Leicester City Council vs HC

This case concerned the capacity and best interests of a 27-year-old woman, HC, who suffers from severe mental health issues, including anorexia. The Court of Protection had to decide whether HC lacked the capacity to decide where she should live and receive care, and if it was in her best interests to move to a new placement using physical restraint if necessary.

TLDR:

• HC suffers from severe mental health issues, including anorexia.
• The court had to determine if HC lacked capacity to decide her living arrangements and care.
• The court concluded HC lacked capacity and made orders in her best interests.
• HC's move to a new placement was considered, with the use of physical restraint if necessary.

HC, a 27-year-old woman with a degree in photography and videography, has a history of mental health difficulties, including anorexia. The local authority and Integrated Care Board (ICB) responsible for her care sought declarations that HC lacked capacity to decide where she should live and receive care, and that it was in her best interests to move to a new placement, D House, immediately, using physical restraint if necessary.

HC's current placement, K House, gave notice to terminate her placement, necessitating an urgent decision. HC's father, RC, opposed the move, believing HC needed specialist trauma intervention. The court had to navigate complex issues of capacity, influenced by HC's mental health conditions and her father's significant influence over her decisions.

Proceedings in the Court of Protection began in October 2022, initiated by the NHS Trust responsible for HC's mental health needs. At that time, HC was severely underweight, and there was a lack of agreement between the statutory bodies and RC about her care. The Trust argued that HC's anorexia prevented her from making informed decisions about her care, and that RC's influence was obstructive.

During the proceedings, various issues regarding HC's relationship with RC were raised but not determined. Professionals reported that HC was heavily influenced by her father, often repeating his views and seeking his approval before expressing her own opinions. An independent expert, Dr. Tyrone Glover, noted that RC's influence, while not malign, was potentially harmful to HC's health.

In January 2023, HC was admitted to hospital as an informal psychiatric patient and later detained under the Mental Health Act 1983. The court did not make any determinations of HC's capacity during 2022-2023. By June 2023, HC's BMI had increased to a healthy level, and she was discharged to K House in November 2023.

An urgent hearing on 15 April 2024 addressed the manner in which the application was made, with complaints about the lack of advance notice and inadequate evidence. The full hearing on 18 April 2024 included oral evidence from HC's social worker, clinical lead, and therapist. HC participated via video-link but was not present at the hearing.

The court concluded that there was reason to believe HC lacked capacity to decide where to live and receive care. The evidence indicated that HC's mental disorders impaired her ability to understand, retain, and weigh information. The court also noted HC's strong influence by RC, which affected her decision-making.

The court considered whether it was in HC's best interests to move to D House. The statutory bodies proposed a care plan requiring further refinement, while RC and the Official Solicitor opposed a forced move. The court ultimately decided against using physical restraint to move HC, citing concerns about her mental health and the potential for trauma.

The court ordered the provision of additional evidence and consented to HC's move to D House if she agreed. If HC did not agree, the court consented to her moving home with RC temporarily, with a proposed package of domiciliary care. The court emphasized the need for professionals to have access to HC without RC's presence.

Legal representatives: Mr Parishil Patel KC (instructed by LCC and Mills and Reeve LLP) for the Applicant and 3rd Respondent, Mr Nicholas O'Brien (instructed by Star Legal Limited) for the 1st Respondent, Ms Katherine Hampshire (instructed by Thaliwal and Veja Solicitors) for the 2nd Respondent, (4th Respondent attendance excused).

Judicial Panel: Ms Victoria Butler-Cole KC (Sitting as a Deputy High Court Judge)

Case Citation Reference: [2024] EWCOP 24