The Trust withdrew Ms Z's crisis support from her home after an incident in which she allegedly pointed a knife at a member of staff. Although Ms Z was not left without adequate support, staff did not assess the risks properly and the Trust did not revisit its decision to withdraw crisis support.
What happened
Ms Z had been receiving crisis support from the Trust for a number of years. This was usually in the form of somebody going to her home to complete a welfare check, and to help her in times of crisis. On one such occasion, a care worker reported that Ms Z had pointed a knife at her. This prompted the Trust to withdraw home support. It told Ms Z that she would have to attend a safe environment if she wished to get support.
This continued for a number of months and Ms Z became more upset at the situation. She felt she was being penalised for an incident that was never proven.
What we found
We partly upheld this complaint. The Trust acted appropriately by initially withdrawing home visits, but there is no evidence it later reassessed the risks. Although we could not say that the care and support Ms Z received was inadequate during this time, we did not see any evidence to justify the continued blanket withdrawal.
Putting it right
The Trust apologised to Ms Z for the failings we identified. It completed a new risk assessment and used this to reconsider whether Ms Z's current crisis plan was sufficient. The Trust also formulated an action plan to show how it would make sure it completed appropriate risk assessments in future.
Barnet, Enfield and Haringey Mental Health NHS Trust
Greater London
Did not take sufficient steps to improve service
Apology
Recommendation to learn lessons or draw up an action plan
Taking steps to put things right