A woman was discharged by the community mental health team only months before she decapitated her mum, an inquest has been told.
An overworked senior psychiatric nurse who helped to care for Odessa Carey told how she warned that she did not have "capacity" to take the patient on, and described working for the mental health trust as "chaotic."
Carey killed her 73-year-old mum, who shared the same name, and cut off her head at her home in Ashington in April 2019, reports Chronicle Live.
Mentally-ill Carey was consequently detained in a secure hospital after a jury at Newcastle Crown Court decided that she was responsible for the killing.
Now at the inquest into the mum's death, Coroner Andrew Hethrington has heard details of the mental health care Odessa received in the run up to the savage killing.
The hearing heard from the now retired psychiatric nurse Wendy Dunn who worked for Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) who were managing Carey's care.
The hearing heard how in early 2018 Wendy had been visiting Carey at least once a fortnight, and sometimes weekly.
Wendy explained that during visits to the home Carey shared with her mum there would be "some delusional content to conversation" and the patient would often speak of her belief that the woman she was living with was not her real mother.
She also believed her mum was letting people into her house to steal her belongings.
It was also noted that Carey was using cannabis and there was a "risk of deterioration in mental health" if this continued.
But she was not sent to a drug and alcohol treatment service, and Ms Dunn said there was no indication that Carey intended to harm her mother.
Wendy said: "When I asked if she would harm herself or her mum she said 'no'."
The inquest heard that in April 2018, she was detained in an acute mental health ward in Newcastle following an assault on her mother.
Wendy told the coroner that she "panicked slightly" when she was told that the patient was set to be discharged in early May.
"We hadn't had time to get anything in place," she said. "And we were aware Odessa couldn't be returned home. Odessa told me she would be homeless on discharge.
"It's important for continuity of care to make sure everything is in place before someone is discharged."
She was discharged on May 30, and a bed was eventually found for her at The Old Fire House, a homeless hostel in Blyth.
Wendy described visiting her at the hostel.
"She remained delusional and was upset about the way her discharge had been handled," she said. "It would have been better if we could have had a co-ordinated discharge and she had somewhere to go. It could have been handled a little bit better."
Wendy also told how Carey had been given only a four day supply of medication when she was discharged, and went onto say she noticed a strong smell of cannabis when she visited.
On August 3 Carey was discharged from the community mental health treatment team altogether.
The inquest heard that "it was thought her needs appeared to be 'social'." But Ms Dunn said Carey contacted the trust herself and asked to be referred back into the treatment team.
"We had discussions with the (hostel) staff," said Ms Dunn. "They are really experienced with drug and alcohol problems. The had no real concerns about her mental health.
"With hindsight I think possibly we could have spent a bit more time working with the team at the fire house but I didn't have any jurisdiction on that."
Norma Tait, Carey's care co-ordinator since August 2017, also spoke at the inquest
Norma explained that when she was assigned the case she told her clinical lead that she did not have the capacity to take it on.
"The workload was huge," she said. "I didn't have the capacity, I made that quite clear, but cases were allocated anyway."
"It was quite chaotic, we had teams within teams. Sometimes people weren't sure what their roles were.
"We had a very scarce amount of consultant psychiatrists. I don't think people wanted to work in the community treatments teams. There were lots of locums who didn't stay very long. It was difficult to have a discussion with consultants."
Norma also told how she was contacted by Odessa senior in March 2018 asking if it would be possible to find her daughter somewhere else to live.
She had said Carey had been staying with a friend for a week and it had been "bliss".
Norma said: "She didn't indicate that she was fearful, but she clearly indicated that her life was better when Odessa had been staying at friends."
She continued: "I most certainly would have explored further with Dessa (Odessa senior) the difficulties she was having with Odessa. That might have made a difference. I regret a lot that I didn't do that.
"I think mum was in a really difficult situation. At the end of the day it was her daughter. I have got children myself. You want to do your best for them."
The inquest continues.
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