ST HELENS and Manchester councils were at legal loggerheads yesterday over who should pick up the £650,000-a-year care bill for a deeply vulnerable woman – described in court as “probably the most expensive adult care package in the country”.

Manchester City Council’s judicial review challenge focuses on the harrowing plight of a woman named only as “P” – who is in her 30’s and afflicted by a “complex and severe” mental disorder, London’s High Court heard.

This leads to her “dissociating” into four alternative identities, a state causing intense anxiety, and which strikes at any time of the day or night, leaving her “unable to focus on the real world”.

Her condition – coupled with entrenched learning problems and other challenging needs – have made her acutely vulnerable and incapable of independent living, resulting in a massively costly package of local authority support that dates back to her childhood.

In 1999, after a series of residential placements, St Helens Borough Council placed her in a house in Greater Manchester and laid on a regime of intensive round-the-clock care.

Stephen Knapfler, for Manchester City Council, said St Helens had provided hundreds of care hours per week, comprising three carers by day and two throughout the night.