Independent Investigation - Hundred Families

Mr. X Investigation Report
person concerned is no longer in need of aftercare services if they have monitored that
person's progress in the community since discharge. The duty to provide services continues
until both authorities have come to a decision that the person no longer requires any services.
Therefore, if any part of the care plan is continuing, such as regular outpatient appointments,
it is not possible to say that the person no longer has aftercare needs.
In the Health Service Circular 2000/003: LAC (2000)3 Aftercare under the Mental Health
Act 1983: section 117 aftercare services, the Department of Health made clear that aftercare
provision under Section 117 does not have to continue indefinitely. It is for the responsible
health and social services authorities to decide in each case when after-care provided under
section 117 should end, taking account of the patient‟s needs at the time. It is for the authority
responsible for providing particular services to take the lead in deciding when those services
are no longer required. The patient, his/her carers, and other agencies should always be
consulted.
In the case of Mr. X both the duties under section 117 and the Care Programme Approach
(see Section 14.1.4.) lapsed without formal consideration of implications of losing contact
with him. If it was believed that he had transferred to the Swindon area, then a formal transfer
of his care was appropriate. The transfer was not satisfactorily achieved by the contact
between the Lincolnshire Care Coordinator and the Swindon Community Mental Health
Team.
The Independent Investigation Team found that the Mental Health Act was initially used
effectively in Lincoln to assess Mr. X and to treat his mental illness. The use of Section 135
to gain entry to his house was appropriately assertive and facilitated an assessment that led to
his hospital admission. The use of a Treatment Order under Section 3 of the Act was effective
in ensuring his compliance with treatment, in particular medication.
Mr. X had access to the appeals procedures of the Act and used them to appeal to both the
Hospital Managers and the Mental Heath Review Tribunal. The decision of the Tribunal to
discharge him was a surprise to the clinical team and there was not an aftercare plan in place
to which Mr. X was committed. Contact with him was maintained through the efforts of his
Care Coordinators.
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