Families and social workers can often find themselves at loggerheads over the care of a loved one. Social work is meant to support people facing challenging circumstances – and usually it does.

But whether it is a child in need of protection, a disabled adult needing help to live independently or an elderly relative with care needs, a professional judgement will sometimes differ from the wishes of those affected.

However in the case of Ms ST, the Mental Welfare Commission says an early decision was taken that she could not return to live at home with her mother. From that point on, the report suggests “confirmation bias” meant workers were unwilling or unable to take on board alternative to their own risk assessment.

The health and social care partnership (HSCP) risk assessment concluded she could not go home. It did not assess the risk involved in uprooting her and placing her in a care home, which she had never experienced. The report details a catalogue of faults in the approach taken by the health and social care team. The HSCP took the view that “Alternative approaches suggested by the independent consultant... were summarily dismissed,” the report says.

Meanwhile a support plan prepared to support the move to a care home stated: “All professionals are in agreement that she requires 24 hour care with waking support overnight.”. The MWC concluded this simply wasn’t true.

The department contested the family’s plans for guardianship because of their insistence that ST should return home. But disagreement with workers, the report says, “is not an indicator of the unsuitability of an applicant for guardianship.”

By failing to refer to Ms ST’s own wishes, the HSCP broke the law, the report adds. When, finally, the family were allowed to resume care of her, the reinstatment of social work support came with a thinly veiled threat to implement Adult Support and Protection procedures against the family should they fail to spend the money precisely as determined by the HSCP. This certainly breaches at least the spirit of Self Directed Support.

Perhaps the most striking feature of this saga is that the health and social care “partnership” was anything but.The opinions of medics involved in Ms STs care appeared to have been ignored, and risk assessments were prepared on this basis: “Social work held the view that further falls could prove fatal, a view reached without recourse to medical opinion,” the investigation found.