NOTICE OF HEARING (Community 17a CTO)
22 MARCH 2018 AT 10.30 AM – Notice of Hearing sent from Mental health Tribunal Secretariat Clerk to the Tribunal First Tier Tribunal (Mental Health) PO Box 8793 5th Floor LEICESTER LE1 8BN
On 22nd March at 9.00 am Elizabeth had to be at Chase Farm Hospital Enfield to see an independent doctor. I gave her a lift to the hospital together with the Manager of her scheme. Neither one of us were allowed to be with her for this assessment or the Tribunal itself despite requests and Elizabeth’s wishes which I have proof of we were excluded.
We sat waiting patiently in the hope that we could attend the Tribunal. Whilst waiting in the MHA Office upstairs I tried to hand in the corrected version of care plan and CTO Report to the MHA Manager (TM). She responded stating that she would not accept the papers – “you are not the Nearest Relative and we are not speaking to you – I am not accepting these papers” – words to this effect. I took a picture of the name plate on her office door . I was spotted doing this and she went ballistic and told me she would have me arrested. A man then came out of his office. I explained I had simply photographed the name plate on the door of the office – he could have even seen this if he wanted. He responded to the effect I could have asked the names and he would have given them to me. So I asked his name which was Michael Chalmers Head of Mental Heath Law. I recognised his name instantly and I referred to his letter of apology of 12 July 2017 that the Trust had infringed Elizabeth’s liberty – “we will be looking carefully at this incident to establish what went wrong and how we can prevent something like this happening again”. “Please don’t hesitate to contact me if you have any questions or concerns or if you wish to discuss this matter with a member of your clinical team or with an advocate or solicitor”. I said it was not good that Elizabeth was illegally detained. On one another occasion I complained that Elizabeth had her solicitors cancelled and knew nothing about it. That is extremely bad. The response I had was that this was with her consent but I want everyone to know that Elizabeth had not asked for her solicitors to be cancelled and knew nothing about it. Mr Chalmers spoke of how hard he was working but I don’t see what this has got to do with illegal detention – perhaps he meant that they were snowed under and that is why such errors occurred but I am only assuming this but in my opinion it is not good enough and I feel that some form of compensation should be given to Elizabeth in the circumstances.
The worse part is yet to come!! I received shocking treatment. I was asked to leave the MHA Office by the manager and refused as I had only taken a picture of the sign on the door and not of anyone else. I was threatened with arrest and next thing a security guard in front of me asking me to leave. I was impressed by his approach having once myself applied to work in this Profession and Police. Unlike the Professionals employed by the Trust his approach was polite and decent so I left to go downstairs. The Tribunal ended around mid-day – all this length of time taken up so many professionals – including representation by hospital manager, Judge, Psychiatrist RC, care coordinator and manager of the scheme who like me had to sit waiting outside. There was also a solicitor representing Elizabeth. This must have cost an absolute fortune for all these professionals to spend all morning attending and the taxpayer is paying huge amounts for such hearings. It is also stressful for my daughter who does not like meetings and to be fired questions at surrounded by strangers. She has been diagnosed as having autism high spectrum aspergers and even going to that hospital is stressful for her. she originally did not wish to attend. Afterwards she had given consent for her solicitor to discuss matters with me. I had prviously sent amended care plan with correct NR on and CTO documents directly to the Tribunals Office. The Nearest Relative (Elizabeth’s sister was away on holiday but applied for myself and other family member/close friend to be present but this was not allowed. Quite frankly there is a lot of money to be made by independent doctors, solicitors, psychiatrists and others in extra funding by continuing a lucrative Order such as CTO. This means regular meetings, progress reports, extra time spent on providing what is least wanted restrictive care, forced treatment and threats of recall which professionals like to use on vulnerable people. Hence the reason I think they should be abolished along with DoLs
As I sat in the foyer waiting I was delighted to bump into someone I knew and had not seen for a long time.
Afterwards Elizabeth, myself and care support/Manager went into the canteen for coffee and Elizabeth had lunch/ . There was a wonderful person who joined us at our table speaking of her role in peer support and how she started with a voluntary position and progressed to a paid position within the Trust. She gave Elizabeth good advice and much to think about. Afterwards I heard her ask the Manager of her scheme to help her get a job. Even if it is a voluntary job just for 1 day a week it would be very good for Elizabeth and with the right kind of support she could regain her confidence. Only time will tell if anyone gives her any help at all in this direction as only 1 person is working within that entire scheme so I heard. In the community people like Elizabeth suffer from isolation and making friends this is not easy if you are not working, stuck in a mental health scheme where not even a front door key is provided and forced to live there. There is nothing wrong with house or area but what is wrong is the way professionals treat people like Elizabeth and under a CTO they can really treat people badly and threaten them with recall to hospital. I knew that the result of the CTO Hearing would be unfavourable and this is because the report is deliberately written so she fails. So I think CTO’s are a waste of public money, are not being used fairly and it is wrong to threaten someone like Elizabeth. I also think that Tribunals on displacement of Nearest Relative for being “unreasonable” is extremely unfair. There is no legal aid to back you in court and you are unrepresented. The remit of the Judge is limited and does not include concerns on diagnosis being contradictory or treatment being harmful or ineffective. The power is in the hands of unaccountable professionals (AMHPS) who prepare a case full of lies and errors. They could not even get my address right and to be honest the court papers were so unprofessional that they should have been scrapped and the Hearing not allowed to go ahead. I was treated extremely unfairly and bullied because when you are threatened with enormous costs you do not wish to lose your home and this is a fact that you are either forced to delegate or accept the Council’s Professional to be NR and then they exclude the patient and that involves a capacity assessment – yet more money wasted. I presented a good case but was at huge disadvantage as when I asked for a report from Huntercombe this was refused. How can I be unreasonable when an entire team have only recently diagnosed Elizabeth with high functioning Aspergers.
As for the Care Plan even if the care coordinator is not named as entering details as to diagnosis/dates and descriptions they are responsible for such a plan as they are aware of such comments that again are deliberately written to sabotage any chance of a fair hearing and this is what has been done in Elizabeth’s case. In addition to the enormous time taken up of those present at the Tribunal Hearings, substantial time had gone into preparing reports – CTO report is 11 pages long, full of typing errors stating he instead of she and other huge errors such as who the NR is. What is frightening is that these records are held on the system Rio so that any new professionals look at these and go by them and no corrections are made and in some cases patients as well as their carers may be oblivious as to what is recorded behind their backs because a team of “professionals” like to bully the weak, vulnerable and their families by way of CTOs and other sections For example the CTO Report contains several threats of recall to hospital therein if someone does not engage with them. This is why CTO’s should be abolished – waste of time and huge savings could be made from public money. If Elizabeth was to behave in a manner seen to be risk to self/others she would simply be recalled anyway under Section 3 which can be dragged out for many many years in some cases.
I have files going way back of disturbing content on the latest CC who goes back to when Elizabeth was sent to Wales – Cambian. It is sad and very wrong that the current system allows for such professionals to abuse vulnerable people, to write defamatory comments and to tear their families apart – such comments can be written about their families too for court purposes to make them look bad which I will feature on another occasion.
I suppose by not having a front door key this is a means of deprival of liberty – they’ve got to be back by a certain time, otherwise they cannot get in as staff are asleep. How degrading is this.
Deprival of liberty is abusive and so is to constantly test someone on their capacity which again is costly – should be done fairly and (not by any AMHPs) involved in their care who judging by file comments speak in the most dreadful terms behind someone’s back – this is totally wrong – comments such as “we must be more robust in that institutional care is the best option” – But to the taxpayer this is the most expensive as incarceration of vulnerable people like Elizabeth carted off to private all for profit prison (hospitals) is of no benefit to someone like Elizabeth and people are dying too in such places. They are just not getting the right care and the environment is totally wrong. I am in touch with those who have lost their relatives and there needs to be proper investigations and recordings of such deaths as in these institutions so that there is accountability of the professionals involved and this is not just covered up – my concerns are for those drugged up enormously and yet no one is questioning what some of the doctors are doing.
CTO Report: – This lists details such as RC and Care Coordinator and Report prepared by Psychiatrist DR NABEEL AHMED ASSOCIATE SPECIALIST. I am wondering if the report is in fact written by the care coordinator but is certainly signed by Dr Ahmed and current RC.
This report is dated 23 February 2018 and information is obtained from Rio electronic records and lists INCORRECTLY the Nearest Relative as Debbie Morgan (AMHP Manager – London Borough of Enfield). CTO Report totally dismisses that of Huntercombe (high spectrum aspergers). I have yet to obtain this report as they have refused to give it and this put me at a disadvantage in court last year. The diagnosis which Barnet Enfield and Haringey MH Trust stick with is F20 Paranoid Schizophrenia (but where is the “Treatment Resistance? – this should not have been removed especially in light of the accurate lab test results on P450 liver enzyme that prove Elizabeth is a non metaboliser of psychiatric drugs.
Letter from RN of ….law Re: Displacement of NR:
“The issue for the Court is whether you have acted “unreasonably” and whether you should be the Nearest Relative. The Local Authority are clearly keen to bring matters to an end and seem happy for CB (Elizabeth’s Sister) to be NR. This is clearly positive. It is what Elizabeth wants and means that the LA do not fulfil that role. I understand you are aggrieved by matters which have happened to your daughter but this is not for the Court to decide. The Court has a limited remit.”
Letter from CB – Delegated NR who appealed against CTO dated 14 March 2018 to TSMH Case Progression@hmcts.gsi.gov.uk:
“I attach Tribunal Appeal on behalf of my sister as NR. On the CTO papers it is recorded that Debbie Morgan is NR when in fact it is myself. These papers should be amended and I will contact MA (CC) regarding this. There are some terrible things written about my sister in the care plan which are totally untrue and have been reported to the Police. A CTO is like a form of punishment and restricting for my sister as she has no front door key and forced to live where she is but this should not be for a long time as both myself and my Dad live in other areas. She may like to move nearer to one of us.
My sister is an adult who should have a front door key. It is degrading not having a front door key and nowhere to hang her clothes so we bought furniture and this is not allowed. I therefore back my sister in appealing against the CTO. It will not do her any good to be taken back on a ward – she may like to live elsewhere and should not be restricted in moving if she wants to. Please ensure you have my name as NR and not Debbie Morgan as this is what was agreed by the Council. My mother was forced to give up her role as NR as she was threatened with huge costs. Is it possible for the Tribunal to be postponed? – I’m only away for 1 week. If not then Elizabeth should be entitled to have someone from her family in accordance with her wishes and I have proof this is what she wants. Her previous solicitor put pressure on Elizabeth to say otherwise and sign some papers.”
The Nearest Relatives comments above have been completely ignored.
DISTURBING CONTENT OF CTO REPORT PREPARED BY DR NABEEL AHMED ASSOCIATE SPECIALIST RECOMMENDING RENEWAL OF CTO.
Past History is wrong. I have re-typed the whole report from scratch. The most disturbing thing apart from the negative comments are the Treatment Plan and Conditions.
- To cooperate with Community MH Team/Care Worker at Supported Accommodation to administer and supervise her oral MH medication on a daily basis.
- Dose and frequency and duration of medication to be reviewed by RC.
- To reside at her accommodation or specified place by HIS CC.
- To see a SOAD at a place agreed if/when needed (as far as I know this has not been done)
- CPA (Care Programme Approach) meeting to be attended prior to CTO end date.
- To allow access to CC, RC and others staff into her property to assess her mental health sate and compliance with prescribed medication
- If she refuses medication CC to arrange appointment with psychiatrist at earliest opportunity and urgent CPA to discuss non-compliance, risk to self/others and RECALL TO CHASE FARM MENTAL HEALTH UNIT AT CHASE FARM HOSPITAL OR ANY IDENTIFIED HOSPITAL FOR ASSESSMENT AND TRATMENT.
- SHE IS WILLING TO COMPLY TO PREVENT BEING READMITTED.
- If non- attendance of second appointment the care coordinator MA to arrange urgent CPA review meeting to discuss non compliance.
- CTO provides a framework for engagement, continuity and has ensured attendance post discharge which has enabled discussions about treatment and negotiation. Should this not work there will be option of recall should severity of the situation necessitate.
LIES: – TOO MANY TO MENTION – that is why I have accurately gone through file records and corrected the whole report. The report is unprofessionally written and mentions he instead of she on numerous occasions. It is written by someone who just like the AMHP who produced the RcJ Witness Statements last year records erroneously: names are spelt wrongly, information fabricated/designed deliberately to make the vulnerable person look dreadful. Beyond doubt a CTO is punishment of the State when you get professionals such as this threatening constantly to recall if you don’t do what they say -I reckon people who go into such a profession love the power to bully someone vulnerable like my daughter and on the whole get away with it. CTOS are virtually impossible to get off but who cares whilst extra money is being made. The law is on their side and there is NO ACCOUNTABILITY and should be. It is truly sad to read such a report stating IQ to be low when Huntercombe and even the newly qualified psychologist at her scheme state IQ to be the opposite – high spectrum Aspergers yet Elizabeth is in a mental health scheme where only 1 person in their entire schemes has a job and is working. Elizabeth is not being treated fairly at all. Elizabeth had to go into her Tribunal without anyone familiar being present and had to answer questions to these people like a criminal trial. We had accompanied Elizabeth upstairs to the Mental Health Act Office.
The time was 9.00 am and Elizabeth had to attend to meet an “independent doctor” first before going into the Tribunal. She seemed quite calm about the whole thing. Numerous requests had been made by her NR to the Tribunal’s Office for someone to go in to the Tribunal with her and constantly it was evident that they did not want any family members or even a close friend of the family to be present. I have a text message from Elizabeth asking me to be present even though I am no longer the nearest relative.
I had corrected the CTO papers along with a Care Plan and Review that contains lies and defamatory comments. This care plan and review was also dated 28 February 2018. Consent Recorded Date 03.08.2017 that she does not want information shared with her mother and has agreed for information to be shared with professionals. Well I luckily have had all the information that Elizabeth has shared with me and just as well because someone needs to be responsible for the pack of lies and defamatory comments therein.
The only person named on this is the care coordinator who is based at Enfield Community Rehab Team who are based at 65c Park Avenue Enfield EN1 2HL – the same team who deprived Clozapine to force return Elizabeth to care at Phoenix House in 2014.
I have already spoken to one of the people who made entries on the care plan under Diagnosis – This person – Tina Keeling knew nothing about the entries and I genuinely believed her.
The most disturbing lies are the following:
- Mixed and other personality disorders 12 June 2017 Sangeetha Kalimuthu
- Mental and behavioural disorder due to use of alcohol dependence syndrome – Jane Hobden – 01.09.2017
- Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances /harmful use – 01.09.2017
- Three entries of history of self-harm by Jane Hobden 01 June 2017 and 15 Feb 2017.
- Problems related to alleged sexual abuse of child by person outside primary support group
It is quite possible that these people have been used in such a way they are oblivious to having made such comments as recorded in the care plan.
SO PERHAPS THE MANAGER OF ENFIELD COMMUNITY REHAB WOULD LIKE TO EXPLAIN WHY SUCH LIES APPEAR IN THE CARE PLAN AND WHY RECORDS HAVE NOT BEEN AMENDED TO SHOW CORRECT NEAREST RELATIVE. THAT MANAGER IS BASED AT 65C PARK AVENUE ENFIELD LONDON EN1 2HL. A FULL ENQUIRY NEEDS TO BE DONE – I would like such an enquiry to be open and honest as the law is being abused so that CTO’s Tribunals fail on account of what is written in reports by certain professionals who deliberately exaggerate or fabricate the truth for which they surely should be held responsible for.
Re: Letter dated 19th September to Elizabeth from Barnet Enfield & Haringey NHS Trust Mental Health Act Office Chase Farm Hospital:
The letter advises CTO expires on 17 March 2018 explaining it will be rescinded if no longer thought to be necessary OR your RC will recall to hospital for treatment for up to 72 hrs if they feel your health or safety or safety of others are at risk. Re-assessment and one possible outcome is revocation of the CTO which would make you liable to be detained in hospital for treatment for up to 6 months. If your RC does decide to recall you to hospital you will be provided with a written notice of recall. If you do not return to hospital voluntarily once you have received notice of recall staff have the power to return you to hospital.
The Trust has a duty to give you certain information under these circumstances. (a leaflet enclosed) – what it means for you and right of appeal. Offering contact with an Independent MH Advocate – understanding and exercising your rights, making your point of view heard.
Extracts from recent email sent to the RC and AMHP enclosing the amended care plan with correct file entries from professionals and the amended CTO papers with the correct Nearest Relative.
Dear Dr M (RC) and MA (CC) ENFIELD COMMUNITY REHAB TEAM
Please ensure that the defamatory comments written about my daughter are corrected for the forthcoming Tribunal. No she never had a drug/alcohol dependency problem. No she never self-harmed. No she has never sexually abused a child re serious allegations. I look forward to seeing those amendments and especially that CB is down as NEAREST RELATIVE.
Please ensure that Elizabeth has the white tablets of Risperidon and not the coloured dye ones as it is recorded in file records allergy.
I have been through all the file records to ensure accuracy.
I would like to know who Jane Hobden is and what is her position within Barnet Enfield & Haringey MH Trust. I would like to speak to her as Tina Keeling knew nothing of her “entries” on the care plan.
I would also like to know about Why DM (AMHP) is put down on the CTO papers as Nearest Relative when it is CB?
In addition I would like to know why you have put No to Section 117 and not given a reason.
A CTO should not be reason to threaten vulnerable people like my daughter and I want them scrapped.
Cygnet and Huntercombe are very unsuitable environments and it was because of Cygnet Stevenage that she came home unstable as they raised the Aripiprazole to double just before release
I will keep you all informed.