Summary: The Ombudsmen will not investigate Ms D’s complaint about the actions of the Trust and Council in relation to an assessment of her mental health. This is because it is unlikely an investigation would find fault in the actions of the Trust and Council.

The complaint

1. Ms D complains about the actions of Greater Manchester Mental Health NHS Foundation Trust (the Trust) and Wigan Metropolitan Borough Council (the Council), in relation to an assessment of her mental health. Ms D says even though she told the Trust she did not need an assessment and tried to cancel the appointment, the Trust continued to contact her by telephone and letter, and by unannounced visits to her home. Ms D also complains an AMHP from the Council relied on inaccurate information and their own incorrect opinions when carrying out the assessment. Ms D says these events put her at risk.
2. Ms D seeks the following outcomes from her complaint:

• an apology from the Trust and Council;
• the Trust and Council to stop this from happening again;
• financial remedy;
• staff to be removed from their roles until they receive mental health training; and
• police to investigate her concerns about an earlier detention in 2015.

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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), as amended).
4. The Ombudsmen provide a free service, but must use public money carefully. They may decide not to start or continue with an investigation if they believe:

• it is unlikely they would find fault, or
• they cannot achieve the outcome someone wants. (Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended).

5. 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)).

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How I considered this complaint

6. I considered information provided by Ms D, and complaint responses from the Council and Trust.
7. Ms D had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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Relevant legislation and guidance

8. Under the Mental Health Act 1983 (MHA), when someone has a mental disorder and is putting their safety or someone else’s at risk they can be detained in hospital against their wishes. An Approved Mental Health Professional (AMHP) is responsible for deciding whether to go ahead with the application to detain the person and for telling the person and their nearest relative about this. Admission should be in the best interests of the person and they should not be detained if there is a less restrictive alternative.

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My assessment

9. In January 2023, the police referred Ms D to the Trust’s community mental health team with concerns about her mental health. The Trust considered the referral, then wrote to Ms D to arrange for its assessment team to visit her at home to discuss the concerns. Ms D telephoned the Trust to cancel the appointment, and spoke to a senior nurse practitioner. The Trust sent a further letter, and Ms D again rang to cancel. However, in its response to the complaint, the Trust said the senior nurse practitioners who spoke to Ms D were concerned about her presentation during the calls. The Trust said this increased its concern about her mental health, and therefore it continued to try to contact Ms D. The Trust specialist community mental health team attempted to visit Ms D at home three times during March 2023.
10. Having received a referral from the police raising concerns about Ms D’s mental health, the Trust had a duty to assess Ms D’s mental health. The Trust explained this to Ms D in its response to her complaint.
11. As noted above, the MHA Code of Practice says that any treatment or care should be the least restrictive option. The Trust tried to engage with Ms D by writing to her, speaking to her on the telephone, and visiting her. The Trust had a duty to assess Ms D, and tried to engage her with community treatment options. Therefore, it is unlikely an investigation would find fault by the Trust in how it dealt with the referral by contacting Ms D.
12. Regarding Ms D’s complaint that the AMHP relied on inaccurate information from her records, the Council said it was contacted to arrange an assessment, after the mental health teams had been unable to contact Ms D. The AMHP then attended Ms D’s property with two doctors to carry out a MHA assessment.
13. I recognise Ms D considers the AMHP was acting on incorrect information from her records and that the AMHP’s own opinions were incorrect. However, the information I have seen indicates the Council acted on the referral it received, and that the AMHP considered the views of two doctors during the assessment.
14. In its response to Ms D’s complaint, the Council said it would not have shared any information from previous records, as this would not have been needed. Therefore, the AMHP appears to have followed the process set out in the MHA Code of Practice, which says AMHPs should apply professional judgment and see the patient jointly with at least one of the two doctors involved in the assessment. Because of this, my view is it is unlikely an investigation by the Ombudsmen would find fault with the Council.

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Final decision

15. We will not investigate the complaint about the Council and Trust. This is because it is unlikely an investigation would find fault in the Trust’s actions prior to the MHA assessment, or in the actions of the AMHP.

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Investigator's decision on behalf of the Ombudsman