DoLS process - best interests assessment

[FiniteSagacity]

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.

The DOLS team would have appointed an independent RPR as soon they noted his objections and that family weren't in agreement with launching a challenge in court anyway. Hopefully his solicitor and RPR will agree that just making the placement less restrictive by increasing community access will be enough.

You'd be surprised at the number of people in care homes that don't have a formal diagnosis. The s21A challenge may direct proper evidence of that as part of the process.

As LPAs, your views will also be taken into account by the court and given weight. Social services will have a minimal role as he's self-funding. Just to make you aware that if increased 1:1 support is required to enable increased community access, he would also be highly likely to be expected to pay for that himself too.

Thank you for mentioning that community access might mean additional cost, all good to prepare myself for.

Family always have at least two people when we take him out and a sibling did wonder if we could arrange to take a carer along on a day trip further afield.

The best interests assessor was reassuring about us spending DFs money on things to benefit him and we’re considering a made to measure chair.

In my experience of S21a challenges, the judge will direct the local authority to complete a needs assessment and position statement as the DoLS authorisation is being directly objected to rather than the placement per se so the person is challenging the local authority.

@Louisetopaz21 Yes, the DOLS is being challenged rather than the placement but social services involvement is limited to the DOLS. It can't make decisions about funding 1:1 support for community access for self funding residents but can still allocate social workers to complete Needs Assessments. Sorry that wasn't clear in my post. Ultimately where a person is self funding with a Finance LPA in place, the LPA would need to confirm whether that support could be affordable or not.

@FiniteSagacity In my experience carers can accompany family members as long as they have enough notice to rota that, leaving sufficient other carers at the home for the other residents, and if the family cover their wages for that time period. There are also independent care agencies that can support community access if the care home can't free up their staff.

Thank you @Mimosa3andmore at this point DF is still mobile and we’d be able to spend on carers from savings, it’s good to know what questions to ask both nursing home and how we might answer any CoP questions.

Hello and thank you also to @Louisetopaz21 - always appreciate you clarifying roles and where the challenge is directed.