South Yorkshire family excluded from care planning for elderly relatives

A dementia sufferer had to stay in respite care, despite his son arranging a private care package that could have allowed him to stay at home, a joint investigation by the Local Government Ombudsman (LGO) and the Parliamentary and Health Service Ombudsman (PHSO) has found.

The man had been living in respite care while his wife, who also suffered with dementia, was being treated in hospital. His son organised a care package to allow him to come home. But two local authorities – Kirklees Metropolitan Borough Council and the South West Yorkshire Partnership NHS Foundation Trust – applied for a Deprivation of Liberty Order, forcing the man to stay in care, apart from his wife, without informing his son of their plans.

Before the stay in respite care, the man was admitted to hospital with acute glaucoma in April 2009. The couple’s son - himself a doctor - told the authorities that he believed the injury had been caused by a blow from his mother, who was beginning to show signs of dementia.
This report was not followed up, and a safeguarding plan was never implemented. Instead the father’s discharge from hospital was hastily arranged and he returned home without any protection.

Then over time, the couple’s needs increased. The woman’s symptoms were deteriorating and in September she was admitted to hospital, and her husband went into respite care. The woman stayed in hospital for six weeks while her son arranged a care package.

Despite the son telling the authorities that he was employing a registered general nurse to provide care when his father came home, the two authorities agreed that that this would be inadequate and applied for the Deprivation of Liberty Order – without involving him in the decision.

In addition to this, when the Trust wrote to the son recommending that his parents be placed in separate care homes, they sent a copy to his mother – causing her a great deal of distress.

The investigation also found that the Trust failed to reassess the father’s prescription for dementia drug, Aricept in line with NICE guidance.

Dr Jane Martin, Local Government Ombudsman, said:

“As a result of actions by both the council and the Trust, the couple were denied the chance of living at home together in a settled lifestyle for longer than they did. The couple suffered a needless loss of dignity, while their son felt ignored, undermined and excluded from any decision about their care.

“I am pleased that both the council and the Trust have agreed to our recommendations and hope they go some way to remedy the poor treatment and upset the family has endured.”

Julie Mellor, Health Service Ombudsman, said:

“Involving their son could have led to better outcomes for the couple. Families and carers can have the key to understanding the needs of their loved ones. That’s why public services must, in law, involve families and carers in making life changing decisions for vulnerable people.”

Both the council and the Trust have agreed to apologise to the man and his parents. They have also agreed to review the way they involve relatives in assessing and planning care for family members with dementia and review their joint arrangements for responding to complaints.

The Trust has also agreed to review the way it reassesses prescriptions for Aricept in line with guidance.

Both the council and Trust have agreed to make a payment of £1,000 to the couple to acknowledge their distress. The Trust will also give the woman an additional payment of £250 in recognition of the distress caused from reading the report about her future care. The authorities have also agreed to make a payment of £500 to the son to acknowledge his distress.

Article date: 28 November 2013