
Relevant law and guidance
- Under section 117 (s117) of the Mental Health Act 1983 (the MHA) Councils and NHS Clinical Commissioning Groups (CCGs) have a joint duty to provide or arrange free aftercare for people who have been detained under s3 or section 37 or transferred to a hospital under section 45A, section 47 or section 48.
- Aftercare services must meet a need arising from or related to the person’s mental disorder and reduce the risk of their mental condition worsening and the need for another hospital admission again for mental disorder.
- The MHA Code of Practice says:
“CCGs and local authorities should interpret the definition of after-care services broadly. For example, after-care can encompass healthcare, social care and employment services, supported accommodation and services to meet the person’s wider social, cultural and spiritual needs, if these services meet a need that arises directly from or is related to the particular patient’s mental disorder, and help to reduce the risk of a deterioration in the patient’s mental condition... As well as meeting their immediate needs for health and social care, after-care should aim to support them in regaining or enhancing their skills, or learning new skills, in order to cope with life outside hospital”.
- Ms X was supported by the Council’s social work team as part of her section 117 aftercare. She says her social worker told her she would support her until some planned therapy began. She says she also understood the Council would help her find supported housing.
- The Council’s records show Ms X was supported by a recovery worker on a regular basis during 2020. Ms X was in regular employment and described herself as “busy at work” during that time.
- The assessment of needs during June 2020 assessed Ms X as having difficulty maintaining family and personal relationships but otherwise able to manage independently. It noted that she was receiving support in managing her previously diagnosed conditions and had not made any further recent suicide attempts. The Council says it did not consider Ms X required supported housing.
- The recovery worker noted that at her last meeting with Ms X in July 202, Ms X was annoyed at the possibility the social care service might be withdrawn. She told the recovery worker she felt let down as she believed she had been promised assistance with housing which had not been given.
- Ms X says her social worker was off work for some months but no-one else contacted her in the meantime. She says it was not until October when the social worker returned to work that she was told she had been discharged from the social care team.
- Ms X complained to the Council about the lack of communication. She said she had never received any written communication to inform her of her discharge from the care of the team and was concerned she would no longer be supported with finding accommodation.
- A manager responded to Ms X. She said “I note from the assessment you had commenced employment and it was felt at this time your mental health was stable. Therefore, a decision was made, in conjunction with your care coordinator, to close your case under review to the Mental Health …. Team. This is the practice within our team where there is no active role for workers.”
- The manager went on to explain that Ms X’s care co-ordinator would remain involved and would refer Ms X back to the team if needed. She said Ms X would remain open to the team on the basis of her section 117 status.
- The manager apologised there had been a period of time when no contact had been made after the final meeting with the recovery worker in July.
- Ms X complained to the Ombudsman. She said she had not consented to or been present at an assessment and disagreed with its findings, as she said she was suffering with severe insomnia at the time. She said the team had not written to her to explain about the discharge from services.
- The Council says the assessment (which is dated as starting on 1 June 2020) was carried on over a period of time and updated during the process. Her former social worker says, ‘the role of social care at that time was to assess in relation to support accommodation and if alternative services were required. On completion of the assessment it was concluded that (Ms X) did not require any further support from the Mental Health…. Team and would continue to be reviewed annually in relation to s117 aftercare.”
- It is not the role of the Ombudsman to substitute his judgement for that of the Council in assessing Ms X’s needs. The Council undertook a period of assessment and decided Ms X did not require further support from that team at that time.
- Mental health services remain available to Ms X in line with her section 117 status and her key contact remains her care co-ordinator.
- The Council has apologized for the lack of contact for a period of time when Ms X’s social worker was not available. While that was frustrating for Ms X, it was clear from her comments to her recovery worker at their July meeting that she was already aware of the situation regarding her discharge from social care.
- I have now completed this investigation as there is no fault on the part of the Council in the way it assessed Ms X’s needs.
Investigator's decision on behalf of the Ombudsman