DOLS and is it applicable ?

[fuzzyllama]

Probably going to be a long one, apologise in advance.

So there's a lady in my supported living service who is becoming more and more depressed, she's got a bi-polar diagnosis. She no longer wants to get up, doesn't want to get dressed and barely talks to any one, staff or family. She seems utterly withdrawn and miserable, a stark contrast to the woman who moved in, she was so chatty, always glamouros and dressed well.

She's been asked if she would like to see the gp and have her medication reviewed and she's declined. Also when asked if she is feeling okay, is she down or depressed she says no.

Can we look to put a DOLS in place and get in touch with her psychiatrist to review her and her medication ?

Asking for advice as we have a staff meeting coming up and I want to be prepared when I'm told by management there is nothing we can do. I really want to help this woman as seeing her mental health decline so rapidly is upsetting.

If your service user is in a supported living unit, fuzzy, I understand they won’t put DOLS in place.

My adult dd is in a managed unit of 16 individual apartments which is presently a residential care home and my dd has DOLS in place covering one area of obsession she has which was deemed could be dangerous for her.

Her managed unit is changing to Independent living within the next couple of months - we have had a very stressful time as there’ was a suggestion dd may lose her home but thankfully all ok now - and we have been advised the DOLS cannot be renewed once her home becomes independent living. We feel she will cope without it now anyway but this is what we have been advised.

Thanks for replying. I think from my understanding a DOLS can still be obtained, but it is a much more long winded process and you have to go through the court of protection to do so?

Our service is a real grey area, none of our clients are actually suitable for supported living as there needs are too great, and it is run mostly like a residential care home.

Hope your daughter transitions smoothly to independent living

DoLS should be in place for supported living now if necessary (it has changed). Has to go via the CoP.

But it doesn’t sound as if she has lost capacity? A DoLS can’t force a psychiatry visit if she has capacity to refuse.

Fuzzy - DoLS is different for residential and supported living. For supported living it has to go directly to the CoP and takes ages. My son is currently in hospital and won’t be able to move into his new supported living arrangement (own home, own team) until the DoLS is in place.

What you should consider is a Best Interest process. DoLS safeguards people who are being deprived of their liberty by the state, so e.g. if the lady were unable to leave the care home without staff supervision, or was being subjected to constant supervision and control the DoLS would be relevant. A Best Interest decision could look at aspects like should she be encouraged to get up / dressed / go out in order to feel better. Or the Mental Health Act could look at prescribed medication, if she is depressed enough to be a risk to herself ECT would even be prescribed.
You sound like a lovely, kind carer, good on you! Hope your managers take your comments on board.

DoLs can be achieved via the CoP if the person lacks capacity to make decisions about living in the placement.

But if your primary concern is about her mental health and possible treatment for a mental disorder, then the MHA is the most relevant act, rather than the MCA.

Talk to the placing team and it's great that you've noticed and want to create a change!