DOLS Advice

[luggy]

I'm looking for some guidance on DOLS Assessments please. Mum recently had her first DOLS Assessment, although she has been deprived of her liberties since April '21 when she was first admitted to a Nursing Home as a bedbound, lacking capacity resident.

Back in March of this year, someone from the DOLS dept contacted me by phone, asking for the details of my LPOA. She also asked me a few questions about mum, which I duly answered. I also asked if there was to be an assessment or meeting for me to be present as mum's LPOA, and she replied no, it could all be done during the phone call.

Today, I received an email with the DOLS documents attached. I have read them and found a number of inaccuracies. Most of the inaccuracies occur in a written report compiled by a Doctor (Mental Health Assessor) who visited mum in her nursing home on 28.1.24 and conducted an assessment with the assistance of care staff. I had no idea that this assessment had taken place and feel that, as mum's LPOA, I ought to have been informed and given the opportunity to attend as mum's representative (I would have attended if I had known).

My initial reaction is to raise this issue with the DOLS dept, with a view to the assessment being done again with me present. However, I'm getting tired and weary of constantly having to fight mum's corner and I have read that these DOLS assessments are just a tick the box exercise.

So, in the great scheme of things, how important is a DOLS? I've attended a few CHC meetings and from what I have seen/heard DOLS barely gets a mention. Am I missing something important?

I'm trying to choose my battles carefully. Many thanks in advance.

 

[Alisongs]

I'm looking for some guidance on DOLS Assessments please. Mum recently had her first DOLS Assessment, although she has been deprived of her liberties since April '21 when she was first admitted to a Nursing Home as a bedbound, lacking capacity resident.

Back in March of this year, someone from the DOLS dept contacted me by phone, asking for the details of my LPOA. She also asked me a few questions about mum, which I duly answered. I also asked if there was to be an assessment or meeting for me to be present as mum's LPOA, and she replied no, it could all be done during the phone call.

Today, I received an email with the DOLS documents attached. I have read them and found a number of inaccuracies. Most of the inaccuracies occur in a written report compiled by a Doctor (Mental Health Assessor) who visited mum in her nursing home on 28.1.24 and conducted an assessment with the assistance of care staff. I had no idea that this assessment had taken place and feel that, as mum's LPOA, I ought to have been informed and given the opportunity to attend as mum's representative (I would have attended if I had known).

My initial reaction is to raise this issue with the DOLS dept, with a view to the assessment being done again with me present. However, I'm getting tired and weary of constantly having to fight mum's corner and I have read that these DOLS assessments are just a tick the box exercise.

So, in the great scheme of things, how important is a DOLS? I've attended a few CHC meetings and from what I have seen/heard DOLS barely gets a mention. Am I missing something important?

I'm trying to choose my battles carefully. Many thanks in advance.

DOLS got slapped on my husband in hospital without my knowledge, consent or involvement. I was named as contact and interested person. Whole document was a farce. See government website. Most enlightening. https://www.gov.uk/guidance/deprivation-of-liberty-orders
And also

Deprivation of Liberty Safeguards (DoLS)

Deprivation of Liberty Safeguards (DoLS) are a set of checks that are part of the Mental Capacity Act 2005. Read about the DoLS procedure, which protects a person receiving care whose liberty has been limited, and tips to help you identify a deprivation of liberty.

www.alzheimers.org.uk

 

[nitram]

In your position if the inaccuracies in the report where used to justify the DoLS and I was both happy with the resulting DoLs and appointed RPR I'd leave things alone.

 

[SAP]

DOLS is a legal requirement to ensure that when someone who is deprived of their liberty in residential home or hospital it is done with in the legislation of the Mental Capacity Act. If most of the report is correct and if you agree that there needs be be a DOLS then I would also leave this one and save your energy. A persons representative would not normally be present at the assessment but would be kept informed of the process and sent the relevant paperwork.
There were a few inaccuracies on my mums report, nothing major and I knew that it had to be in place so I left it. I have LPA for mum and apart from a phone call I wasn’t involved in the process either. Realistically these assessment are not like best interest meetings , they are there to so that the home or hospital can so they are complying with the law.

 

[luggy]

Thank you all for your replies. The document is a template which appears to be used over and again, being altered each time with the individual's details etc. Trouble is, they don't always delete the previous person's details, so there's information recorded on the document which relates to somebody else. Like everything else, it seems to be par for the course these days.

I'll take the advice, and not waste time and energy on this one.

 

[Kevinl]

But as SAP says the state requires some legal procedure to detail someone, it is a free country after all.
The police can arrest you, you can be sectioned under the mental health act usually section 2 or 3 or they can use a Deprivation of Liberty Safeguarding Order, there has to be some legal framework to keep you safe.
No secret on here due to a viral brain infection I've been section 2 and 3 and under a DoLSO too, all better now and sat here posting from my boat on the canal.
I suspect that if you start /threaten to back off then suddenly they might start to reach out to you, it's a horrible game I call Patient's Poker.
K

 

[SAP]

Although I would be tempted to rattle a few cages and mention that they are in breach of GDPR 🤣

 

[Alisongs]

But as SAP says the state requires some legal procedure to detail someone, it is a free country after all.
The police can arrest you, you can be sectioned under the mental health act usually section 2 or 3 or they can use a Deprivation of Liberty Safeguarding Order, there has to be some legal framework to keep you safe.
No secret on here due to a viral brain infection I've been section 2 and 3 and under a DoLSO too, all better now and sat here posting from my boat on the canal.
I suspect that if you start /threaten to back off then suddenly they might start to reach out to you, it's a horrible game I call Patient's Poker.
K

When I got a solicitors advice about a farcical inaccurate and unreasonable DOLS, the hospital was suddenly only too keen to support my husbands discharge, everyone became super nice and accommodating and insisted at every turn that the DOLS would lapse on discharge........ It was actually not within the required legal framework, not fit for purpose and not legal!

 

[sdmhred]

Although I would be tempted to rattle a few cages and mention that they are in breach of GDPR 🤣

Yes I agree with @SAP. DOLS is much less contentious when folks are at the end stage of dementia. There is largely no issue that they are restricted. I would send an email however that you have received someone else’s details - that will give them a kick up the backside as that is a severely fineable offence.

 

[luggy]

But as SAP says the state requires some legal procedure to detail someone, it is a free country after all.
The police can arrest you, you can be sectioned under the mental health act usually section 2 or 3 or they can use a Deprivation of Liberty Safeguarding Order, there has to be some legal framework to keep you safe.
No secret on here due to a viral brain infection I've been section 2 and 3 and under a DoLSO too, all better now and sat here posting from my boat on the canal.
I suspect that if you start /threaten to back off then suddenly they might start to reach out to you, it's a horrible game I call Patient's Poker.
K

Thank you @Kevinl . Glad you have recovered, and what a lovely day to be on your boat

 

[luggy]

Thank you @SAP and @sdmhred. There have been no GDPR breaches - nobody elses personal details have been disclosed. More a case of mum being described as having a sight and hearing impairment (she has neither), has difficulty finding her way around the care home (she's been bedridden for 3 years with knees contracted up to her chin), has a good appetite (she doesn't eat) and does not display challenging behaviours (mmmm, behaviour charts portray a very different picture). Enid Blyton's 'Noddy in Toyland' would make more sense. At one point, reference was made to the Waterlow Score as being the Waterloo Score, so even Napoleon put in a guest appearance. I think I'll file it away and forget about it.

 

[Kevinl]

It's a lovely day and night to be on my boat well 3 nights now, Mr next door is picking me up tomorrow so home to a house I now hate.
Back to the point, a deprivation of liberty safeguarding order is a safeguarding issue whether it be to protect the person concerned or society from them, it's no biggie, been there, done that got the paperwork.
Doesn't alter the fact I'm sat here on my boat posting, alone, going home tomorrow with a few cycles of washing to do.
DoLSO is the light option sectioning can lead to free care, no suprise it's the one they prefer to use. K

 

[SAP]

Thank you @SAP and @sdmhred. There have been no GDPR breaches - nobody elses personal details have been disclosed. More a case of mum being described as having a sight and hearing impairment (she has neither), has difficulty finding her way around the care home (she's been bedridden for 3 years with knees contracted up to her chin), has a good appetite (she doesn't eat) and does not display challenging behaviours (mmmm, behaviour charts portray a very different picture). Enid Blyton's 'Noddy in Toyland' would make more sense. At one point, reference was made to the Waterlow Score as being the Waterloo Score, so even Napoleon put in a guest appearance. I think I'll file it away and forget about it.

Clear as mud then.! Yes keep your self for tomorrow’s fight. X

 

[Alisongs]

Thank you all for your replies. The document is a template which appears to be used over and again, being altered each time with the individual's details etc. Trouble is, they don't always delete the previous person's details, so there's information recorded on the document which relates to somebody else. Like everything else, it seems to be par for the course these days.

I'll take the advice, and not waste time and energy on this one.

They should be filling in an online form and printing off copies. This sounds decidedly unorthodox but typically lazy, shoddy and incompetent

 

[northumbrian_k]

Hi @luggy A DOLS authorisation is done to ensure that a person may be kept safe in a setting where their ability to leave freely is restricted (Deprived of Liberty). The key point is to Safeguard the person in the least restrictive way.

My experience of the assessment process and the subsequent documentation has been largely positive over a 6 year period. I haven't found anything that might be described as shoddy or incompetent.

I have found the assessments by the Psychiatrist and Best Interests Assessor to be fair and accurate in most respects. The paperwork is both illuminating about my wife's condition and - due to the format of the forms - somewhat repetitive.

If there are inaccuracies in the documents one could ask to have them rectified. But if doing so would not materially change the finding that the DoLS Authorisation is appropriate to the circumstances, one might take the view that it is that conclusion rather than the detail that is more important. Perhaps rectifying some of the more glaring errors could be done when the Authorisation is renewed (they are for a fixed period that is renewable).

 

[luggy]

Hi @luggy A DOLS authorisation is done to ensure that a person may be kept safe in a setting where their ability to leave freely is restricted (Deprived of Liberty). The key point is to Safeguard the person in the least restrictive way.

My experience of the assessment process and the subsequent documentation has been largely positive over a 6 year period. I haven't found anything that might be described as shoddy or incompetent.

I have found the assessments by the Psychiatrist and Best Interests Assessor to be fair and accurate in most respects. The paperwork is both illuminating about my wife's condition and - due to the format of the forms - somewhat repetitive.

If there are inaccuracies in the documents one could ask to have them rectified. But if doing so would not materially change the finding that the DoLS Authorisation is appropriate to the circumstances, one might take the view that it is that conclusion rather than the detail that is more important. Perhaps rectifying some of the more glaring errors could be done when the Authorisation is renewed (they are for a fixed period that is renewable).

@northumbrian_k Thank you for your reply. You seem to have had a much more positive experience. I probably didn't word my post very well. I know what the purpose of the DOLS process is, but this is the first time I have received a copy of the completed document, although I believe mum has probably been assessed for a DOLS previously.

Having been grappling with the CHC process for the last 3 years, I'm very aware of the need for accurate records/documents. If a CHC assessor were to read this document, they would get a very misleading impression of mum's condition. A CHC assessment is evidence based and an assessor is far more likely to base their decision on what has been recorded than anything I might say to the contrary, however correct my explanation might be. Having said that, previous assessors haven't paid the DOLS too much attention so, hopefully, it won't be an issue - if it does become an issue, that will be a battle for another day.

 

[Dirge]

@luggy I have been the RPR for my mother for many years and have constantly found inaccuracies in the annual submission, often the comments are just cut and pasted from previous years! I have reached the point where I list the errors and return the forms to the DOLS team unsigned with my reasons for doing so, they generally come back to say that one (or more) of the assessors have now left their post and therefore they are unable to correct the errors leaving the reports unsigned by me.

 

[luggy]

@Dirge I think they've cut and pasted someone elses symptoms on mum's document! I haven't been asked to sign anything.

 

[Rayreadynow]

I believe there is a backlog of DoLS assessments for Care Homes. Anyone identified as being interested in a persons welfare ( including friends and relatives ) should be consulted by the Best Interests Assessor.

However I seem to recall that the Independent Doctor does not have to consult anyone. Its yet another system that has good intentions but seems to have little support.

My PWDs local council were quite happy to let the DoLS be out of date for upto a year until I made a formal complaint ( using their complaints system) on the basis that it left them vulnerable and it was illegal.

If the council response is not acceptable then they direct you to the Local Government Ombudsman complaints procedure.

You really need a lot of resilience to get through all these processes, which is why many people just assume everything is OK.

 

[luggy]

I believe there is a backlog of DoLS assessments for Care Homes. Anyone identified as being interested in a persons welfare ( including friends and relatives ) should be consulted by the Best Interests Assessor.

However I seem to recall that the Independent Doctor does not have to consult anyone. Its yet another system that has good intentions but seems to have little support.

My PWDs local council were quite happy to let the DoLS be out of date for upto a year until I made a formal complaint ( using their complaints system) on the basis that it left them vulnerable and it was illegal.

If the council response is not acceptable then they direct you to the Local Government Ombudsman complaints procedure.

You really need a lot of resilience to get through all these processes, which is why many people just assume everything is OK.

Thank you for that information.