Summary: Mr B complained about the assessment and decision to detain him under the Mental Health Act, and the care provided in hospital. We will not investigate Mr B’s complaint about the decision to detain him under the Mental Health Act, as he has previously appealed this decision at the mental health tribunal. We will not investigate Mr B’s complaint about the care he received while he was staying on the hospital ward, as it is unlikely an investigation would add to the response Mr B has already received from the Trust.

The complaint

1. Mr B complains about an assessment under the Mental Health Act by Islington Council (the Council) and Camden and Islington NHS Foundation Trust (the Trust). Mr B complains he should not have been detained under the Mental Health Act and that his human rights were breached as a result. Mr B also complains about the care and treatment he received on the hospital ward, including a lack of support with applying to the tribunal, staff not listening to him when he raised his concerns, not being given food and drinks, poor facilities on the ward, and disturbance from other patients.
2. Mr B said these events caused him anger and upset, and have had a long-lasting impact on him.
3. In bringing his complaint to the Ombudsmen, Mr B would like the Trust to acknowledge failings in his care, and to hold a meeting with him to discuss his concerns.

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The Ombudsmen’s role and powers

4. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
5. The Local Government and Social Care Ombudsman investigates complaints about adult social care providers. (Local Government Act 1974, sections 34B, and 34C, as amended). The Health Service Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’ in the delivery of health services (Health Service Commissioners Act 1993, section 3(1)).
6. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• it is unlikely we could add to any previous investigation by the bodies, or
• we cannot achieve the outcome someone wants.

(Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

7. The law says we cannot normally investigate a complaint when someone can appeal to a tribunal. However, we may decide to investigate if we consider it would be unreasonable to expect the person to appeal. (Local Government Act 1974, section 26(6)(a), as amended and Health Service Commissioners Act 1993, section 4(1)(a))

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How I considered this complaint

8. During my assessment of Mr B’s complaint, I considered information from Mr B and the Trust.
9. Mr B had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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My assessment

10. As Mr B has complained about both the Mental Health Act assessment, and the care provided in hospital, I have set these out under separate headings, below.

Mental Health Act assessment

11. Under the Mental Health Act 1983 (MHA), when someone has a mental disorder and is putting their safety or someone else’s at risk they can be detained in hospital against their wishes. This is sometimes known as ‘being sectioned’. Usually, three professionals need to agree that the person needs to be detained in hospital. These are either an Approved Mental Health Professional (AMHP) or the nearest relative, plus a doctor who has been specially approved in Mental Health Act detentions and another doctor (Section 12 doctors).
12. The AMHP is responsible for deciding whether to go ahead with the application to detain the person and for telling the person and their nearest relative about this. Local authorities are responsible for the actions of AMHPs.
13. People who have been detained under the MHA can apply for a hearing to the First Tier Tribunal (Mental Health) if they disagree with the decision. The Tribunal must discharge the person from detention if, on the day of the hearing, the person does not meet the criteria for detention.
14. Mr B was assessed under the MHA and was detained under Section 2 of the MHA. The purpose of detention under Section 2 of the MHA is for assessment of a patient’s mental health and to provide any treatment they might need. Patients can be detained under Section 2 for a maximum of 28 days.
15. Regarding the decision to detain Mr B under the Mental Health Act, Mr B had a right to appeal the decision at the Tribunal. Mr B lodged an appeal to the Tribunal, and the Tribunal decided Mr B should be discharged from Section 2. Mr B then left the ward the following day.
16. As Mr B used his right to appeal, we cannot investigate his complaint about the decision to detain him under the MHA. The appeal was the most appropriate way for Mr B to challenge this decision.

Care provided in hospital

17. Mr B also raised concerns about the treatment and care he received while he was in hospital, initially at the Mental Health Crisis Assessment Service and then during his stay on the ward. Both services are managed by the Trust.
18. Specifically, Mr B complained the Trust failed to support him to apply to the tribunal, and that staff did not listen to him when he raised concerns about his treatment. The Trust said Mr B was informed of his right to appeal but acknowledged there was a delay in submitting his paperwork to the tribunal. The Trust response said since Mr B’s complaint, it has taken steps to improve services by recruiting a ward manager who also oversees staff training on procedures, ensuring this training includes agency staff. Mr B has said he does not consider this is sufficient. However, as the Trust has apologised to Mr B and put measures in place to improve services, it is unlikely an investigation could add anything further for Mr B on this point.
19. Regarding Mr B’s complaint that staff did not listen to him when he raised his concerns about his treatment, the Trust said his concerns about medication were noted at the time. However, the Trust acknowledged it could have discussed Mr B’s concerns with him in more detail. The Trust apologised to Mr B for this, and said that following Mr B’s complaint, the staff involved in these discussions reflected on how they communicated with Mr B. Therefore, it is unlikely we could add to the Trust’s response on this point for Mr B.
20. The Trust also apologised that Mr B did not get any food or drink on the day he was admitted to hospital, and that when he arrived back on the ward after a scan he had missed meal time. The Trust apologised to Mr B for this and said since Mr B’s complaint, it had introduced a system where hot food can be ordered 24 hours a day. My view is that as the Trust has apologised to Mr B and taken steps to improve services, it is unlikely an investigation could add to the response Mr B has received on this point.
21. Regarding being disturbed by other patients on the ward, the Trust acknowledged this was upsetting for Mr B, and apologised for any distress he experienced. It is unlikely an investigation could add to the Trust’s response on this point for Mr B.

Summary

22. I recognise Mr B’s view that these events were upsetting and caused him great distress. We cannot investigate Mr B’s complaint about the decision to detain him under the Mental Health Act, because Mr B has already appealed to the mental health tribunal about the decision. Regarding Mr B’s complaint about care provided on the ward, the Trust has apologised for any distress caused to Mr B, and has put service improvements in place. Therefore, we will not investigate Mr B’s complaint about care provided in hospital, as it is unlikely we could add to the response Mr B has already received from the Trust.

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Final decision

23. We will not investigate Mr B’s complaint, for the reasons set out in the Assessment section, above.

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Investigator's decision on behalf of the Ombudsman