Councils must not regard care programme approach as exhaustive

The Care Programme Approach (‘CPA’) is intended to provide a
means of securing a seamless process of assessment and provision
between health and social service authorities of those with mental
health needs in the community. 

Social services and health authorities have in place joint
procedures and eligibility criteria. 

Social services authorities frequently treat their CPA criteria as
being exhaustive of the duties to assess and meet all community
care needs of those with mental health needs. This is wrong, as
Munby J held in R (HP and KP) v LB Islington.

In that case, ‘HP’ was diagnosed as suffering from reactive
depression and possibly the early stages of dementia. Islington
Council assessed him under the CPA, concluding that he did not meet
the CPA eligibility criteria because he did not have a severe and
enduring mental health problem. On that basis, it was concluded
that he would receive no community care services, and all of his
considerable needs were left to be met by his family.

Mr Justice Munby quashed the assessment. He held that the decision
that HP did not meet the CPA eligibility criteria was not
determinative of whether he nonetheless had a need for generic
community care services. 

The assessment identified that HP was at risk of severe
self-neglect, was vulnerable to deterioration in his mental state
and had a number of pressing needs. 

Islington ought therefore to have produced an assessment
identifying those needs which could potentially be met by the
provision of community care service (the community care needs
assessment), and then to have decided whether those needs called
for the provision of such services (the service provision
decision). 

Kate Markus
Doughty Street Chambers