State hospitals often didn't provide good care or safe conditions, they say, and the quality of life was poor. But N.C. law doesn't require that the homes are licensed, which means Raleigh regulators are not making site visits or checking staffing levels. Only homes that serve two or more adults must get a license from the state's Division of Facility Services. Lynnette's home wasn't licensed because she was the only client living there. The 39 local mental health offices throughout the state often don't ensure that Thomas S. caregivers are trained, families say, even though those patients have complex needs.
Families also worry about oversight.
Though Thomas S. caseworkers have smaller loads than other mental health officials, they are often inexperienced and don't always detect substandard care. And when violations are found, families say, little is done to correct the problems. Police say Lynnette was slapped and hit in the weeks prior to her death, and have charged a second worker with three counts of assault. Lynnette's family wonders why no one detected problems in the home. Many communities don't offer enough vocational programs and employment opportunities to Thomas S. clients.