On the 19th March 2014, the law with regards to people who lacked capacity to make decisions as to where they live and about their care planning arrangements changed overnight in England and Wales. A simple ‘acid test’ was introduced by the Supreme Court in that anyone who had been placed in a Residential/Nursing Home, Hospital or Supported Living project and lacked capacity; who was monitored 24 hours a day and not allowed to go out alone would need to be assessed for a Deprivation of Liberty Safeguards (DoLS).
The aim of the safeguards are to ensure that the most vulnerable people in our society are given a ‘voice’ so that their needs, wishes and feelings are taken into account and listened to when important decisions are taken about them. It is to ensure that people’s human rights are maintained and that decisions are made with them and not done to them.
What’s changed?
In order to comply with the new law, Conwy had to ensure that systems and processes were in place to meet the demand. It is the Residential/Nursing Homes/Supported Living projects responsibility to refer anyone who meets the ‘acid test’ into Social Services. Once a referral has been received and agreed, a Best Interests Assessor (BIA) and a Doctor who has been approved under the Mental Health Act 2007 will go out and assess the person concerned.
What difference has it made?
For the majority of people assessed as meeting the DoLS requirements, Conwy Social Services have issued to Care Homes an authorisation which allows them to deprive someone of their liberty, albeit in the person’s best interests to keep the person safe.
Recently, a BIA and Doctor went out to assess Mrs Jones, a 78 year lady who suffered from Dementia and lived in a Residential Home. Mrs Jones clearly lacked capacity to make decisions as to where she lived and her care planning arrangements, however her family were concerned about her care. During the assessment it became clear that Mrs Jones had sustained a number of falls over several months, and a visit to A & E with stitches required.
The BIA and Doctor placed Mrs Jones on a DoLS, however they also recommended that Mrs Jones’ case was referred to the Protection of Vulnerable Adults (POVA) panel, due to their concerns about the number of falls and felt that this needed to be investigated – this is in line with S128 (3) of the new Social Services and Well-being (Wales) Act, 2014.
Whilst, the Deprivation of Liberty Safeguards are primarily about people’s human rights, it is also a safeguarding process to ensure that vulnerable people who lack capacity are protected from harm and kept safe.