"Oxleas: Stepping Stones - failing to appropriately assess needs and respond to complaints"

About: Oxleas NHS Foundation Trust / Adult mental health

(as a carer),

The young woman I care for (my sister) has multiple mental health diagnoses. The one that most restricts her life though is agoraphobia. Severe agoraphobia means you can't go out except somtimes with a 'safe person'. This has all been explained to Stepping Stones and the formal complaints team. So what has happened?

1. My sister has been repeatedly discharged from services for not attending appointments despite the fact the very nature of her illness is that she can't get out to things.

2. As a result she has been denied access to a psychiatrist as a direct result of her mental health disability. At no point during her last referral was she seen or been appropriately assessed by a psychiatrist.

3. Since her last discharge (which I consider to be completely inappropriate), her GP , her advocate and her counsellor have all expressed the view she should be under the care of the mental health team. The GP counsellor is so worried about her that they have raised a safeguarding adults issue about my sister.

4. In assessments, I feel the team have distorted information to their own ends to justify discharge. For instance, they repeatedly say that my sister attends educational and other activities by herself. In fact she has, on one occassion in the last 3 years, gone to the theatre with a friend who is a qualified social worker, and the route to the theatre was one I take her on frequently and was therefore a 'safe' route. For a 26 year old to see one friend in 3 years hardly suggests she is no longer in need of mental health services.

5. Another issue is that my sister was not told about all her diagnoses. She thought she was being treated for agorpahobia but it turned out there were a lot of other diagnoses they never told us about. We requested the criteria she meets for them in a formal complaint (something that should be easy to access as it is medical record guidelines to record criteria when dx is made) but this has been repeatedly denied to us and she has been told to see a psychiatrist to talk about it - but no provision has been made for her to get to an appointment in order to do so.

6. The team has consistently made ridiculous suggestions and then insisted things have been put in place. For instance, on her discharge they signposted her to resources eg credo that would require her to take bus/trains to areas she has never been to - clearly impossible for her and yet when we say they have made no suitable suggestions they just keep repeating she should go to things which are inaccessible to her because of the limitations caused by her mental health problem.

7. Related to the above, as far as we are aware the team has not properly looked at or told her about her options. For instance, they repeatedly told her to go to Bromely community Counselling - a fee paying service when NICE guidelines say she should receive psychological treatment on the NHS, and also miles away from her home and therefore inaccessible to her. Furthermore, after she was discharged we contacted BCC who said her needs were far too complex and she should be at least on high intensity IAPT. This option has never been suggested to us and would have been much more sensible as the local IAPT service is 15 mins rather than 1. 5hours away.

8. It feels to us as though the limitations caused by her mental health problem have been repeatedly blamed on her and she has been told she has to 'take responsibility' and use self help material. I very much doubt a highly intelligent young woman who was at a top university when she got ill would 'choose' out of 'irresponsibility' to spend 4 years gaining ten stone, losing her entire social network and basically having her whole life destroyed, if all she needed to do was a few self help book exercises!

Although I am her carer I also have a severe disability myself which means I cannot provide her with all the help she needs. Oxleas has failed to appropriately assess my needs and my own care co-ordinator has expressed extreme concern about how looking after my sister is impacting on my health. They have looked at my sisters needs assessment and my carers assessment which identified 'no risks/needs' and said that they are both unsatisfactory.

My carers assessment is another instance of Oxleas staff totally distorting what has been said. Apparently I have no needs because I no longer wish to be a carer (and therefore am not a carer). What I actually said, and have repeated to them lots of times, is that I want my sister to be WELL so I don't HAVE TO BE a carer - I think even the most confused person could understand the difference between that and saying I am not providing any more care.

I feel there is so much more wrong with the way with have been treated by Oxleas but I just hope that other people with symptoms of agorpahobia are not being denied access to services and inappropriately asssessed in the way I feel my sister and I have been.

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