NHS board and Wandsworth Council pay £650 over autistic boy's care failings

NHS South West London Integrated Care Board (ICB) and Wandsworth Council have been found at fault for failing to adequately assess and review the care of an autistic boy, identified as J. A report by the Local Government and Social Care Ombudsman concluded that these failures caused significant stress and uncertainty for the boy's mother, Mrs D.

The ombudsman's investigation found that both the ICB and the council did not fully assess J's needs before determining what support they were responsible for after he left hospital. J has autism, a borderline learning disability, dyspraxia, and OCD.

Concerns over mental health decline

Concerns about J's deteriorating mental health were raised in June 2023 by his GP, who wrote to the ICB warning of a potential rapid decline that could lead to him being "inappropriately sectioned". Mrs D had requested an urgent care and treatment review in September of the same year, following an incident where her son assaulted a companion. She stated he was in crisis and lacked a suitable service to oversee his care, expressing fear for his safety given a previous traumatic hospitalisation.

The watchdog questioned why professionals initially did not believe the conditions for a review were met and found the ICB at fault for not providing Mrs D with a clear response to her request. J was later sectioned after another assault and admitted to a mental health hospital in early October. He received a care and treatment review later that month, and another provider agreed to offer support.

Compensation and apologies ordered

The ombudsman's report stated that the ICB's failure to arrange a review or explain its decision caused Mrs D "stress and frustration" and left her with "lasting uncertainty about whether more could have been done to prevent J’s detention in hospital". The report also found fault with the ICB and council for attempting to determine responsibility for J's aftercare before his needs were fully assessed. This led to Mrs D experiencing further frustration and distress due to a perceived lack of progress in discharge arrangements and uncertainty about her son's hospital stay duration.

Additionally, the ombudsman noted that insufficient consideration was given to J's participation in activities during his admission and as part of his discharge planning. He had to wait a month after his late January 2024 discharge for the ICB to fund his attendance at day centres five times a week. Mrs D was left with a "lasting sense of uncertainty about whether J missed out on an opportunity to benefit from earlier access to activities".

The ombudsman directed the ICB to pay Mrs D £400 and Wandsworth Council to pay £250, totalling £650, for the distress caused by their failings. Both organisations were also instructed to formally apologise to Mrs D.

Organisations review processes

An NHS South West London ICB spokesperson stated: "We are sorry that Mrs D and her family did not receive the standard of support they should have. We have accepted the ombudsman’s findings and have apologised to Mrs D. We are taking the actions set out in the report, including reviewing how the case was handled and working with Wandsworth Council to identify improvements to the way care and support are planned and coordinated. We are committed to learning from this case and improving our processes."

A Wandsworth Council spokesperson added: "We take our responsibilities towards those in our care very seriously. We are sorry for the distress caused and will complete a review of the council's handling of the case to improve our processes and ensure this does not happen again."