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|Bassetlaw CCG (19 006 727a) and Nottinghamshire Healthcare NHS Foundation Trust (19 006 727b) (2019) MHLO 67 (LGSCO)||Complaint not upheld by LGSCO||LGSCO summary: "The Ombudsmen found no fault by the Council, Trust or CCG with regards to the care and support they provided to a woman with mental health problems. The Ombudsmen did find fault with a risk assessment the Trust completed. However, we are satisfied this did not have a significant impact on the care the Trust provided."|
|Blavo and Co Solicitors (SRA decision: closure) (2015) MHLO 70||Reasons for closure of Blavo & Co Solicitors||The SRA closed down Blavo & Co Solicitors and suspended John Blavo's practising certificate, giving the following reasons: (a) there is reason to suspect dishonesty of the part of a manager or employee of Blavo & Co Solicitors Limited; (b) there is reason to suspect dishonesty on the part of John Blavo in connection with his practice; (c) to protect the interests of clients of Blavo & Co Solicitors Limited.|
|CQC v Hillgreen Care Ltd (2018) MHLO 50||Prosecution of care home provider||(1) The care home provider charged with failing between 1/4/15 and 1/12/15 to comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 by failing to provide care and treatment in a safe way for service users (reg 12) and failing to put in place, and operate effectively, systems and processes to protect service users from abuse, including sexual abuse (reg 13). The provider had known since 2004 that its resident XX posed risk a of causing sexual abuse. Following an allegation of anal rape of a woman in 2008 his care plan stated that he "identifies with both male and female around his sexual orientation" and that he "needs to be supported at all times and not to be left alone unsupervised when around other service users and when in the community". XX admitted to having sex with two other residents, neither of whom had capacity to consent: a female resident AA in April 2015 and a male resident YY on 1/11/18. The provider had not followed the care plan and the district judge concluded that "[t]he incident with YY could not have happened had there been an extra member of staff on duty to watch XX and where he went." It was found guilty of both charges and was fined £300,000. (2) The judgement states that the CQC's inspection of the care home and seizure of documents took place on 27/7/17: this is the same day as a critical article in the Times (Andrew Norfolk, 'CQC covered up suspected rape in care home' (Times, 27/7/17)). Information about the chronology can be found in the CQC's subsequent report (CQC, 'CQC publishes independent investigation into its regulation of 14 Colne Road' (press release, 13/6/18)).|
|Derbyshire Healthcare NHS Foundation Trust (17 012 839a) (2019) MHLO 44 (LGSCO)||Complaint about community care delay||LGSCO's summary: "The Ombudsmen do not consider Derbyshire County Council and Derbyshire Healthcare NHS Foundation Trust delayed providing support for Mrs X’s mental health needs. We have not found fault with the way the Council decided what support she needed. The Ombudsmen consider Derbyshire County Council delayed completing Mr X’s carer assessment and should have considered carrying out an integrated assessment with Mrs X. However, it has remedied the distress Mr X suffered."|
|Greater Manchester Mental Health NHS Foundation Trust (18 018 548a) (2019) MHLO 66 (LGSCO)||Carer's assessment failures||LGSCO summary: "The Ombudsmen have upheld Mrs G’s complaint about the way her carer’s assessments were carried out. We have not found fault with the way the Trust, Council and CCG arranged Mr H’s accommodation under s117 of the Mental Health Act or how the Trust communicated with Mrs G and Mr H about this."|
|LV v UK 50718/16 (2018) MHLO 22||MHT/Parole Board delay||"Complaint: The applicant complains under Article 5(4) of the Convention that she did not have a speedy review of the legality of her detention. In particular, she contends that her right to a speedy review was violated both by delays on the part of the Public Protection Casework Section and the Parole Board, and from the unnecessary two-stage Tribunal/Parole Board process. Question to the Parties: Was the review of the applicant’s detention which commenced on 24 May 2011 and concluded on 21 March 2013 conducted 'speedily' within the meaning of Article 5(4) of the Convention?" (The first paragraph of the decision is wrong as the applicant's solicitor works for Campbell Law Solicitors.)|
|Milton Keynes CCG (17 018 823e) (2019) MHLO 61 (LGSCO)||Section 117 complaint||"Whilst the Trust was acting on behalf of the CCG in carrying out the s117 actions, the CCG is ultimately responsible for s.117 provision, along with the Council. ... The CCG, Trust and the Council should, by 23 December: (a) Write to Mrs B apologising for the impact of the fault in relation to not refunding the care fees relating to the supported living placement. (b) Confirm with Mrs B and refund the supported living fees which have not already been reimbursed. Mrs B may need to provide additional information to the organisations about fees paid as part of this. (c) Write to Miss A and Mrs B personally and apologise for the impact the lack of s.117 planning had on both of them individually due to the length of time Miss A went without adequate support. They should also apologise for the uncertainty caused by not knowing whether the incidents outlined above could have been avoided. (d) Pay Miss A £1500 and Mrs B £1000 each in recognition of the impact of the and length of time Miss A had a lack of s.117 support. By 20 February 2020, the Council, CCG and Trust should create an action plan of how they will notify and cooperate with each other to ensure patients are assessed promptly and s.117 care put in place in line with the MHA Code of Practice. This action plan should include a review of progress and the impact of any changes following implementation of the plan."|
|NHS Guilford and Waverley CCG (18 007 431a) (2019) MHLO 60 (LGSCO)||Section 117 complaint||"(1) Within one month of my final decision, the Council and CCG will: (a) Write to Miss X and Mr Y, acknowledging the fault identified in this decision and offering meaningful apologies; (b) Jointly pay Mr Y £500 for failure to provide support as outlined on his s117 aftercare plan, delayed care planning, loss of opportunity to re-engage him and distress as a result of poor communication around his care plan and eviction; (c) Jointly pay Miss X £150 for poor complaint handling, stress and inconvenience. (2) Within three months of my final decision, the Council and CCG will ensure that Cherrytrees and all other providers acting on their behalf under s117 review their policies and procedures to ensure compliance with the relevant parts of the Code of Practice: Mental Health Act Code 1983, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Act 2014, in relation to: (a) Care planning; (b) Daily record keeping; (c) Complaint handling, including ensuring all points are responded to adequately and complainants are properly signposted should they wish to escalate their complaint."|
|PB v Priory Group Ltd (2018) MHLO 74||Damages for unlawful psychiatric detention||A Part 36 offer of £11,500 plus legal costs was accepted in this claim brought for unlawful detention and breach of Article 5. The patient had been detained under s5(2) when not an in-patient, and this section had lapsed for nearly seven hours before detention under s2 began.|
|R v Edwards (2018) EWCA Crim 595||Sentencing guidance, including s37 and s45A||These four cases were listed before the court to consider issues arising from the sentencing of mentally ill offenders to indeterminate terms of imprisonment. (1) Comparison of release regimes under s.37/41 and s.45A. (2) Rules governing applications to this court to advance new grounds or fresh evidence. (3) General principles: "Finally, to assist those representing and sentencing offenders with mental health problems that may justify a hospital order, a finding of dangerousness and/or a s.45A order, we summarise the following principles we have extracted from the statutory framework and the case law. (i) The first step is to consider whether a hospital order may be appropriate. (ii) If so, the judge should then consider all his sentencing options including a s.45A order. (iii) In deciding on the most suitable disposal the judge should remind him or herself of the importance of the penal element in a sentence. (iv) To decide whether a penal element to the sentence is necessary the judge should assess (as best he or she can) the offender’s culpability and the harm caused by the offence. The fact that an offender would not have committed the offence but for their mental illness does not necessarily relieve them of all responsibility for their actions. (v) A failure to take prescribed medication is not necessarily a culpable omission; it may be attributable in whole or in part to the offender’s mental illness. (vi) If the judge decides to impose a hospital order under s.37/41, he or she must explain why a penal element is not appropriate. (vii) The regimes on release of an offender on licence from a s.45A order and for an offender subject to s.37/41 orders are different but the latter do not necessarily offer a greater protection to the public, as may have been assumed in Ahmed and/or or by the parties in the cases before us. Each case turns on its own facts. (viii) If an offender wishes to call fresh psychiatric evidence in his appeal against sentence to support a challenge to a hospital order, a finding of dangerousness or a s45A order he or she should lodge a s.23 application. If the evidence is the same as was called before the sentencing judge the court is unlikely to receive it. (ix) Grounds of appeal should identify with care each of the grounds the offender wishes to advance. If an applicant or appellant wishes to add grounds not considered by the single judge an application to vary should be made." (4) The court considered the individual appeals/application, noting that it is appellate not a review court and that the question is whether the sentence imposed was manifestly excessive or wrong in principle.|
|R v Spencer (1987) UKHL 2||Nurses' appeal against ill-treatment conviction||Six nurses appealed against convictions for ill-treating a patient contrary to s126 Mental Health Act 1959 (the old equivalent of MHA 1983 s127), three successfully.|
|Rotherham Doncaster & South Humber NHS Foundation Trust (18 010 101a) (2019) MHLO 43 (LGSCO)||Failure to carry out carer's assessment||LGSCO's summary of decision: "The Trust and Council were at fault in not carrying out a carer’s assessment and not involving Mrs S during her husband’s period of treatment. There was also fault in record-keeping and delays in responding to the complaint. These failings caused an injustice to Mrs S as she lost the opportunity for additional support and is likely to have suffered additional distress. The Trust and Council have already taken action to address these failings and improve processes. The Trust and Council have agreed to pay Mrs S financial redress and the Trust has agreed to monitor and report on improvements in its complaints handling."|
|Staffordshire County Council (18 004 809) (2019) MHLO 41 (LGSCO)||Failure to carry out DOLS assessments||LGSCO decision: "The Council has acted with fault in deciding not to assess low and medium priority Deprivation of Liberty Safeguards applications. The Council is also taking too long to deal with urgent applications. This is causing a potential injustice to the thousands of people in its area who are being deprived of their liberty without the proper checks that the restrictions they are subject to are in their best interests." The final sentence of the conclusion states: "[I]t is not acceptable that the only way low and medium priority applications are resolved is because the people involved move away or die."|
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