A disabled man has spent almost 10 months in a busy basic hospital as a result of no appropriate residence has been discovered for him in the neighborhood.
Matthew Sharp, who has a spread of advanced situations, says he has been left in limbo whereas his native NHS and council attempt to determine who’s liable for his care.
Council bosses in England say disputes between the NHS, native authorities and households over who ought to pay for essentially the most advanced care instances are rising.
Matthew’s native well being and care system says it really works with people, households and others “to know the kind of care a person wants”.
Following a number of BBC reviews over the previous 12 months, greater than 250 individuals have contacted us elevating considerations about NHS-funded social care – together with Matthew and his household.
The 36-year-old has been in Epsom Basic Hospital in Surrey for greater than 290 days – for many of that point he has been medically match to go away.
“I am simply caught in a jail mainly,” Matthew says. “Life could be very tough, life is gloomy, and I’ve bought a number of anger.”
His household says that the scenario has brought on his well being to deteriorate.
Matthew has Tourette’s syndrome. It causes tics or involuntary spasms, a few of which have been so violent they’ve broken his backbone – the explanation he’s now in a wheelchair.
One other tic means he involuntarily calls out and repeats phrases – generally the phrases could be offensive. He says his tics have develop into “extra chaotic” due to the stress he’s below.
He additionally has a studying incapacity and a spread of extra bodily and psychological well being situations, together with ADHD and Obsessive Compulsive Dysfunction (OCD).
On 6 October final 12 months, Matthew was taken to hospital with a urinary tract an infection.
He had been in supported housing, however that placement had damaged down, so he was not in a position to return.
Since then, Matthew has been dwelling in a aspect room within the hospital. He finds the fixed noise and being on a ward with extraordinarily sick individuals very irritating.
We’re assembly on the College for the Inventive Arts close to the hospital. Matthew is a gifted artist and his mother and father have introduced one in every of his work with them.
He manoeuvres his wheelchair so he can get a greater take a look at the image which reveals three boats jumbled on a shiny yellow strip of seashore.
The ocean and sky are vibrant blue, however Matthew factors to the gray railings and pavement that run throughout the underside of the image.
“That represents my life,” Matthew says. “The barrier stopping me doing the issues I wish to do.”
His mother and father, who’ve their very own well being points, describe the scenario as extraordinarily distressing.
“Matthew is now in that place whereby he is not likely seen as a person,” says his mom, Christine. “He has no significant life.”
Matthew’s help was being funded by NHS Surrey Heartlands Built-in Care Board (ICB) below a scheme known as Persevering with Healthcare (CHC). Solely individuals with the very best wants are eligible for this free NHS social care.
After almost two months in hospital, he obtained a letter from the ICB saying it had tried 145 totally different properties offering care and help. They recognized three which may probably take him.
The ICB now says the household declined numerous appropriate choices earlier than reaching this extra formal stage.
Matthew’s mother and father strongly dispute this. Additionally they say one of many three properties listed was preferrred however ultimately no place was provided.
When the ICB wrote to Matthew once more on 4 December 2023, he was advised there was only one residence the place he may be capable of stay.
The household says the house was completely unsuitable for somebody as susceptible as Matthew, with drug-dealing taking place overtly on the road outdoors.
The ICB letter mentioned it believed the position met “his assessed wants”, and will he refuse it then “which means that you decline CHC funding and make your personal non-public preparations”.
CHC funding was withdrawn on 21 December. The ICB says it made a referral to Surrey County Council for it to supply his care.
The council says it was made conscious of Matthew’s case in December however didn’t develop into concerned till Might.
Matthew’s disabilities – and being on advantages – imply that if his care is just not funded by the NHS, then it must be offered by his native authority.
However within the following months, neither appears to have taken on the job of discovering him someplace to maneuver to.
It’s a advanced case, however we have now not been given a transparent reply as to why this occurred.
The consequence for Matthew is he’s caught in hospital.
The estimated value of a typical NHS hospital mattress in 2020/21 was nearly £2,500 a week.
Matthew’s mom, Christine, describes the present scenario as “not honest on anybody”.
“The quantity it have to be costing to maintain Matthew in a hospital mattress must be being spent on someplace that he’s in a position to stay his personal life and revel in,” she says.
In Might this 12 months, eight months after Matthew arrived on the hospital, the ICB says well being employees requested a assessment to see if he was nonetheless eligible for NHS-funded Persevering with Healthcare.
Official steering says the brink for this screening course of “has been set intentionally low, with a view to make sure that all those that require a full evaluation for eligibility” have that chance.
It additionally says individuals must be given cheap discover when that is to occur. Consultants say that will often imply just a few days.
Matthew’s household says he was given simply 10 minutes’ discover that an evaluation or “guidelines” could be carried out.
He known as his mother and father, who stay an hour away. They couldn’t get there in time to help him. He says he requested for the guidelines to be delayed however was advised it might go forward with out him.
We in contrast the guidelines in opposition to earlier multi-disciplinary assessments of Matthew’s well being and care wants. There are vital variations.
Within the guidelines, his Tourette’s syndrome is talked about in passing, and there seems to be little acknowledgement of the severity or affect of his tics.
There may be additionally no point out of his ADHD, OCD, or the deep mind stimulator which is used to assist management his tics, and which he requires assist with.
The guidelines was accomplished utilizing hospital notes. The ICB says it was undertaken according to the nationwide framework, with well being professionals concerned in Matthew’s care.
However the household says the member of employees concerned was new and didn’t know him.
“It simply made me upset. So mainly, they are not listening,” says Matthew.
His household says his well being has deteriorated since he was final assessed, however the conclusion of the guidelines was that he was now not eligible for CHC.
Claire Stone, NHS Surrey Heartland’s chief nursing officer says whereas it can’t touch upon particular person instances, it really works carefully with these concerned to “present help and recommendation and guarantee a clean transition to any new preparations”. She additionally says “anybody who chooses to say no CHC care” can reapply at any time.
Surrey County Council says it started plans for Matthew to be discharged to a everlasting residence in June, including that “on the coronary heart of this advanced case is a person and it’s essential that Matthew’s wants are put earlier than the rest”.
Councils present means-tested help for individuals at residence, in care properties or supported dwelling, if they’re discovered to have excessive care wants somewhat than well being wants.
A recent survey by the Association of Directors of Adult Social Services (Adass), representing the individuals who run council care, says care employees are more and more being anticipated to tackle duties as soon as accomplished by well being professionals.
Out of 153 English councils with social care obligations, 143 replied. Practically three-quarters (74%) reported an increase in native disputes over whether or not councils or the NHS ought to fund an individual’s care.
Additionally they say care employees are more and more being anticipated to tackle duties which might have as soon as been accomplished by well being professionals.
And with their very own budgets below stress, almost all administrators say they’ve little confidence they may be capable of meet their authorized duties to help individuals within the 12 months forward.
Tom Brown, who speaks for Adass, says the present scenario is just not sustainable: “I feel native authorities are being made the supplier of final resort for individuals with a few of the most advanced wants.”
He says funding in neighborhood companies is required to permit well being and social care “to make a profound distinction in individuals’s lives”.
Matthew’s mother and father describe the prevailing well being and care system for individuals like him as damaged.
“The affect it has is to destroy lives,” says his father, Roger. “It’s destroying Matthew’s life, and it’s severely impacting on ours.”
Nevertheless, Matthew stays optimistic. He needs to develop into a well known Tourette’s artist – doing summary artwork and installations, and galvanizing others.
“I’m truly wanting ahead to the longer term,” he says. “However I must be out of hospital, to really achieve my future.”
The Division for Well being and Social Care says it’s “decided to sort out head-on the numerous challenges social care faces” and it’ll undertake a “deep-rooted programme of reform”.