Ben, a young adult diagnosed with learning disabilities and Prader-Willi syndrome, faced significant health challenges due to his rapidly increasing weight. His condition made it difficult for him to control his eating habits, posing severe health risks.
The staff at his residential home were committed to supporting him. But, their efforts to encourage healthy eating were met with limited success. As Ben’s weight climbed, it became clear that more stringent measures were necessary to protect his health.
Identifying the Need for a DoLS Assessment
The residential home staff proposed restricting Ben’s access to the kitchen and ensuring he was always supervised to prevent him from consuming excessive food. While well-intentioned, these measures significantly restricted Ben’s freedom and autonomy.
Recognising these restrictions would deprive Ben of his liberty, the home manager applied for standard authorisation. The DoLS assessment is a safeguard aimed at determining whether the proposed measures were in Ben’s best interests and necessary for his safety.
Conducting the DoLS Assessment
The DoLS assessment process is rigorous and multifaceted, involving several vital steps to ensure that any deprivation of liberty is lawful. There are six parts to the assessment:
- Age Assessment: Confirming that Ben was over 18 is crucial.
- Mental Health Assessment: A qualified mental health professional assessed Ben to confirm that he had a mental disorder. In this case, Prader-Willi syndrome and associated learning disabilities.
- Mental Capacity Assessment: Evaluating Ben’s capacity to make decisions about his care and eating habits. It was determined that Ben could not make these decisions independently.
- Best Interests Assessment: The best interests assessor (BIA), a trained social worker, nurse, occupational therapist, or psychologist examined Ben. They assessed whether the proposed restrictions were necessary to prevent harm and whether any less restrictive alternatives existed.
- Eligibility Assessment: Ensuring that Ben was not already detained under the Mental Health Act 1983, which would preclude the use of DoLS.
- No Refusals Assessment: This involves checking for any existing advance decisions or legally appointed representatives who might refuse the proposed care plan.
The Role of AACA
Advanced Adult Care Assessments (AACA) were brought in at this critical juncture to provide expert guidance and support. AACA’s intervention was pivotal in developing a comprehensive care plan that balanced Ben’s needs and rights.
We accepted the referral from a Local Authority we work closely with to carry out a DoLS assessment for Ben. The assessment was person-centred, ensuring the involvement of Ben, his Relevant Person’s Representative, the Section 12 Doctor, and other key individuals. Adjustments were made to support Ben in fully engaging with the process, ensuring that any restrictions on his liberty were proportionate and prioritised his well-being. Our approach ensured that Ben’s rights and needs were at the forefront of the care plan.
Outcome and Impact
The DoLS assessment concluded that the restrictions in place were appropriate, proportionate to the risks identified, and necessary for Ben’s health and safety. The constant care and supervision, alongside assistance with daily tasks like medication, dressing, and personal hygiene, were deemed vital to prevent harm. The local authority authorised the deprivation of liberty, ensuring Ben’s well-being. Following the care plan, Ben’s health stabilised, improving his weight and overall well-being, all while maintaining his dignity and rights under structured care.
The structured environment provided by the residential home, combined with the expert guidance from AACA, ensured that Ben received the care he needed while respecting his dignity and rights.
Conclusion
Ben’s journey highlights the complexities and challenges of implementing Deprivation of Liberty Safeguards in adult social care. It underscores the importance of a thorough and compassionate approach to assessing and balancing the needs and rights of individuals with learning disabilities.
AACA’s expertise and collaborative efforts with the residential home staff played a crucial role in achieving a positive outcome for Ben, demonstrating the value of professional support in navigating the DoLS process.
