Odessa Carey was discharged from the community mental health team looking after her treatment just months before she decapitated her mum, an inquest has heard.
And a senior psychiatric nurse involved in her care has told how she warned her superiors that she did not have "capacity" to take the patient on as she described working for the mental health trust as "chaotic" at the time.
Mentally-ill Carey killed her 73-year-old mother before cutting off her head in April 2019. Her mum, who had the same name, was found dead on a bed at her home in Ashington.
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Carey was later detained in a secure hospital after a jury at Newcastle Crown Court ruled she was responsible for the killing.
Now as an inquest into Odessa senior's death gets under way Northumberland Coroner Andrew Hethrington has heard details of the mental health care Odessa junior received in the run up to her mum's death.
The hearing heard evidence from now retired community psychiatric nurse Wendy Dunn who worked for Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) which was managing Carey's care.
The inquest heard how in early 2018 Ms Dunn was visiting Carey at least once a fortnight, but sometimes weekly.
Ms Dunn told how during her visits to Carey's home, which she shared with Odessa senior, there would be "some delusional content to conversation" and the patient would regularly express her belief that the woman she was living with was not her real mother.
She also said she believed her mother was letting other people into her house to steal her belongings.
It was also noted that Carey was using cannabis and there was a "risk of deuteriation in mental health" if she continued to do so.
But Carey was never referred to a drug and alcohol treatment service. And Ms Dunn said there was no suggestion that Carey intended to harm her mother.
Ms Dunn said: "When I asked if she would harm herself or her mum she said 'no'."
In April 2018, Carey was detained in the Lowery Ward, an acute mental health ward, in Newcastle following an assault on her mother, the inquest heard.
Ms Dunn 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."
Following her discharge on May 30, a bed was eventually found for Carey at The Old Fire House, a homeless hostel in Blyth. Ms Dunn 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."
Ms Dunn also told how Carey had only been given four days worth of medication when she was discharged, and that there was a strong smell of cannabis when she visited.
Then 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."
The inquest also heard from Norma Tait, who had been Carey's care co-ordinator since August 2017.
She told how 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 psyciatrists. 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
Ms Tait 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".
Miss Tait said she explained it was not her role to find patients accomodation.
She 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."
When asked by the coroner if she would have done anything different Ms Tait said: "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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