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Elderly parents
Original poster

DoLS process - best interests assessment

31 replies

FiniteSagacity · 17/05/2025 17:51

I’m asking for your collective wisdom to educate me on the DoLS assessment process - I’ve read AgeUK and NICE guidelines about what is supposed to happen but please share your experiences so I can understand what might happen next in practice in my DF’s case and how I should prepare.

To summarise, we have both finance and health LPAs for DF who is already in a nursing home. DF is still mobile with aids but a falls risk. He is a difficult character who has no diagnosis of dementia but medical opinion is that he needs 24 hour supervision - this was a hospital in a different area though and I’m considering a subject access request to gather evidence.

I think the DoLS application (by nursing home) was in the Autumn of 2024 but I recently had contact with social care about something else and the social worker mentioned DF is still on the waiting list and that there will be a best interests assessment that we’ll be invited to.

DF has become quite hostile and will say he’s in prison and it’s my fault to an assessor (it’s a very nice prison and he is self-funding for now). I was present for social care needs assessment and NHS FNC assessments so I have a timeline of the rollercoaster that led us to nursing home.

OP posts:
Louisetopaz21 · 17/05/2025 19:43

Lightuptheroom · 17/05/2025 19:12

DOLs (deprivation of liberty) applied for by a nursing home are normally part of the assessment process when they are looking at the permanency of his placement, so if he's been there more than 6 weeks for example, it would be the first review. Power of attorney wouldn't be activated unless he hasn't got capacity to decide where he should live for example. My mum has a DOLs as she lives in a care home but believes that she is in hospital and everyone is trying to kill her. It's for the staffs protection as well as technically without a dols a resident could request to leave and they wouldn't be allowed to stop them.

You have good understanding of the DoLS process. However it is an independent assessment from the needs assessment so if the person meets Lady Hale's acid test from being admitted to the home they should be submitting a referral doesn't matter where ever the person is there short or long term. The DoLS authorisation doesn't strictly prevent leaving the home, it basically runberstamps the best interests decisions in place one would be the person would be stopped leaving the home otherwise it would be problematic if someone had not had an assessment due to a backlog.

Lightuptheroom · 17/05/2025 19:12

DOLs (deprivation of liberty) applied for by a nursing home are normally part of the assessment process when they are looking at the permanency of his placement, so if he's been there more than 6 weeks for example, it would be the first review. Power of attorney wouldn't be activated unless he hasn't got capacity to decide where he should live for example. My mum has a DOLs as she lives in a care home but believes that she is in hospital and everyone is trying to kill her. It's for the staffs protection as well as technically without a dols a resident could request to leave and they wouldn't be allowed to stop them.

Louisetopaz21 · 17/05/2025 19:00

I replied and didn't post it.
Do not worry BIAs are very experienced so we have seen it all. I assessed a school teacher who thought she was living in a school and all the residents were her pupils. We try and gently orientate the person but will not directly challenge and cause distress. The assessor will need to find your dad's understanding of where he is living, what care he receives and the restrictions in place such as he would be stopped from leaving the home. However this is done sensitively. A section 12 doctor will also visit jusy to check he is not eligible under the mental health act and that he meets the criteria for a impairment of the mind/brain. It is good practice to invite families so they can support the person. Ypu don't need to prepare though I always appreciate a pen picture of the person so I can understand what is important to them.

Iloveeverycat · 17/05/2025 18:50

Looking with interest as my DM had a dols assessment last week but I was told there was no need for me to attend . They didn't really say what they were going to discuss with her. They mentioned deprivation of liberty.

Original poster
FiniteSagacity · 17/05/2025 18:04

@Louisetopaz21 thank you. I guess my anxiety about this comes from recent rants where DF says I must relinquish my LPA and that he believes he is in prison. My siblings are thankfully all on the same page as me but they are not subjected to his anger. It’s familiarity breeds contempt - so it may well be my siblings who join the assessment rather than me.

I guess I’d like to know what the assessor will need or already have, to take into account?

To add, DF has got wind of another resident in the nursing home having the freedom to go out on a mobility scooter… what will be explained to him about the assessment?

OP posts:
Louisetopaz21 · 17/05/2025 17:55

I am a best interest assessor and signatory. Is there anything specific you want to know?