Council’s charging advice is ‘flawed’

Leicestershire Council’s advice to staff on
charging users for mental health aftercare services is
“fundamentally flawed”, according to the local government

The ombudsman’s investigation concerned
£10,000 in nursing home fees claimed by the council from the
estate of Victoria Field (not her real name), who had been in the
council’s care for the two years before her death in 1996. Before
being moved to the nursing home, Field, aged 78, had been sectioned
under the Mental Health Act 1983 after being diagnosed with
dementia and suffering “fixed delusions and paranoia”.

Under section 117 of the act, mental health
aftercare is provided free of charge, but, once specialist mental
health services have been withdrawn, the council is entitled to
charge following consultation with the patient and any carers. The
council decided that Field had been discharged from aftercare
shortly after entering the nursing home in 1994, but it did not
make this decision until after she died in 1996.

“These two statements seem to me
incompatible,” said the ombudsman in his report. “I understand why
the council will want to determine retrospectively a date when
aftercare stopped. But I do not believe that the council can do so
in the absence of the consultation that government guidance
requires, and I conclude therefore that its current advice to its
staff is fundamentally flawed.”

The ombudsman said the issue of the aftercare
costs themselves would have to await the outcome of an appeal to
the House of Lords of a 1999 appeal court case, which had ruled
charges may not be made for aftercare services, including

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