I think you should check this by asking court staff if that is the case. I cannot see the logic to it. The patient is sadly not at all likely to return home, is she? If that is correct why would the court want an order in place to stop her leaving the care home? I think @Louise7 has it right.
Court Order wording confusion
- Thread starter 123jump
- Start date
Sorry to hear about your dad. Has your mum been in the care home long? Hopefully the social worker will be able to find some record of the 'best interests' decision being made for your mum. If she went straight to the home from hospital then the 'best interests' meeting would most likely have taken place at the hospital, with your dad's input if he was able to express a view at that time and potentially input from a hospital based social worker. If you have problems in getting through to the OPG then it may be worth giving the Dementia Connect support line a call as they are knowledgeable about all sorts of things dementia related: https://www.alzheimers.org.uk/dementia-connect-support-line
DOLs isn't only about preventing someone from leaving, a deprivation of liberty could relate to all sorts of things, and my Mum's home seem to put them in place in relation to all residents that lack mental capacity, not just those who may want/are able to leave. For example, things like use of bed rails or applying a safety belt when in a wheelchair would be considered a deprivation of liberty. You may find this factsheet useful as it provides more information:
Examples of making decisions or placing restriction on someone with dementia could include deciding on the person’s routine, stopping them from walking about at night, or preventing them from leaving. Care home or hospital staff should make sure that all care a person receives involves as little restriction as possible. However, sometimes it will be necessary to take away some of the person’s freedom to provide them with the care they need.
https://www.alzheimers.org.uk/get-support/legal-financial/deprivation-liberty-safeguards-dols
The Court does not know that, it wants to know where she is currently living and what reasons are there that she will not return home.
The court is trying to make sure that her stay in the care home will be permanent. They want to avoid the possibility that she will be allowed to come home when you have already sold it.
I wondered about this and ended up reading parts of the mental capacity Act and the DOLS Code of practice again. I think you define denial of liberty too widely, the bed rails and straps are not DOL. They are necessary restrictions but fall short of the bar to be DOL. I don't agree that a deprivation of liberty could relate to all sorts of things. It is essentially about detention of the person without their consent, and also to permit vital or life-sustaining treatment. It sounds as if the care home mentioned that applies for DoL authorisation for every resident is on thin ice unless perhaps it is a specialised home where it really is needed for all the residents. The code of practice is clear that DOL can't be used for the convenience of the management!
Thanks. I now see where the Courts are coming from.
So should the NH have already applied for Dols? (They haven't, according to council)(bed-bound, no cognition/mental capacity, PEG fed, paralysis on one side, unable to communicate). Mum has been at this NH for 11 months. Do I need to insist they apply for Dols?
Or attempt to contact COP to clarify situation?
Thanks in advance
So should the NH have already applied for Dols? (They haven't, according to council)(bed-bound, no cognition/mental capacity, PEG fed, paralysis on one side, unable to communicate). Mum has been at this NH for 11 months. Do I need to insist they apply for Dols?
Or attempt to contact COP to clarify situation?
Thanks in advance
Hello @123jump The home should consider for themselves whether an application for DOLs may be necessary - you shouldn't need to insist that they submit an application as they should have already considered this. The link below to a guide relating to the use of Dols in care homes states the following:
There is no need to request authorisation routinely for all residents, even if they do lack capacity, to stay in the home.
The general advice, however, is to err on the side of caution and make an application if the home believes deprivation of liberty may be occurring.
It is not the role of the DoLS office to ‘pre-screen’ potential applications. If a home believes a resident’s care regime amounts to a deprivation of liberty it should submit an application to its supervisory body.
https://www.scie.org.uk/mca/dols/practice/care-home
You can ask the care home if they consider that an application for DOLs is necessary. If they don't feel that it is then you can let the COP know. Likewise, if you find out details of a 'best interests' decision from the social worker you should also let the COP know. If you want to clarify with the OPG whether a DOLs / 'best interests' decision is necessary in order to sell the house give them a call.
Having checked my Mum's DOLs paperwork the care home made an application and the assessor decided that a deprivation of liberty was occurring due to the fact that she was 'under constant supervision' in the care home, plus she was 'not free to leave' as she would need the assistance of staff to leave (due to lack of mobility) and would be at risk in the community. The assessor also recorded that as Mum's house was being sold to pay for her care 'returning home was no longer an option that could be considered', but the house wasn't actually up for sale at the time of the DOLs assessment - it wasn't sold until almost 2 years later.
There is no need to request authorisation routinely for all residents, even if they do lack capacity, to stay in the home.
The general advice, however, is to err on the side of caution and make an application if the home believes deprivation of liberty may be occurring.
It is not the role of the DoLS office to ‘pre-screen’ potential applications. If a home believes a resident’s care regime amounts to a deprivation of liberty it should submit an application to its supervisory body.
https://www.scie.org.uk/mca/dols/practice/care-home
You can ask the care home if they consider that an application for DOLs is necessary. If they don't feel that it is then you can let the COP know. Likewise, if you find out details of a 'best interests' decision from the social worker you should also let the COP know. If you want to clarify with the OPG whether a DOLs / 'best interests' decision is necessary in order to sell the house give them a call.
Having checked my Mum's DOLs paperwork the care home made an application and the assessor decided that a deprivation of liberty was occurring due to the fact that she was 'under constant supervision' in the care home, plus she was 'not free to leave' as she would need the assistance of staff to leave (due to lack of mobility) and would be at risk in the community. The assessor also recorded that as Mum's house was being sold to pay for her care 'returning home was no longer an option that could be considered', but the house wasn't actually up for sale at the time of the DOLs assessment - it wasn't sold until almost 2 years later.
I have the same conditions as the original poster, but nothing to do with being or becoming a trustee. I did approach the OPG for some clarity about what was required for the 'best interests' conclusion, and OPG didn't even know of the existence of these conditions for me. They were provided on a separate Order to the deputyship Order (a separate bit of paper) and the OPG said they didn't have this. Anyway as the previous poster says the OPG would not clarify requirements as the arrangement is between me and the Court.
Still not got a reply from NH, but did manage to speak to social worker who said:
-no best interests meeting took place as we (family) agreed a NH best option (correct)
- suggested we would need to ask GP to apply for Dols
So if no 'best interests' and no Dols, does that mean COP won't make us trustees?
-no best interests meeting took place as we (family) agreed a NH best option (correct)
- suggested we would need to ask GP to apply for Dols
So if no 'best interests' and no Dols, does that mean COP won't make us trustees?
Not necessarily, they do need some reassurance that she will not have a need for the house to live in in the future.
You, together with social services, have made an uncontested best interests decision without the need for a formal meeting.
Is social worker prepared to put this in writing?
It seems to me that as others have said, what they are trying to establish is whether there is any possibility that the person may return home in the future, which obviously they couldn't if you had sold their house.
You cannot provide evidence you do not have! I would have thought a brief letter signed by the GP saying that she is 1) immobile, 2) has severe dementia and 3) she will need full time residential care for the rest of her life (or even just 3) would suffice.
You cannot provide evidence you do not have! I would have thought a brief letter signed by the GP saying that she is 1) immobile, 2) has severe dementia and 3) she will need full time residential care for the rest of her life (or even just 3) would suffice.
As @Jaded'n'faded has said a note from her GP could be useful.
I don't think the GP can apply for a DOLS, they will not be imposing the deprivation, the home will.
I don't think the GP can apply for a DOLS, they will not be imposing the deprivation, the home will.
Just an update for anyone who has similar issues and might find it useful:
We phoned the Court and they were very helpful. Basically told us to find out of NH had already got Dols, or were planning to apply for Dols in the future. If there was no Dols, then clarify that mum had been assessed as not requiring one. All their responses to be documented on form COP24 (evidence)
We phoned the Court and they were very helpful. Basically told us to find out of NH had already got Dols, or were planning to apply for Dols in the future. If there was no Dols, then clarify that mum had been assessed as not requiring one. All their responses to be documented on form COP24 (evidence)
Hello I wondered if you had submitted your COP forms and what sort of response you have had. I have similar requirements (stood over with liberty to restore by submission of Cop9 and 24) and have submitted them, but I do not know what the court does next. I have had an acknowledgement they have the forms. Do they issue another Order allowing the house sale?
Any further info would be great. I asked these questions to the CoP by email but haven't had anything back yet.
Ta
