Man found dead at home with front door unlocked
The case was one of two reviews included in an annual report for the Wirral(Image: Google Maps)A review has found more could have been done to help an alcoholic 61 year old man who died after being found by his sister. Terry, not his actual name, died by suicide in March 2022 and eight recommendations have been made.According to an adult safeguarding review carried out after his death, an ambulance crew “found Terry slumped on his sofa surrounded by vodka bottles” alongside “an undated note which described how unhappy he was with his life.”The independent review covered a period from January 2021 until Terry’s death in March 2022. It concluded in January 2024.He had been found by his sister who was able to go inside the house as the front door was left unlocked, something she said was common. Terry had “a background history of excessive alcohol use, agoraphobia, and self-neglect.”The matter was later referred for further scrutiny following a submission by Wirral University Teaching Hospital NHS Foundation Trust “as a result of concerns about safeguarding, the use of the Mental Capaciy Act and on the basis of a pattern of self-neglect.”Terry’s case is one of two reviews included in an annual update for councillors at an adult social care and public health committee meeting on July 15. The other case involved a 61 year old named Tina who “had been found choking and unresponsive by a member of staff, who had left Tina alone briefly while she was eating.”The review said Terry “was described as being very rigid and having a very controlling attitude to his mum and sister,” adding: “In earlier adulthood, he tried to prevent them from leaving the family home and his sister suggests that her mother was a virtual prisoner for ten years [...] he became violent if he was disobeyed.”In the last two years of his life, he only left the house when paramedics took him to hospital. Despite his mum being two minutes away in a care home, he never visited her.The review said: “His sister described his house as “disgusting”: cobwebs, paper, mess everywhere…Sofa and bed and old jeans…drenched in urine and stink. Has been faeces on the floor often…Fire risk from all the mess…”The review said Terry had been drinking since 13 but things got worse after he had a serious car accident at 21. In 2021, ambulance staff observed large amounts of alcohol in the home.When the ambulance turned up at his house in March, “crew documented that there was no furniture, and the walls were bare downstairs. There were multiple crates of beer and vodka in the living room. Patient had injuries to his face, and it was unclear how the patient fell.“Patient was incontinent of urine and had seven cigarette burns to his fingers and hands. There were quantities of tablets in the property and Terry was documented to live in one room upstairs.”Terry was in hospital on multiple occasions for possible overdoses, intoxication, and falls as a result. An ambulance was called 27 times over the two years and two months and police were involved on 14 occasions between 2013 and 2021.In hospital, Terry was “difficult to engage in care” and is described as “a complex patient.” Concerns around financial exploitation had previously been raised following attempts “to move large sums from his bank account.”Despite not wanting to stop drinking or go into rehab, Terry was treated by local alcohol services on four occasions. While the first treatment resulted in him being discharged alcohol free, the other three were unsuccessful due to Terry declining treatment.While he was admitted to a mental health unit following family concerns, he discharged himself against medical advice. Despite further assessments including by a psychiatrist, “there was no evidence of a severe or enduring mental illness.”Services felt Terry’s main problem was alcohol misuse as well as anxiety and agorophobia. However the report said. “He demonstrated other negative patterns of behaviour such as his very controlling behaviour towards his family, real anger when they attempted to tidy his house, very rigid patterns of thinking and his very dismissive approach to people who tried to help him professionally.”However due to repeated head injuries as a result of falls, the review raised concerns about brain damage as a result. One psychiatrist did refer Terry onto an early onset dementia clinic.The review said Terry’s case highlights the need for greater understanding of brain issues as well as autism in dependent drinks, adding: “It appears very predictable that without more structured intervention he would become more and more seriously unwell physically and mentally.It also said Terry’s care highlighted the need for local guidance on how staff can deal with those who don’t want to engage with services including assessments, interventions, and escalating concerns.The review said Terry “would have benefited from clear leadership,” adding: “Certainly in the last nine months of his life, no one worker appears to have taken on the role of coordinating and leading his care.” The review said work between organisations began late in the process.On safeguarding and social care services, the review said more could have been done to project Terry from harm. 12 safeguarding concerns were raised and there were missed opportunities to raise further concerns.The review said there was a lack of clear leadership around assessing Terry’s mental capability. It said: “No safeguarding process can guarantee a person’s wellbeing, but given the number of referrals, this does raise questions about whether the safeguarding process was being used to the best effect with him.”The review also suggested there might need to be changes to laws and further guidance to allow services to better support those who are dependent on alcohol. It added most agencies made efforts to help Terry and there was some good practice including a planned home safety check, his case being kept open, as well as an assessment by a psychiatrist.
