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This morning, I decided to visit Suffolk Ward, Chase Farm Hospital Enfield, to find out whether Elizabeth’s possessions had been found and, if not, sort out reimbursement to the value of circa £100, which included Birthday presents going back to February 2021, including M&S leggings and top. These items valued at around £35 were never replaced and the Deputy Ward Manager who took the receipts never got back to me. Also a brand new tuppaware container containing the Birthday cake went missing. Whilst not much money, it is a matter of principle. Elizabeth has recently been discharged from Chase Farm Hospital, Suffolk Ward and several more items of possessions have gone missing ie., black and white Morrisons jacket, new pair of Sainsbury’s sandals and a pair of mock sheepskin slippers. Also, when Elizabeth was chased around the room by four male “nurses” she did not recognise and dragged into a seclusion room to be injected, during this scuffle her handbag was broken and I am requesting this to be replaced too; it was ripped off her shoulders and during all of this she lashed out with her feet and was kicked in the leg in retaliation by a male member of staff. I am sure the Morrisons jacket was more expensive but when I found out the price recently it had gone down to just £12 so with these items plus the Birthday presents everything amounts to around £100.

I was advised by the new Manager of Suffolk Ward (KS) that everything was in Pal’s hands so I decided to visit the office of Pals who said they had received absolutely nothing in terms of paperwork. I was advised to call at the ward which I did. I was told the Manager was coming first of all. I stood there patiently for a very long time and then was told again that the Manager was coming. I waited again for a very long time then a male nurse came to the door and offered to take the receipts off me but I then said that not only did I wish to give the receipts but I also wanted to discuss the Discharge Notice Elizabeth has just passed to me. It must have been about an hour I patiently waited in total and this male nurse disappeared but it was obvious that no-one was going to come out. I then called at reception and asked to speak to someone more senior. I was told to wait in the foyer which I did and all the time Elizabeth was phoning to see where I was as she was waiting for me at her flat. Then I noticed the person coming towards me was someone who is described in her previous response letter to Elizabeth’s complaint as “Covering for Suffolk Team Manager” JA. I had previously had contact with JA but was unsure of her title. Anyway, JA’s response was typical in terms of being defensive when challenged of anything wrong and I was not impressed with her response to Elizabeth’s complaint as I had nothing to do with this. In my opinion it takes guts for a patient to voice their concerns which I will outline in this blog. When I complained to JA that £100 of items went missing she was unsympathetic stating that it is a patient’s responsibility to look after their possessions on the ward. I responded that this was highly unsatisfactory since when things had gone missing on other wards such as Huntercombe and Cygnet, items had been reimbursed so I did not see why Suffolk Ward should viewed as a special case. She repeated it was a patient’s responsibility to look after their possessions. I said “easier said than done” when a patient such as Elizabeth was drugged to the hilt like a zombie and had found patients entering her room late at night on more than one occasion. I also questioned as to what Elizabeth was doing on their MH acute ward as she had autism to which JA responded that none of the patients on Suffolk Ward had anything other than a mental health diagnosis to which I said “rubbish” and showed her the 24 Hour Discharge Notification with ICD10 codes purely on physical health only. I also pointed out that Mencap/NAS and Access would not have got involved had I not been able to produce substantial evidence from the very beginning and referred to substantial divide in opinion by other professionals. She pointed out that the ICD10 code was for mental illness ie Elizabeth is said to have paranoid schizophrenia for which the team have refused to budge, however I have looked up ICD10 and this is what I have found:

ICD-10

ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. Work on ICD-10 began in 19…

This is the first time ever I have come across a list of physical health conditions such as:

Other abnormal findings on diagnostic imaging of central nervous system

Other and unspecified symptoms and signs involving cognitive functions and awareness

Pruritus unspecified.

I am not a doctor or nurse but this reads to me as though Elizabeth has suffered injury in the course of one year’s incarceration where she has been drugged to the hilt on drugs previously found to be allergic to by several doctors and the depot version of Risperidone administered now switched to max level of Clopixol depot for which it has been promised regular reductions and titration right down. The Community RC explained that a reduction of the max level of Clopixol would commence at the next due depot injection which Elizabeth says is due on Monday and the first reduction is 50mg but this sounds quite high to me. Previous attempts at reduction have been too steep/cold turkey and had failed but this was recorded as relapse of mental illness, whereas it was withdrawal syndrome. This time the community RC explained that care would need to be taken on the very low dosage and that this could cause delusions/hallucinations – all the symptoms said to be of mental disorder when in fact these are the side effects of withdrawal. He also said he would have to increase his visits to see Elizabeth but this alone might be triggering for her as even a phone call from the MH team affects Elizabeth’s mood and puts her on edge.

JA could not explain re the Discharge Notice and said she was not a medical professional but KS new manager of Suffolk Ward is a medical professional who did not wish to come out and see me.

Since being discharged from Suffolk Ward Elizabeth is looking better but her breathing is of great concern. Never before was she like this. I know something is wrong and I am not even a nurse/doctor.

Elizabeth has had a chest Xray which I took her to. She has a blood test coming up and eye appointment, all of which I have to take her to. She says she has blurred vision and balance problems, that she has chest pains and headaches. She can barely walk.

Today I decided to ring Elizabeth’s GP to ask for a Neurologist appointment. The GP said she had to justify this appointment so I told her that I had the discharge papers that highlighted what appeared to be physical health concerns under ICD10. I also said that last time Elizabeth saw a Neurologist the Neurologist suggested genetic tests for rare condition of Wilsons Disease and that nothing should be ruled out as it says in the files “Lets rule out anything organic” but now I want everything organic looked at properly including the MRI scan Elizabeth wanted in the first place. The GP did not understand about the Discharge Notice contents and said before any referral could be made to see a Neurologist she needed to find out more about the things listed as the tick boxing had to be done very carefully otherwise the request would be rejected.

Elizabeth telephoned frequently to see where I was and I was mainly stuck at Chase Farm Hospital waiting in vain.

I have the letter in response to Elizabeth’s complaint by JA in front of me. To summarise:

You reported that nobody has explained to you why you are sectioned as you do not believe you are mentally ill. JA responded listing Tribunal’s decision going back to 2008, mentioning CTO and section 136 and that everything was explained to her. “I am sorry you do not believe you have a mental illness but would like to assure you that the correct process have been followed. “I am sorry that you do not believe that Elizabeth has been misdiagnosed as otherwise the wonderful organisations of Mencap/NAS and Access otherwise would not have got involved and as for the recent discharge note it would appear that Elizabeth has suffered injury and would assure you that there was no mention of mental disorder whatsoever – the first time this has ever been seen.

You told us that we have informed you that we are sending you to another hospital and you do not know why and you think that we may be waiting for a bed: “The team has a conversation with you in January 2021 that they were considering longer term placement as part of your care plan ie Priory placement. I hope that following this meeting you now are up to date with any plans for ;you to move. Likewise thanks to NAS and Access thank God stopping another six month OOA placement at Priory. Yes, definitely Elizabeth was right as per the latest files. For instance beds in hospitals all over the country were being considered where seclusion was the option, hence Cygnet Godden Green (Requires improvement) now closed by CQC who agreed to take Elizabeth for 5 weeks.

St Andrews &Huntercombe – Full Cannot accommodate  
Cygnet Woking – full, Cygnet Brierly – full, Cygnet Beckton – declined and Cygnet Appletree  
Priory Nottingham – no seclusion  
Southern Hill PICU – no beds

In addition to all of these above, Priory Darlington, Priory Hemel Hempstead, Elysium locked Rehab Bromley Road, Elysium Thornford Park (2 months) St Pancreas Hospital Ruby Ward.

You stated that the office staff (Suffolk Ward) keep telling you to speak to Dr HM but she does not listen and does not give any information: “On Suffolk Ward we empower patients to have discussion with their consultant if the information they are asking for is not within the remit of the nurses. We encourage patients to speak for themselves during their meeting with the consultant or other ward doctors. Nurses prompt patients during this meting if they are having difficulties to express themselves or have forgotten the points they wanted to raise at their meetings. This is the reason the staff were encouraging you to speak to Dr HM. An example of such discussion is “you have got paranoid schizophrenia” “no I have autism”

You reported that you were taken to seclusion when during your admission about a year ago your bag was ripped off and the manager kicked you in the leg. “I am sorry but I have been unable to find any evidence in your record to suggest that this incident took place. However on 29 July 2020 you were reported to have lashed out at staff, kicking the ward manager in the groin and punching female staff repeatedly. ” I am sorry but what we have heard is that Elizabeth was chased around the ward by several nurses she had not seen before who got hold of her and got her in some kind of seclusion room to give the depot to which Elizabeth did lash out but there were no female members of staff present – all male and her bag got ripped off her shoulder in the process and she got kicked in the knee. She did not punch female staff repeatedly as what we heard was there were only male staff present.

You stated that your mother could not see you because of breach of social distancing on Xmas Day. Your mother reported there has been Covid 19 on the ward but no communication and wanted you to be treated fairly. Elizabeth’s mother’s blog describes the shocking experience on Xmas Day and how her car was surrounded by staff threatening to call Police which they did do despite the fact that permission had been given by the RC but the bed management overrode that decision and that was because it was proposed to move Elizabeth that day, due to the ward being changed to Amber category.

JA then talked about the CTR (which was cancelled 3X due to a completely independent and person of experience being appointed by NAS who were not happy at the lack of support for Elizabeth leading up to this meeting by advocacy, minutes of the CTR still awaited.

JA then explains re S17 that they were unable to grant this on the grounds of Covid 19 other than to attend urgent physical health appointments. This rule was explained to you and your mother. It certainly was not explained to me at the time but I found out.

You reported that you have not been treated fairly and we are trying to treat you for schizophrenia when you have autism. Your records show you have been receiving treatment for paranoid schizophrenia since 2008. You also have diagnosis of Asperger Syndrome since 2016. You are administered Clopixol 400mg depot injection (intramuscular) every 2 weeks as part of your treatment for schizophrenia. We would like to know the aspect to which you reported that we have not treated you fairly so that we can improve the care and support we provide you. Since you ask, you recognise the diagnosis of Asperger Syndrome was given since 2016 (in fact it was given in 2008 also) so how come the change to schizophrenia and where is the term “treatment resistance” meaning poor / non metaboliser. You only have to look at the treatment over the past year and see how many institutions were being considered out of area at huge expense by various nursing staff/night bed management. You only have to read the latest file records of which Elizabeth’s mother has acquired in which she herself was being labelled behind her back with a MH diagnosis by a junior doctor who has never met her. Then you only have to look at how the CTR was handled and cancelled three times with the Chair stating “the whole thing stinks”. Then take a look at the discharge to her flat – nothing apart from Crisis/Home Treatment Team phoning every other day and totally disabled. Elizabeth cannot get in and out of her small bath. She has no shower. So disabled now I am a full time carer, not able to work in a full time job right at this moment or in fact any job other than caring. Elizabeth has breathing difficulties like never before has to rest several times during the day and has no energy to do anything that is because she is on max levels of the drug Clopixol which the community RC is taking her off having been alerted to the fact Elizabeth’s mother has the Discharge Notice that states physical health concerns.

Finally JA goes on to say “I hope we have addressed your concerns. If you feel that there are any outstanding issues you can contact me on ………….”

I told JA what I thought of her letter today and will finalise my blog by replying to the above comments stating “no” and “yes” – there is the issue of £100 of Elizabeth’s missing possessions and then Elizabeth’s mother wants full clarification as to what exactly is meant on the Discharge Summary by “Abnormal findings on diagnostic imaging of central nervous system” – Please explain.

As NR, in a letter sent by courier to the Hospital Managers at Chase Farm Hospital Enfield I discharged Elizabeth from S3. This was due to expire on 1 June and I was expecting the usual ie., that dreaded call from the AMHP asking for my objection to S3, to then be barred and then dragged to court, or for Elizabeth to be placed on CTO, previously ineffective and used to bully and force her to engage with the community team or else be recalled to Chase Farm Hospital. Now the difference is Elizabeth is trapped by fortnightly depot injections and the team would know instantly if she refuses to take it. I never received that dreaded call but instead, a letter from the MHA Office stating Elizabeth is no longer subject to Section 3 as the Responsible Clinician Dr HM decided the section should be rescinded on 28 May 2021. So Elizabeth was told on the spur of the moment she was “free” to go but no discharge papers were given and so we were not quite sure what was going on.

The discharge papers have only just been received with an official discharge date of 5th June. As NR I was not given a copy other than through Elizabeth.

Under Principal Diagnosis (ICD10 Code) it is disturbing reading:

No mention of paranoid schizophrenia or autism (for which Elizabeth is awaiting a proper assessment). Instead the focus is on physical health.

“Other abnormal findings on diagnostic imaging of central nervous system

Other and unspecified symptoms andsigns involving cognitive functions and awareness

Pruritus, unspecified.”

Under specific risk and safeguarding it says N/A

Then there is a list of contacts in the Crisis Plan:

Mind Crisis Line

Saneline

The Maytree

NHS 111

North Mid Hospital

Barnet Hospital

Emergency Services

ENABLE COMPASS

IAPT

Anxiety UK

Samaritans

Elizabeth was discharged back to her flat under Enfield Crisis Resolution and Home Treatment Team service who phoned her every other day and visited only twice. Then care was transferred back to ECRHT, responsible for instigating court case after court case including CoP, RcJ – county court displacement of NR and even Section 42 meeting.

The only care currently in place is the fortnightly depot and her care coordinator visited recently to adminster the Clopixol at 400mg.

Elizabeth got completely worked up prior to the depot being administered and also when the Home Treatment Team phoned and wanted to visit. No doubt this was all very triggering for her.

Yesterday, a surprise visit from the Community RC, Dr IM – I was not advised other than through Elizabeth. He brought with him an AMHP well known to us as a family. They came yesterday afternoon- I wondered why Elizabeth appeared so stressed out. The community RC stated he was there because of her mother’s request. On reading the discharge files I had requested something be done about Elizabeth’s medication. Due to what appears to be too high a dosage, Elizabeth is just lying around with no energy, fit for nothing and has come out of hospital so disabled to the point she is no longer venturing out alone and is a shadow of her former self. She has balance problems, blurred vision, breathing difficulties particularly noticeable when walking and she has trouble swallowing/choking. He asked for input but was only interested in Elizabeth’s input. When I mentioned side effects this did not go down well and I was told he only wanted to hear from Elizabeth her comments.

Not sure if we were being recorded as the social worker (EJ) kept fiddling around with her phone in her handbag. The AMHP asked Elizabeth if she remembered her to which Elizabeth replied “no” and I replied “yes”. How can I ever forget The CoP and attempted DoLs to force her return to a care home where she had no food at the weekend ie Phoenix House Stepping Stones rated good by the CQC. This was also when the Clozapine was deprived for four days prior and in the first instance “Deprival of Medication Community Care”.

The community RC then announced his proposed titration of Clopixol down to nothing starting starting with 50mg which I am not sure is too high but I will check. It is only when Elizabeth has tried to stop taking the drugs too steeply there has been problems caused by this and not relapse of so called “illness” Now only physical conditions mentioned on the discharge notice so I can see.

It was questioned why Elizabeth was so quiet, glum and guarded but noone stopped to think why. “you wasn’t like this last time and how was you whilst in hospital in comparison?” Any kind of questioning Elizabeth absolutely hates. I told them that since coming home from hospital at least she was sleeping well but the problem is Elizabeth is highly sedated and sleeping during the day and constantly having to take a rest. This surely is not right.

I mentioned I had acquired the latest files of shocking content in which is stated “of high risk of mortality and choking”. Whenever Elizabeth gets stressed out she seems to have excess saliva which was evident during their visit.

In the past, reductions of medication have been refused but the RC stated he had reduced Risperidone down from 2mg to 1.5. I advised I had reduced it from 1.75 to 1.5 as Elizabeth could not cut a small tablet into four and neither could staff at her supported housing scheme Reservoir House. I also mentioned how Elizabeth should never have been prescribed this drug previously found to be allergic to that had lines put through countless drugs charts. The drug, Risperidone is subject to Class Action yet recommended by CQC’s SOAD as was Paliperidone, depot form in addition to plus drugging at max levels, except not recommended was the two antipsychotic IM injections given at Elysium. It is no wonder people with LD/autism die early – you only have to look at the files “Mews Score 2 /3” – that is serious and then look at the drugs prescribed against STOMP even above BNF level. I have all the proof of what goes on in these institutions.

It was also discussed that when the drug is reduced to very low level this is when care needed needs to be taken as this is when there is risk of “relapse” (withdrawal syndrome). I then commented to the effect of injury as per the comments on ICD10 diagnosis on physical health.

For safe reductions there are no facilities other than locked acute wards that are noisy and untherapeutic. When there is risk of “relapse” during drug reduction surely there should be the right kind of help given and in particular a facility that specialise in research in respect of drug withdrawals not an acute ward or PICU.

It was discussed about the CTR minutes and the fact that no minutes had been received by anyone. I have tried to chase these up as they are overdue.

After they left Elizabeth was visibly upset. She spoke of her life being ruined, not wanting to live and wanting to be free. She used the word “abuse” several times and that she wanted to be left alone by professionals but there is no chance of that now whilst she is on a depot and this is the only “care” in place right now.

In terms of risk – absolutely nothing is mentioned apart from N/A.

In terms of health and safety – no mention either but I would comment that since December’s lockdown Elizabeth had spent a great deal of time in her bedroom on the ward not venturing out. She was phoning me constantly asking me to bring things but I could not visit and she was not even allowed a fresh air break. She says she is amazed she is still even alive but comments that life is not worth living. I can see what she means by that and it is very hard to hear such comments. The situation of the lockdown led to her physical health being neglected. Tomorrow is the XRay appointment regarding her breathing and next week are more appointments re her eyes which are troubling Elizabeth. Totally dependant on me as her carer with no help in place these appointments fall on me in order to take her.

Worse still, Elizabeth has gained enormous weight from no exercise over so many months of incarceration and as a result, she can no longer get in and out of her bath and there is no shower so I have had to bring her back home for this purpose.

I have never seen Elizabeth come out of hospital quite so disabled and she appears to have agoraphobia and worse still breathing difficulty which is quite noticeable at times.

Elizabeth was suddenly discharged from Suffolk ward, Chase Farm Hospital Enfield last week. I was not sure in the absence of any paperwork whether she was properly discharged. I have requested the discharge papers several times but to no avail. I have still not received the minutes from the CTR meeting. I knew when Section 3 was due to expire so I arranged a courier to take my standard letter as NR to the MHA office at Chase Farm Hospital Enfield. I was expecting the worst – yet another court appearance through barring. It was nerve wracking waiting but no Barring Notice was issued on this occasion. I see Sections as being nothing more than punishment and this has a knock-on effect that is most devastating on everyone in the family. As Nearest Relative I have been taken to court so many times and treated like a criminal. CoP threw the case out in 2014. Elizabeth was found to have capacity to decide on where she wanted to live. In 2017 I was taken to RcJ for displacement by an AMHP who went back to the time Elizabeth suffered extensive abuse at a local supported housing scheme but I acted as Litigant in Person as I did not see her as being suitable as NR having read her file notes previously. Besides it is a conflict of interest that an AMHP working for LB Enfield should be even considered as the nearest relative. Previously I was taken to Bromley Court (court papers sent to my work email address) deluged with phone calls re agreement to S3. It was attempted to displace me with her father who in their opinion was of best interest Elizabeth was at Bethlem Nat Psychosis Unit and her Section 2 had come to an end. I did not realise back then that I could have taken Elizabeth away from them but since I have gained knowledge as to how corrupt things can be and how vulnerable people can be hauled into hospital – sectioned unlawfully and all they get is £1 compensation and treated like criminals. I have a cheque for when I challenged the first unlawful section for just £1 which I have had framed. Since then another unlawful section has come to light. Why should a vulnerable person be treated any differently to anyone else. The system is a disgrace and works against the weak and vulnerable and their families. A system not fit for purpose where tribunals are a complete ordeal for someone like my daughter who has been misdiagnosed and has autism/LD. Some Tribunals can be biased and even threats of imprisonment are voiced by some Judges. Imprisonment if I dared to talk about the tribunal and I feel like doing just that because after all this is public money.

So now Elizabeth has been discharged without any paperwork but It is all thanks to Mencap, NAS and Access – without them she would undoubtedly have been sent to the Priory for six months in yet another locked facility out of area which she did not wish to go to.

This is the advice I have just received (my comments in bold)

“Firstly, it appears that Elizabeth should be eligible for s.117 aftercare services, separate to any duties arising from the Care Act; (After-care services mean services which have the purposes of meeting a need arising from or related to the patient’s mental disorder and reducing the risk of a deterioration of the patient’s mental condition (and, accordingly, reducing the risk of the patient requiring admission to hospital again for treatment for mental disorder); What mental disorder? Elizabeth should be under different care – she has a neurological condition not a mental disorder and this is recorded going way back as “Anterior Region Medial temporal compromise. I am not even a Doctor to know this is not a mental disorder and I checked everything with Headways. What does affect Elizabeth’s condition is the team themselves as all they can talk about is medicating and of her next depot injection and she has a fear of needles plus the depot has been given roughly where the needle has broken. Prone restraint and all men giving the depot. It should be called “aftercare abuse” in my opinion. The depot does nothing for her and does not even work.

Secondly, you have a freestanding right to a Carers Assessment under the Care Act s.10 even if Elizabeth does not want to engage with a Care Act assessment. This could be a good way to begin discussions on what support options there are and certainly of recording the impact on you in the absence of formal support. It is said in Elysium’s files that I was offered a Care Act Assessment but refused it. In fact this was a MHA Assessment but luckily I obtained the files and found out back in 2014. Luckily I did not go in the circumstances.

Thirdly, even if Elizabeth does not want to engage with a Care Act assessment, there may still be a duty to do one:

s. 11 Refusal of assessment

(1) Where an adult refuses a needs assessment, the local authority concerned is not required to carry out the assessment (and section 9(1) does not apply in the adult’s case).

(2) But the local authority may not rely on subsection (1) (and so must carry out a needs assessment) if

(a) the adult lacks capacity to refuse the assessment and the authority is satisfied that carrying out the assessment would be in the adult’s best interests, or I do not like the word lacking capacity. From the files I have obtained it is obvious Elizabeth has FULL capacity and knows exactly what she wants. Best interest – this is some kind of joke to think that a best interest is a locked prison facility for a start.

(b) the adult is experiencing, or is at risk of, abuse or neglect. Elizabeth has said the abuse is from the Professionals forcing this kind of treatment on her that does not work.

(3) Where, having refused a needs assessment, an adult requests the assessment, section 9(1) applies in the adult’s case (and subsection (1) above does not).

(4) Where an adult has refused a needs assessment and the local authority concerned thinks that the adult’s needs or circumstances have changed, section 9(1) applies in the adult’s case (but subject to further refusal as mentioned in subsection (1) above).

(5) Where a carer refuses a carer’s assessment, the local authority concerned is not required to carry out the assessment (and section 10(1) does not apply in the carer’s case).

(6) Where, having refused a carer’s assessment, a carer requests the assessment, section 10(1) applies in the carer’s case (and subsection (5) above does not).

(7) Where a carer has refused a carer’s assessment and the local authority concerned thinks that the needs or circumstances of the carer or the adult needing care have change. At Elysium it was said I refused a Care Act Assessment when it was actually a MHA assessment! Never been offered a Care Act Assessment before.

Do you know whether a capacity assessment was done to assess Elizabeth’s capacity to make decisions about her care and support and/or where she lives? Many capacity assessments (in every case found to have capacity) have been carried out but it is disturbing when certain professionals turn to MDDUS when they do not wish to disclose the contents of the files in order to get the wording to respond to me on capacity. They were advised to say she had No Capacity so I then said that I had POA and that is where POA is useful. I have everything in writing so there is no excuse for the GP Surgery to decline under GDPR Rules.

I have spoken to Elizabeth and as you say she is presently reluctant to engage with a Care Act assessment. I have left it that I will speak to her again about this. However, as a first step, we have agreed that I will chase up the minutes of the Care Treatment Review and try to obtain a copy of her discharge plan. Such was Elizabeth’s distress she was up all night worrying about a visit from her Care Coordinator and no doubt it was triggering as she has not got over the last unlawful detention of around 5 days. Where is the warrant for this? I would like a copy for my records.

You are probably aware that the Mental Health Act Code of Practice, paragraph 33.13 says:

33.13 Before deciding to discharge or grant more than very short-term leave of absence to a patient or to place a patient onto a CTO, the responsible clinician should ensure that the patient’s needs for after-care have been fully assessed, discussed with the patient (and their carers, where appropriate) and addressed in their care plan. If the patient is being given leave for only a short period, a less comprehensive review may be sufficient, but the arrangements for the patient’s care should still be properly recorded. They have already seen that a CTO does not work. It is cruel and abusive to place my daughter on a CTO and I have a good mind to put the entire CTO papers for everyone to read from the last time as the Nearest Relative was documented incorrectly when in fact It was ME who was NR as I had taken back my role from the RcJ when I realised that I was in fact still the NR. The CTO papers were full of threats of recall and the contents were disgusting to read.

I have written to Dr M this morning for further information about the discharge plan and to ask whether capacity assessments have been completed.” There is no plan and most definitely capacity assessments SHOULD NOT BE CARRIED OUT BY PROFESSIONALS FROM THE TEAM AND NEITHER SHOULD AN AUTISM ASSESSMENT. THIS IS CONFLICT OF INTEREST.

All along Elizabeth has had FULL capacity and I would commend her from speaking up for herself at Elysium and Cygnet and saying she did not want to go to a locked rehab facility out of area for the fourth time. She missed her flat and her pigeons. Elizabeth adores animals and at Elysium asked to go to a care farm but this was ignored as the team had their own agenda and a CTR was originally refused until I produced substantial evidence to Mencap/NAS and Access on autism going right the way back to the very beginning in 2008.

Since Elizabeth has come out of hospital she has declined to such an extent that she relies on me to do everything. Without any support at all I ensure Elizabeth has food in, her bills paid, I go round in my car to collect her to bring her home as she has no shower and the bath is too small for her now. It is a struggle to get Elizabeth in and out of my car which is low down and the seat belt does not fit her. I ensure all her washing is done. I ensure the flat is tidy and clean, I try to encourage her to make her bed and do basic things but all too often nothing is done and this is not how she was when she first acquired the flat. Elizabeth relies on me to collect her – at least at home she can sit out in the garden and see her cat. Elizabeth adores the pigeons and birds she sees from her balcony windows. I have put netting up to ensure that the balcony is clean. Elizabeth has balance problems and clings to my arm whilst walking. We have no adaptions in the shower at home and I was trying to get all this in place. You would think that during the course of one year something could have been done about her flat and a shower put in but noone would deal with me at the GP surgery or council’s OT assessors because she had not been discharged from hospital. I will have to try this again now she is out of hospital and see the response. The autism assessment cannot be done immediately because there is a massive long waiting list. With the diagnosis in grave doubt and up in the air this means professionals can carry on with the distressing treatment of depot injections. I am determined that a better solution can be arrived at but cannot see that this can be achieved via a MH team in the community who do not have the experience of neurological conditions and I have advised Elizabeth all the time not to stop taking the drugs steeply but yet I understand her distress at the depot injection given every two weeks and if she was to refuse then what would the team do?

In the files it says “high risk of choking and mortality”. She was not like this going back to when first admitted but it is no wonder why when hospitals such as Elysium prescribe drugs at high levels ignoring STOMP and give face down restraint plus surely it is wrong to prescribe two antipsychotic drugs IM – these being Clopixol depot plus olanzapine resulting in Mews Score 2??? No wonder there are deaths in these institution as two IM antipsychotic drugs were not advised by the SOAD. Not one of these institutions has assessed her for autism properly and enormous amounts of money have been spent in one year that has made Elizabeth come out of the system more disabled than ever and totally reliant on me.

Despite all of the above I am still so happy that Elizabeth is not on a Section right now. I think they should offer her a reduction and slowly reduce this drug as it really does not work. The effect on Elizabeth is not good for her physical health.

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