Mental capacity and PoA

[LibraLeo]

Hi – I wonder if anyone can help.

I and some local friends watch out for an elderly lady. She recently stopped answering her phone and we eventually discovered she'd been moved to a care home. No one was contacted.

As far as we can work out, she is paying for this herself - although she doesn't realize it! She has no family and, as far as we understand, no one has PoA. In what circumstances can a local authority intervene to take control of someone's finances? Will she still have access to her own money? Would she have had to sign something? Is this decision reversible?

We believe she has mild dementia but still has capacity. She very much wants to move back to her flat (managed by a housing association) and probably needs support – which she would be entitled to, I'm sure.

What can we do? She is desperately unhappy being in a home and out of her comfort zone. We also believed this was managed so badly – she was made to believe the move was temporary (while the flat was cleaned) and took none of her personal belongings – obviously deeply distressing for her.

Could it have been a GP or carers at home who may have escalated issues (eg falls, self-neglect, safeguarding) to social services and she was placed as an emergency? She should have had a social care assessment before being placed somewhere. Sometimes placements are funded if they are for a temporary period of assessment. There should also be a financial assessment at some point. If she is happy for you to be involved then she can ask the home to arrange a meeting with them / social worker to discuss mental capacity / best interests / plans going forwards.
Is she happy to give you a key to collect her belongings?

Thanks for your reply. Yes, that sounds like a good idea to set up a meeting. We have been trying to work out who is pulling strings and it seems incredibly complex! I believe she would be happy for us to help out in this way, and also to enter her flat.

The home said she was being 'money managed', but I don't think she realizes it. Will she still be able to access her account in those circumstances...?

Does anyone else have experience of this?

I’m pretty sure she will have been consulted on the decision to move to the care home. She will have been assessed by social services as either having or not having the capacity to make this choice at the time she was moved. It may be a temporary move and is awaiting review.

A separate issue is her finances, again she’s either managing these herself and has understood the costs or the local authority will have tested her capacity and may have taken over managing her finances under a best interest decision. They may have told her she’s liable to pay but she may not remember - you’ve said she has mild dementia. Perhaps she wasn’t managing as well as you thought if she had to be moved out whilst her place was being cleaned?

If she wants you involved or you have concerns, then you can contact social services about it and explain she’s asked to return home.

Your post is a bit vague - have you visited her in the care home? When you say “nobody was contacted” who do you think should have been contacted given she has no family or POA, and who should have done the contacting? Why did the flat “need cleaning” so badly that she had to move to a care home? It sounds as if there is quite a back story here that may have made things more complicated.

Hi, I'm a Mental Health Nurse and work with older adults. It will depend whether professionally she has been deemed to lack capacity. Capacity depends on: retaining information, communication a decision, weighing up risk, and understanding information. It is decision specific.

If she has been deemed to lack capacity and has no POA, Adult Social Care can apply to take over finances via the Court of Protection. She won't have had to sign something if she lacks capacity, as she wouldn't likely understand what she was signing. I don't know for certain, but I suspect it must be reversible, because depending on the condition, some people regain capacity (e.g. after a stroke sometimes, or things like delirium).

What I will say is that Adult Social Care absolutely do not put someone in 24 hour care unless absolutely necessary. Like, unless everyone wants it, it's not easy to put people in case, or find appropriate places. It's also a decision made by multiple people e.g. in a best interests meeting, which would involve people like a GP, any family, social care, someone from her care agency if she had carers at home, etc. If she truly had no one, she should also have had an independent advocate involved in this.

If a best interests decision has been made and she's been deemed to lack capacity around placement, it will be difficult to get her out without PoA. And tbh, are you sure there are things behind the scene you're not aware of? Often people can seem quite cognitively able from a communication perspective, however are self-neglecting/functioning quite poorly.

Edit: you could get in touch with social care and share your concerns, but it's confidential so I'm not sure how much they'll share.

Sorry, don’t mean to be vague.

She was told the flat needed a deep clean but it seemed like a ruse. She was assured it would take just 3 days - 3 weeks on, she’s still in care. Because she believed it would be just a few days, she didn’t take details of contacts like myself or other friends and has felt very isolated.

Nobody helped her to contact us as time passed. She was so relieved to see me when I finally tracked her down - and yes, I have visited several times.

She has always lived chaotically, but we do believe she is capable of living alone.

Thank you - this is extremely helpful info.

It's not linked to scam highlighted on radio 4? Basically robbing the elderly of their homes/ money?

Can you advocate for her?

Do you have a link to an article for this?

If she has been assessed to not have capacity, it is no longer possible for someone to apply for lasting POA and it would be down to the court of protection to appoint a deputy. They would usually appoint a family member or close family friend. If they don't have somebody suitable, it is usually appointed to a solicitor/accountant etc.

As others have said, Social Services are very reluctant to place someone in a care home, it is seen as a last resort. They do everything they can to keep people in their own homes.

If her flat needed a 3 day deep clean, it sounds as if things had deteriorated considerably, so the lady may well be more unwell than you realise. My mother could put on a good front when actually she was not able to care for herself at all.

Social Services may initially have thought the move would be temporary but have since investigated further and believe she needs more care than can be provided at home. Or it could be that the lady is confused and misremembering what was said.

You could try contacting Social Services but it is unlikely they would divulge anything to you.

This is probably the story that poster was referring to: https://www.bbc.co.uk/news/articles/cp3zd40kdgyo

Thanks for this. Shocking to read these accounts!

We are going through this for a relative. No close family, no PoA. It is essentially what @ladamesansmerci has described. There is very very little you can do. You now know where she is staying and can visit. I will also say that it could still be respite while they sort her out. 3 weeks delay is nothing in the system right now.

Possible application to court of protection for deputyship? Speak to SS who can do a capacity assessment to determine

I think in these circumstances an advocate is appointed for residents. But the wheels turn extremely slowly.

In my experience SS assume capacity and advocate to keep out of care so things may be much worse than you know.

Ring social services when you are with her, tell them you have her permission to speak to them and pass the phone to her to confirm this to them. Tell them she wants to know what is going on. They should provide an independent advocate who represents her needs. If it has been arranged via social services they need to follow processes. If it has been arranged privately via a family member then social services need to know as a potential safeguarding issue.