Lancashire and South Cumbria NHS Foundation Trust

6. Mr E was arrested on 11 February 2025 and taken to a police station.

7. The following day, a mental health assessment was completed while he was still at the police station, after which he was transferred to the Trust for further assessment.

8. He was admitted to the Trust on 14 February 2025. During his admission on the Adult Mental Health Ward, Mr E was reviewed by a consultant who assessed his insight and capacity in relation to his care and treatment.

9. Following these assessments, Mr E was detained under Section 2 of the Mental Health Act (MHA) and was issued a letter explaining this decision.

10. The letter also informed him of his right to appeal and about available support from an Independent Mental Health Advocate (IMHA). His medical records note he was also provided with a leaflet containing further information about his rights and the role of an IMHA, including the support available for Tribunals.

11. On 17 February 2025, Mr E was prescribed oral Zuclopenthixol, an antipsychotic medication. According to the Trust’s records, he refused the oral medication on 18 February, and it was administered by injection instead.

12. A further mental health assessment took place on 10 March 2025, which concluded Mr E should be detained under Section 3 of the MHA. He was notified of this decision in writing on 14 March 2025. This also provided information of the support available to him.

13. Mr E was subsequently discharged from the Trust’s care on 3 April 2025.

14. On 12 May 2025, Mr E contacted the Trust by telephone to raise a complaint about his care from February 2025. His concerns included being given an injection without consent and questioning the justification for his admission.

15. The Trust responded to his complaint on 3 July 2025.

16. As Mr E did not agree with the response, he referred his complaint to us on 21 August 2025.

17. Mr E was again detained under Section 2 of the MHA in December 2025 and Mr E challenged this decision at a Tribunal.

Staff inappropriately detained him for 28 days under the (MHA)

20. The law says we cannot investigate a complaint if there is or was a legal remedy that the aggrieved could pursue or could have pursued, unless it is not (or was not) reasonable for them to do so.

21. Our role is not to determine whether legal action would succeed, but whether it would have been a reasonable option for Mr E to pursue.

22. This aspect of Mr E’s complaint concerns his detention under Section 2 of the MHA. A person detained under the MHA can apply to the Mental Health Tribunal, which has the authority to decide whether or not the legal criteria for detention are met.

23. We discussed the complaint with Mr E to understand his circumstances and the outcomes he is seeking. Mr E told us he is looking for service changes and a financial remedy, with financial remedy being his primary outcome sought.

24. Mr E has said that he considers compensation of over £12,500 to be appropriate because of the issues he has experienced and the linked impacts. The Tribunal could not have awarded the compensation Mr E seeks, its role is to decide whether the criteria to detain Mr E was met, rather than awarding damages or compensation.

25. Whilst Mr E would not be able to achieve the financial award by going to the Tribunal, had Mr E been successful at the Tribunal, the impacts Mr E explains as a result of his detention may also not have occurred.

26. Mr E told us he would be willing to pursue legal action to address the issues he is raising but had approached our service first.

27. We asked Mr E if there were any barriers to him applying to the Mental Health Tribunal at the time of his detention. When discussing, he did not explain any barriers that stopped him from pursuing the matter through the Mental Health Tribunal.

28. Ward staff or an IMHA can assist patients who are detained under the NHA to contacting a solicitor, and legal aid is available for Tribunal representation. This means cost would not have been a barrier to Mr E pursuing the case through the Tribunal.

29. We note in December 2025, a Mental Health Administrator from the Trust approached HM Courts and Tribunals Service on Mr E’s behalf to appeal a separate occasion when he had been detained.

30. We asked Mr E why he appealed the detention in December 2025 and not the detention in February 2025. He explained he did not recall taking part in the Tribunal process in December 2025.

31. The referral documents from the December 2025 Tribunal confirm Mr E had appealed the detention, the referral was made on his behalf and Mr E attended the hearing.

32. Mr E’s medical records show he was provided with a copy of the decision from his Tribunal hearing on 16 January 2026.

33. We have seen Mr E was able to engage with the Tribunal process when he chose to do so. We have not identified any barriers that would have prevented him from pursuing legal action at the time.

34. Based on the information available, we are satisfied Mr E had an alternative legal remedy available to him that was reasonable for him to pursue. We will therefore not be taking any further action on this part of his complaint.

Staff injected him with unknown substances which he did not consent to

35. The Trust administering medication to Mr E’s was done as part of his detention under the MHA.

36. Mr E told us he ‘was held down while they forced a needle into {his} body with unknown substances’. We recognise the seriousness of this allegation and have reviewed the available evidence to understand what occurred.

37. Under the Mental Capacity Act (MCA), a person lacks capacity if, at the relevant time, they are unable to make a decision for themselves because of an impairment or disturbance in the functioning of the mind or brain. This applies whether the impairment is temporary or permanent.

38. The MCA also requires that any action taken on behalf of a person who lacks capacity must be in their best interests.

39. The evidence provided by the Trust indicates it was the view of the clinicians Mr E was unwell during this period and was assessed as lacking capacity to make decisions about his treatment which had led to his detainment under the MHA.

40. As the treatment was carried out under the MHA, we have seen Mr E had a legal remedy available to him to appeal his detention, and therefore his treatment.

41. To reach a view on whether the Trust was correct to administer medication without Mr E’s consent we need to determine whether the decision to detain him was correct. As explained above, it would be for a Tribunal to decide on Mr E’s appeal against his detention and treatment. We consider this could have formed part of Mr E’s legal appeal against his detention at a Mental Health Tribunal.

42. We can, however, look into how the Trust delivered the treatment whilst Mr E was detained. Having done so, we have not seen any evidence in the medical records to indicate Mr E was restrained at the time the injection was given to him.

43. We asked Mr E for further details, including the date of the incident, to help us explore this aspect of his complaint. Mr E was unable to provide this information. We have been unable to identify any event supporting his account of being physically held down. We are therefore unable to form a view on whether Mr E was restrained and whether or not that was appropriate.

Conclusion

44. We have seen Mr E’s detention and treatment was done under the MHA. Mr E had a legal route available to him to challenge the decision to detain and treat him. We have seen it would have been reasonable for him to pursue this action at the time.

45. Whilst this legal action would not have achieved the financial remedy he seeks, the impact he describes from the detention and treatment may have been mitigated had he been successful at appeal.

46. We do want to make clear we understand how upsetting this experience must have been to Mr E and we are sorry to hear of his difficulties during this time.

47. We hope we have been able to explain why we will not be taking this complaint any further. We recognise this conclusion may be difficult for Mr E, given the emotional impact of his experience.

1. We have carefully considered Mr E’s complaint about Lancashire and South Cumbria NHS Foundation Trust (the Trust). Having reviewed the available information we have decided not to investigate this complaint further at this time because we consider Mr E had the opportunity to explore this matter through a Mental Health Tribunal.

2. We are very sorry to hear of the circumstances surrounding Mr E bringing his complaint to us, and the way he feels he was treated by the Trust. We recognise the impact these events have had on Mr E, and his strength of feeling regarding this matter.

Complaint

3. Mr E complains about aspects of the care and treatment he received from the Trust between February and March 2025. Specifically, he complains:

• staff inappropriately detained him for 28 days under the Mental Health Act (MHA) • injected him with unknown substances which he did not consent to

4. Mr E says as a result of this detention he lost his job and his home. His partner refused to let him move back in once he was released following his detention. He was fearful for what he had been injected with.

5. By bringing the complaint to us Mr E requests a financial award equivalent to level 6 of our severity of injustice scale to address his homelessness and loss of job, and service improvements so the Trust do not act in this way to anyone else.