Case No. EWHC-185-(Admin)

37.Various reports from occupational therapists (OT), most of which had been seen by the Ombudsman, were in the trial bundle. On the 20th of May 2020 a telephone assessment was completed by Intisar Osman. The Claimant's GP was listed as the Torriden Medical Centre, Catford; which is odd being far away from Westminster. The Claimant’s carer, called Hadi, reported he was providing 35 hours of care and that the Claimant’s sister and another friend were providing the remaining hours to complete 24 hours of support per day voluntarily. The carer asserted the Claimant needed 24 hours care, so day and night. Mr Hadi asserted that he was receiving a carers allowance through the Claimant’s PIP payments for 35 hours care per week. The carer asked for manual handling equipment which had previously been recommended by an occupational therapist but could not be issued due to lack of space in the property and narrow door widths. Under “relevant medical information” the Claimant asserted he had suffered a road traffic accident leading to frozen left shoulder, spinal disc degeneration and nerve damage. He asserted he attended pain management and neurology clinics. He also asserted that he suffered tachycardia, asthma, migraines and tremors, constipation, dyslexia and anxiety. The Claimant asserted he was a permanent wheelchair user but was unable to use the wheelchair properly in his flat due to restricted space and door width. The carer reported the Claimant had minimal weight bearing capacity and was requesting a tripod walking stick due to reduced balance. The OT advised the carer to liaise with the GP however the GP was in Catford. The OT advised the carer to liaise with the neurologist at clinic. The Claimant was able to self-propel his wheelchair indoors. The OT noted that the Claimant needed maximum assistance with steps and front door access. The OT noted a previous recommendation for a profiling bed but that there was insufficient space in the flat for that. The Claimant had been provided with a raised toilet seat and frame to assist with toileting. The OT noted assistance was needed with mobility, personal care, shopping, meal preparation, feeding, housework, laundry, correspondence, community access and prompting medication. The OT noted the Claimant had a bath lift and needed assistance with transfers. The OT considered the current property unsuitable and described it as temporary accommodation. The OT reported no adaptation was possible. The OT recommended a move to suitable step free accommodation where his complex needs could be met with suitable equipment.38.On the 20th May 2020 the same OT filled in a “telephone assessment form”. The OT noted that the Claimant spoke English and needed no interpreter. There had been a referral from adult social services asking the OT to complete a functional mobility assessment because social services had been informed that one carer was unable to manage. That carer, Hadi, was acting as advocate for the Claimant. He received carers allowance to provide 35 hours care per week. Informally more care was being provided by a family friend and the Claimant’s sister. The carer was requesting an increase in supported care. As to the question of whether the carer was managing, the OT wrote the carer advised that he was managing. The OT accepted that the Claimant was unable to negotiate stairs and was wheelchair dependant. The OT advised that the current property was not suitable for the Claimant’s complex needs. The OT recommended completing a form for consideration of an increase in paid for care.39.On the same date, 20th May 2020 a Care-support plan was provided by the OT. In that the OT advised that the current informal package of care was not meeting the Claimant’s needs and that the Claimant needed a care package review. Although the box for consent to access to medical records is ticked by the OT there was no signature from the Claimant and no details of the GP or any consultant were listed on the form.40.These OT reports were available before the Defendants’ medical assessor in mid 2020 and the doctor’s assessment did not support the level of disability the Claimant reported to the OT.41.Four months later, in September 2020, the same OT provided a further report having visited the Claimant. The Claimant, his sister and his cousin were present. The Claimant asserted he was sleeping on the floor because he was unable to tolerate lying on a soft mattress. The OT observed transfers from the floor and observed that the Claimant had a frozen left shoulder and minimal weight bearing through his legs. The OT recommended removal of the double bed and installation of a profiling bed, installation of a mobile hoist and reassessment in a formal way to assess his care needs. The OT also suggested a follow up visit.42.In May 2021, Jermaine Frazer, a different OT reported. She was asked to focus on care and equipment because the Defendants’ social work department did not think that the Claimant needed 24 hour care. The OT met the Claimant and his sister, Rezar. The Claimant asserted his health had deteriorated with increased migraines and more severe back pain so he slept on the floor. He reported he was still seeing a neurological team, a cardiology team, a pain management team and going to an asthma clinic. There was a mini sling in the flat. The Claimant asserted he only slept on the floor. The Claimant asserted 2 informal carers lifted him without use of the hoist. The OT suggested a hospital bed but this was refused because the Claimant asserted the landlord would not give permission for any of the furniture to be removed. He did not use the commode because he had no one to empty it. Therefore he waited for two carers to assist moving him into the bathroom. He refused incontinence pads. The Claimant’s sister asserted that the Claimant was provided with 24 hour care and that she wanted to get back to her life now that COVID restrictions were lifting. The OT informed the Claimant that a 24 hour care package would not be recommended. The OT focused instead on the need for assistance with transfers and the need for more space. The OT noted the Claimant’s concern about the fire risk if the fire alarm went off and advised that the property was not suitable for the Claimant. The OT supported rehousing on an urgent basis because more space was needed for the carers to use a hoist. In the recommendation section the OT noted the Claimant was in crisis and required rehousing urgently and recommended a full care review. The OT did not recommend 24 hour care but did recommend the need for a formal care package because of the risk of the voluntary informal care package breaking down. The OT considered the Claimant needed assistance with transfers, washing, household tasks, shopping and toileting.