Adult social care

[Louisetopaz21]

I work as a senior practitioner within adult social care and I am a signatory for Deprivation of Liberty Safeguards (DoLS). I am happy to answer any questions you may have.

You sound like a wonderful mum. Social worker is wrong and either you would need to have legal authority so would be deputyship to make a decision of where you daughter lives, this is a big life changing decision. If I was you I would ask your social worker for an advocate for your daughter who will be able to support. The social worker needed to complete a mental capacity assessment and then facilitate a best interests decision including yourself to look at all viable options and determine what is in your daughters best interests. This document could be shared with housing and then cop involved to sign any tenancy agreement. If your social worker is fobbing you off ask to speak with her manager x

Thank you. I will get I will get with the social worker and try and get things moving. I need to pull my finger out and chase things up, things have got on top of me as dd has been unwell and we are trying to sort respite etc.

Not surprising, getting run down and carer stress, ask for a carers assessment. Good luck ❤️

You do need to bear in mind that Carer's Assessments no longer carry the weight that they used to when the system was first brought in. I was involved with its inception and the gains to the carer that were intended by the legislation have since been circumvented and no longer act to the same advantage. All that happens now is that the LA can say that it has been done. It seldom confers any better care or better outcomes for the carers.

Hi. Do you have any ideas/advice for a situation where an elderly person in the early stages of dementia, but with capacity, insists they want a living situation that is entirely impossible/unsustainable and family can't/won't agree on what would be best?
My DM is physically capable of living alone and has a single storey home, but is scared to be alone at night. Initially there were frequent calls to family members in the middle of the night claiming to have some physical illness/fall but when tests etc found no physical problems and things were put in place to prevent falls this became constant calls saying there were intruders etc. She has lots of dementia symptoms and is awaiting formal diagnosis. I am reasonably sure that she has not had any falls etc (she is quite frail and bruises easily but none of her 'falls' result in so much as a mark on her body) and there have been no intruders but I am also sure that she truly believes that what she says is true and is terrified. She now refuses to stay in her own home alone at night but will not consider assisted living/care home etc so the only immediate options seem to be a family member with her every night (in her own home or theirs) or leaving her alone and afraid and dealing with the consequences. Family members don't have space to accommodate her sensibly and have too many other commitments to move in with her. She had a needs assessment when the first 'falls' happened and it was concluded that she just needed some practical adjustments, a fall alarm and maybe a cleaner/carer to drop in occasionally as well as visits from family. I am the only family member who thinks she needs to consider residential care- others think family should do as she asks but have reasons why that shouldn't be them. She has just over the savings threshold so would be self funding for a while at least, but does not have enough funds for a live-in carer/over night carer for long (she would need to sell her home if she was to fund residential care).
So I suppose my questions are a) have you seem similar cases and do you have any advice on other options we may not have thought of; and b) if we asked for another needs assessment would her refusal to be alone at night change the findings, even though she is in no physical danger at night.

Thank you!

What a difficult situation and it must be really scary for your relative. I have seen this a lot for me reading your post I would question whether they have mental capacity to make the decision in question, I think it sounds more on the weighing up the risks and benefits. This is around executive functioning can talk the talk but not walk the walk. They might appear coherent if answering questions so firstly I would be asking for an assessment around capacity around making decisions about their care and support needs being met. I would also push that they consider evidence that you provide to be include within their capacity assessment as well. It might be with a care package in place and technology they might be able to remain at home, which residential care should be the last resort. Alongside the capacity assessment they should complete a needs assessment. I hope this helps.

@Louisetopaz21

Do you have any suggestions for suitable accommodation for my just-turned-18-year-old adopted daughter? Our relationship broke down years ago, mainly due to CPVA, stealing, multiple going missing episodes and false allegations, one of which saw me arrested and detained in custody for 21 hours. My LA repeatedly refused a s.20 before my AD1 turned 18. I was then put through a s.47 inquiry because I asked for her to be accommodated by the state! My AD1 is in a specialist national college for a very specific and serious disability, plus she is multiply neurodivergent, and diagnosed with NAS and likely has FASD. My LA did not do her transition to adulthood in a timely way. Children’s services were awful and engaged in much parent blaming and shaming. My AD1 has never been allocated a CWD SW, in clear breach of the LA’s own policies and she has never had direct payments or respite etc. For a brief period while she was on a CP plan, she had one hour per week with an outreach worker.

I will no longer house my AD1 as the threat of false allegations is too terrifying and I have an AD2, who is nine, still at home. There is no supported living accommodation for teens in my LA and Shared Lives have said her needs and behaviours are too extreme for their scheme.

AD1 is refusing to return to her 35-week college placement (this happens every holiday) and she has decamped to my elderly mother’s house. My mother is 82, has multiple serious health conditions and is immobile to the extent that she relies on a stair lift. The last time AD1 lived with my mother, the latter developed stress-induced psychosis and she has never fully recovered.

I never want AD1 to live in our home again but I do feel a sense of duty to try to help her (even though her PDA means she pretty much sabotages everything good in her life). The issue is that now she is chronologically 18 (but probably half that age in terms of brain maturity), no one from services will speak to me. Just to add, my AD1 has a rare autoimmune disease and she is meant to take weekly chemotherapy. She is not attending GP appointments for bloods monitoring and so her prescription cannot be renewed.

There is so much to unpick here. Sorry for your situation with your daughter I have personal experience of child to parent abuse and having false accusations made, soul destroying and made me so ill including the missing episodes. I really have an understanding. Must be such a difficult to say out aloud you cannot have your daughter back so many emotions but you have to look after your younger one. I was let down by children's like you parent blamed. Firstly I think you need to make a formal complaint to children's services and I found therapy helpful to work through my feelings. Secondly your daughters living circumstances are not viable so make a referral to adults for a needs assessment and mental capacity assessment as I think she might have an impaired decision making ability and make it clear you need support to appropriately rehouse her. Good luck and honestly get some support for yourself as you have experienced trauma xx

The GP has a duty to consider if she has mental capacity to make decisions about her medical treatment and if adult services won't speak to you put in a formal complaint x

Thanks so much for your kind response. I’m sorry you have experienced CPVA too, plus the standard parent blaming and shaming from children’s services. It’s interesting to me how many social workers find themselves on the wrong side of children’s services when they have complicated home lives. I imagine that one upside is that it makes you more compassionate and understanding in your own work?

I definitely agree that AD1 has impaired decision making abilities but this is driven more by her PDA and other neurodivergences, I feel. She is an academically able girl who passed her 11+ and was predicted 10 GCSEs at grades 7-9. As it is, because she has sabotaged her educational opportunities, she only has two GCSEs at 18. Her birth father had schizophrenia (and died by suicide) and her birth mother has BPD, severe depression and psychosis.

Her diagnosis will be the link (causative nexus) of why she can't make the decision. Absolutely made me really think how I treat people who I work with x

Thank you. I think the trickiest issue here will be that Mum wants me and another family member (who lives closer to her) to both be with her for any needs assessment. The other family member is of the opinion that her current issues are a short term thing and will be fine soon so she just needs family to rally round for a bit longer. Presumably a diagnosis would help show that they are incorrect but how would I best deal with getting evidence across to the social care team without involving them in a battle and upsetting mum?

I don't think having a diagnosis will evidence her capability however if I was you I would keep a diary and write down your worries, what is not working and what is working well which means you include everything. Sometimes families can be in denial at timed about their loved ones which can be difficult to navigate but probably best who knows her the best is there so nothing is missed.

Thank you. That's useful advice

Thank you for this information. AD1 has a very kind and efficient adult SW now. I did have a phone conversation with her today. The SW did explain about the complexities of the mental capacity test. AD1 has a very rare autoimmune disease and is currently choosing not to take her chemo meds. She is also not attending GP appointments for bloods and monitoring. She is also stonewalling her SW and the PASW. She has not responded to my messages or phone calls since December 29th. There are also self-injurious behaviours involved so it’s all a complete nightmare as I can’t do anything to help as she is deemed to be a chronological adult even though her brain maturity is half her age. It’s helpful that the adult SW has a 10-year background in fostering SW so she understands about trauma, attachment, neurodivergences and heritable mental health disorders.

I am really pleased to hear you have a supportive social worker. I wish you all the luck in the world and stay strong, six years on I still suffer with the trauma of the past, so difficult. Hopefully your ad will get the support she really needs x

Thank you. Sadly, I’m not sure my AD1 will ever get the help that she deserves. And I have spent 17 years battling services. I hear you re: the lifelong impact of the traumas we experience.