Archive

Tag Archives: mental-health

SYSTEMS GENERATED TRAUMA CONFERENCE & PARENT BLAME 09.07.2024

July 20, 2024
Uncategorized
1 Comment

The Conference comprised of speakers including Chair: Beverley Hitchcock, Elly Chapple, Professor Andy Bilson, Professor Luke Clements.

“Trauma related practice: is a phrase increasingly used by public bodies to convey their awareness that many of those with whom they interact have experienced life changing traumas. As a rule, the traumas referred to are ‘other’ -in the sense that they are the result of adverse childhood experiences, domestic violence, mental health difficulties and so on. What is generally acknowledged is that many users of public services identify their most traumatising experiences as the way they were treated by the public bodies that they had approached for support.

Complex Systems Generated Trauma: what needs to be done: Chair: Dr Ana Laura Aiello; Mary Busk; Dr Peter Baker; Vivien Cooper OBE

Systems Generated Traumas of this kind are a daily experience for many people in contact with the social welfare system, including carers, disabled adults and disabled young people. There are a myriad of intersecting examples, but for the parents of disabled children these can include being prosecuted when their disabled child is ‘school refusing’, being refused support by children’s services when in desperate need, but then having their home inspected and their children interviewed for child protection purposes: being accused of fabricating or inducing their child’s o;;mess (FII) because they have asked for a second opinion from a health professional; being unable to access justice to gain redress for the damage done by behaviour of this kind – and so on.

About the speakers:

Ana Laura Aiello – post doctoral researcher on the Cerebra LEaP project (Leeds University) – (an innovative problem-solving project that helps families of children with brain conditions cope with the legal barriers they face. We listen to families and help them get knowledge they need to access health and social care/other support services and identify common legal preventative problems) Ana has studied law and human rights in Argentina, Spain and UK and worked for Amnesty International, Disability Rights International and CHANGE and at universities in Argentina, Spain and UK.

Beverley Hitchcock: Head of Research and Information – Cerebra

Derek Tilley: Senior Development Officer – Cerebra Legal Rights team.

Elly Chapple: Founder of #Flip The Narrative – TEDx Speaker

Luke Clements: Cerebra Professor of Law and Social Justice at the School of Law, University of Leeds

Mary Busk – worked for public/voluntary sectors and founder member of NNPCF currently working for NHS England LD and Autism Programme and spoke in a personal capacity as a family carer and mother of one disabled child.

Peter Baker – Senior Lecturer in intellectual disability at Tizard Centre, University of Kent. Has worked as a Consultant Clinical Psychologist for NHS in Sussex with leadership responsibilities for Learning Disability psychology services in E. Sussex/Brighton & Hove. He is widely published in the area of challenging behaviour and intellectual disability.

Vivien Cooper OBE – parent of young man with severe learning disabilities and Founder and CEO of Challenging Behaviour Foundation.

It was good to meet up with some of my social media contacts and see such a huge turnout of parents and carers from all over the country who have experienced the most terrible traumatic interactions with various public bodies particularly social services and an ever increasing group of us parents and carers remain in touch via discussion groups on social media to share ideas and individual negative experiences and we all agree something needs to be drastically done to change a system that is completely broken.

Our Negative Experiences:

This goes back to 2010 and even beyond this and I honestly think things have got worse. 2010 was when Elizabeth was placed in a local scheme. The placement started off well but went to pieces when a support worker left and others took over. Isolated in her individual flat where “noone knocked on her door” Elizabeth quickly declined. There was not the 24 hr support in place just members of staff who occupied one room at the top of the building and no observation through the night as to whom entered the building. I wont go into what happened but because of no security this put a vulnerable person at huge risk of abuse. That was the start of my main complaints and then you see the ugly side in terms of response. Blame was focussed on me as a parent that I visited too often however I worked full time and was on a police training course on Saturdays. CCTV cameras went missing along with all of Elizabeth’s possessions but the blame was then put on Elizabeth. She should never have been placed at this scheme and I was right to voice concerns but when you voice concerns this is when you come up against negative reactions. If they see a parent as a problem who has every justification to be concerned, quite often if a placement has not worked out then out of area solutions are funded. On huge dosage of drugs Elizabeth could not function. Health and safety/risks not followed up on and that should mean if a placement is not safe then something else needs to be provided but carers and parents are cut out.

Elizabeth has been placed in many out of area placements as far away as Wales where restrictions were in place for visitors. Following on from this private hospital was a care home where suddenly there was a poor signal and you could not get through on the phone.

Fast forward to today Elizabeth has suffered immense trauma and so have I as a parent watching her go downhill with one wrong placement after another and the guilt feeling that if we had never moved we would not be in this awful position today.

Safeguarding cutting out parents and carers is used to distance and isolate a vulnerable person. This is our current experience. It amounts to organisational abuse when someone sits writing notes constantly and you have 2-1 supervision like you are a criminal. This is going on right now and has been for the most part in the new area where we have moved.

What they do is take the phone away and basically virtually stop contact between you and the person you care for. Nothing is done correctly as far as safeguarding goes. Safeguarding should be done in an open transparent manner. If there are concerns they should include you in their meetings that go on behind your back. It is bullying to carry out safeguarding in this manner.

I have raised safeguarding myself. Elizabeth has been isolating in her room and missing meal times but then the response they give is “there is nothing we can do – she is an adult and it is up to her – we cannot force her to eat”. However bearing in mind capacity they say she has none this is surely negligence. It was not me who complained to the CQC and I think this was the reason they acted but then the same problem reoccurred.

At the moment I am totally alarmed that Elizabeth is being prescribed a combination of drugs against BNF by a locum doctor – This is the 11th one employed by an Agency. I have raised concerns and even given references to relevant research papers. Faulty prescribing can cause significant harm leading to death and injury yet many doctors just ignore this completely and carry on.

Elizabeth never had seizures before coming to this new area. The safeguarding is clearly there to protect themselves. The seizures are life threatening so it is not unreasonable that I as a mother, carer and Attorney should draw this to attention.

The treatment my daughter has had amounts to cruelty, abuse, bullying and some of the staff over the past three years have acted in a callous manner and against me Police have been used by staff calling them during my visit such as Xmas Day and then a ban lasting months and months on end by the Responsible Clinician.

All sorts of blame and accusations are thrown at you and where is this safeguarding going to end. They failed at taking away the POA but there is no means for Elizabeth ever to be discharged – a prisoner for life as they took away that under the displacement of NR and “unsuitability” claims whilst those involved in safeguarding never visited but when required had to do reports and those reports showed conditions to be squalid and negative. During this time patients had approached me in the grounds to voice their concerns and to tell me that THEY were doing the safeguarding.

Many of the parents attending this conference have had the most negative experience of social services and I was not alone. It was shocking to hear how many had experienced similarly traumatic interactions with those supposed to care. The only good experience I have ever had from social services was with my father’s social workers who instead of working against me worked together and I kept my father out of care for many years as a result.

Nothing such as the above has been my experience of social services under MH. I have never had a care act assessment done. Elizabeth has never had direct payments to enable her to have some support in the community. The reports they may are full of error and untruthfulness which has been our experience both previously and presently. There is nothing but a blame culture and in file records negative reporting against you to justify their aims.

A lot of public money could be saved not wasted if professionals worked together with families instead of against them. This worked effectively in the case of my father who had Alzheimers so I am not saying they are all bad but my experience has been the vast majority have gone out of their way to destroy family relations and cause more harm than good.

The last thing I will mention is because of my concerns I applied for police records. I know not everyone’s experience of police has been good but I actually trained with the Police and their course was excellent. I also trust the Police who have not responded in the callous way social workers have but their time has been wasted on several occasions. The police records outline the huge amount of calls Elizabeth made in desperation which is the real reason they took the phone away. Elizabeth was desperately trying to get help from the Police at a time she was according to other patients being abused by the vast majority of night staff. In certain records it stated that her calls related to her being starving hungry as because of over drugging and constant RT she isolated in her room for much of the time and the drugs were raised to double leaving her fit for nothing.

When you ask if safeguarding is in place due to excessive restrictions and raise safeguarding concerns yourself there is flat denial and refusal of a meeting that could be useful to dispel concerns (such meeting once took place behind my back ie s42 with everyone present) except the person they make out to be the perpetrator but luckily Elizabeth picked up the minutes and gave them to me. I feel like featuring them to show how vicious professionals can be behind your back.

Safeguarding should be open and transparent and not done in a biased secretive manner and because this is going on presently I am not allowed to see my daughter alone and have been deprived meaningful contact for so long I see this as extreme bullying – as one member of staff commented “it is evil to keep her from her mother on her Birthday”. It is constantly being mentioned this is being done to “keep her safe” however safe from what exactly as from her appearance Elizabeth is clearly going downhill, her face full of red marks and distressed about staff making notes during visits and most concerning is where are these notes leading and they are bound not to be pleasant. It is cruelty and abuse of power on the part of professionals to do this to a parent and carer knowing full well that this is also impacting greatly on the vulnerable patient who is clearly unhappy about all of this and then to rob her of her mental capacity in tests that were not done properly. I am talking here not just of social services but Health Boards too. It is done out of control to isolate and work towards severance of contact as I see it.

There is no greater punishment by professionals to stop a parent and carer from having contact or put enormous heavy restrictions in place and it is also detrimental to the vulnerable person to be isolated in this way. It is harmful that a team can stick together in such a way and there be no accountability. It is harmful that file notes are not accurate and contain untruthful comments. For parents and carers their lives are ruined and I would describe my life as barely worth living solely down to the way we have been treated like criminals and it is only ever one sided.


NO REFERRAL TO SHEFFIELD NEUROLOGY  – WHY NOT? – A WALL OF SILENCE FROM THE NHS WHAT LENGTHS DO YOU HAVE TO GO TO?  HOW CAN YOU HAVE FAITH AND TRUST IN THE MEDICAL PROFESSION.

April 22, 2024
Uncategorized
Leave a comment

Today i have spent quite some time trying to get through to Sheffield Hallamshire Hospital where my daughter who is held a virtual prisoner under Castle Ward can have the extensive tests she needs on her physical health which the MH would appear to be obstructing. Elizabeth is having seizures that are frequent. Her Responsible Clinician says I am partly to blame for such seizures and there are heavy restrictions in place on just me right now visiting my daughter with 2-1 supervision and not allowed any time with my daughter to take her even in the hospital grounds. This is bullying to the extreme by Lincolnshire Partnership Trust. It is also huge neglect as all they have done is cancel referrals already made by a previous area that the new GP said I should take her to. Everything was put in the way of that at Ash Villa, the previous hospital. Now the RC has put massive restrictions in place contrary to the health and wellbeing of my daughter.

Elizabeth is going downhill. Her face was a mass of red blotches and forehead looked as though she had hit her head on the wall or door – a hard surface. Her knuckles were encrusted with scars that had obviously healed from bleeding. She said she had been injected again recently. She started having the seizures at Ash Villa and there was a cancer scare – they say tests for came out normal. I had private scans done. I sent them to various experts on disk and all said the same thing that certain images need to be closely investigated by Neurology. You can imagine how happy I was when finally she was referred to a Neurologist under United Lincolnshire Partnership Trust. On the 3 January was supposed to be her appointment. She was not taken there by the MH team. I turned up instead with the private scans I had done in a small window of opportunity because for the most part LPFT have stood in the way of all leave and visits highly restricted. It is almost as if they are trying to protect themselves or know more than they let on. There is clearly something physical wrong for my daughter to have such frequent fits. She is not being monitored for her blood oxygen levels and following each fit they give lorazepam which is extremely wrong so I have been told. If she has temporol lobe epilepsy the treatment would be different but Elizabeth is treated as though she is a MH patient and nothing else. LPFT have ignored all the screenings and all the past assessments done by Huntercombe who claimed she had high functioning Aspergers. That was back in 2017 under Enfield. It would appear that ALL the doctors seem to be protecting each other because today I have had to go to enormous lengths to write and enquire about these scans. Because of my grave concerns about my daughter’s wellbeing and safety on the MH ward (Castle Ward) Lincolnshire – no way should it be left to a team of MH professionals to film my daughter against her wishes having seizures. This is against GMC guidelines. Secondly her capacity is highly disputed. There are three flawed capacity assessments done purely for the purpose of getting rid of me as nearest relative which they succeeded in. All are heavily flawed and not in line with Principle 4 and Masterman-Lister case and they do not take into account the causative nexus. The causative nexus is highly important to see determine impairment. This has not been done, making all three capacity assessments not fit for purpose.

I finally got through to Sheffield who told me that absolutely nothing had been arranged.   The person concerned when to some lengths to check and refer to a supervisor.

It is hard to trust anything the NHS does as when things go wrong there is nothing but a wall of silence and it is very hard to age any kind of justice even when someone dies as a result of negligence.   There appears to be a wall of silence right now.  Certain doctors (even those assigned to look at physical health) appear to be standing in the way of my daughter’s much needed physical health referrals which has been the case since we moved to this dreadful area of Lincolnshire. The word normal most certainly does not mean normal and they are depriving my daughter of the necessary physical health referral to a Neurological ward where she could have extensive tests done to determine the real reason for the fits and not rely on just observations and comments that state “it is the mother’s fault”. The reasons for my appalling treatment is because of “concerns” by her Responsible Clinician on my part and an entire MDT all acting ultra vires against their own code of conduct and treating Elizabeth as someone who has no capacity. LPFT HAVE COMPLETELY ABUSED THE MCA AND NOT GONE ACCORDING TO NATIONAL GUIDELINES. I am now a BI assessor myself and am frankly disgusted at such enormous dishonesty and in addition after all this time she has not had proper pathological tests or any psychological input. The law is failing to protect vulnerable people such as my daughter.

I have written to Pals today, the Neurological department of ULHT, care concerns (LPFT) and my MP and here are my emails below. You should not have to go to these lengths. Elizabeth agreed to go to Sheffield. There seemed to be more concern about her breaking expensive headgear which she promised not to break than her physical health and wellbeing and the necessity to have these extensive tests. This is highly negligent on the part of the NHS. ABSOLUTELY NOTHING ARRANGED FOR THE SECOND TIME as today I checked with Sheffield.

From: susan bevis
Sent: 22 April 2024 10:48
To: NEUROLOGYSECRETARIESLINCOLN (UNITED LINCOLNSHIRE HOSPITALS NHS TRUST) ulh.tr-neurologysecs.lincoln@nhs.net
Cc: PALS (ULHT) pals@ULH.nhs.uk; MARISCORECEPTION (NHS LINCOLNSHIRE EAST CCG) LECCG.MariscoReception@nhs.net; Christopher Reid Chris.Reid@parliament.uk; voiceability.org;
Subject: Elizabeth Bevis For the Attention of Dr CS
 
FOR THE ATTENTION OF DR S
I would like an appointment to discuss my daughter’s care with you.
I have today checked with Sheffield Hallamshire Hospital only to find out that NOTHING has been arranged.  E is having life-threatening seizures and I visited her yesterday.  I have grave concerns for her wellbeing. 
My daughter no longer wants to live.   She was covered in red marks, she is having constant fits which ARE NOT mental health conditions.  You are responsible for referring her to have extensive tests which Lynsey has agreed to have done.  Why has this not been done?    
This matter is subject to a high court case right now.  I would like to know your reasons for not referring my daughter to Sheffield or has she been referred elsewhere?
I would like your reasons why a MH team should film my daughter against her wishes and that you should wish to take their word when they are not qualified to comment.  I was assured by your department when I called last Wednesday that an appointment had been made and it has not as I have checked today.   How can you possibly monitor my daughter when you are not there 24/7.  
I was also told by Sheffield to contact the GP which I have done.
I would like to know the details of what exactly has been arranged.

Since moving all E’s Neurology appointments have been cancelled which is highly neglectful.  She has had several accidents and her face was absolutely covered with red marks.   I want my daughter to have the physical health checks she needs and under Martha’s Rule she is entitled to have this.  Nothing has been arranged so I need to know all the details of the appointment to pass onto the court.
Her condition in past files points to neurological not mental health.  I look forward to hearing this information from yourselves and the GP.  I have not had response to my emails from your department and I need that response today.  Thank you.   I am beginning to feel like no-one wishes for my daughter to have extensive tests done and are ignoring her physical health completely.
It is also against GMC guidelines to film a patient who has said she does not wish to be filmed.   Not having these tests done is preventing my daughter for being evaluated on her capacity ie the causative nexus which is subject to high court action right now.
Yours sincerely

Susan A Bevis  T

From: susan bevis
Sent: 22 April 2024 11:19
To: PALS (ULHT) pals@ULH.nhs.uk
Cc: NEUROLOGYSECRETARIESLINCOLN (UNITED LINCOLNSHIRE HOSPITALS NHS TRUST) ulh.tr-neurologysecs.lincoln@nhs.net; MARISCORECEPTION (NHS LINCOLNSHIRE EAST CCG) LECCG.MariscoReception@nhs.net;
Subject: Elizabeth Bevis For the Attention of Dr S (Case Ref: VA18567)
 
TO WHOM IT MAY CONCERN

I need to know the full details of the referral that was meant to be done on two occasions now to Sheffield for E to have an MRI scan done under a Tesla 3 scanner.  On two occasions now I have phoned sheffield because no-one is responding to my emails.  No appointment has been made on two occasions now despite assurances.  I therefore need a copy of the referral details as obviously I cannot go by their word.  I have spent a long time trying to get through only to be assured that absolutely nothing had been arranged.

Please therefore let me know the details of the referral and if this referral has gone to another area such as Nottingham by any chance?

I look forward to hearing from you regarding this urgent matter.

Yours sincerely

Susan A Bevis   

From: susan bevis
Sent: 22 April 2024 10:57
To: Christopher Reid Chris.Reid@parliament.uk
NEUROLOGYSECRETARIESLINCOLN (UNITED LINCOLNSHIRE HOSPITALS NHS TRUST) ulh.tr-neurologysecs.lincoln@nhs.net;

Elizabeth Bevis For the Attention of Dr CS
 
Dear Mr Reid

When I came to Dr S clinic last Wednesday I did not have an appointment arranged and did not expect to barge in front of others.  I explained that no appointment had been made for Sheffield.  Two ladies (managers) came out to see me witnessed by *******   All they could do was pass messages on to Dr S.    I was then assured that the necessary appointment for E to go under a Tesla 3 scanner had been made.  i had explained that nothing had been arranged previously and that this was being looked into and that a referral had been made when it had not been made according to Sheffield.   I am absolutely in despair to hear yet again Sheffield have no record of any appointment or referral even being made.

Please can you look into this matter and provide me with details of the appointment.   It is almost as if noone wishes my daughter to go and have the extensive tests needed and are trying to play down the necessity of it all.

The seizures are life threatening, the MH team are not monitoring her blood oxygen levels properly.  She is being treated in the most appalling manner.   I am scared for my daughter’s life.  The referral to Sheffield  was meant to extensively look into my daughter’s physical health and wellbeing and yet again for the second time nothing has been arranged.  I totally despair.

I need to know the full details of the appointment as under Martha’s Rule my daughter is entitled to a second opinion and this can only be achieved through extensive tests done through Sheffield.

This is now urgent.  I need full details of the appointment they claim had been arranged yet no-one is responding to my emails under the Neurological department of Dr S.

Yours sincerely

Susan A Bevis

2.5 years of appalling imprisonment under the barbaric NHS where not one person takes responsibility.

Everyone working together to cover their backs in the form of MDT that goes way beyond nursing and doctors codes of conduct.

Total conflict of interest at Board level with no-one taking responsibility.

In the middle of this mess is a vulnerable person now covered in marks, scratches where she is obviously totally distressed and injected frequently, missing meals and that in itself is dangerous and to make up for missing meals is taken to the shop where she may buy crisps and snacks to compensate. At least at home she would be looked after nicely and now she no longer wishes to live so she has told myself and others who have visited her.

She is treated as though she has no capacity and is being denied her physical health assessments which have not been referred as advised on two occasions.

Absolutely dreadful situation. No accountability and these doctors try to play down their responsibilities and try to put all the blame on you as a parent/carer instead of take an interest and investigate what could possibly be the cause of these life threatening seizures. To think they are more worried about her breaking equipment she is supposed to wear on her head to monitor properly than the wellbeing of my daughter.

Then I get an email from a Ms Lowe of Marisco Medical who has said she has been told not to answer my emails because I am writing to her via her own personal email address that states NHS/ICB but I just wrote back and said that can simply copy in by cc to her personal NHS email address the correct email address as what had been given to me had emails bounce back. I do not expect to hear anything but it is good communication to point out that this is the wrong email address and copy in the correct email address surely? She is supposed to be a lead safeguarding person under the GP surgery. This is a safeguarding matter they need to be aware of as two referrals have not been done. At least instead of dismissing such concerns the person should write more clearly and then why use a personal email address in the first instance to correspond with me then now say this is wrong?

So now I have to wait several days if not weeks before I get any kind of response I have asked for ie date of referral and details of what has been arranged. Why is that so difficult when Elizabeth has given consent and it seems like NOONE wants me to know anything.

In the meantime a Ms Emily Scott who is supposed to be the Clinical Lead for Castle Ward has told Elizabeth she is moving elsewhere or words to that effect that she is being taken to see a place but noone in the family is being advised of this and so the information is via Elizabeth.

When I visited Elizabeth she clearly said she wanted to come home, she misses her cat and misses her home and family. Elizabeth has spoken more than one of staff shortages on the ward and I have this in writing.

I am the only person who comes to visit each week without fail. My visits are heavily restricted 2-1. Even a prisoner is treated with more respect.

As regards capacity I had bought Elizabeth something where it indicated there was 9 pieces in a box. I had not eaten myself and after doing all her shopping for her had no chance because the visit was 2.30 and I had two pieces from that box myself. This shows tremendous capacity for Elizabeth to question where the other two pieces were. In addition to this I had bought all the nice things she wanted me to. Food is the only comfort for a patient treated like a caged animal you would see in a zoo. In a prison warders may be present and walk up and down but do not sit there taking notes of everything being said in a small cramped room, Ms Munro describes as “spacious”. So why are they doing this – it is on order. An Executive decision or that of the Responsible Clinician who is clearly not taking into account the fact that this is not conducive to recovery. It has not been taken into account that she would like some leave after all this time and only has 45 minutes so the only other enjoyment is going to the hospital shop and even that was used as punishment for appearing hostile, the subject at the time of an interlocutory injunction. This could not go forward due to county court not having the jurisdiction.

When a responsible clinician goes down the legal route first before medical concerns this is highly negligent. Why are they filming her on the ward having seizures and trying to make out this is caused by her mother. Why dont they do the responsible thing by refer her to sheffield and for the endocrinology tests as already proven in private tests there is dysfunction.

It would seem there are no standards and those at the top also work for the care quality commission and the ICB.

All I have ever wanted is for my daughter to be treated fairly.

Sadly I have chosen to live in a beautiful area that would benefit Elizabeth but she is not allowed any meaningful contact – there is complete abuse of human rights under this area. There is no accountability.


A CARER’S STORY BY “ANONYMOUS” AGE 91

February 10, 2024
Uncategorized
1 Comment

Not everyone has access to a computer or internet but I am totally inspired by my contact who is 91 having to stand up for her son who by the sounds of it has been totally misdiagnosed and denied the correct pathological tests by the NHS.

A Carer’s Story by “A” (I am using the exact words of my guest blogger as written in a letter by request)

“I have been involved with Mental health for many years as a carer for my son, even though the diagnosis is totally wrong.

My son has had nothing but persecution – stress – no life whatsoever.

Resistant to some medications.

The service should provide the resistance test, only then would patients be on the right medication.

It would save a lot of problems – also a lot of money. 

Most of all – The misery that these medications cause. They are addictive and very difficult to withdraw from.

It needs a special clinic, experienced person to make sure the withdrawal is successful. 

My son has two disabilities from the medication.

He is in a wheelchair for over 20 years suffering from TD – Tardive Dyskinesia from the medication – injury to the brain – spine (Clozapine) no dopamin in this system

Disability (Risperidone) – brain disturbance so now lacks capacity.

They only knew one thing – pills/Tablets.

The system needs to change. Put the right people in the right jobs.

Mental health destroys everything ? (The system).”

BY MY GUEST BLOGGER AGE 91 YEARS OLD

THE GREATEST PUNISHMENT

January 13, 2024
Uncategorized
1 Comment

Wishing all my readers a Happy New Year. 

I can only hope 2024 will be better than the last.

Xmas was the worst I have known for a long time.  Elizabeth was not allowed home and wanted to see her cat but this was not allowed not even for one day. She is still held under heavy restrictions by Lincolnshire Partnership Trust on a never-ending section with phone taken away.  The phone restriction has been going on for some time along with visiting restrictions said to be an MDT decision but we know that this is not the case. Restrictions commenced every two weeks, then a further two weeks and then increased to every four weeks up until 26 January. Even more restrictions seem now to be in place because when I have phoned following New Year since I had not spoken to Elizabeth for some time, several staff appeared reluctant to even hand the phone to her. The Clinical Lead, ES, stated the phone would only be given if Elizabeth specifically asked for it, others said “I will see if she wants to speak to you”.   I know for a fact rest of family not treated the same but taking the phone away is very nasty and very restrictive and this is NHS not private sector care. Taking the phone away and locking it in the office or wherever makes it difficult for everyone in the family to keep in touch with Elizabeth who is cut off from the outside world and held a virtual prisoner after 2.5 years. It is not easy to get through to the ward. This is cruelty and I see it as punishment no doubt aimed at me but inflicting upon Elizabeth.  Also, Elizabeth is deprived of playing her music on her phone and seeing pictures of her cat who she misses so much. She no longer has a life and neither do I, our lives ruined by the decision I made to move to what we thought was a lovely area.  I have made a huge mistake moving here as although the immediate area is lovely I had not bargained for how ruthless the NHS is under MH care or the fact provision in the community is poor. Having said that, there is so much going on in the local area, things that Elizabeth would enjoy but instead she is locked up by a group of strangers(MDT) who think they know best and could not care less about the impact their punishment is having on the family, even those who are not under restriction are affected by taking the phone away yet there is no consideration whatsoever towards anyone. It is also forgotten about values, medical ethics and duty of care according to their individual Code of Conduct. They are in fact acting ultra vires by depriving s17 ground leave to the shop as a means of punishment for instance as instructed.

Xmas Eve, rest of family visited and reported Elizabeth “not so good”.

Xmas Day could not relax, cook a nice dinner or have people over this year.  I had just 45 minutes with a member of staff supervising in the small visitor’s room.   Elizabeth was OK at first but when the second member of staff took over she became upset by this person then a group gathered outside the visitor’s room and I was told to leave.  I had heard through Elizabeth that she had a reduction in her medication and I wanted to know what reduction she had and it was very upsetting that so many staff outside grabbed hold of her and that is when she tried to defend herself but so many of them involved and all she did was shout at them. Police were called to the ward yet again by staff told to report concerns yet these concerns were nothing like I was accused of.   It is alarming how many times Police have been called, as if they do not have enough to do for no reason.  Always there has been nothing to report and no evidence whatsoever recorded on CCTV, only members of staff who are told to report adversely so as to make me out to be someone who is hostile, aggressive, etc.  I now do not ever visit alone as I feel I am up against so many who are against me.  So Xmas was awful.  I had no idea Police had been called after I had left the premises that day.    The first I knew about this was on the 28th December at on line ward round.  I was told I was banned indefinitely by the RC for inciting Elizabeth to attack staff which was totally untrue.    I have since received another unsigned letter from the MHA legal office stating the ban is four weeks until 26 January. They are not following NHS Guidelines and have no regard to the latest Government paper on hospital/care home visits or Code of Conduct of the MHA. It seems like a never-ending ban just like Elizabeth’s never-ending section – an imprisonment for life by LPFT. I have just been told I must no longer contact the carers champion.  I must only write to one designated email address.   Since moving, I have had no carer’s assessment and was actually told previously I was not entitled to this.

Most disturbingly of all, the Neurologist appointment on the 3 January was not attended by Elizabeth and when I questioned why, I was told by ES, Clinical Lead that nothing was in the diary and no one knew anything about it.  Again this is totally untrue.  It is obvious LPFT did not want her to either have an MRI scan all along or see a Neurologist or Endocrinologist in the first instance. It seems the most important thing is the drugs they force and the law they twist to suit themselves re MHA and MCA.  All her physical health appointments were cancelled as unnecessary upon our move.   I am also banned from taking Elizabeth to any physical health appointments.   Our treatment has been even more appalling than the former area and I thought that was bad.

There does not seem to be any regard for human rights or Codes of Conduct/Guidelines.

For anyone else going through hell as we are I am going to share with you some points of law as what I am seeing is a whole group of professionals sticking together, totally disregarding their own code of conduct and ignoring the law. There seems to be no accountability.  Some of these professionals are responsible for health and wellfare of the most vulnerable patients but what has happened is several have acted ultra vires relying on colleagues and MDT backing, going along with what they are instructed to do regardless of what is correct and according to law and medical ethics and they are in breach of their own code of conduct.  Already restrictively detained under s3 MHA , Elizabeth is excessively deprived of any kind of liberty whatsoever, treated like a object not a person. It should be the least restrictive care under MHA but under LPFT, detention is more like what you would expect a restricted prisoner to have and no one seems to care less or to give a thought as to how they would feel if they were treated in this most degrading and undignified manner as Elizabeth is:

“It is no longer adequate for a medical practitioner to invoke the opinions of colleagues as authority for a decision. That mechanism known from the case of Bolam v. Friern Hospital Committee [1957] WLR 582

There is very strict policy as regards takeaways and Elizabeth loves Saturdays on the ward when patients are allowed to order a takeaway.  Whilst I would agree that takeaways are not good on a daily basis, there have been occasions where Elizabeth has been so tired she has missed all her meals and been in bed most of the day.  This is because of the huge amount of drugs prescribed have taken away every bit of quality of life leaving her with no energy and nothing but tiredness. I have drawn to attention of staff that missing meals is very bad and can affect behaviour but any sign of hostility is met with punishment and deprival of ground leave like one nurse did.  Even though she was instructed, she still went along with it and this is surely not part of her role to dish out punishment, therefore she is acting ultra vires.  On another occasion when without warning I was banned we thought we were going to the Carlton Shopping Centre but this was cancelled on the spur of the moment without warning by the RC of Castle Ward and Elizabeth was visibly upset. I had promised a meal for her and brought food to the ward and was told by a nurse that it was not permitted and to take that away along with gifts a friend brought.  It was totally undignified as Elizabeth was looking through a slit in the glass door and could see we had arrived and we were told to leave the premises and that it was an Executive decision.  I was told to get away from the door by another nurse as it was upsetting to Elizabeth. Again acting upon orders by banning a visitor to see a vulnerable patient who was excited and expecting our visit in her non existent life and these nurses stood in the way in the course of doing their job yet they acted ultra vires. It is not part of their job to ban visitors and then say it is an MDT or an Executive Decision not theirs when in fact they are the ones acting against their own Code of Conduct and even Trust Policy states about dignified care. Their actions along with the other nurse was totally undignified and degrading.

DENYING FOOD PARCELS AND TO ORDER FOOD FROM OUTSIDE 

L v Board of State Hospital [2011] CSOH 21; 2011 SLT 233

The hospital had been ultra vires in denying patients the right to have food parcels and to order food from outside.

Whilst I agree ordering of takeaways every single day is not good or healthy but neither is missing meal times and there should always be exceptions but such is the environment, more restrictive than any prison this verges on abuse.

House of Commons House of Lords

Joint Committee on Human Rights

Protecting human rights in care settings

Fourth Report of Session 2022–23

Report, together with formal minutes relating to the report

Ordered by the House of Commons to be printed 13 July 2022

Ordered by the House of Lords to be printed 13 July 2022

HC 216 HL Paper 51

Published on 22 July 2022

by authority of the House of Commons and the House of Lords

This is a very interesting paper to read.

Joint Committee on Human Rights

The Joint Committee on Human Rights is appointed by the House of Lords and the House of Commons to consider matters relating to human rights in the United Kingdom (but excluding consideration of individual cases); proposals for remedial orders, draft remedial orders and remedial orders.

The Joint Committee has a maximum of six Members appointed by each House, of whom the quorum for any formal proceedings is two from each House.

Current membership

House of Commons

Harriet Harman QC MP (Labour, Camberwell and Peckham) (Chair)

Joanna Cherry QC MP (Scottish National Party, Edinburgh South West)

Florence Eshalomi MP (Labour, Vauxhall)

Angela Richardson MP (Conservative, Guildford)

Dean Russell MP (Conservative, Watford)

David Simmonds MP (Conservative, Ruislip, Northwood and Pinner)

House of Lords

Baroness Chisholm of Owlpen (Conservative)

Lord Dubs (Labour)

Lord Henley (Conservative)

Baroness Ludford (Liberal Democrat)

Baroness Massey of Darwen (Labour)

Lord Singh of Wimbledon (Crossbench)

“We were also concerned to hear about ongoing issues with Deprivation of Liberty Safeguards (DoLS), the check that is put in place to ensure that detention in care settings is within the law and in line with the prohibition of torture and inhuman or degrading treatment under Article 3 ECHR, and the right to liberty and security, under Article 5 ECHR. There are often unacceptable delays in authorisation of DoLS and there is often no access to legal aid if care users wish to challenge their deprivation of liberty in court. Whilst the DoLS system is going to be replaced by a new Liberty Protection Safeguards System (LPS), there is no timetable for this to be rolled out. We ask that the Government must work with the regulator and all stakeholders to ensure that providers fully understand the functioning DoLS and comply with statutory requirements, and that access to legal aid for those who wish to challenge is widened. The Government should also set a timetable for rollout of the LPS system and keep us updated on progress.

We have reported before on the visiting arrangements for those in care settings during the pandemic. Evidence submitted to this inquiry showed that through and beyond the pandemic problems persisted with providers following guidance. We also believe a lesson learnt from the pandemic was the harm caused by blanket bans on visiting. We have called in the past for the Government to legislate and do so again here. The Government must introduce legislation to secure to care users the right to nominate one or more individuals to visit and to provide support or care in all circumstances, subject to the same infection prevention and control rules as care staff. The Government must also legislate to give the CQC the power to require care settings to inform them of any changes to their visiting status, and to report live data on levels of visiting and restrictions. The CQC must make compliance with visiting restrictions a key consideration when undertaking its regulatory and monitoring roles.

Under the HRA, public authorities must act compatibly with ECHR rights. Those providing care services in care settings, however, are not all public authorities. Unless care legislation, such as the Care Act 2014, contract law, or consumer standards provide equivalent protections, there is no way for privately funded individuals in private care settings to enforce human rights on the same basis as for those in publicly funded care settings. This can mean that two residents in the same care home might have different legally enforceable rights. We recommend that the Government should consult on extending the protections of the HRA to those receiving care and support from all regulated providers, and suggest a way this could be done through an amendment of the Care Act 2014.

When something goes wrong, the users of a service should have access to an effective complaints mechanism that is capable of investigating those complaints, and putting things right, in a way that is transparent, fair, and proportionate. However, the complaints system for care users is confusing, time consuming and too often does not result in effective resolution. The system needs to become easier to navigate. Care users must not be frightened of retribution if they complain. We recommend changes to streamline the process, with the roles of the CQC, the Local Government and Social Care Ombudsman (LGSCO), and the Parliamentary and Health Service Ombudsman (PHSO) clarified and with all three organisations operating a “no wrong door policy”.

The right to life (Article 2 ECHR, Article 10 CRPD).

• Freedom from torture and inhuman or degrading treatment or punishment (Article 3 ECHR; Article 15 CRPD).

• The right to liberty and security (Article 5 ECHR; Article 14 CRPD).

• The right to family and private life (Article 8 ECHR; Articles 22 and 23 CRPD).

• Freedom from discrimination in the enjoyment of human rights (Article 14 ECHR; Article 5 CRPD).

• The right to the highest attainable standard of health (Article 12 International Covenant on Economic, Social and Cultural Rights (ICESCR); Article 25 CRPD).

ARTICLE 3 DEGRADING TREATMENT WHICH APPLIES TO ELIZABETH WHO IS HAVING FORCED INJECTIONS VIRTUALLY ON A DAILY BASIS.

ARTICLE 3 HRA

The failure to give her appropriate treatment for a condition she has been diagnosed as having creates a situation where she is subjected to inhumane and degrading treatment.  Elizabeth has complex PTSD which is totally ignored by LPFT along with her physical health.

Constant Restraint and frequent RT is in breach of Art 3.

Deprivation of family rights is a consequence of this.  They say she is dangerous but have done nothing to address that, apart from to subject her to close surveillance at all times. Elizabeth likes animals and adores her cat and pigeons. She is totally misunderstood by these professionals and I would say her treatment at times has been that of cruelty and abuse.  

This is in violation of her rights under Art.3 ECHR and represents inhumane and degrading treatment as in  Sławomir Musiał  v.Poland (2009) & Raffray Taddei v. France (2010)

 Incidentally the ECHR has ruled that whatever obstacles the patient may have put in front of the treatment team that did not dispense the state from its obligations to protect their human right to being protected from inhumane and degrading treatment, Claes v. Belgium (2013).  

Right to take legal proceedings, ECHR Article 5(4) Storck v. Germany (Application No 61603/00), 16 June 2005.

Article 5(3), which deals with the rights of a person who has been detained.

“Everyone arrested or detained in accordance with the provisions of paragraph 1(c) of this article shall be brought promptly before a judge or other officer authorised by law to exercise judicial power and shall be entitled to trial within a reasonable time or to release pending trial. . . .”

The difference between a right to “take proceedings” and a right to “be brought promptly before a [court]” must be deliberate. It stops short of requiring judicial authorisation in every case. 

It leaves to the person detained the choice of whether or not to put the matter before a court. MH (by her litigation friend, Official Solicitor) (FC) (Respondent) v. Secretary of State for the Department of Health (Appellant) and others.

DENYING VISITS IN HOSPITALS ETC

Visiting Report December 2023

https://www.gov.uk/government/consultations/visiting-in-care-homes-hospitals-and-hospices/outcome/government-response-to-the-consultation-on-visiting-in-care-homes-hospitals-and-hospices

DISCRIMINATION

Equality Act 2010: guidance – GOV.UK

https://www.gov.uk/guidance/equality-act-2010-guidance

Code of Conduct from the Nursing Midwifery Council and would comment on one or two points here:

1 Treat people as individuals and uphold their dignity To achieve this, you must:

1.1 treat people with kindness, respect and compassion

1.5 respect and uphold people’s human rights

3.4 act as an advocate for the vulnerable, challenging poor practice and discriminatory attitudes and behaviour relating to their care

4.4 tell colleagues, your manager and the person receiving care if you have a conscientious objection to a particular procedure and arrange for a suitably qualified colleague to take over responsibility for that person’s care

iv) A person is not to be treated as unable to make a decision merely because he or she makes a decision that is unwise (see Heart of England NHS Foundation Trust v JB [2014] EWHC 342 (COP)at [7]). The outcome of the decision made is not relevant to the question of whether the person taking the decision has capacity for the purposes of the Mental Capacity Act 2005 (see R v Cooper [2009] 1 WLR 1786at [13] and York City Council v C [2014] 2 WLR 1 at [53] and [54]);[2]

Masterman-Lister v Brutton & Co 2003

The leading case is Masterman-Lister v Brutton& Co [2003] 3 All ER 162 in which Lord Justice Chadwick stated at paragraph 75: the test to be applied….is whether the party to legal proceedings is capable of understanding, with the assistance of such proper explanation from legal advisors and experts in other disciplines as the case may require, the issues on which his consent or decision is likely to be necessary in the course of those proceedings. If he has capacity to understand that which he needs to understand in order to pursue or defend a claim, I can see no reason why the law – whether substantive or procedural – should require the imposition of … a litigation friend and at paragraph 79: a person should not be held unable to understand the information relevant to a decision if he can understand an explanation of that information in broad terms and simple language; and … he should not be regarded as unable to make a rational decision merely because the decision which he does in fact make is a decision which would not be made by a person of ordinary prudence. The Court of Appeal re-considered the Masterman-Lister test in Bailey v Warren [2006] EWCA Civ 51. At paragraph 126 of her judgment Lady Justice Arden concluded: The assessment of capacity to conduct proceedings depends to some extent on the nature of the proceedings in contemplation. I can only indicate some of the matters to be considered in accessing a client’s capacity. The client would need to understand how the proceedings were to be funded. He would need to know about the chances of not succeeding and about the risk of an adverse order as to costs. He would need to have capacity to make the sort of decisions that arise in litigation. Capacity to conduct such proceedings would include the capacity to give proper instructions for and to approve the particulars of claim, and to approve a compromise. For a client to have capacity to approve a compromise, he would need insight into the compromise, an ability to instruct his solicitors to advise him on it, and an understanding of their advice and an ability to weigh their advice Capacity to conduct proceedings was further considered by the Supreme Court in the post-MCA case of Dunhill v Burgin (Nos 1 and 2) [2014] UKSC 18. At paragraph 13 of her judgment Lady Hale noted: The general approach of the common law, now confirmed in the Mental Capacity Act 2005, is that capacity is to be judged in relation to the decision or activity in question and not globally. Hence it was concluded in Masterman-Lister that capacity for this purpose meant capacity to conduct the proceedings (which might be different from capacity to administer a large award resulting from the proceedings). This was also the test adopted by the majority of the Court of Appeal in Bailey v Warren[2006] EWCA Civ 51, [2006] CP Rep 26, where Arden LJ specifically related it to the capacity to commence the proceedings (para 112). It would have been open to the parties in this court to challenge

that test, based as it was mainly upon first instance decisions in relation to litigation and the general principle that capacity is issue specific, but neither has done so. In my view, the Court of Appeal reached the correct conclusion on this point in Masterman-Lister and there is no need for us to repeat the reasoning which is fully set out in the judgment of Chadwick LJ.

Subject: Guidelines on Restricting Hospital Visits

Visits from friends and relatives are considered crucial in the recovery and welfare of patients and research carried out on the severe restrictions imposed during the Covid pandemic indicates a clear detrimental effect on patients who missed visits from loved ones and friends. The impact on visitors has also resulted in an increased incidence of depression and anxiety being recorded. Elizabeth had once enjoyed my visits and especially on just one occasion the two hour leave unescorted at the Carlton Centre just around the corner from the hospital.  

Excluding or restricting visits should therefore be imposed only in exceptional circumstances where there are reasonable ground for believing that a visitor may have a detrimental effect on the patients therapy. I have been told I am indefinitely banned by the RC but in order to do that surely an application should have been made by LPFT to the Court of Protection to get rid of me for good.  What they are doing is very wrong.

A decision to exclude visitors on the grounds of his or her behaviour or propensities must be fully documented and explained to the patient and where possible the appropriate person concerned.  In the case of psychiatric patients the nearest relative should be informed of any visitor exclusions and supervision decision and if it is they who are excluded or supervised an explanation in writing is to be provided to them. Nothing has been done properly.  The nearest relative who I became nearest relative to has most certainly not been informed and no proper explanation has been given other than I am said by the RC to be a “bad influence”.  I am even said to be partly the cause of the episodes that look like fits but most of these have taken place when I have not been around.  The real reason is that they want to send her far away from home and family and cut contact altogether and they are doing this by isolating Elizabeth from her family already.

A visitor may be excluded or restricted to visits under supervision if the visit is considered to be anti-therapeutic (in the short or long term) to an extent that a discernible arrest of progress or even deterioration of the patient’s mental state is evident or can reasonably be anticipated if contact is not restricted.   It is the MDT of so many, none of whom take individual responsibility who do not want me to visit and why?    It has been said “why do you think Everyone ….……..   everyone agrees with his decision, everyone of practically 30 who are invited to MDT meetings agree and every one of them going along with EXECUTIVE decision made by one or two who do not want me on the premises because they do not want information shared. That is the real reason.

An impact assessment should be carried out in consultation with the patient to assess the impact of any denial or restriction of visits on the patient’s welfare.  Where a patient lacks capacity or is impaired as to their capacity an assessment by a suitably qualified best interests assessor should be carried out to assess any negative impact that denial or restriction of visits may have on the patient.   

Here is the impact these professionals are having on my daughter as stated on Xmas Day  “I no longer wish to live”.   This is the effect of the so called “care” by LPFT rated good by the CQC.   It is the worse experience we have ever encountered.

CLINICAL CARE LPFT TRUST POLICY DOCUMENT

8. Admission to Hospital/Keeping an individual in hospital

8.1 Policy Statement Care in a residential or hospital setting should be provided at the lowest level of security and restriction based on an individualised assessment of need, risk and capacity. Alternatives to residential or hospital care such as home treatment and crisis intervention should be considered as a less restrictive alternative to hospital admission where possible.

8.2 Consent to Admission to Hospital/Keeping Someone in Hospital If the individual has the capacity to decide whether to come into hospital or remain in hospital, then informed consent should be sought in all cases. This means that the individual is given information about the environment, routine and purpose of the inpatient setting / admission. If the individual does not consent, then consideration should be given to assessment and admission under the Mental Health Act (MHA) see MHA Policy 6a. If the individual does not have capacity to consent to hospital admission, then the MHA should be considered or the Mental Capacity Act (MCA) utilised as per Policy 6b. Any restrictions should have an accompanying care plan.

 Examples of restrictions include: • Ability to leave the ward (should remain on ward for first 24 hours minimum).

 • Contact with others

• Movements within ward

• Privacy

• Discharge

• Day to day activities

• Personal care

 If an individual lacks the capacity to consent to admission and the admission is completed using the best interest framework then this should be recorded as per policy 6b and an urgent authorisation for a Deprivation of Liberty should be submitted to the Supervisory Body as per the MCA Policy 6b.   After 2.5 years held like a restricted prisoner with no respect towards family with one goal and that is to send away – far away from home and family.  Best Interest is theirs not my daughter’s and every single capacity assessment is flawed.   “Go away my Mum is the NR”   “I am not going to engage”   –  It was their wish to get rid of me as NR only for me to become NR again lol!

Advocacy should be considered and advised to the patients / carers as appropriate upon admission and discharge.   

8.3 Consent to Admission for Under 16s’ (Also refer to Chapter 18 (18.3) of the clinical care policy)

Section 131A of the Mental Health Act (1983) requires hospital managers to ensure that patients age 18 or under are admitted to an environment suitable for their age (subject to their need). This duty applies to both detained and informal patients. It is not an absolute prohibition on the admission of such patients. If the young person is deemed competent (Gillick Competency or Fraser Guidelines) and consents to admission it can proceed. Parents and guardians should be kept informed (see chapter 13 of Clinical Care Policy).   Total breach of MHA and its Code of Conduct 11:14-11:16.

Where the young person objects to information being shared with a parent or guardian who has parental responsibility then further advice should be sought from the Trust’s safeguarding or legal team.   Elizabeth is sharing information such as the assessment that took place for a care home a very long distance away from home.

In cases of a dispute, priority should be given to the ‘parent’ with whom the young person lives or to the court involved. Advice should always be sought from the Trust’s legal team where there is dispute or a lack of clarity.     Nothing but court after court and investigation after investigation since I have moved.

Information should be provided to the patient and appropriate family/carers about visiting times, mealtimes, school hours etc.      Was told I could only visit evenings but Elizabeth told me other parents were visiting during the day.  Now I am completely banned.

8.7 Visitors to LPFT Premises LPFT considers the safety and dignity of all visitors to its premises as extremely important. The link below provides guidance and procedures regarding the management of all visitors to Trust premises and includes process for managing visits by children: Please refer to visitors process within safeguarding policy 11  What they have not done is offer any alternative.  If you ban someone from visiting there should be alternative arrangements

In November 2006 the Department of Health launched a ‘Dignity in Care’ campaign with an aim to put dignity and respect at the heart of care services, which extended into Mental health Services in 2007; and is now applicable in all health and social care settings. This campaign, led by the National Dignity Council, identified a 10 point Dignity Challenge to organisations which remains fully applicable today as follows:

1. A zero tolerance to all forms of abuse

2. Supporting people with the same respect you would want for yourself or a member of your family

3. Treat each person as an individual by offering a personalised service

4. Enable people to maintain the maximum possible level of independence, choice and control

5. Listen and support people to express their needs and wants

 6. Respect people’s right to privacy

7. Ensure people feel able to complain without fear of retribution

8. Engage with family members and carers as care partners

9. Assist people to maintain confidence and a positive

10. Act to alleviate people’s loneliness and isolation.

9.2 Purpose and scope of this policy 9.2.1 To provide clear information to workers, enabling them to provide care and treatment that respects and maintains patients (service users) rights to privacy and dignity.

9.4 Privacy and Dignity

9.4.1 Privacy refers to freedom from intrusion and relates to all information and practice that is personal or sensitive in nature to an individual.

9.4.2 Dignity refers to how people feel, think and behave in relation to the worth or value of themselves and others. To treat someone with dignity is to treat them as being of worth, in a way that is respectful of them as a valued individual. In care situations, dignity may be promoted or diminished by the physical environment, the organisational culture, by the attitudes and behaviour of the care team and others; and by the way in which activities are carried out. Dignity applies equally to those service users (patients) who have capacity and to those who lack capacity.

9.4.3 Maintaining a service user’s (patient’s) privacy, dignity and respect is central to the delivery of effective health and social care, working in partnership with service users (patients) and where appropriate their carers / families.

9.4.4 Since July 2016 all organisations that provide NHS care or adult social care are legally required to follow the Accessible Information Standard. Meeting the standard requires workers across the Trust to ensure people who have a disability, impairment or sensory loss are provided with information that they can easily read or understand with support, so they can communicate effectively with health and social care services.   Sensory issues in Elizabeth’s case who cannot stand crowds, noise and bright lights which makes the current environment totally and utterly unsuitable.  She would be better off in a care farm where there are animals, a natural environment but the MDT and commissioners do not see it that way.

9.4.5 The following are examples of how to maintain a service user’s (patient’s) privacy and dignity:

Always ask a service user (patient) which name or title they prefer to be addressed by; and ensure all staff respect the service user’s (patient’s) expressed wishes.

• Ensure the Accessible Information Standard is consistently applied so all patients (service users) and carers where appropriate, are able to effectively access Trust (LPFT) services.

• Ask a patient (service user) if they wish their carer to leave for specific conversations or procedures which may compromise their privacy or dignity.

• Maintain a patient’s privacy when asking or assisting them to dress or undress.

• Close curtains or screens in areas where patients are expected to undress.

• Close observation windows in bedroom doors unless they are being used for observation at that time.

• Obtain informed consent before undertaking examinations or treatments.

• Ensure privacy and confirm the boundaries of confidentiality when discussing any confidential and sensitive issues such as diagnosis, symptomatology, sexual orientation and gender identity.

 • Respect privacy and dignity at all times, such as during the delivery of personal care, when undertaking all observational duties, when entering treatment rooms, single sex rooms or bedroom areas, toilets and bathrooms.    And do not give prone restraint by several men!

• Always knock or make your entry clear through announcing entry and waiting for a reply before entering* (* except where there is a clinical or care rationale not to do so, which includes during night periods when service users (patients) are sleeping).

• Don’t discuss worker or patient personal information with co-workers whilst carrying out care or within hearing distance of service users (patients), carers and visitors.

• Ensure a service user’s (patient) choice is adhered to in respect of the gender of the staff member carrying out intimate care, such as assisting with washing or undressing.

Ensure reasonable adjustments are made to support a service user (patient) to function at their highest level possible. This may include ensuring a service user (patient) receives timely assessments, such as by a Physiotherapist or Occupational Therapist, and that related prescribed care and / or equipment is provided in a timely manner.

9.9.1 Board of Directors The Board of Directors are responsible for the Trust having policies and procedures in place which meet national and local requirements and / or legislation in order to provide a service which is based on best practice. The lead Director responsible for this policy is the Director of Nursing and Quality   Quite frankly what is the point of a Policy when no one takes any notice of it.   LPFT would do well to consider OPEN DIALOGUE.

9.9.2 Divisional Managers, Quality Assurance Leads and Team Leaders for in-patient services Divisional Managers, Quality Assurance Leads and Team Leaders for in-patient services are responsible for:

• Monitoring compliance with this policy

 • Ensuring timely reporting of any non-compliance of this policy through the DATIX incident reporting system.

• Investigating any reported non-compliance with this policy

• Implementing any actions required following audits, incidents or patient / carer / worker feedback relating to Privacy, dignity and mixed sex accommodation. This may include individual worker development where there is evidence of failure in respect of related practice.

9.9.3 In-patient Ward / Unit Managers and their Deputies In-patient Ward / Unit Managers and their Deputies are responsible for:

• Ensuring workers are aware of this policy, its content, where to access it; and their individual related responsibilities.

 • Ensuring timely reporting of any non-compliance of this policy through the DATIX incident reporting system.

• Ensuring timely recording in the service user (patient) record of the date, time and reason for the breach occurring.

• Ensuring service user/s (patient/s) and their carers (where appropriate) receive an apology and an explanation of the reason for the breach.    

• Ensuring patient safety is maintained during the period of the breach.

• Ensuring risk assessment/s, care plan/s and observation level/s are closely monitored and reviewed during the period of the breach.

• Ensuring timely escalation within service management structure where support or resource is required to ensure patient safety during the period of the breach.

• Investigating any reported non-compliance with this policy, including taking corrective action to prevent any recurrence.

9.9.4 All workers All workers are responsible for:

 • Actively promoting the service user’s (patient’s) privacy and dignity at all times.

 • Ensuring that all service users (patients) are cared for with privacy, dignity, and in single sex accommodation (as defined within Section 8.5 of this policy). Page 28 of 642

 • Ensuring they are aware of their role to support privacy and dignity including when carrying out practice such as observational work.

• Timely reporting of any breaches of this policy, including those reported to them by service users (patients), carers or other workers through the DATIX incident reporting system.

Associated Documentation

 1. NHS 13-14 Standard Contract

2. PL/CNO/2010/3, Professional Letter, Department of Health

3. DSSA Principles, September 2009, Department of Health, Gateway Reference: 12610

4. DSSA in Mental Health and Learning Disabilities, December 2009, Department of Health, Gateway Reference: 12940 5. Assessment of Same Sex Accommodation. Brief Guide for Inspection Teams (CQC 2015). 6. Accessible Information Standard Specification (NHSE 2015).

Staff must be mindful of the impact of mental health conditions on the wider family and support network, not just identified carers and next of kin, ensuring that information is shared as appropriate and wider family members are given the opportunity to seek advice, information and express any concerns they may have. Although it is recognised that the sharing of information may sometimes be difficult, it is crucial to the ongoing wellbeing of both the service users and their carers.

Staff must acknowledge that the carer is frequently the person who knows the service user best, often having regular contact over many years throughout many changes in mental health well-being, social networks and professional support.  Not recognised one bit.

The carer is often the person who has to offer support during out-of-hours crises, which can be stressful. By involving the carer in the development of the care plan and crisis plan where appropriate, or ensuring they have a copy of it, the carer can feel supported in assisting the service user to follow it.

Some service users will have entitlement to Section 117 after-care. The elements of the care plan which are provided under this entitlement must be clearly and separately articulated (see Mental Health Act Policy 6a) Help and guidance on assessment and care planning processes can be obtained from the Team Coordinator – Assessment & Care Planning. Application of the Care Programme Approach – CPA Whilst the expression Care Programme Approach was first introduced in mental health services in 1991, since the publication of Refocusing the Care Programme Approach (DoH 2008) the term Care Programme Approach is now specifically used to describe the approach used in secondary mental health care to assess, plan, review and coordinate the range of treatment and support needs for people in contact with secondary mental health services who have complex characteristics as defined below. CPA care and support must be discussed and agreed with the service user and the practitioners involved in the care. Where there is disagreement within the Multi-Disciplinary Team about the level of support from CPA, advice should be sought from relevant clinical leads or managers within the service, such as the Team Leader, Divisional Manager, Quality Lead or Clinical Director. Where there is a disagreement that cannot be resolved, the service user can appeal against the decision

This may be the last blog for some time on my part. What I would like to see is choice and there is none. There is no care in the community and we live in a District where provision is poor although there is a wonderful charitable sector and a lovely community. This would have all benefitted Elizabeth greatly. Like so many other parents and carers I have turned to social media but now I can see I could be doing this for the rest of my life and getting nowhere whatsoever. I am now taking a different route as there is no more choice and also I am one of many affected. It is not right or fair for parents to have to fight fo their sons and daughter’s because of organisational abuse by powerful public bodies.