Mental health and social care: one record across the boundary

The Mental Health Act record, the Care Act assessment, DoLS, safeguarding, children’s social care and the carer register, held against the same person under the same access rules. What is live, what is demonstrated, and where the seams still are.

1 One person, four statutes

This is where “one record” stops being a slogan and becomes a legal problem. The same woman can be detained under the Mental Health Act, hold a Care Act needs assessment and a personal budget, be under a DoLS authorisation, sit inside an open safeguarding enquiry, and be cared for at home by a daughter who is herself a patient of the same organisation. Four bodies of law, five professional groups, and in most places five systems that can’t see each other.

The coordinator column is the bit that gets missed. One of those plans is coordinated by a social worker and one by a consultant psychiatrist, in the same place, under the same access rules.

2 The Mental Health Act record

Detention is the part of mental health care where a date is a liberty. The record holds the section type, the start, the expiry, the responsible clinician, the nearest relative and any tribunal date, against a person instead of a spreadsheet row.

3 The national return comes out of the record

The Mental Health Services Data Set is a monthly statutory submission. In most organisations a small team pulls numbers out of the clinical system, reconciles them by hand, and submits something that no longer matches what the clinicians wrote. Here the extract is a query over the same rows, and it drills down to the records behind each count.

Two things there matter more than the numbers. Every tile opens to the rows behind it, so a count that looks wrong can be argued about with the record in front of you. And it’s treated as an export of special category data: the extract is logged, and the lowest access level can’t open it, because one payload carries names, NHS numbers and detention records together.

4 The Care Act side of the same person

A Care Act needs assessment records what the person can’t do for themselves, whether they meet the national eligibility criteria, and what the support is likely to cost each week. From there it becomes a care package, or continuing healthcare, or a residential placement.

5 Capacity, and one place for DoLS

A Deprivation of Liberty authorisation that has quietly expired is one of the commonest findings in an adult social care inspection, because keeping track of them is diary management dressed up as governance. The platform derives status from the expiry date every time the list is read, so one can’t show as active a year after it lapsed.

The row at the top of that list expired in September 2024 and the platform says so, without anybody having to notice. The conditions column is the other half: an authorisation is lawful because of what is attached to it, and those conditions have to sit where the care staff read them.

Underneath there’s one authorisation store. Older rows fold into the same spine on read, matched on NHS number, so a person can’t carry one status here and a different one there.

6 Safeguarding, adults and children, in one queue

Section 42 enquiries for adults, Section 47 for children, MARAC referrals for domestic abuse and the child protection register are four statutory processes and, most of the time, four views of the same family. The Safeguarding Hub holds them in one alert queue with a risk level, a status and a case-note trail.

Look at who raised those alerts: a teacher, a police constable, a health visitor, a receptionist and a community psychiatric nurse. The average-days-open figure makes the alerts nobody has touched visible.

7 Children, and the people doing the caring

Two groups the health record habitually loses. A child on a child protection plan is a Children Act case with statutory visit intervals counted in days. An unpaid carer has their own right to an assessment under the Care Act, and usually gets recorded as a line in someone else’s notes.

That screen is a demonstration. The endpoints exist and the page calls them, but what it renders is the seeded caseload instead of records held against a person in the platform’s spine, and I would rather say so here than let a buyer find it in a pilot. The shape is right: Section 17, Section 47, Section 20, interim care orders, kinship placements, care leavers, a confidentiality flag on child protection rows, and visit dates that go red before they’re breached. The SEND and education, health and care plan surface sits in the same position today.

The carer register is live and does real work with two columns. Was this person offered their own assessment, and were they pointed at support. Three of the twelve have had neither, and one of them is a young carer. That’s a number a commissioner can hold somebody to. The fuller carer assessment surface, with young carer casework and wellbeing outcomes, is a demonstration today and reads seeded content.

Where it lives in commvita