Summary: Ms X complains the Council, Trust and ICB are not providing her with section 117 aftercare support which she is entitled to after being detained under Section 3 of the Mental Health Act 1983. We will not investigate this complaint because we have seen evidence all the organisations have offered support, Ms X does not agree this is the right support for her so she is not engaging. An Ombudsmen investigation is unlikely to find fault.

The complaint

1. Ms X was detained under Section 3 of the Mental Health Act 1983 (the MHA) in November 2021 and she is entitled to section 117 aftercare which is provided by Liverpool City Council (the Council), Mersey Care NHS Foundation Trust (the Trust) and NHS Cheshire and Merseyside Integrated Care Board (the ICB).
2. Ms X complains;
• The Council has failed to allocate a care coordinator, has not given her a section 117 aftercare plan and she has not been reviewed since October 2023.
• The Trust discharged her back to her GP without offering any help and support.
• The organisations have refused to transfer her to a different authority.
3. Ms X attempted suicide in February 2025 because she has been left without support. Ms X was then detained under Section 2 of the MHA and still no aftercare plan has been agreed. Ms X feels let down by the organisations and requested a transfer to a different authority so she can get the help she needs.
4. Ms X wants to be allocated a social worker to support her with a Care Act assessment. She wants a section 117 aftercare plan to be created and guaranteed yearly reviews will take place. She wants an apology from the organisations which acknowledges the distress she has suffered and financial recompense.

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The Ombudsmen’s role and powers

5. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
6. We investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, we 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). If it has, we may suggest a remedy. Our 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.
7. We 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. If there was no fault in how the organisation made its decision, we cannot question the outcome. (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

8. I have considered information Ms X provided in writing. I also considered information from the Council, the Trust and the ICB.
9. I have considered the Ombudsmen’s assessment code.

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What I found

Background

10. Ms X was detained under Section 2 of the MHA in October 2021, this was changed to Section 3 in November 2021.
11. Anyone who may have a need for community care services is entitled to a social care assessment when they are discharged from hospital to establish what services they might need. Section 117 of the Mental Health Act imposes a duty on health and social services to meet the health/social care needs arising from or related to the person’s mental disorder for patients who have been detained under specific sections of the Mental Health Act (e.g. Section 3). Aftercare services provided in relation to the person’s mental disorder under Section 117 cannot be charged for, and are known as section 117 aftercare.
12. Ms X was released from hospital with a section 117 aftercare plan in December 2021.

The complaint

13. Ms X complains that from mid 2023 onwards, the organisations have not supported her and her mental health declined, resulting in her attempting suicide in February 2024.
14. I asked Ms X for further information and she explained the Council failed to allocate a care coordinator to her despite her asking many times. She says she does not have a section 117 aftercare plan and she is not receiving any support. She says she has not had any form of review or assessment since October 2023. She explained the Trust have discharged her back to her GP without offering any help for her depression and refused to help her. When the relationship broke down, she asked to be transferred to a different authority but this has been refused without explanation. She wants a Care Act assessment as she has needs which are not being met, but the Council has also refused to help her with this.
15. I asked all three organisations to explain what role they had in providing Ms X’s section 117 aftercare.
16. The Trust completed a care plan for Ms X in August 2022, this was after she was admitted to hospital for a second time under Section 2 of the MHA. Ms X was offered support from the home treatment team, and a mental health support team through the Trust. Ms X did not want to engage with either as she did not believe this was the correct treatment path for her, so she asked to be discharged.
17. The Trust accept there was a delay in offering a section 117 aftercare plan review meeting due to the pandemic, but she did have a care plan in place and was being offered help and support. I am aware Ms X disputes this to be the case. The Trust reviewed Ms X in October 2023 and found she had no outstanding needs which could not be met in primary care, i.e. by care of her GP. She was offered various treatments and medications which are in line with the National Institute of Clinical Excellence guidelines, but Ms X did not agree with the diagnosis. Because of her unwillingness to engage, it was not possible to allocate a care-coordinator, and this was explained to Ms X in the same meeting.
18. The ICB was told the relationship between the Trust and Ms X had broken down, and she requested a transfer to another authority. The ICB took over this action and approached a number of other authorities on Ms X’s behalf.
19. In its complaint response 7 June 2024, the ICB explains to Ms X what had happened with her request. It said in August 2023, it had told her it would commission another NHS provider if one could be found who was willing to accept her into its care. Ms X’s GP then made a referral to another Trust (the out of area Trust). On receiving Ms X’s complaint, the ICB contacted the out of area Trust to ask them to explain what had happened with the referral. The letter explains the out of area Trust refused to accept Ms X at the time because she was receiving crisis support. The out of area Trust had “significant concerns around the level of risk and the [out of area Trust’s] ability to support her appropriately. It is our opinion that it would be clinically unsafe to provide her care”. The out of area Trust wrote to Ms X and told her because she lived outside their catchment area, it would need to be the ICB who ask for the transfer.
20. As Ms X remained unhappy with the care she was receiving, to help her, the ICB asked the out of area Trust if it would then (in June 2024) accept Ms X into its care. The out of area Trust said it “would not be able to transfer the care responsibility for [Ms X] … If [Ms X’s] clinical lead and care team believe that a second opinion would be appropriate, the ICB could commission an assessment” from it. The ICB offered this option to Ms X, and she decided not to accept.
21. The Trust or ICB has not refused to transfer Ms X to another authority, the authority she chose has instead refused to accept her transfer to its care.
22. In a further attempt to help Ms X, the ICB offered several interventions in its letter which it could do to help her with her care. I asked the ICB as part of this assessment if Ms X had responded to these offers or chosen which she would prefer, the ICB said Ms X had not responded.
23. In February 2025, the Trust sent Ms X a letter explaining it was discharging her back to the care of her GP because she was refusing to engage with the Trust’s offered treatment plans.
24. The Council has explained that in October 2023 it responded to a complaint from Ms X. In its response it accepted it could have been clearer with its communication to Ms X and arranged a section 117 review meeting for later that month. Ms X made another complaint to the Council, and it responded in June 2024. It told Ms X it understood she did not agree with her diagnosis, but she was being offered support for the diagnosis she had, which was appropriate. Ms X made another complaint soon after about two practitioners being present at a Care Act assessment, but the Council was unable to determine what happened because there were conflicting accounts of events.
25. As part of this assessment I asked the Council if it was providing any funding for section 117 aftercare at this time, and what its recent contact with Ms X had been. It confirmed Ms X had a Care Act assessment in May 2025, and she was found to not have any eligible needs. It also confirmed it was trying to arrange a S117 aftercare review meeting.

Summary

26. We cannot decide what level of care is appropriate and adequate for any individual. This is a matter of professional judgment and a decision the relevant responsible organisation or organisations has to make.
27. My assessment has found there is a difference in opinion between what Ms X feels she needs, and what the organisations have assessed her as needing. This is not something I can decide on. If Ms X disagrees with the outcome of any assessment or diagnosis, she would need to speak with the organisation or professionals who made the decision.
28. I have seen evidence the organisations have tried to help Ms X, and continue to do so. The organisations have accepted there have been delays in arranging review meetings because of difficulties communicating with Ms X, however I have seen evidence the organisations continue to try to help her. Further investigation by the Ombudsmen is unlikely to find fault.

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Decision

29. We will not investigate this complaint because it is unlikely we would find fault.

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Investigator's decision on behalf of the Ombudsman