EU – does it do anything?

The European Commission on 5th March 2014, wrote to me stating that a reply from the UK Government is well overdue. Seven weeks later and, still no news. With the email below, sent today, I am still trying to find a resolution to my 2012 and 2013 complaints. I view the “systems” like a colander – leaking water everywhere.


Sent: 18 April 2014 13:33

To: ‘’
Cc: ‘’; ‘’; ‘Sarah Ludford MEP’; ‘’; ‘’
Subject: RE: 5158/13/JUST

Dear Mr. Meduna,

On many fronts, Europe (and the EU) are disintegrating. Almost ONE year ago you have asked the British Government for comments about my case; to-date they have failed to respond.

The British attitude is, without a doubt, a mockery of the system (if there is one) . Laws and Legislations are only applicable to selected people and events.

These British offices that you have contacted, must (I assume) exist!? Room 101 or whatever & wherever they are, they must have an address and, hopefully, a person; someone responsible to reply to your queries. Could you please tell me who and where they are?

If all failures to respond are met by apathy it is fair to notice the ineffectiveness of actions taken or the futility of certain “offices”. I am still hoping that, eventually, there will be a reply regarding my case and I can wish a good and sensible turnout to the next elections.

Kind Regards
A B M Procaccini
(Facebook + Blog)


From: []
Sent: 05 March 2014 12:49
To: max
Subject: RE: 5158/13/JUST

Dear Mr Procaccini,

Thank you for your latest e-mail.

I regret to inform you that we have not yet received any reply from the UK authorities that are now well past the deadline.

On 26 February 2014 we urged the UK authorities to reply as quickly as possible.

Yours sincerely,

Michal MEDUNA (Mr)
Policy Officer

Unit C.2 Union Citizenship and Free Movement
Directorate-General Justice
European Commission

GPs and NHS up the wall?

The GPs have become “Vending Machine” for the pharmaceutical industry and the word PREVENTION does not exist in their dictionary. No matter what is wrong with you, Paracetamol is the answer (or Statins or anti-depressants). GPs are all too quick to prescribe medications (for stomach ulcer, for example) without carrying out proper tests and considering all side-effects. We must all remember that side effects very often lead to other problems and… to more medications. Many patients are happy to take palliatives and tests show that even placebos sometimes work better than the actual drug.  I am disappointed with my local surgery because proposed alternatives are, very often, leading to wasting my time, they are not addressing the causes and eventual remedies to my complaints, and are wasting resources and money for the whole NHS. To follow is my letter to the surgery….


Dear Ms. S.

I am writing to you to inform you that I have not received satisfactory service from your surgery. This letter should be considered an official complaint. I fully understand that your surgery follows general guidelines and I am aware that you are often over-stretched and that you are also under all the usual pressure to deliver the best service possible. Indeed I am generally reluctant to use your surgery because I do not wish to waste either my time or yours. I consider you to be an emergency option – however, and as such, I expect you to offer professional solutions.

Firstly – I have now received four standardised letters from your surgery telling me that you do not have my blood pressure on your records. You should have this information because a) I have given you the information in the past and, b) my blood pressure has also been checked by the doctor. I don’t know how many patients you have but if you are experiencing this problem with even a small number of people then you are wasting your resources – time and money.

Secondly – your referrals have proved to be a disaster on many occasions and there has been a general lack of understanding on the part of the doctor(s) as to what my final aim is or will be. For instance, if I ask to see a dietician, it is probably because I need to lose some weight as I am obese. But if I also mention that I am concerned with my metabolism, the doctor should know that the dietician is not the right person for me to see. This has finally been worked out by your staff but, in the mean-time, I have been passed around from referral to referral and this has been an utter waste of time (and NHS resources). I doubt that mine is an isolated case and I suspect that a great deal of time and money has been expended on badly estimated and ultimately unnecessary referrals of this sort at your surgery.

Thirdly – recently I have been on the receiving end of negligent decision made by your doctors. If I telephone the surgery requesting a morphine injection from the GP it is sensible to assume that there is a rational reason for my request – that I am probably in serious pain. In this instance I have also informed the GP that I have been taking Tramadol (2 x 50mg every 8 hours) for the last 24 hours, which should be a good enough indication of the severity of the pain.

As per NHS guidelines:

  • Step 3 (moderate to severe pain)  = morphine injection 10mg/mL, 15mg/mL, 20mg/mL, 30mg/mL: see BNF

The GP should “remember” that I have access to MST (morphine sulphate) and Temgesic (buprenorphine) tablets. It seems sensible to assume that a person in my position might decide to take such tablets should the pain continue unabated. The only reason that I am not taking them is because they give me headache and do not take away my symptoms – and I know this from experience. Suggesting that I take utterly redundant co–codamol only shows indifference and an uncaring stance on the part of the doctor and – worryingly – a lack of concern about the other medication a person such as myself might take should the doctor refuse to help in a difficult situation such as this.

Fourthly – there have been a number of worrying incidents concerning my mother who is also patient at your surgery. I am currently her primary carer and I was promised that a GP would come to see her four weeks ago. This has not yet happened – despite three repeat requests! I have also made three requests for my mother to be seen by a Counsellor. These have fallen over a two month period. I have not heard back on this either. There are numerous reasons for such requests and I will gladly discuss them with anyone at the surgery should they be prepared to listen. Neglecting my mother will only increase her dissatisfaction and my own. I strongly believe that a counsellor will be able to generate a positive experience, rebuilding and renovating aspects of her life. As I am also suffering from chronic stress – and because there is a clear antipathy between my mother and myself – the presence of a counsellor would give me more “space” in which to look after my own health while still guarantying her with her wishes of an independent life.

Fifthly – I am the patient and should seem like an ignorant party when compared to my GP. Why then is it  that when I mention LDL [subclass phenotype A]  and [subclass phenotype B], PCS or Mirizzi syndrome, the GP has no idea what I am talking about? Does this mean that my levels of LDL type-B will never be found out – ? – or that my cholecystectomy is just part of some previous life?

Finally – I understand that your being explicit about the problems of your patients may cause offence in some instances; nonetheless, I expect a sincere and frank attitude from my GP. You will achieve nothing by treating me like a child. For instance – should I refuse to take Statins; it is because I have what I deem to be good and valid reasons for not doing so. And should you wish to argue the contrary with proven details – i.e. not those of the Allhat study, Ascot-LLA trial or Jupiter trial – then I will gladly listen. There has been no attempt to do so on your part. Instead your staff has reiterated the same tired arguments.

In conclusion – the service delivered by your surgery has been severely lacking in the above instances. Generally speaking, the level of professionalism from almost all of your doctors has been excellent when compared to other surgeries in the area and I will not move on, yet. However – I must stress that I need solutions.

I am coming to the end of my personal capacity to deal with this situation. If nothing improves I feel that I may have to involve an external party in order to take this complaint further. I really hope that this does not become a necessary course of action!

I very much enjoyed a lengthy conversation with the senior doctor at your surgery some six months ago. She has always been very caring and understanding. It is a real shame that she has decided to retire. I am always available and happy to communicate should your current management wish to respond.  I sincerely hope that you do.

Please note that I have not mentioned any names in my letter because it will also be published on my blog and NHS websites.


Yours sincerely

LGO – A Final Decision

The Adjudicator maybe has some 20 files/cases to look after at any one time (my finger of blame points to “management”). This is probably why it has taken her 10 months to come up with a final decision; a series of complaints that were originally logged in November 2012 (16 months ago).

Councils and the Ombudsman wish is to take away your energy, your will to fight against a corrupted and wasteful system. Out of every 1000 cases, probably only a handful reach some kind of resolution. Due to my perseverance I have been one of the “lucky” ones. My cost has been my deteriorating health, but I feel it was worth it.

Severe cases make it to the headlines and yes, we should all be outraged that it takes months, even years, to get attention and, finally, a decision. The decision is far from being flawless but, perhaps in my naïve way, I hope that this will give the courage and the determination to others not to give up.


25 March 2014

Complaint reference: – 13 001 803

Complaint against: London Borough of Ealing

The Ombudsman’s final decision
Summary: The Council was at fault in the quality of the home care it provided to Mrs Y and in the way it dealt with Mr X’s complaint about this. It has agreed to take action to improve the quality of care and complaints handling, and to put right the injustice to Mrs Y and Mr X.

The complaint
1. The complainant, whom I shall call Mr X, is the main carer for his mother, Mrs Y. He complains about the quality of care provided to Mrs Y at home. He says carers:
• Do not stay the full time.
• Do not carry out the tasks agreed.
• Do not arrive at the times agreed.
• Do not carry out tasks properly. For example:
a) cleaning the toilet and then using the same gloves to handle food.
b) leaving the front door open.
c) administering medication wrongly.
d) leaving his mother without food because they are unable to communicate with her to find out what she wants.
e) falsifying records to say tasks have been done when they have not.

2. Mr X also says that:
• Assessments have not been carried out as expected.
• Different carers come all the time.
• The change to a new care agency caused an “escalating series of incompetence, neglect and extremely poor communication”.
• There is a lack of capacity in suitable carers with suitable skills.
• His mother needs a carer who speaks in her own language and the Council does not recognise this.

3. Mr X also complains about the way the Council dealt with his complaint. He says he thinks the care plan is fine and with the right carers he would be happy. He just wants his mother to be looked after and direct payments would enable her to employ her own choice of carer.

The Ombudsman’s role and powers
4. The Ombudsman investigates complaints of injustice caused by maladministration or service failure. She cannot question whether a council’s decision is right or wrong simply because the complainant disagrees with it. She must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3))
How I considered this complaint
5. I have considered information from Mr X and from the Council.
6. I consulted with our legal team.
7. I have provided both parties with copies of my provisional view for comment.

What I found
8. Where a local authority exercises a function entirely or partly by means of an arrangement with another person or body (in this case a care provider), the local authority ultimately retains responsibility. Any recommendations the Ombudsman makes following an investigation into devolved functions are for the council to implement, rather than the person or body acting on its behalf.
9. The Care Quality Commission (CQC) is responsible for registering and regulating care providers.
10. The section 20 regulations of the Health & Social Care Act 2008 (HSCA (2008) include:
• Regulation 9 which says “The registered person must take proper steps to ensure that each service user is protected against the risks of receiving care or treatment that is inappropriate or unsafe”.
• Regulation 17(h) which says that care providers should “take care to ensure that care and treatment is provided to service users with due regard to their age, sex, religious persuasion, sexual orientation, racial origin, cultural and linguistic background and any disability they may have”.
11. The Council’s contract team has a routine monitoring programme which includes monthly returns from providers. The Council provides guidance to providers on completing the return and it covers a suitably wide range of criteria under the headings: service delivery; quality assurance; staffing levels; training and supervision. It requires feedback from the electronic telephone monitoring system which records the time of arrival at the user’s home and time of departure. The return must be submitted within a specific timeframe or sanctions may result.
12. The home support services are arranged under a framework agreement with detailed specification.
13. Mrs Y is severely sight impaired and deaf; she does not speak English. She came from another country to live with her son, Mr X, and his family in April 2012. Mrs Y was assessed and received support from a care agency arranged by the Council.
14. Mr X is Mrs Y’s main carer. He was unwell from April to August 2012 and struggled to care for his mother during this period; he spent much of this time on strong painkillers and unable to walk without support. He says Mrs Y was unsettled by the change of environment and this caused her to have daily outbursts of anger and aggression.
15. Mrs Y was assessed again in September 2012 and April 2013. Mrs Y’s support plans from October 2012 to May 2013, clearly set out her needs with details of the support she needed with detailed instructions.
What happened
16. On 27 September 2012, the Council assessed Mrs Y and found her to need two personal care calls per day. It found she was at high risk of falls and needed intensive support requiring constant or near constant presence of at least one other person. It found her needs were such as to have a very severe impact on the main carer’s independence.
17. Mr X says the care agency was fine and the staff “superb” until they needed a weekend carer. This carer was unsuitable and he complained. The agency withdrew its services from Mrs Y. Mr X felt this would not have happened if the Council had dealt with it better. The agency said Mr X had been insulting and used offensive language; Mr X disagrees.
18. On 4 November 2012, Mr X emailed the Council asking it to include various tasks in Mrs Y’s care package. The Council responded the same week explaining the tasks had not been agreed and that the aim of support is to maintain independence not increase dependency. It recognised the pressure and stress felt by Mr X and reiterated its offer of various services including respite, day centre, extra care housing and residential care.
19. Three days later, Mr X emailed the Council who responded the same day. Mr X complained there was no food for his mother and no medication; he said the previous agency was willing to reinstate the package and asked for it to be transferred back. The Council explained arranging for medication to be available was not part of the care plan and not something the Council deals with. It said it was not normal business practice to take a package away from a provider that had just taken it on. The Council also said Mrs Y had only one domestic call a week and that was six days ago. It asked whether the carer bought enough food, and who drew up and agreed the weekly shopping list. It asked Mr X to let it know about the outcome of his discussion with the agency about this. Mr X was not happy as he thought the Council should be dealing with his complaint and should consider reinstating the previous agency for the benefit of his mother’s health and wellbeing.
20. The Council responded and asked if Mr X wanted the Council to pursue the complaint about food with the agency. It said “whilst living in the same house, choosing not to feed your mother could have serious consequences for both your mother and you. Mr X pointed out that living under the same roof did not mean he was there with her and she should be getting the support for that reason.
21. An Occupational Therapist assessed Mrs Y on 14 November 2012 and equipment was provided to reduce the risks to her.
22. A new care provider was commissioned as a result of Mr X’s complaints.
23. On 9 January 2013, a safeguarding adults’ investigation was begun. This followed Mr X’s allegations that carers had missed calls and Mrs Y had been left without food and medication. He said carers did not know what they were doing and could not communicate with Mrs Y. Mr X complained there was a different carer almost every visit. The Council transferred Mrs Y’s care to another agency.
24. On 21 January 2013, Mr X complained to the Council. He said:
• They had a different carer almost every other visit.
• Carers had little or no knowledge of what they should be doing.
• Many tasks were not being completed because of language barriers.
• Carers come at times which are more suitable to them, not as agreed.
• Carers do not perform all tasks and leave before they should.

25. Mr X gave examples of the problems with the carers. The list was extensive and included:
• Using the same gloves to clean the toilet and handle food.
• Leaving gas on the cooker for several hours.
• Wrong administration of medication.
• Asking for money from the family.
• Leaving the front door open.

26. He said there was no point in raising the issues as he felt the previous arrangement had been terminated because he complained.
27. The Council changed provider four times by the end of January 2013. Mrs Y had previously had one carer, from the first agency, who lasted from June to October 2012. Mr X says she was providing an excellent service so it was possible to get suitable carers.
28. The Council gave an interim response to Mr X’s letter on 7 February 2013. It said:
• There had been difficulty covering calls after Mr X had asked for a regular carer to be removed.
• All carers had been trained and were signed off as competent carers.
• All carers speak English; a minimum requirement. The support plan is displayed in the house and tasks are logged and signed off by Mr X or Mrs Y.
• Call times were being looked at through the safeguarding investigation. Time sheets had been requested and will show the time spent on each call.
29. On 19 March 2013, the Council wrote to Mr X to offer a fresh start and meeting with a senior manager.
30. In April 2013, Mr X made several complaints about the carers. He asked for one to be changed because she was too small to lift Mrs Y; he said others were late or did not stay for the full time. The care provider refused to change the first carer because the support plan did not include lifting Mrs Y and there were no other suitable carers available. The Council investigated and found while several calls were late or shorter than planned, there were also several visits which were longer than planned. Mr X disagrees with this and says the electronic monitoring does not work properly. The agency upheld part of Mr X’s complaint in respect of some late calls and offered to change one of the carers; Mr X said he would prefer to keep that carer. The Council apologised for the occasions where the calls had not been within the time planned and said it had addressed it with the agency.
31. On 16 April 2013, the agency gave the Council notice that it would terminate the provision of care to Mrs Y. It said a number of carers would not work on this package because they felt Mr X was not happy with the service; it felt the relationship with Mr X had broken down and he had lost trust in the agency. The agency agreed with the Council it would continue to provide a service until alternative arrangements could be made.
32. Mr X referred to previous complaints about the carers provided by this agency. These included complaints about how the carers served meals, broken equipment, hygiene and leaving the front door open. Mr X also complained about a visit which lasted only 2 minutes. The agency was unable to substantiate the complaints about the meals, equipment and hygiene since there was no evidence and the carers refuted the allegations. The agency’s records showed the visit lasted 26 minutes rather than 2 so the Council asked Mr X for the CCTV evidence he’d said he had. It also asked for the names of the carers involved. Meanwhile it asked the agency to increase spot checks on the carers who had attended to Mrs X and to remind all carers of the health and safety policy. Mr X did not supply the names or the CCTV evidence.

33. Mr X complained again about medication and that his mother was not supported to mobilise. He said medication was not being properly administered and he had found medication on the floor. The Council’s review of the medication sheets found that on 15 April 2013, a carer failed to record that medication had been administered. The agency was alerted and took it up with the carer concerned. The Council found that there were occasions recorded when Mrs Y refused to mobilise and explained that carers can only encourage, not force, Mrs Y to comply.
34. On 8 May 2013, Mr X met with officers from the Council to discuss options around Mrs Y employing her own carers. This was not possible because Mrs Y did not have a National Insurance number. The Council explained she has the choice to arrange her own care through a care agency of her choice.
35. On 20 May 2013, the agency stopped providing a service to Mrs Y because the weekend care assistant refused to return.
36. On 21 May 2013 Mr X complained to the Council because Mrs Y had developed a grade 4 pressure sore. Mr X said this was due to the carers not being sufficiently observant. Another safeguarding adults referral was made.
37. Mr X wrote to the Council expressing concern about care agency capacity. The Council responded explaining about the market for home care services and how it monitors capacity.
38. Over time, Mrs Y’s care package had increased in several stages from 17.5 hours per week in two calls per day to 29 hours per week over four calls per day. The Council adjusted Mrs Y’s support plan throughout to take account of her changing needs and environment.

Was there fault leading to injustice?
39. The Council assessed Mrs Y and had a suitable support plan in place. This was reviewed as required. It also had a service specification and monitoring system in place to ensure services were effective. However, it is clear that services were not always effective.
40. There is no doubt Mrs Y experienced significant levels of poor care, especially over the three month period from November 2012 to January 2013. During this period serious issues around medication were raised and substantiated. This indicates a possible breach of regulation 9. The Council is not responsible for the provider meeting the regulations, but it is responsible for the care it commissions. I find this to be fault causing injustice in unnecessarily increased risks to Mrs Y. The Council subsequently dealt with these incidents appropriately and therefore the injustice was minimised, but it did not account for the injustice caused.
41. I have not seen evidence of significant delays in the Council’s handling of Mr X’s many complaints but Mr X did not feel it was dealing with the issues. This is not entirely justified as Mr X was not aware of the efforts made by the Council with the agencies concerned. However, the Council’s comment about choosing not to feed Mrs Y was not helpful and the Council should have taken this complaint more seriously. Mr X said Mrs Y was without food and medication; this was the issue to be dealt with immediately and any discussion about who should have done what should have been dealt with once she was known to be safe. Shopping for food was one of the tasks the agency was required to provide. Mr X is quite right when he asks why this would be paid for if it wasn’t needed. I found fault in this and this led to injustice to Mr X in frustration and anxiety. The medication was not the agency’s responsibility and Mr X did not identify any injustice to Mrs Y as a result of the lack of food.
42. Mr X emailed the Council regularly copying the email to many officers. Mr X says this was because all these officers had been dealing with him. His style of complaining may have been difficult for the Council to deal with and the Council’s approach undermined any remaining trust. The Council recognised this in its offer of a fresh start and meeting with a senior officer. I cannot say this in itself was fault which led to injustice, but it contributed to an overall deterioration in the relationship.
43. Mr X made several complaints in April 2013 which were partially upheld by the Council. These were mostly about timekeeping which was no doubt inconvenient and annoying but did not necessarily increase the risks to Mrs Y. Taking into account the ongoing nature of the problems with the care provided, I find this to be fault leading to some injustice for Mr X, in terms of frustration and inconvenience. Again, the Council dealt mostly appropriately with these issues when they were raised but it did not address the injustice to Mr X and did not consider the wider issue of the ongoing problems across agencies.
44. Mr X’s complaints about carers leaving the oven and front doors open, staying only two minutes when the agency record says 26 minutes and various hygiene issues were not substantiated. Mr X did not supply the Council with the information it required to investigate. I cannot therefore find fault here.
45. Understandably, Mr X has repeatedly requested carers who speak his mother’s native language. Regulations say the care provider must have “due regard” to this and her other cultural needs. However, recruiting carers who have these specific skills is not easy. The Council has ensured clear instructions are available in English and has pursued the option of carers speaking this language; these have been supplied when available. I therefore cannot find fault in this. The Council has done its best to ensure Mrs Y’s needs are met appropriately.
46. Mrs Y lives with her family so fortunately, the risks of neglect and harm were lower than it might otherwise have been. This reduces the potential injustice but does not mitigate the fault.
47. Mr X’s standards are high although he does not agree with this, and sometimes his expectations and the volume of communication caused some difficulty with carers and agencies that operate under time-pressured conditions. This is not to say the quality of care has been acceptable but this may have limited the scope for resolution.
48. Additionally, from those examples I have seen, it was clear to see why Mr X’s comments could be taken as insulting and offensive. However, agencies should be more tolerant and widely accepting of different approaches particularly in view of the multicultural context in which they operate.

49. I have found fault in some of Mr X’s specific allegations about the quality of care and not in others. I also found some fault in the Council’s handling of some of his complaints. I have not found fault with the assessments, the change to a new agency, the capacity issue or the provision of a carer speaking Mrs Y’s native language.
Agreed action
50. I recommended that the Council:
• Reviews its quality monitoring system to ensure it feeds into an effective action plan for improvements across agencies.
• Reviews its complaints procedure to ensure complaints are responded to appropriately under all circumstances.
• Pays £250 to Mrs Y for the unnecessarily increased risk to her well being.
• Pays £350 to Mr X for his frustration, anxiety, inconvenience, and time and trouble in bringing his complaints.
51. The Council has agreed to my recommendations.
Final decision
52. I have completed my investigation and found there was fault by the Council which caused injustice to Mr X and Mrs Y. I am satisfied the action the Council will take is sufficient to remedy their injustice.

Investigator’s decision on behalf of the Ombudsman

LGO – a waste of time and money

The Ombudsman (LGO) similar to all authorities, are very good at promoting their policies on fairness and efficiency. It is easy to publicize good standards, not so good to actually sustain what they publicize.
On the LGO website about “Complaining about us”, amongst many of their obligations, they write “We are committed to responding properly to your complaint”; needless to say that they have still not acknowledged or replied (a fortnight later) to my letter of 21.01.2014.
BMG Research (0800 358 0337), only three weeks ago conducted a survey with the view to “Understanding peoples’ perceptions and experiences is very important to the Local Government Ombudsman. It will help us to develop our services for the future…” (?)
Glad that they wish to improve their services but I feel that my letter to them is self-explanatory and there is still a massive gap regarding fairness and what resembles their disposition to corruption.

Hereunder is the full letter.

Recorded delivery

Commission For Local Administration (Ombudsman)
2 The Oaks
Westwood Way
Westwood Business Park
21st January 2014

- Case ID – 13001xxx

Dear Sirs,

Following is a series of complaints that I raised throughout the previous year to the Local Government Ombudsman (LGO) concerning a series of incidents of maltreatment and inappropriate care that my 92-year old mother encountered at Ealing Council Social Services. The process of the investigation of complaints by the LGO regarding the matter has been ongoing since November, 2012; and I have yet to see any constructive results. I have become increasingly frustrated by the assistance, or lack thereof, that the LGO has offered to date.

After I initially approached the LGO back in 2012, a few weeks later, after multiple discussions with your offices, I received the following email from Mr. Hobley:

• 31.Jan., 2013 – Mr Hobley wrote: “When we consider that the Council has finished its complaints process. I would be grateful if you did not keep emailing us with more information”.

Ealing Council has, to date, never addressed any of my complaints. I found the email from Mr. Hobley off-putting due to the “we will contact you, don’t contact us” tone that was taken, since the reason given was to let the pertinent council finish their own complaint process first, even though the Council has ignored deadlines without the provision of any results. I then decided to approach Dr. Martin.

• 13.Feb., 2013 – A letter and additional documentation was sent via special delivery to Dr Jane Martin, receiving of both has not yet been acknowledged.

After a few months of silence following the delivery, I received a telephone call, by the end of May 2013, from Ms. Jane Smith, an investigator from the LGO. She sounded positive, and appeared to be dedicated towards the resolution of my case. Eight months of exchange of information through emails followed since the initial phone call from Ms. Smith without progress on my case; as can be observed from the correspondence I received from her.

• 31.May, 2013 – I will be in touch as soon as I have any news. As I explained before, this will probably be in approximately 4-6 weeks.
• 12.July, 2013 – I hope to come to a provisional view on your complaint soon.
• 23.July, 2013 – I will do my best to come to a conclusion as quickly as possible. You will no doubt appreciate that there is a lot of information for me to consider.
• 02.Sept., 2013 – Thank you for keeping me up to date. I hope to be able to send you my provisional view in the next two or three weeks.
• 17.Sept., 2013 – I am unable to let you have my provisional view yet. I am now on leave for two weeks and expect to continue work on this once I return
• 05.Nov., 2013 – It is difficult to anticipate how long this will take but I hope it will be done in less than three weeks.
• 15.Jan., 2014 – I have asked for some legal advice and should be in a position to issue my provisional view. Our legal advisers have 28 days to respond.

The last email, as per the norm that I have been observing over the period of the last 2 years, arrived after reticence of nearly two months. In addition to giving yet another deadline of 28 days, the email only addresses the issue of the provision of payments, while completely ignoring the maladministration and subpar service quality that my mother had to put against at Ealing Council.

The list of failures include, that I have requested the LGO to investigate, as has been mentioned on previous occasions but to no avail, the following offences:
• Incorrect action and/or failure to take any action
• Failure to follow procedures or the law
• Failure to provide information
• Failure to investigate
• Failure to reply
• Misleading or inaccurate statements
• Inadequate liaison
• Inadequate consultation
• Unfulfilled promises

While an initial response was expected from Ms. Smith not later than mid-July 2013, eight months later we have yet another deadline of an extra 28 days.

This raises significant questions on the procedural impropriety that seems apparent on observation of the LGO’s responses over the last two years regarding the case in question.

I have been trying to resolve my mother’s care since April 2012. During this time, I have repeatedly been stonewalled over a period of 21 months. After such a long time, I am unsure of what to make of the situation and the reasons for the prolonged delay and lack of constructive response. The matter of the fact is, despite seven clear occasions on which Ms. Smith expressed her intention to consider the case and come up with a decision, we still have a general failure of the consultation.

The Ealing Council have had, undoubtedly, a lot to say about their vision of fairness and competency on the matter when contacted; but the fact remains that, despite a number of promises, they consistently failed to provide any positive outcomes from deadlines.

The point is not to blame any specific entity. I am simply seeking an efficient flow of proceedings regarding my case, since the whole case with the LGO started back in November 2012 and any action has yet to be taken. I implore you to assist me in the resolution of this matter and help put the dispute to rest; almost two years have passed since it began.

Yours Faithfully

A B M Procaccini

This Blog is NOT about me – Please read this one “with care”

A couple of Thoughts on Contained Jargon in an Uncontained World: or why you can be an arsehole too!

A friend sent me the link that I’ve pasted below. It’s a very personal and moving account of what it is like to be the parent of a child who is being ‘supported’ by UK social services. But I would extend this to anybody who has anybody they care for within the UK care sector.
I used to work in the UK care sector. I left school at 16 years of age with no qualifications. The only real option for me was to go away to sea. This was firstly in the UK merchant navy and then the UK Royal Navy. It was hard work, full of hard men and women. It was a life full of the ‘rude’ and the ‘savage’ to use Ruskin’s words. It was a wonderful world full of colour and ‘dance’. Then I left the sea and became a ‘care worker’ in the UK ‘supporting’, ‘caring for’ the up to date jargon escapes me, young people with profound learning and physical disabilities. I have seen brutality in my life. I have seen what human beings can do to one another and the care sector was a brutal and brutalising place to work.

During my time working in the care sector I saw staff physically abuse, assault, degrading behaviour, and in admittedly an extreme case I caught a member of staff attempting to set fire to a client’s testicles. Prior to joining Royal Holloway to do my PhD I began a PhD at Lancaster. I supported myself by working at a residential home for a similar ‘client’ group.
Here I found abuse on an industrial level. When I reported an incident of assault by a member of staff on a client to the manager, the member of staff was promoted. At this particular ‘care’ home I found a young woman who was ‘challenging,’ being illegally and cruelly confined in her room. This distressed her more so she began to bite chunks out of her body and tear at her orifices. Her experience is beyond words. I was faced with the ‘choice’ of staying and in effect condone the behaviour or report it and leave and as a consequence lose my support for the PhD. I had no choice.

As an aside it may be tempting to tell yourself ‘Ah, this is men.’ The problem that you have there is that I saw women abuse as well. When I reported the setting fire to the testicles incident it was women who actively attempted to cover up the incident. I was ostracised by these women because “they thought I was going to report their friend.” No one or nothing has a monopoly of moral height; in the words of that eminent philosopher, Frank Zappa, “You can be an arsehole too.” To think otherwise is to take yourself and the rest of us down an intellectual and ethical cul-de-sac.
So why is this appearing on a webpage by someone who writes and thinks about social and political thought? Precisely because I write and think about social and political thought.
After the sea a friend, Richard Shipp, the same friend that sent me the link, persuaded me that I needed to be educated (He has a lot to answer for). I enrolled on a course in Politics, Philosophy and Economics. The only regret for me was the litany of despondency that is otherwise known as the reading list. It was a world of solipsistic fantasy that in spite of itself still managed to be impoverished. I had come from a world of colour and now found myself in a world of black and white, of either/or. A world of childhood tantrums where certainty is always self-assured. It was a world in which the language used was unrecognizable to which it was applied. It was a world in which the different lights that humanity have used to stumble through the condition of being human, have suffered, to misuse that most poignant of phrases from Tagore, the silence of obscurity. It is the world of the representative agent in which the uncontainable nature of humanity is contained, controlled, and feared. It is a world in which challenges, if not in your language, or what you define as language, become threats. The truth is that he or she confronts me through despair at my proselytizing certainty. It is from this world of words that the ‘representative agent’ becomes ‘empowered’, with ‘circles of support and influence’, who ‘feed into’ ‘care plans’ that ‘promote independence’. Whilst this may be good for conferences, interviewing skills, to use as keywords or fashionable research themes the reality is that it disguises, it looks away and reassures itself, you and me, from this brutality through the use of jargon that it inherits from social and political theorists. It is like the stage setting in a theatre that sets order, the narrative but which fails to acknowledge the chaos behind the set designer’s construction.
In our world, the world of those that spend their time thinking of the social and the political, we nicely side step the ‘rude’ and the ‘savage’ when we restrict the use of the political and the social and how we can think about such terms. We restrict vision and the social possibilities of the everyday, to a brutal account of the rationality of a tradition of a word. If we do not see it, it does not need to be changed. We then gift this to the applied sciences. It is a philosophy of constipation that treats thought as a historical artefact that blinds us to the genealogy and to the political and social status that it has privileged. If the political and social theorist requires certainty may I suggest beginning with three certainties before you start transforming the world into your own image. It is the world in which the model of living, and the paucity of thought on, in the ‘Western’ democracies condemns the most disadvantaged to three certainties. They know that they will be poorly educated, they know that they will be provided with poor life opportunities and they know that they will die earlier than those with better socio-economic and political advantages. The greatest opportunity that we can offer those that we silence, and we offer it with pride, is the opportunity to kill or to be killed for us, or at least what we are told is a ‘us’. Welcome to their world and you wonder why you fear them. They experience these certainties every moment of their lives. These are lives in which Cosmopolitanization is for an Islington coffee table. This is the world that the young man in the article lives in. He and his family, because of their dependency to the law, are amongst the most vulnerable in the UK. Their world is the world of the unsaid. Rather than condemning life to the obscurity of silence, unable to ‘communicate appropriately’, the problem of social and political thought, and the tools we give to others, should be to provide a ‘space’ through which worlds reveal itself to ‘I’.
We are face to face with and also inhabit the unsaid. But by relying on a genealogy of a tradition of ‘thought’, Thought fails to acknowledge that human beings experience communication, communicating and communicate in a variety of ways beyond a precise science of language. And whilst a strain of de-colonial thought may privilege itself by distancing itself from these people and their experiences, the problems of living together will not be answered through any sort of ontological or epistemological account of moral height but in an account of humility and openness. Theory must be relevant to the features of our political and social situation. It must be realistic from the perspective of the lived experience. What it describes must be imaginable beyond ‘your’ imagination. In challenging imagination you create new possibilities. The theorist can write of abstractions, of agents, of individuals, and project his/her certainty to the outside world in order to provide someone else with a better future. But before you do this look at your own world and if your words cannot be seen behind the face of the most vulnerable and fears beyond your own, then set your pen aside.

Is Race Discrimination a one way system, only?

“If someone discriminates against you because of your race, the colour of your skin or where you’re from, that’s racism. And racism is a crime”.


Dear Sirs,

We are forced to make a complaint about racial discrimination, we should not be victimised because of it, or treated differently.


The complaint is in support of my elderly mother, Mrs. Elvira Maggini; an Italian national and citizen born in Milan, Italy, in 1921. I have full Power of Attorney registered with the Office of the Public Guardian in England.


Race discrimination against my mother and I was produced to us, in writing, on more than one occasion by Mr. Stephen Day (Director of Adult Social Services at Ealing Council) and his staff.


This was written by Mr. Day and/or on his behalf:


·         “She falls within the second class of persons from abroad”

·         “As Lord Phillips in the case of Kimani v London Borough of  Lambeth [2003 EWCA Civ 1150]”

·         “She should be deported”


It is clearly not my intention to examine the legitimacy of UK laws and legislations with regard to UK Border Agencies regulations and it is, of course, the duty of every citizen to respect and obey them.  While in his correspondence, Mr. Day has clearly, and rightly so, stated that: “prohibition on local authorities to provide social care services to EEA nationals – as part of 2002 and 2006 Regulations and Acts”, he did not have to inflict and insert racist statements.


We strongly disapprove addressing a ninety-two year old Italian national as a “second class person” and are offended by the unfounded suggestion that she should be deported. We also find it offensive that my mother, a Caucasian Italian national should be compared to an illegal immigrant from Nigeria that was expelled from UK on the basis of a bogus marriage.


It is with vindictive and racist ire that Mr. Day and his team continued with such allegations for a period of over five months.


Where Mr. Day  has addressed my mother as second-class/person-citizens, there is a sense in which, in addition to his gross moral failings, he is supporting the notion that she is an inferior person and is thus showing hatred and being contemptible towards her. The equal status of European nationals, in modern liberal societies, is enshrined both in anti-discrimination legislations, and in social practices which largely affirm the ideals that underpin such legislation.


All Councils should be seen as fair and racial discrimination on the part of an official body is extremely upsetting and worrying. Ealing Council have ignored the rightful pleas of an elderly woman and constituent – they have expressed an utter disregard for her well-being and human rights, inflicting false attacks, racist remarks and allegations.


I would kindly like to request an investigation into Mr Stephen Day and his team.

MPs and Councillors don’t assist, – at all.

Open Letter – Ealing Council – Adult Social Care
This open letter follows both my meeting with a representative of Ealing Council (Linda C.) on July 4th 2013 and my letter addressed to the council on July 15th 2013. Despite all that Mrs Hunter has implied in her long reply to my letter, no complaints have been addressed or resolved successfully – ever.
I am still waiting for updates, implementations, conclusions and the visit from the occupational therapist – all as promised by Ealing Council, five weeks ago. It is upsetting enough that nothing has been achieved over this time, but I now understand that Linda C. has gone on holiday until August 22nd.
Am I therefore to assume that nothing will be done until September?
I would have thought that the department could have put in place the necessary measures to accommodate for those members of staff being on leave during the holidays. Unfortunately, my mother cannot take a holiday from her own distress!
It feels as if Ealing Council has kept adding bad ingredients to an already rotten soup in the blind hope that it may, one day, be edible. Both Mrs Hunter and Mr Day have acted in an intimidating and obstructive manner consistent throughout my 15 months long dealings with Ealing Council. Both have exhibited bullying and, at times, racist behaviour including the utterance of a racial slur – “second class citizen”.
It is utterly disgraceful that all other political parties and other official bodies involved and informed of this case (including those represented by MPs and local Councillors) have decided to ignore the rightful pleas of an elderly woman and constituent – that these individuals have expressed an utter disregard for her safety, well-being and human rights.
However, it is plain to see that in the public eye, any sustained process of constraint, intimidation, neglect, manipulation and viciousness against a ninety-two year old elderly person is despicable, unjust and discriminatory. For this reason, it is a specific concern of mine that Ealing’s local newspaper (The Ealing Gazette) has refused to cover the affair.
Nobody can understand the level of aggression, abuse and harassment that my mother and I have received over the last sixteen months, at the hands of Ealing Council. However, there is now significant interest in the wider media community, regarding poor standards of care provision. Despite the welcome interest – I sincerely hope that we can draw this case to a suitable conclusion before it becomes a topic for serious discussion in the media or in the Courts.
While I never expected the best for my mother, I deem it to be vital that she is, at least, treated with dignity and not like an animal.
I look forward to your response and to a time when we might find some conclusions to our last meeting.
Kind Regards

No News is good news, but should Stephen Day resign?

Back in January 2013 <> and, again, in February 2013 <>, Italy News brought to the public’s attention a shocking case of discrimination in which Ealing Council targeted a ninety-one-year-old woman named Elvira Maggini.

Elvira Maggini is an Italian national who has every legal right to reside in the United Kingdom. When we last covered her situation, she was in so poor a state of health that she had to be cared for, during every moment of every day. And so we were shocked to learn that council management had planned to suspend Elvira’s vital social care services. They had instead decided and insisted that she should be asked to leave the country. We were then appalled to hear that members of Ealing council staff had even described her as “a second class citizen” because of her nationality as an Italian living in the UK.

Six months ago Italy News spoke to Elvira’s son, Max Procaccini (MP). He had been forced to turn to his solicitors in order to counter the false accusations laid out by Ealing Council. We interview him here, asking whether the situation has improved. We want to know how he and his mother have dealt with racial intolerance, bullying and obstruction from the very people who are meant to ensure their civil rights.

Journalist  –  Is your mother still receiving care in Ealing?

MP – The Director of Adult Social Services at Ealing Council, Mr Stephen Day, has been very clear in his position that my mother should be made to leave his constituency. That includes his suggestion that she be deported but has also been made apparent by his department’s repeated attempts to prevent my mother from accessing any care at all. We have been waiting over half a year for the situation to be properly internally assessed but it has dragged on and on without much hope of conclusion. My mother is still eligible for limited care but the standard of those services is appalling. She has gone through five potential agencies and over twenty-five new carers in the time that it has taken to communicate with Ealing Council. In the meantime, I have tried to keep all communication with Stephen Day to a minimum because he clearly feels that it is okay to bully my mother into silence by alleging that she will be thrown out of the country.

In several letters Mr. Day argued, with certainty, that a piece of legislation not pertinent to our case, meant that my mother is not to be considered a family member and – as per Schedule 3 of the Nationality Immigration and Asylum Act 2002 Schedule 3 NIAA 2002 and EEA Regulations 2006 – he insisted that she should therefore return to Italy.

Journalist – How accurate are these allegations?

MP – Mr Day is the Director of Adult Social Services at Ealing Council. A man in his position should really know what he is talking about, including how and where relevant laws and legislations are applicable. Earlier in the year I asked for assistance in dealing with Ealing Council from my local representative in the House of Lords. Baroness Ludford MEP offered to look at the situation in regards to my and my mother’s paperwork and rights to residency. Baroness Ludford was able to summarize that my mother and I both possess full rights of residence in the UK. She then pointed this out in a letter addressed to Mr Day. He has persistently ignored her expert advice. Mr Day has instead maintained an arrogant position and has continued to bully my mother with hollow threats.

Journalist – Have the council continued to press for deportation even in the absence of evidence: is your mother to be deported?

MP – Council legislation demands that EEA nationals who wish to claim for social care benefits must have lived for more than five years in the UK. We have been able to produce paperwork which supports my permanent residency and my mother’s residency as my dependent. Much of this paperwork dates back to the 1980s and 90s. Some of it was even signed by Ealing Council with whom I used to work as an independent contractor.

The lack of social care has been absolutely crippling and has forced me into early retirement so that I can remain at home in order to properly care for my mother. The constant threats of deportation and the racist slurs such as “second class citizen” have been deeply upsetting. Ealing Council have intimidated my mother over the last year and a half to the extent that her health has begun to deteriorate dramatically. We have been put under an incredible amount of unnecessary stress. My mother was eventually hospitalised for twenty days in March 2013.

On 19th March 2013 an unpredicted letter arrived from Ealing Council. We had been contacted by Mrs Angela Morris, Head of Older People Services at Ealing Council. After twelve months of communication regarding my elderly mother this was the first time I had been made aware of either Mrs Morris or her department. Completely to my surprise and in contrast to Mr Day’s opinions, Mrs Morris wrote: “I have decided that it would be inappropriate to withdraw social care services from your mother. It is important that we build a collaborative on-going working relationship.”

Journalist – Good news then… And out of the blue! Where does that leave you now?

MP – I certainly wish it had turned out that way. After my mother was released from hospital a new care plan was set up by Ealing Council. There were two good carers but another three care assistants clocked off early at the weekends and still claimed for their full hours. The time that they stole amounted to fifty percent of the time my mother was allowed to spend with carers. I was able to prove that this was happening but instead of simply replacing the carers, Ealing Council decided to carry out an initial investigation – which has taken three whole months and which has delivered no results!

Instead of taking a disciplinarian or common sense approach Ealing Council decided to change the care agency, yet again. It has been a continuous disaster with most of the new agencies and their care workers. Suffice to say that there have been many more recent dissatisfactory incidents.

I suppose that leaves us here. We don’t have to worry about being deported. The very idea was ridiculous. It was enough to badly scare my mother though. And nothing has actually changed. We still have to worry about the source of the problem: the obstructive behaviour and the bullying attitudes that generated those threats in the first place.

Journalist – What happened to the “collaborative on-going working relationship” and what about finding support elsewhere?

MP – I met Mrs Morris in April 2013 but I have not been able to get hold of many people from the council since then. I have sent emails and left messages but they have been ignored. Baroness Ludford is the only representative of any official body to have helped with my mother’s case but her influence, as an MEP, is somewhat limited.

Our local MP, Mr V. Sharma has never taken into consideration or addressed my case. He is actually failing his constitutional obligations by ignoring this case. Three weeks ago a letter written from a member of the House of Lords was addressed to Mr. Sharma asking him to look into my mother’s situation. He has ignored this letter as well.

All of my local councillors are aware of the degrading state to which my mother has been abandoned and I have presented our case to several MPs including but not limited to Lynne Featherstone, Don Foster, Jeremy Hunt and Liz Kendall. All to no avail. Charities such as Dementia Concerns and AgeUK have also stayed well away from our case and institutions, like the Ombudsman have failed to reply to my concerns since November 2012.

Journalist – What do you think to be the main problem and the proper solution to all of this?

MP – Sorry if I reply with a question but would you eat in a restaurant where the food you are served is cold and the plates are dirty; would you want to go back to a restaurant infested with mice and cockroaches where they also ask you to pay the bill?

There are two problems. Firstly that the Care Service Providers are failing to support their clients; and my mother has suffered as a result. Secondly, Ealing Council have refused to confront this as a genuine issue. Nobody can truly understand the level of aggression, abuse and harassment that my mother and I have received at the hands of Ealing Council. Ultimately this problem goes far beyond my mother’s anguish and my distress though. There will be many others like ourselves who are caught up in this failing system. The council have wasted huge amounts of their funds and I suspect that they will simply not address the issue for fear of being held to account. And once again it is the innocent and the vulnerable that have to suffer. People like my mother. Ealing Council has spent and wasted a vast amount of public money by delaying my case and I would like to see them answer for their failings if only so that we can establish a system in which people, like my mother, can receive the vital care they need. That would be the care that it is outlined and promised in many brochures or on Ealing council website. The care for which we have already paid our taxes and where money from the EU has been pouring in.

Blog 6 luglio

Top Agencies in Ealing

* As per previous email, Carewatch is not the biggest agency in the Borough. This is a list of some of them taken from “Adult Services – Approval to extend homecare and supported living contracts” – Ealing Council

The approximate annual value of the current homecare contracts is as follows:
Carewatch – £1.7 million
Supporta Care – £3.2 million
Medico – £1.9 million
Plan Personnel – £1.7 million
MNA – £0.9 million
Excelcare – £0.7 million
Genesis – £0.1 million
Supreme Care – £0.7 million

Care Agencies – What Politicians prefer to ignore.

As Carewatch have not been able to provide adequate services, the email below was sent to Ealing Council (and political representatives) as a reminder of how regulations have failed and are failing the elderly.


Dear Brenda,

<< Please pass this email to whom it may concern within Ealing Council >> 

I may be old fashion with old fashion values, but, in my book, stealing is stealing whichever form it takes. I also do not ever think that I might be special, so if something happens to me, it is likely to happen to a load of other people.

Now if, at the weekend, my mother’s allocated time was provided at the rate of 50% – resulting in hours not worked by the carers but still paid for by the Council to the Agency, what does happen on a larger scale, please?

I don’t know how many elderly ‘clients’ Ealing Council has on their books, but if the above happens to 1000 of them – can you please see that we have a substantial waste of public money and resources?

(1000 x 4 hours = 4000) = (4000 x £13.00p.h) = £52,000 (y*) [£13.00 being the average figure that Ealing Council pays to Agencies per hour]

The above figure is a hypothetical amount but one that is very likely.

Should we multiple the above amount by the 326 Boroughs in England – the figure would be VERY alarming indeed.

*y X 326 X 52 weekends = £881,504.00

For well over a decade, we have all tried to come to term with the tragic death of Victoria Adjo Climbié in 2000 and “a system” that should have learned from previous mistakes.  However, the very recent death of abandoned Gloria Foster, aged only 81, was yet another reminder that something somewhere is not just bad, but it is rotten.

Coming from the private sector I surely fail to understand many policies adopted by Councils. It is safe to assume that a Care Agency will provide their services to Ealing Council via some contractual agreement.

Almost a year ago, the agency Genesis provided care services to my mother for just over five months. An excellent carer called Nadia provided such services. The “bad apple” was a young weekend carer that, to culminate her list of poor performances, one Sunday failed completely to provide services (breakfast, medications, personal care and lunch) to my mother. A smaller “incident” that what happened to Gloria Foster, but nevertheless a wakeup call to the standard of care, or lack of care that should have concerned very much not just us but both the agency and the Council.

Genesis should have followed their own clear guidelines and complaint procedures but they failed to do so. Instead, due to “capacity”, they pulled out from their contractual agreement.

I don’t really understand how any contractual agreement can take into consideration the word “capacity”. Should we not have “capacity” for rubbish collection, we would have our streets full of rubbish and rats, for example.

Capacity has now come up four of five times (I have lost the count) with the same amount of agencies within the last six months.

Carewatch, the biggest agency in the Borough*, has also now come up with the word “capacity” and they have also given their notice. How can the biggest agency in the Borough of Ealing have no capacity?

Identical to the incident with Genesis, the only carer that was not doing her work gets the message that it is all right not to do her work, to leave saucepans dirty, floors and really everything dirty and to leave early. Considering that the carer is an 18 years old student from Nepal, studying to be a carer, what kind of values are we teaching these young students? Are we teaching them that it is ok to cheat and take advantage of the system and that it is corrupted?

Despite several complaints, Carewatch has been condoning and covering for her unprofessional conduct.

The two good carers, Barbara and Tatiana, that were looking after my mother, Monday to Friday, lost their jobs thanks, once again, to one singular “bad apple”.

The contractual agreement is between Ealing Council and Carewatch and there should not be allowances for such sluggish performances.

“”A FUNDAMENTAL failure by social services may have led to the death of Gravesend schoolboy Edward Barry, according to a new report”” [20thMay 2013].

Why are we all becoming complacent with the above headlines and why are there no “real” independent checks on what the carers do? We know that CQC is in place, but it seems that they are only able to tackle the tip of the iceberg.

In the meantime, with agency no.5 (or is it 6th?), my mother has become, once again, withdrawn and clearly upset.  She was happy with Barbara and Tatiana and she doesn’t like the new carer. Translated into her behaviour, she is in a mood and eating lesser food (all we need, now, is a hunger strike)!

If the word capacity is not mentioned in Ealing Council contractual agreement with the Agencies, this should be looked at carefully and instated. It is extremely unfair for the elderly and the Council that Agencies are able to hold us at ransom while failing to provide proper and up to standards services.

With 2.52 MILLION unemployed out there in the UK, I am sure Councils would be able to find more professional workers and agencies.


cc. -

Rt. Hon Mr. Jeremy Hunt – Secretary of State for Health – Department of Health – Richmond House – 79 Whitehall – London SW1A 2NS

Rt Hon Andy Burnham – Shadow Secretary of State for Health – House of Commons, London, SW1A 0AA

Norman Lamb MP -Minister of State (Department of Health) – House of Commons, London, SW1A 0AA

Liz Kendall MP – Shadow Minister (Health) (Care and Older People) – House of Commons, London, SW1A 0AA

Ms. Lyn Romeo – Chief Social Worker for Adults – Argyle Street, London WC1H 8NJ