Lousia Ovington independent investigation report ... - NHS North East

CHAPTER 4 – THE CARE PROGRAMME APPROACH (CPA)
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at this time to a psychotherapist, Psychotherapist 1 but due to mislaid forms, the
appointment did not take place until early 2002.
Louisa Ovington was noted to be under the care of Consultant 13 in January 2002
as Consultant 14 had left the area 83 . A care plan dated 18.February 2002 notes
that there had been/would be referrals to the drug and alcohol services ‘as and
when required’, referral to psychotherapy and general monitoring. (Psychotherapist 1
reported in June 2002 that Louisa Ovington would not be suitable for psychotherapy.)
In December 2002 Social Worker 4 felt that Louisa Ovington had been stable for
an extended period of time and he should transfer her to the local community
mental health team. A CPA meeting was planned for 23 January 2003 but had to be
cancelled. The handover of care took place on 27 January 2003 when Social Worker 5
advised Social Worker 4 that she was becoming Louisa Ovington’s care coordinator.
Social Worker 4 visited Louisa Ovington on 28 January 2003 to inform her.
A joint visit with Social Worker 4 and Social Worker 5 took place on 10 February 2003
to meet Louisa Ovington. Social Worker 5 visited Louisa Ovington on 13 March 2003
and it was agreed that visits would occur six weekly with Louisa Ovington being able
to contact her at any time in between should the need arise. There were no major
events during the remainder of 2003, although Louisa Ovington continued to drink
excessively, was seen by ESMI and suffered spells of depression and premenstrual
tension.
On 26 February 2004 Social Worker 5 discharged Louisa Ovington as she was leaving
the area. The care coordinator recorded that Louisa Ovington “agreed” that she did
not need further input from the “team”. The case was closed to social services but
was “still open to the CMHT” and care coordination was transferred to Consultant 2,
without apparently any consultation with him. There was no evidence of planning or
discussions around this handover of care.
COMMENT
As is detailed in the narrative in chapter 1 and elsewhere in this report, 2004 marked
a period of increasingly chaotic and turbulent behaviour in Louisa Ovington’s life, with
extensive police and probation involvement and the intervention from time to time of
the CRT. The details are not repeated here. From February 2004 to August 2004 there
was no care coordinator allocated from the CMHT- it appears that either Consultant 2
or Staff Grade Psychiatrist 1 took the formal role.
On 10 May 2004 Louisa Ovington was admitted to the University Hospital of
Hartlepool following a visit to A&E. Staff Grade Psychiatrist 1, care coordinator at the
83 The issue of large number of doctors apparently involved with Louisa Ovington and the problems with the provision of
psychiatrists in this area is dealt with at other points in this report.