Woman wins £27,000 payout over care package row between council and NHS

A woman with mental health needs who had both her legs amputated was left with an inappropriate care package for more than a year due to a dispute between a council and an NHS trust over her care needs, an investigation has found.

Sheffield City Council and Sheffield Health and Social Care NHS trust took 14 months to agree how much the woman, referred to as Mrs D, should receive in a personal budget. As a result she used her own savings to fund £14,000 of care that should have come from her personal budget and suffered stress from a “frustrating and prolonged battle” with authorities, the ombudsman found.

Pay out

After a joint investigation, the local government ombudsman and the health ombudsman recommended that the council and NHS trust to pay out a total of £27,000 to the woman in recognition of the damage caused by the delay.

The pay-out included a £14,000 reimbursement for the care costs she funded herself, £12,000 to acknowledge the impact of not having an appropriate personal budget in place and £1,000 to acknowledge the stress, frustation and ‘justifiable outrage’ from having to pursue her complaint.

In a joint statement Moira Wilson, Interim Director of Adult Services at Sheffield City Council, and Kevan Taylor, Chief Executive at Sheffield Health & Social Care NHS Foundation Trust, said: “We accept the Ombudsman’s findings and are very sorry that Ms D had the experience she had. We sincerely apologise for this and for the stress and anxiety this obviously caused her.

“This is a very serious matter and we are working closely together to ensure that lessons have been learned and to make sure that in future people with mental and physical health needs receive a much better joined up service.”

A frustrating and prolonged battle

Between 2009 and a hospital admission in February 2013, Mrs D received a personal budget of around £7,000. This was funded by the NHS trust. The hospital admission led to her requiring an amputation. The change of her circumstances meant her personal budget needed to be reassessed.

In August 2013, the council and NHS trust agreed to 50-50 funding for a new self directed support budget for Mrs D. However, they failed to agree how much support she should receive for 14 months.

The delay left Mrs D with ‘significantly less support’ than she’d before her amputation. From January 2014 she no longer had her £7,000 personal budget. Instead she received a basic care package. This consisted of two visits a day by agency workers to help with basic tasks but they were unable to take her out of the house.

This left Mrs D mainly house-bound. She found it difficult using public transport so had to spend her money on taxis to medical appointments and other activities. She also used her own savings to buy the extra support she needed.

Warnings

Over the course of the dispute, Mrs D’s clinical psychologist, physiotherapist and prosthetist wrote a joint letter to the local authority to warn that the hold-up was having a ‘significant adverse impact’ on the her physical and mental wellbeing. They said Mrs D’s mental health history was clear and she would be put at ‘significant risk’ if there was no agreement between the trust and council within a reasonable timeframe. Her GP and psychologists sent further letters raising concerns about the delay.

Mrs D complained to the council and the trust in January 2014. The trust upheld her complaint in March and Mrs D expected a resolution soon after this but disputes about her overall budget continued for months. She raised the matter with the ombudsman in July 2014. In January 2015 the trust and council wrote to the ombudsman to apologise for the delay.

The council and trust agreed to fund a personal budget at the level in place before Ms D’s operation subject to the agreement of a final plan. Mrs D has requested that her support planner leads the development of the plan and disputes some of the comments from the trust and council, the ombudsman said.