The Department for Work and Pensions (DWP) failed to alert GPs and social services to the “very extensive” difficulties a disabled man was facing, three months before he died in conditions of severe self-neglect.
A safeguarding review of the death of Mr A, from Leeds, concluded that a healthcare assessor working for a DWP contractor was probably the last person to see him alive, other than his disabled wife.
The face-to-face benefits assessment was carried out so Mr A could be transferred from long-term incapacity benefit to employment and support allowance (ESA).
The assessment report was passed on to DWP, and he was placed in the ESA support group, but no attempt was made to contact his local GP or Leeds City Council, to inform them about the substantial problems he was facing.
It is just the latest evidence of years of failings by DWP to prioritise the safety of benefit claimants, with ministers repeatedly declaring that the department does not have a legal duty to “safeguard” its claimants.
When Mr A’s death was reported by his wife, his body was found in his bed “surrounded by piles of household waste, his body severely neglected, emaciated and decomposed”.
Paramedics who attended the property in the early hours of 12 March 2017 found “hoarded materials, accumulated waste, evidence of rodent infestation and animal faeces” from the couple’s dogs and chinchillas.
Mr A had died sometime in the previous 48 hours, having spoken to a friend on the phone two days earlier.
The face-to-face assessment in November 2016 is believed to have taken place in an assessment centre in Leeds and the review said it revealed that Mr A “stayed in bed all day and every day because of severe pain, leg swelling and mobility difficulties, had dizziness and poor balance and muscle wasting in his upper and lower limbs”.
But neither DWP nor its assessment contractor* alerted his GP or Leeds City Council’s adult social care department to his substantial and urgent support needs.
The safeguarding review described the face-to-face assessment, and DWP’s failure to alert other agencies, as a “significant factor”.
It says the assessment “appears to be the last time anyone saw Mr A before his death three-and-a-half months later”.
Mr A and his wife lived in an adapted bungalow. He had been in severe pain and poor health for many years, and the couple’s relationship had become increasingly difficult, with each of them occupying different rooms and communicating by mobile phone.
She brought food to his room, as well as bottles and puppy pads for toileting, which he placed in plastic bags by his bed after using them.
The squalid conditions in the adapted bungalow, and the “chaos” she was living in, impacted the health of his wife, who herself had obsessive compulsive disorder and other impairments.
She later described her husband as “manipulative, argumentative and violent” but she also made excuses for him.
The safeguarding adults review was not published until January 2020, and this is believed to be the first time its contents have been reported publicly.
The review made a series of recommendations, including a call for DWP to strengthen information-sharing with GPs “and referral pathways to other agencies such as Adult Social Care when DWP or their agents identify potential care and support needs and/or circumstances in which safeguarding action may be necessary”.
Other public bodies were criticised by the review for failing to take action to safeguard the couple, including the city council, the local NHS, police and fire and rescue service, Leeds Safeguarding Adults Board, and Leeds Federated Housing Association.
But the review said the housing association was the only organisation that had identified significant potential risk in Mr and Mrs A’s situation, and “made persistent efforts to engage others in supporting Mr and Mrs A but appeared to meet an impasse at every turn”.
The review pointed out that Mr and Mrs A made “very clear and successful attempts” to “remain off the radar”.
But it also said: “It is hard not to conclude overall that agencies simply did not worry enough to prompt them seeking to learn more about Mr and Mrs A and the conditions in which they were living or to take timely action.”
It added: “The absence of Adult Social Care involvement was a major factor in this situation remaining under the radar.
“It must be questioned why there were no referrals to Adult Social Care from health agencies, in the light of their knowledge of the Mr and Mrs A’s health conditions and the difficulties they posed.
“Equally, why there was no referral to Adult Social Care from either [the assessment company] or DWP in the light of the medical assessment in November 2016, which identified the circumstances in which Mr A in particular was living.”
Five organisations told the review that they had brought in changes as a result of the case, but there was no mention in the report of any such changes made by DWP.
Leeds City Council refused to comment on its own failings and how DWP had responded to the recommendation made by the review, and it also refused to answer questions about the face-to-face assessment and DWP’s role in Mr A’s death.
DWP declined to answer questions about the safeguarding review, its own failings, what action it had taken in response to the review’s recommendation, and whether it had carried out its own review into the death of Mr A.
It claimed that because “safeguarding adult reviews are anonymised to protect the individuals involved” it would “not be appropriate to divulge any further detail on this specific case”.
But a DWP spokesperson said in a statement: “While the department does not have a statutory duty of care or safeguarding duty, we can help direct our claimants to the most appropriate body to meet their needs.
“More than 30 advanced customer support senior leaders (ACSSLs) have been appointed across Great Britain… to reach across local communities, underpinning our relationships with other organisations that provide support to our customers.
“We are always looking to maximise our opportunities in our interactions with customers to signpost vulnerable claimants towards support.
“We want to ensure that chances to flag concerns to agencies with statutory safeguarding responsibilities are not missed.
“The department frequently collaborates with these agencies.
“For individual claimants, we can liaise with health and social services to consider next steps, contact GPs for evidence for disability benefits decisions, or access HMRC salary records to calculate child maintenance.”
The US outsourcing giant Maximus*, which is believed to have carried out the WCA, had not responded to requests to comment by noon today (Thursday).
*Although the review says the WCA was carried out by Atos, the assessment took place nearly two years after the contract was taken over by Maximus, which delivers its WCA contract through the Centre for Health and Disability Assessments. It is therefore likely that the WCA was carried out by Maximus, although neither Maximus nor DWP had confirmed that by noon today (Thursday)
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