I spoke before about why steps that family members take with good intentions can actually be a significant issue for social care practitioners to navigate. Shortly afterwards a judgement was published which demonstrated that issue very well for me. And it’s not that every instance of these measures always does turn out to be a problem, but cases like that of GA are the reason why the safeguards exist and such issues need to be properly explored.
The case concerned an 87 year old lady who went by the initials of GA for the purposes of the judgement. She lived in a housing association property which she rented, with 2 of her 6 (now adult) children.
One of those sons, referred to in the judgement as TA appeared to be his mother’s sole carer at home (the other son having a care package of his own). TA had previously managed his mother’s finances as her financial attorney but had been removed from that post following a conviction for fraud and abuse of position. These offences appear to have directly related to his management (or mismanagement) of his mother’s finances.
TA’s behaviour throughout the proceedings appears to have been unusual (to say the least) and he did not attend some hearings despite being order to and did not provide information when required to under the court orders.
What stood out to me when reading it was the number of the issues that I’d said require investigation in my previous post, that appeared in this case. GA was locked in the house when TA left the building. He had surveillance in place, linked to his mobile phone. She had not left the house for more than a year, and there were occasions when TA would not permit medical professionals access to GA, despite having a history of heart problems that required medication and monitoring. That medication did not appear to be being given to GA. Other family members were not permitted to visit her, and TA delivered all her care and support including intimate care.
This was a particularly extreme case. Nevertheless I have no doubt that TA did not consider what he was doing to be in any way inappropriate. But the level of restrictions to which she was subjected was beyond what the local authority would have put in place. TA exhibited a very high level of control over his mother’s life, with little apparent consideration of his mother’s best interests within the meaning of the Mental Capacity Act 2005. This is, as those of you reading this know I am sure, completely different from ‘whatever I think best’. It requires consideration of what GA would have wanted (and indicators were that she would not have wanted her care delivered by her son, and that she had previously been very sociable and would not have wanted to become as isolated as she did).
It also requires consideration of less restrictive options, and of whether restrictive measures are proportionate. As I discussed in my previous post, surveillance on a 24 hour basis, and locking of doors are unlikely to be considered proportionate in most cases. Other options are usually available.
And on the face of it, it might seem that surveillance remotely is less restrictive of her rights than having a 24 hour staff presence. Except that staff can leave the room when they are not needed, they can avert their eyes to preserve modesty, they can be observed themselves. Remote surveillance can do none of these things.
Transmission of remote surveillance to someone’s mobile phone is even more restrictive, because of the potential for wider dissemination of the video footage if digital security is breached (or if TA chose to post the videos online, which he appears to have done with some videos relating to his mother’s care).
The judgement of Cohen J grapples with the issues in much more depth than I possibly could in a short post. And it is clear, on reading it, that he dealt with the issues sensitively and did try to work with TA to achieve an outcome that would enable him to remain in the family home. But that was not to be, and instead the order was made preventing him from continued occupation at the property, and enabling social care to put a package of care and support in place at her home.
For anyone wondering why social workers are getting involved in their arrangements to look after their family member at home, this case is an example of what could be going on. That doesn’t mean they think it is what is going on, and it may well be that they are happy to preserve the arrangements going forward. It just means they have to have checked, just in case.
In situations where the care at home is genuinely in the person’s best interests then either the social worker will go on their merry way, or they will have to submit the case for approval by the Court of Protection to ensure the person’s rights are protected. That last is nothing to be afraid of, and really does exist for everyone’s benefit.
And for anyone who is reading this thinking that it sounds awfully similar to a case they are working on, the judgement provides really useful guidance on how to approach these cases and what the court can do to end these arrangements where necessary.
It is worth nothing, though, that in this case TA did not have a tenancy at the home, and it was rented in GA’s sole name. That made the process of removing him from the property much more straightforward than if they had held a joint tenancy. Nevertheless, enforcement could still be difficult, if TA refuses to leave, or attempts to return to the property and resume his previous role within the household. Hopefully he respects the decision of the court though, and I like to think that GA now finds herself in much improved conditions, and has now been able to spend some time with her grandchildren.
In case it isn’t obvious from the fact I still haven’t identified the authority I work for, the views expressed on this blog are my own opinion and not the opinion of that local authority