DEPRIVATION OF LIBERTY (OR DOL)

What could be wrong with it? Sounds an excellent idea.

Good care homes usually arrange outings for residents if the residents are physically and mentally able. In our town it's very usual to see a uniformed carer pushing a resident in a wheelchair or accompanying a more mobile person on a trip to the seafront. One such home had a resident who took a trip to the seafront every day until she was more than a hundred years old.

In my mum's case, Shane the care home wanted to have a DoL order for her and they had to have an independent mental health nurse to agree it - he didn't! He said they were open to abuse in that CHs used them to have an easier life! I'm not sure that's what you are saying Printmiss or are we at cross purposes?

It does sound excellent but . . . . if they are not able to go out alone, who would go with them? If everyone in the care home wanted to go out - with help - to different places at the same time, there would just not be enough staff to cope. What about those who stayed home, they would need the staff to look after them. Would there be provision for enough trained staff to cover a worst possible scenario?

Having a right to do something (and I agree, people should have this right) is not the same as being able to do it or get it arranged. It would seem the details of arranging for the 'activation' of such a right are tedious and unstraightforward. Once details are dealt with the problem that might remain is having enough carers to accompany those who need help executing their outings. Cost, as usual, will be the limiting factor.

The principle itself is fine.

It's a really important subject PRINTMISS, but I think you are conflating two separate processes

The Deprivation of Liberty Safeguards (DoLS) come under the Mental Capacity Act 2005 and were put in place (as you might guess from the term) to safeguard those who lack mental capacity to make decisions about their care from being detained without regard for their best interests and with undue restriction of their freedom. Hence an independent professional has to assess whether the person lacks capacity under the terms of the Act. The assessment is 'decision specific' ie. it is entirely possible that a person might lack capacity to make a decision about one issue but not about another, so someone might have the capacity to decide what they want for tea but not where they would like to live, for example. So in your mum's case kitty I am guessing that the DoLS assessor (who can be a nurse, social worker, occupational therapist etc who has had specialist training) decided that she did not lack capacity in relation to that particular decision, or that her liberty was not being restricted unreasonably (correct me if I'm wrong).

The payments you mention PRINTMISS arise from an assessment of care needs by Adult Services. This might follow an assessment of capacity so you are correct that the two can be linked. However people might also have an assessment of their care needs when there is no question about their mental capacity - those with physical disabilities for example. If people are entitled to services they can choose to have a personal budget in the form of direct payments or to let Adult Services manage this budget and provide care directly. This is an attempt to get away from the paternalistic way in which services were delivered in the past, thereby giving people more control over which services they chose. For example someone might prefer to use their budget to go to a social group of their choice rather than a local authority Day Centre. The philosophy behind this change can only be a good thing, although there can be problems in the way it works in practice due to financial constraints and sometimes inflexible practices.

That's about it Nightowl. Both the assessor and my brothers and I saw it as a way for the home to 'contain' mum, whose behaviour was worsening, because they were hugely understaffed.

We moved her soon after!

I just wanted peoples views on the subject, and these are interesting. I have no objections to people having the right do to things, I was just pointing out the effort that goes into getting people these rights. I also think it is sometimes important for us to face the fact that we do not live in an ideal world, and we cannot always have what we would like. Those people who are deprived of their freedom through no fault of their own do deserve as much help as they can get, but there is a limit to resources. There again, I can put the argument that those who are less able are the ones who get the least, but need it the most. It was just a subject I threw in for discussion, since we held a big debate with various scenarios at our meeting, and there were diverse opinions about those. It is of course a great pity that everything in the end comes down to money, and it is an unfair world we live in.

I didn't mean any criticism PRINTMISS as i agree its an important subject for discussion. It is indeed an unfair world and the ideals of the law are not always met in practice. But I do think these are important safeguards for those who can't speak for themselves, particularly if they have no relatives or friends to speak up for them. As you say, they are often the ones who get the least.

nightowl I did not take it as a criticism, sorry if I gave that impression, that is the trouble with the written word, it can be taken so many ways! I thought it was an important issue, and might lead to some interesting discussion, it certainly did so at the meeting I attended.

I thought I had offended you! So difficult as you say, the written word.

DOLs are a useful tool for keeping people safe. I have only ever seen them used for that.

If someone is in a dementia home and always asking to go out, they cannot be kept in and kept safe without a DOL in place.

The law is to protect people and only have those who really are not safe to go out alone in, while making it clear others are allowed out.

Whether they go out at all is another matter, and has been suggested, reliant on money, staffing etc.

One home I have worked in would let some of the people go out, with a card with the address on them. That was enough to keep them safe. Others, that would not work for had to have a DOL BUT they were taken out regularly and allowed in the enclosed garden freely.