Isabel at Christmas in Ireland.
After we returned from two weeks in Ireland with Issy in January 2013, NAS workers kept up the pressure on us to consent to her undergoing, a 12 week residential assessment at Ruby Lodge, a CAMHS’s Care Pathway Centre.
I read the literature and was shocked to see, the psychiatrist, heading up the centre, was the lady we complained to CAMHS about in 2007.
Issy’s risperidone trial at 9, and others, appeared to have justified the building of a multimillion pound complex of assessment centres, based on the long term use of this antipsychotic medicine, despite it’s licence being only for psychosis and short term severe behavioural problems .
Isabel did not have psychosis and her aggressive behaviour was due to an untreated impaction which I had continually pointed out and unknown to us then, tooth decay.
All due to NAS, social services and neglect costing over a million tax free.
But this cause could not be investigated.
If it were NAS and the LA and NHS as commissioners of the service would be liable.
The prerequisite for admission to Ruby Lodge was an IQ of less than 50.
Yet Isabel at 5, had been assessed with an IQ of over 100.
NHS had stated, she had no general learning disability.
Once in thIs care pathway centre, Isabel would have only received a perfunctory medical examination by a nurse.
The examination per se could not have discovered her impaction and even if it had would be denied as it had been for months.
And it would then be exacerbated by her removal and their treatment with risperidone.
This was all despite a review in 2012, eventually conceding to my demand Isabel be examined for an impaction by a GP.
But no GP had ever been sent to Clayton Croft, even though actioned in a safeguarding meeting in 2011.
And she was not examined until her return home.
Worse still NAS workers and CAMHS continued to deny, that she had an impaction, in the face of clear evidence of poo incontinence, aggressive behaviour, a 48 bruise restraint trigger and a previous impaction in 2007.
Workers actually stated, categorically in reports, as did CAMHS, that she was not constipated/impacted.
Such was the cover up and need to process Issy in a CAMHS assessment centre, to obtain a risperidone prescription which would then make it impossible for her to be aggressive.
As this was the only pathway for the LD/autistic.
Care Quality documentation via the web, show 50% of even a general nursing examination, is not undertaken, due to lack of consent and only reasonable attempts need be made to examine.
This, in any event would, and more crucially could not pick up an impaction, which all agencies denied.
Although physical examinations are not forced on patients, paradoxically, any amount of medication, can be enforced without such consent.
From Ruby Lodge’s literature, it was veiled, but clear, that any assessment could only lead to permanent antipsychotic medication, as their objective was to ‘control without restraint’.
When we dropped Issy off on Sunday, after her first weekend home after the Christmas holiday, at her regular return time, no one in her NAS home opened the door.
This had been a continuing problem, for years.
We waited outside for 20 minutes and Issy was was not that happy to return and in view of her condition particularly anxious.
Later that evening, the NAS home rang to inform us, she had had a melt down, immediately upon entering, and had to be restrained.
I emailed her team leader complaining that they knew she was in a bad way, it was her regular return time and in future could then ensure the door was opened.
I did not receive a reply.
But, she did email, asking for our consent to an assessment in Ruby Lodge.
The next weekend our social worker rang to say Issy was ‘too distressed’, for her usual home weekend.
But we insisted.
And thankfully, the van driver braved the snow, and waited outside, when Issy, was not ready.
Thank God he did.
On Sunday night, Issy put her coat on as usual, to get into the van, and walked to the door, at least 8 times, but could not bring herself to go.
This had never happened before.
Eventually, the van driver left, and we notified her NAS home.
Staff from her NAS home, came several times, during the following three weeks, as did the social worker, to try to get her to return, but she would not .
Isabel was generally very distressed, during the months after her return.
Up all night, and repeating/echoing in a thick Yorkshire accent, abuse, from a particular NAS worker,‘ ‘You can’t live with your f’in family’, ‘Stop f’in mithering me, woman’, ‘Strange kinda luv’. ‘ Havi’ to deal with your f’in family’.
But even, this was used, to the state’s advantage.
NAS and CAMHS nurse reported this echoing, as evidence of Isabel ‘hearing voices’, and, this showed she was psychotic.
Why, they were in thick Yorkshire accents,sounding like her keyworker, was not explained.
Psychosis, justified long term risperidone medication.
The social worker heard these echos on her visits.
And, I emailed the phrases to her and complained.
The social services decided they could have been heard whilst out in the public.
The impossibility of this, and the fact, that Isabel did not go out in her NAS home, only in Ireland , made no difference.
The social worker arranged a visit of a CAMHS psychiatrist, psychologist, and psychiatric nurse for 9.00, hoping, no doubt, Issy would be in bed and distraught.
But, fortunately, Isabel’s six sense kicked in.
On my waking her, with ‘the social workers are coming’.
She was out of bed, and dressed with hair washed, by the time the entourage, arrived in the kitchen.
Within 5 minutes of them settling into their chairs.
Isabel walked into the meeting, sat down on an empty chair, in the middle of the group, and behaved impeccably.
What a star.
On my return from the loo, I noticed our social worker, whispering in the psychiatrist’s ear.
She replied, ‘We don’t like using it, unless there is evidence of psychosis’.
Isabel had saved herself from a 12 week assessment in Ruby Lodge, and the horror of a permanent, and increasing respiridone prescription .
And a return to her NAS residential ‘school’ as she would now be compliant.
The social worker, and NAS, had fought hard, but CAMHS had lost the assessment fee of £60,000.
NAS were still being paid £ 6,000 a week, as tax free, for the next 3 months, as required by their contract with the LA, and NHS.
For this money, we got a phone call a week from the abusing care worker.
At the time, I had naively, thought this, her personal concern for Issy.
And two nights, baby sitting.
When the two of the workers arrived for this, Issy wanted them to take her out for a walk, but, they were not insured.
Eventually, on the 4th May, we commenced our agency care worker package.
Two workers came for 4 hours, two days a week, and 8 on Saturday.
Issy was always dressed, bathed, with hair washed by 10, when they arrived.
They went out with them each day, all over Sheffield, in shops and cafes.
The social work core assessment, completed on the 19th March 1013, states
‘In the weeks Isabel was at home, she became less withdrawn and more able to interact with others. Isabel currently presents as happy and settled with her parents who are in agreement o her staying at home’
‘It is noted that Isabel is more tolerant of others since her return home. She will now come and sit with visitors, and interact well with them, requesting things such as cups of tea and a DVD. Isabel appears to enjoy having visitors and reportedly likes to meet new people’.
And, would have loved, to have gone to her special needs school, up the road, but that was no longer funded.
CAMHS’ concluded that given Isabel’s change in mood and appearance it was likely that her low mood was attributable to being unhappy in her placement. It is also notable that Isabel’s menstration impacts upon mood’.
Yet, at just over 7 stone and 5ft 6 inches, Isabel had not had a period for over a year, and no one had commented on this.