CARE QUALITY COMMISSION
Mental Health Act Administration Office
Trust Headquarters
St Georges
Long Leys Road
Lincoln
LN1 1FS
25th January 2024
Dear Mrs Bevis,
A decision has been made by the multi-disciplinary team (MDT) in charge of Elizabeth’s care to suspend your visits to Elizabeth for a further 4 weeks.
This follows the initial decision to suspend your visits which was made on 28th November 2023 and will be reviewed again on Thursday 22nd February 2024.
The decision made by the MDT on 25th January 2024 was in response to ongoing clinical concerns regarding the impact of your visits on Elizabeth’s presentation, In addition to security concerns raised following the events of 25th December 2023 which are currently being investigated.
Kind Regards,
The Mental Health Act Team.
EMAIL FROM MARK MHA OFFICE COMPLAINTS CQC TEAM
Dear Ms Bevis
We are writing to you from the Mental Health Act complaints team at the Care Quality Commission (CQC).
We have now received a copy of the letter summarising the outcome of the investigation into your complaints. We believe that a copy of this letter dated 14 November 2023 and signed by Dr Toby Greenall the Consultant Psychiatrist at Peter Hodgkinson Centre has already been sent to you, but please let us know if this is not so.
The Mental Health Act grants the CQC a discretionary power to investigate complaints where they are about the use of the powers and duties in the Act. If you are not satisfied with the response provided to you by the service, you could request that the CQC consider reviewing your unresolved concerns.
We do sometimes receive complaints about matters that we are not able to investigate because they are not within these powers. The CQC complaints process cannot make any recommendation about matters that can only be decided by a court of law. For example, we cannot rule on whether a detention is lawful, nor would we be able to provide any clinical opinion re diagnosis.
Before we could decide if there is a role for us, we would need a clear statement from you outlining what you are unhappy with in the provider response, any outstanding issues and your desired outcome.
Alternatively, you can contact the Parliamentary and Health Service Ombudsman Office (PHSO) within the next twelve months, saying why you are not satisfied. Their address is: –
The Parliamentary and Health Service Ombudsman for England
Citygate
Mosley Street
Manchester
M2 3HQ
www.ombudsman.org.uk/making-complaint
Telephone: 0345 015 4033
The PHSO can consider whether to investigate complaints that the NHS (and NHS funded care) in England have failed to act properly or fairly or provided a poor service. If the Ombudsman feels that it is more appropriate for the CQC to consider the outstanding concerns, they may refer you to our organisation.
The PHSO is the final arbiter in any complaint matter and therefore the CQC cannot consider any request for investigation once the Ombudsman has either completed or declined an investigation into your complaints.
Could I please request that you use the above reference number on any correspondence in relation to this case. If we do not hear from you within 15 working days of the date of this letter, we will assume that you have received satisfactory answers to the issues you have raised through Local Resolution and your enquiry will be closed.
Yours sincerely
Mark
Mental Health Act Complaints Team
Email to Mark and to David Inspectors of the CQC
I have already responded to David in his most unsatisfactory response to me so I am now going to respond to Mark.
I do not wish to hear a lecture on what the CQC can and cannot do when I contacted you re Ash Villa the only people doing the safeguarding were the patients themselves. I do not wish to be signposted to the Ombudsman who have only ever conducted 1 report satisfactorily on the safeguarding going on behind my back for which Elizabeth kindly gave me the minutes.
There is plenty for your team to look into and I am not happy with your email below for the reason that it is now 2.5 years of restricted detention and that you should refer me to PHSO when I do not see anything being done about the current situation which is unlawful. Most of all when you get a complaint the first person you should go and see is the patient and their advocate.
The last letter re Dr Greenall was on medication and I know that is something you will say you cannot get involved in however you do have SOAD’s who have rubber stamped everything including massive dosage of drugs without reading the files properly or seeing my daughter. What about the private scans and Neurologist appointment that has been missed. A SOAD only agrees with the drug regime for the convenience of psychiatrists who may be in favour of certain drugs they promote and drugs that despite being on S3 should have the patients consent. How convenient going down the route of no capacity and best interests. However now that I have done a course on this I have become very knowledgeable about how things should be done properly. MDT in meetings that consist of around 30 people all agree with one another or else if they do not agree God help them as I have experienced bullying like never before. These same doctors blatently ignore the law or else they are ignorant towards the law whilst management pretend they do not know it when I am sure they do know. They act ultra vires including all the staff on that ward, all backing each other in what they blindly see as “best interest” and the come up with “best interest”. Off the record they may have differing opinions and as one RMN said previously “it is more than my job is worth”. Others might comment “it is evil to keep her from her mother on her Birthday” - here is another comment “I quite understand how your mother feels”.
Anyway getting back to your letter so an inspector cannot/will not look into medication but RT is not part of the treatment and comes under Art 3 -degrading treatment and how regularly this is being administered for instance should be of interest and whether correct blood oxygen levels are being monitored before/after RT as well as the forced blood tests which are not part of MHA treatment from what I understand.
Moving on, what your organisation should be looking at is the breaches in law and cruelty to people like my daughter with her phone taken away and although they say “the phone is there if she wants it” – what is being said otherwise is “she can only have her phone if she asks for it. OR ”I will see if she WANTS to speak to you. Sometimes it is necessary to phone the ward. Sometimes you need to ask questions even though you get varying answers. If something like a bank card for instance goes missing and Elizabeth has commented it has been missing a week but I have only just found out. This is of concern and family need to be informed. Without a phone, without any contact with the outside world Elizabeth is cut off from reality. It could be that the card is somewhere in her room. Today I visited the ward but I could not even go into the reception area. I just drove over an hour’s journey just to drop in some food. I was then told she could not have some of the food because of health and safety and storage. Staff (2 of them) came outside the building to pick up the food. They straight away said “there are new rules”. I said what are these new rules? mentioned above. I asked if I could bring a miniature fridge to the ward that has just been pat tested. I was told a firm no to that. I just commented that this shows being on the ward is far too restrictive and today is takeaway day – the only thing Elizabeth has to look forward to and I am left wondering if the card has been taken away and put in the office or whether it has been stolen. I have mentioned this to other family members tonight and that they should find out as there have been conflicting answers. Some have said the card is in the office whilst others confirm it has gone missing which will leave me with no alternative but to report the missing card to the Police if I do not hear further.
I have asked the rest of the family to find out and to arrange for a takeaway for Elizabeth as otherwise she will be left out of the only day patients can look forward to ordering what they want unlike the rest of the week when they are under strict control. I thought the MHA and MCA were all about the least restrictions but not under LPFT. I have seen other patients going out unescorted but Elizabeth is treated differently in breach of the Equality Act 2010 and so am I.
As regards ban I have heard six months mentioned. I wonder why that is??? No doubt all will be revealed and the truth always comes out in the end. I just do not understand why the NHS are not decent enough to speak the truth and as regards the records I have been refused my own data by LPFT and no doubt this is to protect themselves. Is it a six month ban? or else is it indefinite whilst they put her in a care home out of area like they are trying to do. Nothing has been done right. To invoke an ongoing ban should go before CoP. Only the CoP can decide on banning someone indefinitely.
In the unsigned letter from the MHA it says about ongoing investigations against me. I have requested that Dr Khokhar and whoever called the Police on Xmas Day be requested to do a s9 statement just as I have volunteered to do. I bet nothing is done about this but if I was in the Police I would be investigating why Police time has been wasted on several occasions and I am only too happy for an investigation to go into the very serious allegations made against me by Elizabeth’s RC. Those at the top of the Trust are only too away and although they say they are taking my complaint seriously this is not the case otherwise something would have been done after all this time.
It is bullying when a team of so many say nasty things about you behind your back and I have featured similar things from Enfield. I thought I might as well get all the files from there also especially from social services. Apparently you cannot have comments deleted – they remain in the files however you can correct them but this will be a huge task for me. However when it comes to paperwork I have a lot of patients and tolerance as I am keen to see things recorded accurately.
The comments can/have been really nasty and adverse in opinion backed by all their MDT colleagues to to make you look bad. This in turn builds up a profile that can be passed from one area to another. I would like to see these comments though nothing will shock me. I have welcomed safeguarding to be done on me. In fact I would like to share the safeguarding previously carried out and it was very helpful when Elizabeth handed me the minutes of the safeguarding meetings in Enfield. I have everyone’s email addresses. The Police were there, the GP and about 9 coercing Elizabeth to tick boxes. Both Council and Trust were forced to apologise. Since then I have been waiting for same in this area but it has not got further than a referral on the part of one or two nurses who have “concerns”.
This is what I would like the CQC or have wanted the CQC to look into thoroughly: No vulnerable person should be subject to this kind of treatment and the phone should not be taken away or any other possessions.
The CP11 RT log and seclusion
How many episodes and how may have led to A&E?
Records of blood oxygen level tests
Record of the accident in the seclusion room.
I would like the CQC to find out why an Impact Assessment has not been carried out in accordance with NHS Guidelines
If everyone or was it just the Clinical Lead unaware of the Neurologist appointment Elizabeth did not attend on 3 January?
How many times has Elizabeth missed meals.
How many times has she had prone restraint and administering of depot by male only staff
Why the Trust has not consulted the CoP about their indefinite as voiced by Dr Waqqas Khokhar
What they are trying to pin on me in terms of criminal allegations exactly? – I would like the Police to get those concerned to sign the s9 statements as there was serious allegations of conflicting nature. There are contradictions between RC and MHA re banning me indefinitely and the Trust’s MHA Legal Team write to say this is not so. Who is telling the truth when the MHA legal team have sent yet another four week ban. Dr Khokhar said he did not like the word BAN. Well I cannot think of a better word than BAN.
What I would be reassured about was if the CQC could contact Elizabeth and go and see her if on the ward.
Professional Standards Authority: Healthcare Regulation
Professional Standards Authorityhttps://www.professionalstandards.org.uk › …
We protect the public by overseeing the regulation and registration of healthcare professionals · How we help to protect the public.
Consultation on the Professional Standards Authority’s good practice guidance documents in support of regulatory reform
What is this consultation about?
Context for our consultation
The Government is in the process of reforming the way that health and care professionals are regulated. It is planning to change the legislation for nine out of the 10 healthcare professional regulators we oversee, giving them a range of new powers and allowing them to operate in a very different way.
The changes the Government intends to roll out will give regulators greater freedom to decide how they operate, including introducing the flexibility to set and amend their own rules. There will also be changes to regulators’ powers and governance arrangements.
The changes will also create an entirely new process for handling fitness to practise (the process by which concerns about healthcare professionals are dealt with). Under the new system, more cases are expected to be dealt with on paper through a process called an ‘accepted outcome’ rather than going to a formal hearing.
We have produced two sets of guidance to help regulators use their new powers effectively:
Guidance on accepted outcomes in fitness to practise
Our guidance on the use of Accepted Outcomes in Fitness to Practise identifies key factors for regulators to consider when developing their own guidance on the use of accepted outcomes. The guidance includes factors to consider when deciding whether a case is best resolved by an accepted outcome or a fitness to practise panel (the disposal route) as well as factors for regulators to consider to ensure the accepted outcomes process is fair and transparent, and to promote effective decision-making.
Guidance on rulemaking
Our guidance on Rulemaking aims to help regulators make effective use of their new rulemaking powers in a way which prioritises public protection. It includes some principles to guide what good rules should aim to do or be, and the rulemaking process.
We are seeking your feedback on both pieces of guidance through this one consultation. The consultation paper explains more about the structure and sets out clearly which questions relate to which guidance.
Read through the full consultation to find out more. It is available in English and Welsh.
Why are we consulting?
We support the reforms to healthcare professional regulation but have also identified certain risks that may arise from the new ways of working. Developing the guidance that we are now consulting on is one of the steps we are taking to help make the reforms a success mitigate any potential risks and realise the opportunities of the reforms.
It is also one of our core roles (under the National Health Service Reform and Health Care Professions Act 2002 to promote best practice in the performance of regulators’ functions, to formulate principles relating to good professional regulation, and to encourage regulators to conform to them). We want to make sure that reformed regulation is as effective as possible at protecting the public.
We are therefore seeking views from everybody with an interest in healthcare professional regulation, including patients, the public, registrants, regulators, professional bodies and employers.
How can I respond?
Please respond to this consultation paper by completing the online survey available in English here or in Welsh here. When using the online survey don’t forget to save your answers as prompted.
You can also submit your response by email – please include the name of the consultation in the subject line. When submitting by email, please reference your responses using the question numbers. Email responses should be sent to: policy@professionalstandards.org.uk
We welcome responses to any or all of the questions in the consultation.
Please respond by 5pm on Monday 15 April 2024.
This looks interesting – if the public are not being protected by the likes of CQC, PHSO, GMC and others it is good that there is such consultation and I am more than happy to take part.
The Care Quality Commission (CQC) is the independent regulator for the quality and safety of care in England (with Scotland and Wales regulating the same under their own independent Care Inspectorates), responsible for regulating providers of healthcare services, social care services and services for those whose rights are restricted under the Mental Health Act 1983. These powers extend to oversight of the NHS, local authorities, independent providers and certain voluntary organisations. The CQC registers and carries out inspections of care services and issues public information in relation to them. Under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 the CQC also holds a range of enforcement powers, including penalties and prosecution, where it finds that fundamental care standards have been breached.
Here are two responses I have received:
The latest one just received from Mark.
Dear Ms Bevis
We are writing to you from the Mental Health Act complaints team at the Care Quality Commission (CQC).
We have now received a copy of the letter summarising the outcome of the investigation into your complaints. We believe that a copy of this letter dated 14 November 2023 and signed by Dr Toby Greenall the Consultant Psychiatrist at Peter Hodgkinson Centre has already been sent to you, but please let us know if this is not so.
The Mental Health Act grants the CQC a discretionary power to investigate complaints where they are about the use of the powers and duties in the Act. If you are not satisfied with the response provided to you by the service, you could request that the CQC consider reviewing your unresolved concerns.
We do sometimes receive complaints about matters that we are not able to investigate because they are not within these powers. The CQC complaints process cannot make any recommendation about matters that can only be decided by a court of law. For example, we cannot rule on whether a detention is lawful, nor would we be able to provide any clinical opinion re diagnosis.
Before we could decide if there is a role for us, we would need a clear statement from you outlining what you are unhappy with in the provider response, any outstanding issues and your desired outcome.
Alternatively, you can contact the Parliamentary and Health Service Ombudsman Office (PHSO) within the next twelve months, saying why you are not satisfied. Their address is: –
The Parliamentary and Health Service Ombudsman for England
Citygate
Mosley Street
Manchester
M2 3HQ
www.ombudsman.org.uk/making-complaint
Telephone: 0345 015 4033
The PHSO can consider whether to investigate complaints that the NHS (and NHS funded care) in England have failed to act properly or fairly or provided a poor service. If the Ombudsman feels that it is more appropriate for the CQC to consider the outstanding concerns, they may refer you to our organisation.
The PHSO is the final arbiter in any complaint matter and therefore the CQC cannot consider any request for investigation once the Ombudsman has either completed or declined an investigation into your complaints.
Could I please request that you use the above reference number on any correspondence in relation to this case. If we do not hear from you within 15 working days of the date of this letter, we will assume that you have received satisfactory answers to the issues you have raised through Local Resolution and your enquiry will be closed.
Yours sincerely
Mark
Mental Health Act Complaints Team
Here is another response received from:
Psychiatric Abuse UK 