“The summary which I set out below was commended to me by Mr Burton KC and Mr Baldwin. It originates from a review which the Defendant conducted in September 2023. It was included within the Defendant's care plan dated 12.4.24 ("the Plan"). A "portacath" is a small piece of medical equipment that can make receiving frequent doses of intravenous (IV) therapy over a long period easier for healthcare professionals and more comfortable for patients. BIPAP is a form of non-invasive ventilation. ‘Daisy is a 35-year-old lady that lives alone in a one bedroomed flat in Brentwood. She is currently in receipt of a personal health budget with which she employs carers over a 24-hour period. Daisy has a long history of mental health disorders diagnosed at the age of 17 and numerous physical health conditions including Diabetes, Gastro issues, Gynae issues, Chronic Lung Condition, Moya Moya disease, Recurrent Trans Ischemic Attacks (TIAs) and Sleep Apnoea. Daisy has multiple interventions to support her breathing including BIPAP, Nebulisers six times daily, a four weekly intravenous infusion, a flutter device (a type of cough assist) and oral medications. Her fluctuating physical abilities mean that she often struggles to manage these interventions without support from her carer. Her carer also prepares all meals for Daisy and when she is present will also serve them to her. Daisy reports that she experiences intermittent swallowing problems especially following a TIA. Currently Daisy can access the toilet to pass urine and open her bowels however, she suffers from both incomplete emptying, requiring intermittent self-catheterisation at least once daily, and bowel dysmotility causing her issues with constipation that did require self-administration of enemas, however, this now appears to be managed with administration of Bisacodyl oral tablets. Daisy is at risk of skin deterioration due to her reduced mobility and as a side effect of oral steroids. She requires assistance from her carer to maintain her skin integrity. She has pro shield barrier cream applied at least twice daily. Daisy has a history of having suffered a stroke leaving her with left sided weakness. She is, however, still able to weight bear using pivot transfers although she stated that this is becoming more difficult each time, she has a further TIA. Currently Daisy requires the assistance of one to two people to assist her with the transfers. No falls have been recorded. Daisy has an electric wheelchair which she can drive herself once she has been assisted into position. Currently this is only used for outside purposes as her home is reported to be too small for wheelchair use. Daisy can verbally communicate clearly and articulately although she can intermittently suffer with mumbled speech especially after a TIA. Currently Daisy is orientated to time, place and person and has good insight into her impairments however, her memory is reported to have been worsening of late to the extent that she now requires prompting with all day-to-day activities. Daisy denies any challenging behaviour and states that she will only say no to something if she feels that she is being put at risk. Daisy has a complex medication regime which she currently manages herself with assistance from her carer although she stated that she is finding this more difficult. She has purchased an Insulin Pump and a constant glucose monitor to manage her diabetes. She requires assistance from her carer to fill and set up the pump and from her carer to enter carbohydrate amounts and blood sugar readings into the pump for it to calculate bolus doses. Daisy is prescribed Codeine to manage her pain however, she reports that this is ineffective, and she suffers constant pain. Oramorph is prescribed for breakthrough pain relief and Daisy can request this from her carer when needed. Daisy has also recently been diagnosed with Endometriosis which causes her to have heavy bleeding from her vagina. She requires assistance from her carer to manage this at times. Daisy is extremely difficult to cannulate and has now had a portacath inserted for easy vein access. Daisy suffered a stroke in 2021 and has been diagnosed with Moya Moya disease which limits the flow of blood to her brain and puts her at risk of further strokes. Daisy stated that currently she is having TIAs daily which temporarily affect her speech, mobility, and cognition. Daisy has multiple conditions affecting her daily life …: Moya Moya disease (under the Bristol, awaiting cerebral vascular bypass operation); Admissions to Queens with stroke and sub-arachnoid haemorrhage; Brittle asthma (under Brompton Hospital); Obstructive sleep apnoea (BIPAP) (under the Brompton); Diabetes Mellitus (presumed type 1, insulin treated, supported by the diabetic nurses); Recurrent episodes of elevated lactate levels (uncertain cause); Schizoaffective disorder; Migraines; Cushing's syndrome from previous long term steroid use. Presumed adrenal suppression due to long term high dose oral therapeutic steroid use; Progressive multiple fatty lumps; Emotional Unstable Personality Disorder. Daisy is known to multiple services including: Neurosurgeon; Respiratory physician; Gynaecologist; Ophthalmologist; Consultant neurologist - Dr De Silva; Dermatology; Diabetes and Endocrinology - Basildon and Thurrock Hospital; Occupational Therapy for support and equipment.’” ‘Daisy is a 35-year-old lady that lives alone in a one bedroomed flat in Brentwood. She is currently in receipt of a personal health budget with which she employs carers over a 24-hour period. Daisy has a long history of mental health disorders diagnosed at the age of 17 and numerous physical health conditions including Diabetes, Gastro issues, Gynae issues, Chronic Lung Condition, Moya Moya disease, Recurrent Trans Ischemic Attacks (TIAs) and Sleep Apnoea. Daisy has multiple interventions to support her breathing including BIPAP, Nebulisers six times daily, a four weekly intravenous infusion, a flutter device (a type of cough assist) and oral medications. Her fluctuating physical abilities mean that she often struggles to manage these interventions without support from her carer. Her carer also prepares all meals for Daisy and when she is present will also serve them to her. Daisy reports that she experiences intermittent swallowing problems especially following a TIA. Currently Daisy can access the toilet to pass urine and open her bowels however, she suffers from both incomplete emptying, requiring intermittent self-catheterisation at least once daily, and bowel dysmotility causing her issues with constipation that did require self-administration of enemas, however, this now appears to be managed with administration of Bisacodyl oral tablets. Daisy is at risk of skin deterioration due to her reduced mobility and as a side effect of oral steroids. She requires assistance from her carer to maintain her skin integrity. She has pro shield barrier cream applied at least twice daily. Daisy has a history of having suffered a stroke leaving her with left sided weakness. She is, however, still able to weight bear using pivot transfers although she stated that this is becoming more difficult each time, she has a further TIA. Currently Daisy requires the assistance of one to two people to assist her with the transfers. No falls have been recorded. Daisy has an electric wheelchair which she can drive herself once she has been assisted into position. Currently this is only used for outside purposes as her home is reported to be too small for wheelchair use. Daisy can verbally communicate clearly and articulately although she can intermittently suffer with mumbled speech especially after a TIA. Currently Daisy is orientated to time, place and person and has good insight into her impairments however, her memory is reported to have been worsening of late to the extent that she now requires prompting with all day-to-day activities. Daisy denies any challenging behaviour and states that she will only say no to something if she feels that she is being put at risk. Daisy has a complex medication regime which she currently manages herself with assistance from her carer although she stated that she is finding this more difficult. She has purchased an Insulin Pump and a constant glucose monitor to manage her diabetes. She requires assistance from her carer to fill and set up the pump and from her carer to enter carbohydrate amounts and blood sugar readings into the pump for it to calculate bolus doses. Daisy is prescribed Codeine to manage her pain however, she reports that this is ineffective, and she suffers constant pain. Oramorph is prescribed for breakthrough pain relief and Daisy can request this from her carer when needed. Daisy has also recently been diagnosed with Endometriosis which causes her to have heavy bleeding from her vagina. She requires assistance from her carer to manage this at times. Daisy is extremely difficult to cannulate and has now had a portacath inserted for easy vein access. Daisy suffered a stroke in 2021 and has been diagnosed with Moya Moya disease which limits the flow of blood to her brain and puts her at risk of further strokes. Daisy stated that currently she is having TIAs daily which temporarily affect her speech, mobility, and cognition. Daisy has multiple conditions affecting her daily life …: Moya Moya disease (under the Bristol, awaiting cerebral vascular bypass operation); Admissions to Queens with stroke and sub-arachnoid haemorrhage; Brittle asthma (under Brompton Hospital); Obstructive sleep apnoea (BIPAP) (under the Brompton); Diabetes Mellitus (presumed type 1, insulin treated, supported by the diabetic nurses); Recurrent episodes of elevated lactate levels (uncertain cause); Schizoaffective disorder; Migraines; Cushing's syndrome from previous long term steroid use. Presumed adrenal suppression due to long term high dose oral therapeutic steroid use; Progressive multiple fatty lumps; Emotional Unstable Personality Disorder. Daisy is known to multiple services including: Neurosurgeon; Respiratory physician; Gynaecologist; Ophthalmologist; Consultant neurologist - Dr De Silva; Dermatology; Diabetes and Endocrinology - Basildon and Thurrock Hospital; Occupational Therapy for support and equipment.’”
“I am writing directly to you because the Council remains extremely concerned regarding your accommodation and regardless of where you make your permanent home, we do not think staying at Railway Square is a realistic option. In October of last year our solicitors suggested to yours that you might be rehoused, immediately, at Rowan Green on a temporary basis. They said, and I quote, that, “… our client will offer an immediate licence to occupy Rowan Green as temporary occupation and it is very much hoped that if, as everyone believes, Ms Simpson settles in, then this will be upgraded to a secure tenancy with immediate effect.”
“18.6 Housing authorities should take particular attention to identify instances where information on an inquiry about a social housing allocation scheme, or an application for an allocation of housing under Part 6, provides reason to believe that the applicant might be homeless or threatened with homelessness. This should be regarded as an application for homelessness assistance.”
“When the Council received that application form, the Council clearly had reason to believe that Mr Gibbons and his daughter were threatened with homelessness. That, in my view, is sufficient to trigger the obligations of the Council under Part 7 of the 1996 Act. See the reasoning of Mr Roger Toulson QC in R v Northavon District Council, ex parte Palmer(1994) 26 HLR 572 . (This case subsequently went on appeal on other grounds which are not relevant for present purposes: see R v Northavon District Council, ex Parte Palmer(1995) 27 HLR 576 .) Accordingly, in the present case, the Council's duties under section 183 and 184 of the 1996 Act were triggered on 10th September, that being the date of the receipt stamp on the application form.”