Mum refused NHS continued healthcare at assessment - help please

Chris-G

Registered User
Jul 11, 2014
105
0
A DOLS is still NOT as you allege, a report. It is a purely procedural requirement. A DOLS is written to prove not that the "need" is high but that the person cannot be allowed to leave the facility where they are resident. They can be and are challenged, and there is much pressure to complete them properly, hence the (probably over detailed for the purpose) example you quote.

As an example, my mother was deprived of liberty most of her time in care and DOLS forms were completed periodically. The emphasised the risk her behaviour posed to her safety (and that of others). But the detail provided, when translated into a DST and CHC National Framework Assessment format (as part of the review of her s117 funding - she wasn't on CHC but the framework used was similar) - meant that she actually scored pretty low.

As an aside, none of what you've described makes me think that the evidence of the very complete DOLS assessment actually differs in any material degree from the evidence you have described being used to assess your mother. They may seem very different to you, but probably differ little in practice. Also what you've described in the DOLS doesn't make me think that the score your mother will get is necessarily sufficient to qualify for CHC, (although what you've posted elsewhere suggests she might.)

PS I was wondering if you are an ex-police officer or Inland Revenue or Customs? Your style reminds me of individuals I've worked with from the police, revenue and customs - that's meant to be a compliment btw!

The fact that what is reported in the DOLS reasoning for continuation, is so radically different from the MDT's DST and the LA's CAP2 report is surely the point.

You wrote, "A DOLS is written to prove not that the "need" is high but that the person cannot be allowed to leave the facility where they are resident."

Yet it records observations of a resident's needs and only if they are High enough, will the DOLS be considered to have lawful validity.

I tried to make the point that the council is agreeing to minimise observed needs after NHS CHC assessments but maximising the observed needs of the resident so that DOLS can continue.

In the light that DOLS is a considerably more "dangerous" thing to get wrong, I would believe it before I would believe a DST.

After all, unnecessary deprivation of liberty could amount to a crime.

Whilst messing about in the CHC process risks what? An appeal made to the very people that messed about in the first place. Hardly scary for them.

For an organisation to confirm the NHS decision that care is within their remit whilst ignoring any and all available reports, some of which conflict with the decision, is a bit ridiculous.

By the way: Long past ex Copper. Civil engineering & Pharmaceutical purchasing, Transport and Logistics. Own account Property developer on the side. Lots of heavy and diverse law and legal wriggling to get past barriers.
I am however honest and fair in everything that I do. I am thankfully cursed, to have a moral compass. (Or I might have run a bank by now).:D

Not being pompous. One later professional job title is actually constrained and described under an Act of Parliament. I actually have to inform a Government dept as to where I am working for example. (even in the private sector).

I could go to prison be fined or be disbarred for so many simple infractions of rules (and many each year are), that it would scare the hell out of a Council or NHS CEO to even contemplate the role.

When was the last time a NHS or Council Director was fined or went to prison for a slip up by a subordinate?

All the best CG.
 

Wirralson

Account Closed
May 30, 2012
658
0
The fact that what is reported in the DOLS reasoning for continuation, is so radically different from the MDT's DST and the LA's CAP2 report is surely the point.

You wrote, "A DOLS is written to prove not that the "need" is high but that the person cannot be allowed to leave the facility where they are resident."

Yet it records observations of a resident's needs and only if they are High enough, will the DOLS be considered to have lawful validity.

I tried to make the point that the council is agreeing to minimise observed needs after NHS CHC assessments but maximising the observed needs of the resident so that DOLS can continue.

In the light that DOLS is a considerably more "dangerous" thing to get wrong, I would believe it before I would believe a DST.

After all, unnecessary deprivation of liberty could amount to a crime.

Whilst messing about in the CHC process risks what? An appeal made to the very people that messed about in the first place. Hardly scary for them.

For an organisation to confirm the NHS decision that care is within their remit whilst ignoring any and all available reports, some of which conflict with the decision, is a bit ridiculous.

By the way: Long past ex Copper. Civil engineering & Pharmaceutical purchasing, Transport and Logistics. Own account Property developer on the side. Lots of heavy and diverse law and legal wriggling to get past barriers.
I am however honest and fair in everything that I do. I am thankfully cursed, to have a moral compass. (Or I might have run a bank by now).:D

Not being pompous. One later professional job title is actually constrained and described under an Act of Parliament. I actually have to inform a Government dept as to where I am working for example. (even in the private sector).

I could go to prison be fined or be disbarred for so many simple infractions of rules (and many each year are), that it would scare the hell out of a Council or NHS CEO to even contemplate the role.

When was the last time a NHS or Council Director was fined or went to prison for a slip up by a subordinate?

All the best CG.

A DOLS is more about risk than need. The individual has to be a danger to themselves or others. They can meet the requirements of a DOLS and have very low needs. As an example: a severe but high-functioning schizophrenic or bipolar disorder sufferer would not be normally meet the requirements for CHC but could meet DOLS requirements from time to time.

NHS managers and Council managers are like anyone else - if they commit a simple infraction of rules, then disciplinary action, including dismissal, or performance action (which can lead to demotion or dismissal) can take place. I can assure you it does.

They can only be prosecuted if a criminal offence has been committed and it meets the CPS public interest test. This chap certainly was:

http://www.leicestermercury.co.uk/NHS-boss-JAILED-pound-43k-theft/story-20357001-detail/story.html

Thanks for confirming my guess about the police. I do struggle to comprehend why you should think a manager should pay for a slip up by a subordinate or be jailed for it. Criminal law is essentially about personal responsibility for one's own actions - how anyone can be held responsible for someone else's failure strikes me as sheer lunacy. I can, for example, be held responsible as a manger in performance terms if I fail to ensure my staff are adequately trained or if I do not manage their failings effectively. But if one of them in their own capacity (for example) falsifies a record at work, then I cannot be prosecuted for their action. (I might be disciplined or fired - a civil law matter - for supervisory failure.) HASAW and RTC&U prosecutions work the same way -and individual can be prosecuted for actions and I as a manager for failure to ensure safe working practices. It isn't the subordinate's failure he's being punished for but his own failure to his part of the legally required process. That's a crucial distinction. And there are plenty of Council and NHS managers with that kind of responsibility.

W
 
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Chris-G

Registered User
Jul 11, 2014
105
0
A DOLS is more about risk than need. The individual has to be a danger to themselves or others. They can meet the requirements of a DOLS and have very low needs. As an example: a severe but high-functioning schizophrenic or bipolar disorder sufferer would not be normally meet the requirements for CHC but could meet DOLS requirements from time to time.

NHS managers and Council managers are like anyone else - if they commit a simple infraction of rules, then disciplinary action, including dismissal, or performance action (which can lead to demotion or dismissal) can take place. I can assure you it does.

They can only be prosecuted if a criminal offence has been committed and it meets the CPS public interest test. This chap certainly was:

http://www.leicestermercury.co.uk/NHS-boss-JAILED-pound-43k-theft/story-20357001-detail/story.html

Thanks for confirming my guess about the police. I do struggle to comprehend why you should think a manager should pay for a slip up by a subordinate or be jailed for it. Criminal law is essentially about personal responsibility for one's own actions - how anyone can be held responsible for someone else's failure strikes me as sheer lunacy. I can, for example, be held responsible as a manger in performance terms if I fail to ensure my staff are adequately trained or if I do not manage their failings effectively. But if one of them in their own capacity (for example) falsifies a record at work, then I cannot be prosecuted for their action. (I might be disciplined or fired - a civil law matter - for supervisory failure.) HASAW and RTC&U prosecutions work the same way -and individual can be prosecuted for actions and I as a manager for failure to ensure safe working practices. It isn't the subordinate's failure he's being punished for but his own failure to his part of the legally required process. That's a crucial distinction. And there are plenty of Council and NHS managers with that kind of responsibility.

W

Sorry everyone Wirralson and I are having a discussion. Feel free to join in.

The DOLS might well have lower requirements than a DST and only record risk. But in so doing the LA also records needs that explain the risks in the DOLS justification report.

If they were recorded on the DST, they would indicate greater needs than are recorded in the DST.
Especially if the risks recorded in the DOLS that signified needs that were complex, intense or unpredictable were actually noted within the DST.

In regard to the point about criminal responsibility for the outcomes of the actions of others:

Administrative law, case law, road traffic law, company law, tort law, criminal law etc... and implied responsibility for the task at hand because of the job title are subjects that most Transport Professionals should understand.

For example a Transport Manager can go to jail for the actions of not only his subordinates, but for actions taken by his superiors if they are sufficiently unlawful and should have been known to him and were not challenged.

In short, he works for his employer and because of the amount and type of mandatory recording and the fact that he must protect his "Good repute" by whistle blowing if required, he also works the Dept for Transport and what used to be VOSA, now DVSA, to a large degree.

His role is a legal requirement in operating most large goods transport and passenger carrying businesses.

https://www.gov.uk/government/uploa...ent_data/file/245251/3-transport-managers.pdf

That above is not the half of it. HSE, Road Traffic Act, Constructions and Use, Accountancy law and so many others, that one might well need a grounding in or even a specialist in depth knowledge of.

Imagine that you run Tesco's entire transport operation. What might you need to know in addition to how many wheel nuts a truck has? Transport Managers are often even responsible for the buildings, rent, purchases, then the incorporation after planning and DfT applications into the business.
It is not just looking after some smokey lorries. As such even renting an inappropriate building or parking area could be on the head of a Transport Professional if it caused any of the many kinds of harm that it could.

Below. Not prison...... but when read, it can be seen that an MOT failure (subordinates, possibly subcontractor's task to sort out and report), was missed by him.

Then his Directors allowed the entire (probably one truck), operation to operate without staying within it's licensed terms(probably against his wishes and a fingers crossed hope we don't get caught type situation).

So he was punished because subordinates and his Director (probably girlfriend), both broke very small rules and he failed to notice or to do anything about it.
Or if thwarted, then report matters to the Dept For Transport/DVSA. Or actually quit to protect his name and good repute, with the reasons listed for the record.

Had there been a resulting injury or fatality he could have been punished in the same way as if he had caused it 1st hand.

For example:-
http://www.commercialmotor.com/big-lorry-blog/loose-hgv-wheelsits-not-a-myst

The article explains how not checking wheel nuts could lead to manslaughter charges for the driver. It is also the case that some circumstances will allow the Transport Manager as well as the perhaps unqualified company Directors to be charged too. (Perhaps failing to provide the means to check wheel nuts or ensuring that it is done)

To give you some idea of the risks; a 44 Tonne truck might have as many as 120 wheel nuts any one of which could by being unchecked cause a fatality.

Under more recent legislation it is easier for even a one vehicle transport operation to be charged with "Gross Negligence Manslaughter" than say a chip shop for example. Few chip shops jump on bus queues and trucks probably catch fire more often that chip shops too.

Records of almost everything done or not done by transport concerns are required by law. Fail in that and the Transport Professional once again carries the can. Regardless of who was making the records.
That recording or lack of it makes it very simple to spot if negligence has contributed to any incident.

The Transport Professional often carries the can for negligence by his drivers and other employees including his subcontractors. (Below, In this instance, the Driver could have refused to use a truck with dodgy brakes. He was experienced and might very likely have been aware of that fact.) I have quailed momentarily, just driving a car down that hill.

It was however, entirely the Manager's fault but he did not have the accident. Nor was he charged under HSE rules. The evidence of poor servicing recorded his failure to do his job properly. That made a fatal road traffic collision that happened many miles from him, his fault.

http://www.thetelegraphandargus.co.uk/archive/1998/01/17/8080531.print/

I have actually been threatened with prosecution in writing by the DfT because of a refusal by my company (Directors), to comply with regulations relating to side guards on Large Goods Vehicles.
The company would have been prosecuted separately.
It is no consolation that when Directors refuse repeated requests from a transport professional, to comply with the law, that their company gets prosecuted.

So yes, it is entirely possible to be prosecuted for somebody else's deliberate flouting of the rules.
 

Markataur

Registered User
Oct 28, 2014
1
0
Stick with the appeal - the guidelines say "1 severe and SEVERAL OTHER classifications" it doesn't even say "several HIGH" ... threaten legal action. The NHS has no money ... in which case they should change the criteria so that fewer people qualify - they shouldn't "fudge" (i.e. lie about) the existing criteria so that people fail the test. We were about to appeal but dad died ... however they did contribute £600 + per week to his care costs for a limited period. Best of luck... everyone in Cornwall needs all the help they can get!
Im so so so angry.
Mum was granted NHS continued healthcare last year. Her alzheimers was pretty bad and she had a variety of other health needs.
At the one year review (which I was assured would be a formality) the health professional actually told me he recommended a continuance as mums condition had deteriorated so much (and he has recommended it on the form).
I have just received the decision by our CCG and Im astounded to say they have refused!
She has 1 severe and 6 high. She has now been determined to have clinical malnutrition and a complexity of health care needs. Needs prompting and continued chivvying to eat & take medication, needs considerable assistance to get up, dress, wash, toilet (doubly incontinent), despite medication is delusional, seeks inapproriate contact with men (any men), thinks her dead parents visit her.....
And the CCG have stated we did not find that you have a primary healthcare need at this time.

Naturally I will appeal it, but I need to vent....and I need advice.
 

pam56

Registered User
Jul 2, 2021
32
0
Your lucky as I cannot even get a DST assessment done despite Mum qualifying with high needs i.e. A's & B's at her Checklist assessment. Said they didn't think she would qualify so didn't bother taking it further!!! So nothing for me to appeal about..in limbo at the moment.
 

pam56

Registered User
Jul 2, 2021
32
0
Stick with the appeal - the guidelines say "1 severe and SEVERAL OTHER classifications" it doesn't even say "several HIGH" ... threaten legal action. The NHS has no money ... in which case they should change the criteria so that fewer people qualify - they shouldn't "fudge" (i.e. lie about) the existing criteria so that people fail the test. We were about to appeal but dad died ... however they did contribute £600 + per week to his care costs for a limited period. Best of luck... everyone in Cornwall needs all the help they can get!

This is an old thread. Farmergirl last logged on 30/07/14.
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Thanks will try anywya