Lack of supervision enabled support worker to steal from woman with dementia

Absence of oversight and supervision in integrated health and care team allowed support worker to steal from woman with dementia

Hertfordshire council
Hertfordshire council offices. Photo: Gary Brigden

A lack of supervision and oversight within a specialist dementia care team enabled a support worker to steal from a service user, a Local Government and Social Care Ombudsman investigation has concluded.

The ombudsman’s investigation found both Hertfordshire Partnership University NHS Foundation Trust and Hertfordshire County Council had been at fault in their handling of the case Ms D, an elderly woman with Alzheimer’s disease who lived alone.

Between 2010 and 2012 Ms D’s care was overseen by the NHS trust’s Specialist Mental Health Team for Older People, an integrated health and social care team that employed the domiciliary support worker who stole from her.

In August 2010 Ms D’s bank manager raised concerns that she was vulnerable to financial abuse, leading to an assessment by a council social worker that concluded she lacked mental capacity.

Court of Protection

The council subsequently applied to the Court of Protection to become Ms D’s deputy and asked the bank to restrict her account so she could only withdraw money if accompanied by her support worker or the social worker.

In November Ms D’s cousin, Ms N, learned of the Court of Protection application and volunteered to become her deputy.

The ombudsman found the council and trust were at fault by not involving or informing Ms N, who visited regularly and was known to carers, of the application.

After being appointed as Ms D’s deputy in 2012, Ms N noticed several suspicious transactions on Ms D’s bank statements. Concerned that the support worker, who had regular unsupervised contact and access to Ms D’s bank card, was responsible, Ms N then notified her new social worker.

Financial abuse

In October 2012 a safeguarding strategy meeting concluded that Ms D had been a victim of financial abuse but there was not enough evidence to identify the thief. The meeting also decided that since Ms D no longer had mental health needs her social worker should end the support worker’s involvement.

The ombudsman found that the social worker failed to notify the NHS trust and so the support worker’s involvement continued putting Ms D at continued risk of abuse.

However, the ombudsman also noted that the social worker did take steps to reduce Ms D’s risk of financial abuse and had identified that since Ms N had lasting power of attorney, the risk to Ms D was reduced.

In December 2012, a professionals meeting heard that some of the suspicious transactions related to equestrian supplies and that Ms D’s support worker owned a horse.

The police were informed and in January 2013 an investigation was launched and the support worker suspended by the NHS trust.

‘State of flux’

The support worker was convicted of theft from four service users, including Ms D, in December 2014 after which she was dismissed from the NHS trust and given a 10-month prison sentence.

The ombudsman said the management of the mental health team was in a “state of flux” during the period that the money was stolen and this allowed the support worker to operate with limited management oversight.

It also found that Ms D’s original social worker should have been supervising the support worker’s caseload but was “largely content to delegate responsibility for managing Ms D’s finances” to the support worker.

“It is likely, in my view, that more effective supervision would have identified irregularities in support worker F’s approach and given the trust an opportunity to take action,” the ombudsman concluded. “This was a missed opportunity and represents fault on the part of the trust.”

Dementia service

A Hertfordshire County Council spokesperson said: “We are sorry for the experience that the individual in this case has faced.

“The social care worker in question was employed by Hertfordshire Partnership NHS Foundation Trust not Hertfordshire County Council at the time of the investigation and while the offences were committed.

“Hertfordshire’s involvement began in 2014 when service users with a diagnosis of dementia were transferred over to our adult social care teams.

“As soon as we became aware of the allegations we co-operated fully with the relevant authorities and the trust launched their own independent investigation. We also took part in a joint response to the review by the ombudsman with our partners.

“Following the outcome of the case, we are working with our partners to address the recommendations that are set out in the report. The safeguarding of adults in our care and the care of our partner agencies is of paramount importance to us.”

Increased training

A spokesperson for the NHS trust added: “We have worked with our county council partners to ensure that we have strengthened our processes following the case of Ms N.

“Whilst the actions were isolated to an individual member of staff who sought to defraud, we recognise the need to increase training and awareness of the staff across both organisations to further reduce the likelihood of this reoccurring.”

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