AC and GC (Capacity: Hoarding: Best Interests) [2022] EWCOP 39


17th October 2023

In the Court of Protection in the County Court sitting at Birmingham Civil and Family Justice Centre, before HHJ Clayton on 15 August 2022, there was a ruling concerning hoarding: best interests, risk of neglect and whether care could continue at home. We look at the implications in this article.

Parties

AC is a 92-year-old female with a diagnosis of Alzheimer’s dementia and alcohol-related brain damage. AC had lived independently at her home for 40 years and her son GC had moved back in to live with her roughly 11 years previous after her husband had passed away.

In 2018 AC created lasting powers of appointing GC as sole attorney for health and welfare and property and affairs and was AC’s full time carer until her placement in a care home.

GC has a diagnosis of Asperger’s Syndrome, anxiety and OCD and occasions of depression.

Both AC and GC had been diagnosed as having a hoarding disorder. As such, Coventry County Council (“the Local Authority”) had been concerned that AC’s care and support needs could not be adequately met in the home environment, as it continued to present a serious health and safety risk due to accumulated belongings.

The 2020 Application

In August 2020, the Local Authority filed an application in the COP under sections 15 and 16 of the Mental Capacity Act 2005, seeking:

  • a) incapacity declarations and best interests’ welfare orders on the basis that AC lacked the capacity to make decisions about her residence, care, hoarding risks and the safety of her home environment; and
  • b) for AC to be moved to a care placement whilst the property’s cleanliness and sanitary conditions were addressed.

As part of those proceedings the court had made the section 15 declarations, and found that that AC lacked the capacity to litigate the proceedings, and make decisions concerning her residence and care.

The OPG had also made an application to revoke CG’s LPOA for health and welfare, on the basis that GC had not been acting in his mother’s best interests. The LPOA for health and welfare was suspended by the Court on the 21st December 2021. GC remained the LPA for property and affairs though later disclaimed both LPOAs.

The 2022 Application

In January 2022, the Local Authority also issued proceedings concerning GC by way of an application for an order for GC to Ieave the property whilst its condition was addressed. This application was consolidated with the 2020 Application, by an order dated 8 December 2021.

Specialist and cleaning agencies were commissioned within the proceedings to assist GC with de-cluttering, disposal and storage of items, and with maintaining the cleanliness of the house. District Nursing, Occupational Therapy services, electricians and Fire Services had also been involved with assessing the wider safety considerations.

On 27 February 2022, the emergency services responding to a call from AC attended the home and transferred AC to hospital saying that they observed poor sanitary conditions in the home and risks to AC’s health and welfare. Whilst in hospital, a suitable nursing placement was identified by the local authority together with GC to expedite her discharge. An urgent application was made with the agreement of the parties.

Pursuant to the court’s urgent order dated 18 March 2022, AC was moved in her best interests from hospital to the care home where she was residing at the date of the hearing and was a self-funder. A deprivation of AC’s liberty was authorised by the Local Authority in March 2022 for 3 months, but was subsequently extended by the court until 5 August 2022.

By an order dated 18 March 2022, the 2022 Application was reconstituted as section 21A proceedings.

Section 21A Proceedings

AC clearly and consistently expressed a wish to go home. However, although positive steps had been taken to improve the condition of AC’s home, it was not, at that point, in a suitable condition for AC to return home.

At the directions hearing listed on the 19-22 July 2022, the following issues were considered:

  • 1. Whether it was in the best interests of AC to remain at the care home or return home with a package of care on a trial basis. If the latter, how should the success or otherwise of a trial period be assessed; and
  • 2. Whether GC, had mental capacity to make decisions relation to:
    • a) his own property and affairs and his own items and belongings;
    • b) AC’s property and affairs and AC’s items and belongings.
  • Whether to appoint a deputy for AC’s property and affairs following GC’s disclaiming of the lasting powers of attorney.

Whilst AC lacked capacity to litigate these proceedings, AC wished to meet with the HHJ Clayton prior to the July hearing to express directly her wishes and feelings about her care and living arrangements. HHJ Clayton visited AC at the care placement with the agreement of all parties.

Evidence

The Court had the benefit of detailed witness statements from AC’s social worker (“SH”) at the Local Authority, describing the condition of the property and which photographic evidence. SH concluded it would not be in AC’s best interests to return home for reasons including:

  • Risk of self-neglect;
  • Continuation of hoarding;
  • Early stages of therapy;
  • Risk of carers ending the care package due to hoarding;
  • Impact on GH’s mental health relating to his belongings being taken away from him

The Court also had the benefit of a witness statement from GC explaining his own difficulties, his wishes for AC to return home and his proposals going forward to enable AC to safely return home.

The Court also had the benefit of witness statements from AC’s ALR, confirming AC’s desire to live in and return to her own home and a letter written by AC to the Court stating her wish to return home.

Decision

Though the matter was finely balanced the Court found that:

  • A trial of care at home would not be without risk, but on the evidence, it is a manageable risk which should be taken to afford AC the opportunity of returning home, in improved circumstances. This is with the expectation that the property will continue to improve in coming weeks and months.
  • AC would bare the costs of the assessment of her home by the Independent Social Worker, and the Local Authority would henceforth agree to pay half of the costs of maintaining the placement at the care home whilst the trial at home goes ahead.
  • It would be in AC’s best interests and benefit to keep the placement open for the duration of the trial at home period, as in the event of a breakdown or distress, AC could return to an environment which she is familiar, and with staff that are known to her.

If you need advice from any aspect of this article, please contact Eve Piffaretti, Tanya Barrett or Daniel Taylor.

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