Although a child's mental health care and treatment were overall of a good standard, some care was unhelpful

What happened

L was admitted to an assessment and treatment unit for children with severe emotional and behavioural disorders in early summer 2013. She had Asperger's syndrome (an autistic spectrum disorder) and severe obsessive compulsive disorder (OCD).

Later in summer 2013 Mr H decided to remove L from the unit because he felt that the daily input she had was not always consistent and helpful for her. L was eventually discharged from the unit's care the following month.

Mr H subsequently complained to the Trust about the care and treatment L had received. He said that she had experienced bullying, intimidation and ill treatment by staff during her time there and that staff did not have any skills or knowledge of Asperger's syndrome. He alleged that staff told L that she had an 'attitude problem' as she would not look them in the eye. Mr H also said that staff walked in on L while she was using the toilet and that she was not allowed to use the phone to call home as agreed. He also raised concerns that L did not receive any treatment during her time at the unit.

The Trust investigated Mr H's complaint and responded. However Mr H was dissatisfied with the response, and complained to us.

What we found

Overall, the care given to L was of a good standard, with comprehensive assessments and care plans designed to treat and rehabilitate her. We were satisfied that generally staff had a good understanding of her needs and her difficulties.

There was, however, a failing by the Trust because of a lack of consistency about L using the telephone to call home. Obsessional rituals, desire for sameness and resistance to change are inherent to L's diagnosis of Asperger's Syndrome and OCD and therefore it was unhelpful that there were multiple plans in place. This would have caused confusion and frustration for Mr H and L.

L was assaulted by another child on the ward and there was a failing in how this was managed. As a young person with problems in social communication and peer relationships, L was likely to have been especially distressed by such assaults. While the Trust had acknowledged that it could have dealt with the matter better, and had apologised for the upset caused, it could have done more to acknowledge the impact of this on both Mr H and L. It could have explained what action it had taken to ensure that it had learnt from this aspect of Mr H's complaint.

Finally, there were failings in how the Trust handled the complaint, namely delays and lack of acknowledgement of correspondence. This would have been a source of frustration for Mr H and would have led to him feeling that his complaint was not being treated seriously. The Trust had not formally acknowledged the shortfalls in its complaint handling or offered Mr H a formal apology for this. It had also not explained what it had done to prevent the same thing happening again.

Putting it right

The Trust wrote to Mr H acknowledging the failings we had identified and the impact these had had on him, and apologising for this. It also prepared an action plan that described what it had done or planned to do, to make sure that it had learnt from the failings identified in our investigation.