1. Wigan

    Wigan Registered User

    May 5, 2013
    73
    Hi

    I have not posted for quite a long time but continue to read the threads. I was wondering if anyone knew whether it is usual for a care home to apply for DoLS for all of its residents?

    Thanks
     
  2. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    Hmmmmm that is a difficult question. In care homes which are 'dementia care' it would be usual to apply for many of the residents but really DoLs should be applied for on an individual needs basis not on a diagnosis.
     
  3. Wigan

    Wigan Registered User

    May 5, 2013
    73
    I just thought it seemed odd to apply for everyone as my understanding of DoLS is that it has to be as a last resort and not used for the convenience of staff or carers.
     
  4. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    I think there is a great deal of misunderstanding about DoLS both amongst professionals and the public and just the word creates panic, add to that the CQC check for DoLS applications and you have mass panic. This is the first time I have heard of blanket applications and I think they might get their hands rapped but you can object to the care home if you don't want them to do the application
     
  5. Wigan

    Wigan Registered User

    May 5, 2013
    73
    Yes, I feel very concerned about their approach and need to look into it further.
     
  6. Sallyjmckee

    Sallyjmckee Registered User

    Jan 20, 2016
    1
    Hi, Dols can be applied as a whole for a majority of people in a dementia home, mainly if it is deemed that they lack the insight into there own safety once they leave the residential care setting. At present it is something cqc are looking at, as evidence that people who have had liberties deprived from them (particularly to leave the properly) that there is supporting evidence to support this. Usually a Dols assessment is a form and supporting evidence to why it is felt that that it is in that persons best interest to deprive them of the right to do certain things. Anyone can apply for one for any reason, and it is up to the local aurhority to grant it.
    It seems at the minute that due to 'dementia' homes all having secure locked doors, there is a huge emphasis on Dols as you are depriving that person of the right to leave when they wish.
    I hope this helps .
     
  7. PeggySmith

    PeggySmith Registered User

    Apr 16, 2012
    1,683
    BANES
    There's been a High Court ruling which has caused an enormous rise in DOLs applications. You might want to read this: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/485122/DH_Consolidated_Guidance.pdf

    It all seems a bit pointless to me - MIL is end-stage of life, unable to move or do anything for herself and rapidly losing all communication skills so I was a bit shocked when we got a phone call about DOLs as the only way she would go anywhere would bo on a stretcher! Apparently, if a person is subject to a DOLs order, if they die there has to be an inquest and this is causing delays in coroner's courts. http://anncoffeymp.com/anns-debate-on-deprivation-of-liberty-safeguards-assessments/ Just more beaurocracy to deal with.....
     
  8. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,289
    SW London
    i had a call back in June from an independent social worker, to say she and a psychiatrist had to interview my mother (then late stage, nearly 97, and had been in her CH for nearly 8 years) to make sure she was not in a secure care home unnecessarily.

    Of course I understand that it's the law now, and nobody wants to go back to Victorian times when people were locked away in asylums by relatives with nefarious motives. I did say that they would be unable to hold any sort of conversation with her, and that she might well not even wake up.

    She phoned me back a couple of months later, to let me know that she and the psychiatrist were satisfied. I then had to tell her that my mother had in fact died a few weeks previously.
    I almost felt sorry for the woman - she was so mortified and apologetic.

    I did think at the time that surely a phone call to the CH would have sufficed, but then of course I suppose you could still conceivably have dodgy CH managers, like the dodgy asylum managers in the past, so they have to see for themselves.
     
  9. gringo

    gringo Registered User

    Feb 1, 2012
    1,189
    UK.
    Most people seem have got hold of the wrong end of the stick on the question of DOLS.
    DOLS. were brought in by the Mental Capacity Act 2005 to ensure that no one is deprived of their liberty without good reason. It also ensures (or should ensure) that the person concerned has an RPR (relevant person’s representative, usually a family member.) to protect their interests. The important letter is the ’S’ which stands for ’Safeguards'. DOLS. have a term, no longer than 12 months, after which there must be a further review.
    I am my wife’s RPR. and have always been kept fully advised of the process and invited to comment at any stage.
    The Dept. of Health pamphlet OPG609 explains the process.
     
  10. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,556
    Female
    England
    Our experience has been the same Gringo. My husband had his third annual assessment just before Christmas, I was present and fully involved and my opinions were asked in his care from personal care to laundry and general housekeeping. His medication was checked and his carers spoken to re how they dealt with him as he could not communicate his needs. A very thorough and respectful assessment.
     
  11. Beate

    Beate Registered User

    May 21, 2014
    11,746
    Female
    London
    A DOLS doesn't deprive liberty, it makes sure that the liberty someone is already being deprived of is lawful and in their best interest. My OH apparently was under a DOLS while he was in hospital. I admit I thought that was stupid but it's apparently automatic these days when someone has lost capacity.
     
  12. Wigan

    Wigan Registered User

    May 5, 2013
    73
    Thanks everyone for your replies. I guess it's when we read about sedation, restraint and other worrying factors that we wouldn't feel comfortable with care assistants having the power to do this and us probably not having any say in it. We could be completely wrong in how we interpret it but I will read the links attached.
     
  13. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,289
    SW London
    TBH I have only ever thought of it in the context of locked outer doors in care homes, i.e. to stop very vulnerable people wandering off and getting lost or run over, which would certainly have been the case many times at my mother's care home (a specialist dementia) if residents had been free to come and go.
     
  14. Bessieb

    Bessieb Registered User

    Jun 2, 2014
    108
    I think there was a change in legislation quite recently which meant that when a person is deemed to lack capacity a DOLS should be applied for to ensure they are being cared for within the law. I think it protects carers from accusations they are acting unlawfully.
    In my parents CH DOLS are not applied for automatically or as a blanket but when a resident is deemed to have lost capacity they do apply for one.
     
  15. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    They really shouldn't be applied across the board they are for individuals. It's a barmy system though - there has to be a better way of protecting people because DoLS is hugely time consuming and isn't fit for purpose
     
  16. Wigan

    Wigan Registered User

    May 5, 2013
    73
    I really don't think it is acceptable that every resident in the care home could be subject to a DoLS. Good care homes should follow the principle of person-centred care as each individual has different needs and capabilities. As said in one of the replies, residents in care and nursing homes have already had their liberties taken away from them but to me by applying DoLS, the person is not always being protected as by restricting input and control (to an extent) away from family members who know their loved ones best, the individual could in fact be put at more risk. An example of this from my point of view was when mum was particularly unsettled, the care home called for the GP. He prescribed a medication that we know mum can't take. Had I not read the mar chart, we would not have known mum was on this as the staff "forgot" to tell us. We thought there was a change in mum and couldn't put our finger on it. It probably suited the staff as it made her very sleepy, but was a completely unfair way to deal with what was in fact an underlying medical condition. Even now, we know when mum has a UTI with the change in her behaviour but the staff wouldn't necessarily think this could be the reason as they usually suggest it is down to her condition, and I often have to remind them that people with dementia don't change overnight unless there is an underlying reason. We always insist a water sample is sent off for analysis to make sure the right antibiotic is prescribed. With a DoLS, I am not sure we could have the same input and say in things and that is the worry for us.
     
  17. garnuft

    garnuft Registered User

    Sep 7, 2012
    6,585
    #17 garnuft, Jan 20, 2016
    Last edited: Jan 20, 2016
    I think it's important you read Gringo's post,Wigan.

    dolS ...deprivation of liberty SAFEGUARDS.

    It is to ensure, or attempt to ensure, that the liberty...freedom, human rights...of a person are not encroached upon without good reason, justification and in the minimal way required to ensure their safety.

    It does not, and is not meant to, replace in anyway, support and welfare of a person in any other matter.

    It simply means that when an organisation is preventing a person from leaving their care that they are not doing it unlawfully and furthermore, the person is monitored to ensure that the ruling....to detain them against their will, is right and proper.
     
  18. tigerlady

    tigerlady Registered User

    Nov 29, 2015
    427
    My husband has a DoLS - it was put on him when his section ended and as well as making it lawful for him to be kept in a secure enviironment, it enables the carers to do safeguarding restraint when giving personal care - very upsetting but obviously they cannot let him go unwashed.
    I am his representative, and I have been kept informed at every stage and been sent all the results of each assessment and have been present at some.
    The DoLS does not prevent me from taking him out for a walk or for lunch or recently to the theatre to a musical.
     
  19. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,045
    Staffs
    You do have a say in it. The person themselves, the RPR or absolutely anyone can appeal a DOLS if they so wish.
    :)
     
  20. Wigan

    Wigan Registered User

    May 5, 2013
    73
    Thank you. Some reassuring replies there and I will make myself more knowledgeable just in case.
     

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