Mother of young children is eligible for s117 aftercare. We are trying to argue that provision of nursery fees could be funded by s117. Note guidance says to take a “broad” approach. Getting push back that this is not related to mental illness and is part of “every day” parenting.
Any guidance/thoughts or signposting to relevant cases would be appreciated 
Whilst the code of practice does say to consider needs ‘broadly’, the Act itself still says that the purpose of s117 is to meet needs ‘arising from or related to’ the person’s mental disorder. It would be helpful to know why you feel childcare is a need that fits this criteria.
I personally would firstly consider universal childcare funding such as 15/30 hours or funding via universal credit, whichever is appropriate. Or if the patient has difficulty parenting as a result of their mental disorder I would contact the local authority’s children’s services as they may offer support under the Children Act
Yes it is every day parenting to provide care for children
The issue rests on whether the S117 aftercare plan included nursery care. If it did originally and was subsequently repeated, then there is a strong case for nursery fees being funded. The MHACOP gives and example of nursery care being something that may fall into the plan. However while the MHACOP is not Statute - it may be persuasive.
But there may be problems if nursery care was never on the careplan. How? Obviously if nursery care becomes a need ‘somebody’s’ budget is going to be hit - and they’re not going to like it. They’ll either look like or say ‘What - are we a blank cheque?’
Reams and reams of text have been generated by the courts. But..but.. who reads these judgements. You may be inclined to think ‘NOBODY’ - because the same issues come up time and again - and money is spent fighting in court.
So - yes - nursery care fees ‘could be funded by S117’. In an individual case it will depend heavily on documentation and how the funding is justififiable.
When they ‘push back’ I push back too with twice as much force. However, I am not everybody and not everybody is me.
I can’t find this in the Code of Practice or Reference Guide. Where did you read it?
As you will know I am unable to provide hyperlinks, or post images and I am limited to 3 responses. I read it in the MHACOP as stated.
Technology method (in Windows-based devices):
If the above doesn’t work - and you do not find the relevant words - your prime option is to conclude that I replicated hallucinated information from an AI.
The word “nursery” is 100% not there…
P.S. I don’t know the answer to the question but think “anonymous90” must be on the right track. I searched the LGSCO decisions database but couldn’t find anything relevant there.
Just for completeness, here’s the extract from the English Code of Practice that’s been mentioned above:
33.3 After-care services mean services which have the purposes of meeting a need
arising from or related to the patient’s mental disorder and reducing the risk of a
deterioration of the patient’s mental condition (and, accordingly, reducing the risk of
the patient requiring admission to hospital again for treatment for mental disorder.1
Their ultimate aim is to maintain patients in the community, with as few restrictions
as are necessary, wherever possible.33.4 CCGs and local authorities should interpret the definition of after-care services
broadly. For example, after-care can encompass healthcare, social care and
employment services, supported accommodation and services to meet the
person’s wider social, cultural and spiritual needs, if these services meet a need
that arises directly from or is related to the particular patient’s mental disorder, and
help to reduce the risk of a deterioration in the patient’s mental condition.33.5 After-care is a vital component in patients’ overall treatment and care. As well as
meeting their immediate needs for health and social care, after-care should aim to
support them in regaining or enhancing their skills, or learning new skills, in order to
cope with life outside hospital.
And here’s what the Welsh Code says:
33.4 After-care services means services which have the purpose of meeting a need arising
from, or related to, the patient’s mental disorder, and which reduce the risk of a
deterioration of the patient’s mental condition (and, accordingly, reduce the risk of the
patient requiring admission to hospital again for treatment for mental disorder).33.5 After-care services may encompass healthcare, social care and employment
services, supported accommodation, and services to meet the patient’s wider social,
cultural and spiritual needs, as long as these services meet a need that arises directly
from, or is related to the patient’s mental disorder, and help to reduce the risk of
deterioration in the patient’s mental condition. In line with the guiding principles set
out in Chapter 1, the services should be the least restrictive necessary.
Probably not providing an answer to the OP, but there is a reference in the MHA Code’s CPA chapter at 34.19 under ‘Care planning’.
It states that “Care planning requires a thorough assessment of the patient’s needs and wishes. It is likely to involve consideration of…
· …parenting or caring needs”
Correct!! 100%
I referred to an example.
The methodology involved searching for ‘the relevant words’. I wanted to say ‘cognate words’ but then nobody would understand that and few would reach for a dictionary.
Anybody could get to 27.13 and see the ‘relevant’ or ‘cognate’ words - but not everybody can or would do so.
Those who are skilled at interpreting law purposively will require no ‘code of practice’ - because the Statute (MHA 1983) is clear enough.
I can’t see any reason in principle why nursery care should not be provided as aftercare under s.117, with the proper argument in place-that’s the beauty and mystery of this provision.
According to Local Authority Circular LAC 2000(3), both your local authority and the ICB should have a local agreement in place which amongst other things lists what they are prepared to consider in scope for s.117 aftercare, but I have never seen such a thing, so you may be quite at liberty in that regard.
You have the observation from MHACoP 34.19 that parenting needs may be considered as part of care planning; we have the view of Mostyn J. in Afework v Camden LBC [2013] (para.14) that eligible aftercare needs may include support in helping…with…family relationships, which this surely may be.
I also note that the 2024 Hospital Discharge Guidelines draw attention to the needs of parent-carers of disabled children which must be assessed and if appropriate provided for under the Children Act. As a free-standing provision if these needs-of-the-parent in relation to looking after children represented aftercare they’d have to be provided for free under s.117; and if parents can have needs in respect of looking after disabled children it seems perfectly arguable that they can have needs in relation to looking after their children generally.
You’d have the option of framing the aftercare need as either arising directly from the patient’s needs or as merely related to them. I don’t have children myself but I am reliably assured that bringing them up places a heavy emotional and psychological burden on parents on account of which they may struggle to discharge their parental duty without, for example, respite arrangements provided regularly by a nursery. The opportunity to work may also address directly a parent’s mental health aftercare needs, especially if understood broadly as the Code requires at 33.4, and this may be impossible without nursery care being provided.
It might actually be a good challenge to admit that the provision of nursery care was not a need directly arising from a mental disorder, indeed to insist on it, and happily agree that it was to meet the direct needs of the children, which were not even mental health needs either: but to argue nevertheless that it was related to the mental disorder, in the manner described above.
It would be a hard-hearted commissioner, surely, who refused to allow that the role of parenting children had any impact on a patient’s mental health-that they’d sooner see the patient’s children removed to the grandparents under a s.20 arrangement or risk being taken into care, and look the other way when the patient’s mental health collapsed as a result, all because the one thing that could really have prevented it wasn’t thought to meet the definition of aftercare.
After that you merely have to show that meeting this need would reduce the risk of readmission to hospital, I think we’ve all made out tougher cases than that.
Isn’t s.117 wonderful?
I cant figure out how to quote Guy, but care planning under CPA (which is not widely used anymore) is not the same as a s117 eligible need. I’m all for considering wider need that impact on mental health but nursery costs are a universal need not directly related to a persons mental disorder.
Don’t you have to focus on the needs of the patient though, being the first principle of the 2024 Hospital Discharge Guidance?
I think there may be some confusion here, introduced by these other two cardinal points, as it were, the needs of children and needs not arising from a mental disorder, which play a part in the constellation of care in this case but are not relevant to s.117 aftercare and need to be filleted out.
There’s no question but that the nursery provision is to meet needs of the children, which are not mental health needs in any case-but it is not about them. The importance of the Children Act reference is that it shows how parents themselves can have needs arising from performing in that role, separate from the needs of the children. Although these needs do not arise from a mental disorder either, they may be related to the mental disorder, and that is what has to be shown.
It’s perfectly possible to imagine cases where all these elements are present but not related-the parent may be tragically indifferent to the children, for example, if their mental disorder is chronic in certain ways, or the nursery costs may be historic, the family has always sent children to the nursery whether the parent is capable of looking after them all the time or not. To jump ahead, it may be that meeting this need does nothing to prevent or reduce the likelihood of readmission, there are plenty of ways the argument can fall down.
But that the need-of-the-parent, as I am calling it here, doesn’t have to arise directly from a mental disorder is plain in statute, indeed it is difficult to see why the term related to is introduced at all, if not to cover situations like this.
I appreciate I am putting on one side here the argument about provision of nursery care, as a respite for example, and as a means of supporting family relationships, being to meet a need arising directly from the caring parent’s mental disorder; but it is the more difficult one to make, I think, whilst the option of meeting needs simply related to a mental disorder has to be a lot easier to justify, doesn’t it?