Court of Protection judge backs trial period of 92-year-old being cared for at home, saying risk was manageable

A Court of Protection judge has approved a trial period where a 92-year-old woman (AC) is care for in her home, in a case where the council argued that she should remain in a care home.

In AC and GC (Capacity: Hoarding: Best Interests) [2022] EWCOP 39  Her Honour Judge Clayton said that a trial of care at home “is not without risk but, on the evidence before me, it is a manageable risk and one which should be taken to try to afford AC the opportunity of returning to her home, in improved circumstances, and with the hope and expectation that it will continue to improve in the coming weeks and months”.

The judge noted AC would pay for the care package at home and towards the cost of an assessment by an independent social worker.

She said the council and AC had agreed to pay half each of the cost of maintaining the placement at the care home during the trial period at home as in the event of this trial proving unsuccessful she would be able to return to familiar surroundings.

AC had lived with her son GC and in December 2021 the council issued section 16 proceedings for an order that GC leave his home so that it could be cleaned.

A court consolidated that case with AC’s case and directed GC’s mental capacity should be assessed.

In March 2022 the court declared it was in AC’s best interests to move from hospital to a care home and that she lacked the mental capacity to conduct proceedings or make decisions on her residence, care and support.

The council argued AC should remain at the care home but said that if a trial period at home were agreed this should be for 10 weeks with the council and AC paying half each.

A social worker produced 10 witness statements one of which showed the condition of AC’s property with evidence of continued hoarding by GC but that “some progress has been made with the communal lounge, hallway, kitchen bathroom and AC’s bedroom”.

Some care agencies approached “had a problem with their own resources and some others were concerned as to whether or not they would be able to manage, given the complexities of this case with regard to the issue of hoarding and the state of the property”.

The social worker concluded it was in AC’s best interests to remain at the care home because of the risk of self-neglect if she went home and refuse care from carers, and the high risk of GC continuing to hoard in the property in light of the reports of the professor of psychology. GC has only very recently started therapy to address his hoarding.

There was also an issue about the impact on GC’s mental health of his belongings being taken away, which was a necessary prerequisite to any return home for AC even being a possibility. 

The judge said: “There is no doubt that the article 8 ECHR rights of AC and GC are engaged, in that each have a right to respect for private and family life and, when undertaking a best interest analysis, the exercise does require consideration of the factors set out at MCA 2005 section 4.”

HHJ Clayton went on: “Ultimately what has persuaded the Official Solicitor that a trial at home is in the best interests of AC is the consistency of her wishes to return, with her having such a strong sense of belonging to her home, to wanting to be where she has looked after people for three generations, where she can remember the past.

“I concur and add that that she has a strong desire to continue to live with her son, who moved back home to help care for her when her husband died, some 11 years ago, where she has familiar things around her, which takes on an even greater significance with someone who is likely to have a hoarding disorder herself.

“There is no doubting the importance to her of her relationship with GC, nor her strong desire to become reunited with her pet cat.... It is these issues which are of magnetic importance in this case, when I bear in mind, she has lived in her home for 40 years, that she is now 92 with straightforward care needs and a limited life expectancy.”

Mark Smulian