The pounds 100,000 fight for a son's care

The father of a physically disabled and mentally ill man took Surrey social services to the High Court to compel them to give his son the care he needed.

Mental health bodies claim the case, likely to cost the taxpayer up to pounds 100,000, exposes shortcomings in the Government's care in the community programme, despite ministerial warnings to social services and health authorities to tighten up procedures.

Andrew Richardson, 35, who suffers from cerebral palsy, schizophrenia and severe epilepsy, claims he has only been promised an assessment at the Royal Hospital for Neurodisability in Putney, southwest London, after leave for a judicial review of his plight was granted. Surrey social services denies it failed to provide for his needs.

His combination of physical disabilities and mental illness has made it difficult to find him suitable community care. He has absconded from residential care, slashed his throat and drunk a bottle of aftershave in a suicide bid. Parents Don and Edwina Richardson, of East Molesey, Surrey, also have a mentally handicapped son and cannot cope with Andrew at home.

In June 1994, Surrey social services sent him to The Summers, a residential home for the physically disabled. ''The place was so inappropriate , he became desperate for help and ran away,'' explained Mr Richardson. ''After 18 months there, he drank the aftershave.''

After the suicide attempt, Andrew was admitted in January to an acute pyschiatric ward at Tolworth Hospital, near Surbiton. The hospital fixed a discharge date for 29 March, and he was only offered accommodation at The Summers.

The Richardsons challenged the decision of the Kingston and District Community NHS Trust to discharge him and the failure of Surrey social services to provide suitable community care .

In the High Court, Mr Justice Tucker granted leave for a judicial review of the decision and ordered Andrew remain at Tolworth until a package was agreed.

Last week, the matter still unresolved, his parents returned to the High Court and secured an undertaking from Surrey County Council that Andrew will stay at Tolworth until his transfer to Putney for a six-week assessment. If a stay in the rehabilitation unit works out, he could remain there, or, if deemed suitable, he could move into his own flat with 24-hour care. The case was adjourned and costs are in dispute.

His parents are furious. ''We suggested to social services that Andrew should go to Putney 18 months ago but were told it was unsuitable,'' said Mr Richardson. ''It has taken months of stress and it looks like pounds 100,000 to make them see sense.''

Their solicitor, Nicola Mackintosh, claimed Surrey only took steps to provide a care package in the run up to the court hearing, and Tolworth breached its discharge procedures, which both refute.

She claimed that both the NHS trust and the county council flouted policy guidance accompanying the NHS and Community Care Act 1990, which came into force in April 1993 and recommended close links between health authorities and social services to help elderly or disabled people to live as independently as possible.

The Department of Health also insists under the Care Programme Approach that the mentally ill living in the community are as much the responsibility of the hospital as they are of social services.

June McKerrow, director of the Mental Health Foundation, claims patients often find themselves trapped in the middle between two warring factions. ''There are not enough resources or care places so there is no point talking about the CPA process. This case is a sad reflection of the problem.'' Brian Parrott, director of Surrey social services, said his department had worked tirelessly to draw up a care package for Andrew.

Fred Little, chief executive of the Kingston and District Community NHS Trust, said: ''The fundamental disagreement in this case was over the type of accommodation Mr Richardson was to be discharged into. The Trust had no intention of discharging him without first ensuring that proper arrangements for his care were in place.''

In the waiting room of his ward, Andrew Richardson shuffled in his wheelchair. ''I would rather kill myself than go back to where I was before,'' he said. ''My condition is more controlled. The only way it can stay like that is in a proper home.''