Summary: Mr B has complained about a supported living placement funded by the Council and Integrated Care Board. We will not investigate this complaint as it would be unlikely that we would find fault with either organisation.

The complaint

1. Mr B complained about a placement (the Placement) which was funded under Section 117 of the Mental Health Act by Worcestershire County Council (the Council) and Integrated Care Board (the ICB).
2. Specifically, Mr B stated he was not made aware by the Council or the Placement that they expected him to attend every support session held. He feels this was contrary to a previous commitment by them to provide him with independence.
3. Mr B said this meant he had his freedoms restricted. In addition, the Placement threatened him with eviction which caused effected his psychological wellbeing and left him suicidal. He felt forced to move out of the placement and now lacks support.
4. Mr B would like an apology from whoever was responsible for the harm he has suffered.

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The Ombudsmen’s role and powers

5. We have the power to jointly consider complaints about health and social care. Since April 2015 a single team has considered these complaints acting for both Ombudsmen. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA)
6. The Ombudsmen provide a free service, but must use public money carefully. They may decide not to start or continue with an investigation if they believe:

• it is unlikely they would find fault, or

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

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How I considered this complaint

7. I considered information provided by Mr B, the Council and the Placement.
8. I considered the Ombudsman’s Assessment Code.
9. Mr B provided comments on my draft decision. I considered his comments before making this final decision.

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My assessment

Background

Section 117 of the Mental Health Act

10. Anyone who may have a need for community care services is entitled to a social care assessment when they are discharged from hospital to establish what services they might need. Section 117 of the Mental Health Act imposes a duty on health and social services to meet the health/social care needs arising from or related to the person’s mental disorder for patients who have been detained under specific sections of the Mental Health Act (e.g. Section 3).
11. Aftercare services provided in relation to the person’s mental disorder under Section 117 cannot be charged for. This is known as Section 117 aftercare.
12. Section 117 aftercare services must:
• meet a need arising from or related to the mental disorder for which the person was detained; and
• have the purpose of reducing the risk of the person’s mental condition worsening and the person returning to hospital for treatment for the mental disorder.
13. The “Mental Health Act 1983: Code of Practice” (the Code) is statutory guidance. This means that councils and ICBs must follow it, unless there are good reasons not to. The Code says that section 117 aftercare can include accommodation and continues as long as the person needs these services. Accommodation can generally only be part of section 117 aftercare if:
• the need is for enhanced specialised accommodation (“accommodation plus”);
• the need for the accommodation arises from, or is related to, the reason the person was detained in the first place (“the original condition”); and
• the “accommodation plus” reduces the risk of the person’s mental health condition worsening and the likelihood of the person returning to hospital for treatment for mental disorder.
14. Mr B moved into his supported living placement several years ago with a support package funded by the Council and ICB under Section 117 of the Mental Health Act. From last year it was run by a charity which provides social housing and support.
15. Mr B agreed to 11 hours one to one support a week with Placement support workers.
16. However, Mr B expressed dissatisfaction with this arrangement. He said that he was not told that he could not miss any of these hours. In addition, he said that he was left with very little independence.
17. Mr B said his diagnosis meant he had difficulty bonding with people and wanted the Placement to provide support workers who he was comfortable with.
18. The Placement said it had been accommodating in providing alternative support workers to find those who Mr B could build relationships with, but there were a limited number of them.
19. The Placement said its support service was modelled and funded on residents engaged with the required 11 hours support each week.
20. It said Mr B could decline the support package. However, his place was dependent on him engaging with the support offered. If he did not engage fully with the support then he would be able to go on living there, and funding would cease.
21. The Placement explained Mr B was using the accommodation without the offered support, it meant other people could not access such a support package.
22. The Placement said it understood that Mr B had lived there for several years, and it felt like home. However, it was never intended to be a permanent home. The Placement said the accommodation and support package was meant to last a maximum of two years.
23. It went on to say if Mr B’s support needs had changed from those he had when he signed an agreement with them, it would support him to find alternative accommodation where he could access the level of support needed.
24. In addition, the Placement said if he no longer required this support it would have to serve an eviction notice which would give him a minimum of two months before he had to leave.
25. Mr B subsequently left the Placement and now lives on his own in a flat without a support package. He said he lacks friends and support in this area.

Analysis

26. I understand the distress caused by the Placement to Mr B by essentially threatening him with eviction and it could have chosen a gentler tone in its correspondence with him.
27. However, the Placement was ultimately correct; if he did not meet the criteria of the support package, he was no longer eligible for it. It seems Mr B found the amount of hours and the support workers provided unsuitable. The Placement also tried to be flexible in providing Mr B with different support workers, but it is the case that there will be a limited number of suitable qualified workers to call upon to support Mr B.
28. Therefore, we will not investigate this complaint as, even if we investigated the Placement’s threat of eviction, it would be unlikely we would find its actions so unreasonable as to constitute fault on its part.

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Final decision

29. We will not investigate this complaint as we would be unlikely to find fault with the Placement.

Investigator’s decision on behalf of the Ombudsmen

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Investigator's decision on behalf of the Ombudsman