Elizabeth Carol Shaw v Lancashire County Council

Decision of Registered Homes Tribunal held at Warwickgate House, Warwick Road, Old Trafford, Manchester on Monday 10 November 1986. Appeal by Mrs Elizabeth Carol Shaw against the decision of the Lancashire County Council to cancel her registration in respect of the premises Stepping Stones Home for the Mentally Handicapped at 17 Parson Lane, Clitheroe and also at 127 Whalley Road, Clitheroe, Lancashire. The Tribunal Mr William Morris Jones (Chairman)Mr R BessellMr Harry Neal Representation Mr Peter Norbury of Messrs Alexander Tatham and Co of Manchester for the Appellant. Mr David Kenny of Counsel instructed on behalf of Lancashire County Council for the Respondent. Interpretation "The 1984 Regulations" means The Residential Care Home Regulations 1984 SI1345 of 1984. The Tribunal adopt Regulation 1(2) of the 1984 Regulations. "The appellant" means Mrs Elizabeth Carol Shaw of 36 York Street, Clitheroe, Lancashire. "The respondent" means Lancashire County Council. "17 Parson Lane" means Stepping Stones Home for the Mentally Handicapped at 17 Parson Lane, Clitheroe, Lancashire. "127 Whalley Road" means Stepping Stones Home for the Mentally Handicapped at 127 Whalley Road, Clitheroe, Lancashire. "Calderstones" means Calderstones Hospital, Whalley, Lancashire. Grounds of Appeal The appellant relied upon five paragraphs of her "Grounds for Appeal" dated 17 October 1986. Issues

1. Deception employed by the appellant in removing residents from Calderstones.

2. The residents concerned were informal patients entitled to discharge themselves from Calderstones.

3. The procedure adopted by the respondent.

4. Prejudice to the appellant.

5. Facts were not of sufficient gravity to justify a finding that the appellant was not a fit person and further the character of the appellant. History 127 Whalley Road was registered in November 1984 in the names of the appellant and Mrs Julie Brown to accommodate six mentally handicapped persons. 17 Parson Lane was registered in August 1985 in the name of the appellant only to accommodate six mentally handicapped persons. In her evidence, the appellant indicated that she had no professional qualifications. She had worked at Brockhall Mental Hospital for a time, and therefore had some practical experience. She then lived, and still does, at 36 York Street, Clitheroe with Mr David Ronald Shaw, her husband, a building contractor. Both the appellant and Mr Shaw own properties and have a property company, which was not material to the considerations before the Tribunal. In or about the end of October 1985 the appellant had six residents for whom she was providing accommodation in 127 Whalley Road. 17 Parson Lane was empty at that time and, because of what she understood to be the policy of the respondent, the appellant was anxious about getting suitable residents for that home. Staff employed at 127 Whalley Road and also available for employment at 17 Parson Lane were the equivalent of day care assistants. A daughter who is also a SEN was available to help from time to time. Mrs Julie Brown had not assisted at either home since the autumn of 1985. Events Mrs Sandra Knappett a nursing assistant at Calderstones in her evidence stated that on the morning of 31 October 1985, she received a telephone call from a man, who did not identify himself, asking if two residents Marjorie T and Dorothy P could have tea with a Margaret S, a former resident at the ward at Calderstones, and then at her home at Glencairn, Padiham, being a private residential care home. The residents were approached by Mrs Knappett but Marjorie T did not wish to go although Joan D, who was nearby when the question was put to Marjorie, said that she would like to go instead. The residents Joan and Dorothy were in fact picked up at about 3 pm that afternoon by a fair haired woman who did not identify herself and there was no indication, either from the telephone call nor from the caller, of who was taking these two residents nor where they were being taken. Mavis Dickinson who is employed as a nursing assistant on the ward known as 19 Ribble Avenue at Calderstones, stated in evidence that she was on duty on 31 October 1985 when she took a telephone call from a man about Ada B visiting a Margaret S at Glencairn in Burnley for tea. Arrangements were made to collect this patient, and later that day a fair haired lady came for the resident. Neither from the telephone call nor from the caller was any indication given of where these patients were being taken, nor who would be responsible for them. It was orally agreed that all three residents would be returned back to Calderstones after tea. There was a conflict of evidence about the date of these telephone calls which Mr Shaw, the husband of the appellant, confirmed that he made, but he stated that the calls were made on Wednesday 30 October 1985 and not on Thursday 31 October. Also he did not agree that he mentioned Margaret S nor Padiham nor Burnley. However, it did come out in the evidence, that the telephone calls were made once only, direct to the wards as suggested, and that Mr Shaw did arrange for named patients to be taken out for tea on 31 October 1985. The appellant stated in her evidence that she was then in touch with a former employee of Calderstones, who suggested the names of the patients, whom she, the former employee, knew during her former employment there. The appellant appears to have relied upon these recommendations. This person did not give evidence. Mr Shaw also agreed that he did not give his name, nor did he indicate where these named patients were to be taken to tea. He was not asked for his name. The telephone calls which were made by him were as the result of the written directions of the appellant, and the appellant confirmed that this was so. Evidence confirmed that the initial arrangement was for the patients to have tea and that they were all to be returned to Calderstones on the same evening after tea. It was also not in contention, that the three patients who were collected from Calderstones were Dorothy P and Jean D from 16 Calder Avenue ward and Ada B from 19 Ribble Avenue ward. This was confirmed by Mrs Brown who stated in her evidence that she was the person who collected the three patients. She did not give her name, nor was she asked any questions by the nursing staff. The three patients were dressed and ready to go out, and they accompanied Mrs Brown to the waiting vehicle. On the evening of the 31 October 1985, a telephone call was received at Calderstones by Miss Betty Porter, a night sister, who on the night in question, was also acting as assistant director of nursing at Calderstones, to the effect that transport would not be available to return the three above-named patients to Calderstones. Evidence showed that the caller did not indicate who she was, nor the whereabouts of the three patients, nor did she ask for any transport to be provided in which to return them. Documents and records kept on the wards were not for subject of discovery. It was not until 1 November 1985, that the patients were officially declared absent, and the staff at Calderstones arranged a full alert and called the police to confirm the whereabouts of the three above-named patients. Mr Christopher Richard Grimsley, who was then the senior social worker based at Calderstones and was employed by the respondent, promptly put matters in hand and organised the necessary arrangements for finding and ultimately bringing the three above-named patients back to Calderstones. In her evidence, the appellant claimed that, once the three patients had the opportunity of seeing 17 Parson Lane, they liked the premises and expressed the wish to stay, although the evidence of Mr Grimsley and of Mrs Clay indicated that Joan D was "greatly disturbed by the events". The appellant arranged for the services of an independent solicitor, a Mr Parkinson, whom she instructed to interview the three patients whom he understood to be informal patients. Mr Parkinson did not file an affidavit nor was he called to give evidence as a witness. In his two affidavits, Dr Hubert Inceman, a consultant psychiatrist at Calderstones, indicated that he had spoken with Mr Parkinson on 1 November 1985. Both the policy of discharging patients at Calderstones and the medication required for one patient, were discussed and it would appear that Mr Parkinson suggested that none of the three patients wished to return to Calderstones and would seek discharge. By 12.45 on 1 November 1985 Mr Grimsley was alerted, as before mentioned, and thereafter, matters were swiftly put in hand. Both Police and also staff from Calderstones arrived at 17 Parson Lane. There is a conflict in the evidence of precisely what happened at 17 Parson Lane, but it is clear that the appellant was opposed to the visit of the staff and police and initially refused to allow members of the staff at Calderstones to see the three above-named patients. However, in the event, the three patients did return with the staff to Calderstones. Mrs Barbara Clay, who was employed in the social services department of the respondent as assistant manager with responsibilities for dealing with registration and inspection of residential care homes in the areas of Blackburn, Highburn and Ribble Valley in which Stepping Stones are situated, gave evidence indicating that she accompanied Mr Grimsley to 17 Parson Lane on 1 November 1985. Clearly there were difficulties between the parties, but matters were sorted out and the three patients were returned with the staff to Calderstones, as indicated above. In his submissions on behalf of the appellant Mr Norbury pointed out the conflict of evidence in so far as dates and times of telephone calls in October 1985. However, it is clear that the evidence identified only one telephone call to each ward by Mr Shaw and the facts of the removal of the three patients, and the way in which this was done which was not in issue. He also criticised the procedure of the staff at Calderstones, and indicated that some enquiry should have been made of those who sought to remove any patients. The Tribunal noted that the evidence of the appellant, indicated that those acting on her behalf, did not volunteer any information either as to the nature of their visit, who they were, nor where the patients were being taken. Mr Norbury also made a point of the specific indication of deception, but here the facts would seem to indicate that the way in which the residents were taken, was as the result of a stratagem devised by, and on behalf of, the appellant. That the three patients were upset on the evening of 1 November is not in issue, but it cannot necessarily be said that this was due, as was submitted, to the number of staff, the attendance of the police and other matters which came out in the evidence. The fact that the three patients had been taken to 17 Parson Lane in circumstances which were to deprive Calderstones of the knowledge of their whereabouts, necessitated enquiries being made by the hospital. The submission that the three patients indicated their wish to remain at 17 Parson Lane is a matter which raises their mental understanding of what they had said to the appellant. Evidence did show, that one of the residents certainly had the intelligence of a child of about 5 years of age. References were also made to the complaints procedure as set out in Home Life paragraph 6.12 on page

60. It would appear, however, that as the result of obtaining legal guidance early on, the appellant had had the advantage of the legal advice of Mr Norbury and his firm for over a year, and that he had attended a meeting with the respondent on behalf of the appellant. Decision When the appellant came to the conclusion that there could be difficulties in obtaining residents for her homes from the respondent, because of what she believed would be the effect of their policy towards private sector homes, she decided to 'introduce' prospective residents by inviting them to tea, and showing them the homes. The way in which this was done was devious in that she did not wish the authorities at Calderstones to know her identity nor that of the home. In the event when transport broke down, the appellant appears to have used this as a means to further her ends. She did not try to arrange alternative transport nor did she seek help from Calderstones. The patients were not able to evaluate the position for themselves in view of their mental state, and the appellant did not take either the staff at the hospital nor the nearest relatives of the patients into her confidence which would be a normal step in admitting new residents following paragraphs 4.4.2 of Home Life (page 40). The patients had no night attire nor any toiletry when the appellant arranged for their stay for the night of the 31 October 1985. There had been no reference to case history of each one of the residents and only the following morning an inquiry about medication was made by a solicitor to the consultant psychiatrist. Evidence and particularly that of the appellant herself would tend to show that the appellant embarked upon a scheme of her own, without due regard to the question of whether the patients were suitable residents, and whether, in the long term, their move from hospital to her home would be for the benefit and the well being of each one of these residents. In all the circumstances of this reckless venture, the Tribunal consider that the appellant is not a fit person to be concerned in carrying on a home. The Tribunal unanimously dismiss the appellant's appeal. Signed:-W M Jones – Chairman R Bessell R Neal December 1986