By Debbie le Quesne

Archive for the ‘deprivation of liberty’ Category

Industry focused on compliance more than care?

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Caring Times editor, Geoff Hodgson’s blog is always welcome. Recently he recalled the story of his time working as journalist in the goldfields of Western Australia.

The narrative he told is a sad one about an old gold prospector who blew himself up rather than be moved from his ramshackle shanty to be looked after, at the state’s expense, in a care home.

At 80-something he had become “very frail and it was clear he could not continue to live independently,” Geoff recalls.

Moving into a care home is never easy and Geoff rightly observes that it is the loss of independence that is such an “anguished step”.

Good residential care environments indeed do have the potential to give people true independence, options, choices and a more fulfilled lives than they would have if they remained at home.

I agree wholeheartedly with Geoff on this assumption, but only, as he puts it “if they’re allowed to”.

We have possibly the most regulated industry in the world and for most smaller providers, all they’re trying to do is make a legitimate living at providing good care.

I genuinely fear that our caring sector is turning into an industry focused on compliance and regulation, rather than care. These two essential of staying in business are huge money-makers in their own right and we can’t deny the expertise being offered by these relatively new players in caring.

Ironically, I envisage a continuing growth in regulatory framework, while the industry it serves becomes progressively smaller.

No ordinary life is without risk. Each day offers new risk choices for all of us and mostly we navigate them safely.

Such is the risk analysis of life in residential care, few tricky decisions can happen instantly. But it is often that spontaneity that defines life and just like Geoff blogged, the danger is that people like his old gold prospector will “continue to make their own arrangements”.

If the demands of governance are such that all spontaneity on decision-making is stifled, people like Billy surely will continue to make their own arrangements.

Rocketing Dols demand means timescales breached

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Deprivation of Liberty Safeguards (Dols) are rocketing to new highs with many still breaching legal timescales for completion.

A landmark Supreme Court ruling last March triggered a nine-fold rise in monthly referrals to councils, a Community Care online magazine investigation has found.

The ruling’s extension of human rights protections has been welcomed by social workers, but they warn more resources are urgently needed to help frontline teams cope with demand.

Under the Dols, local authorities must assess whether people who lack capacity to consent to their care arrangements are being deprived of their liberty in care homes or hospitals and, if so, whether this is in their best interests and necessary to protect them from harm.

The legal landmark was set with cases involving Chester west and Chester Council and Surrey County Council. The outcome was a revised test that has lowered the threshold for deprivation of liberty in care.

Six months on from the ‘Cheshire West’ judgment, a Community Care investigation, based on data obtained under the Freedom of Information Act from 103 local authorities in England and 19 councils and health boards in Wales, showed a massive impact it has had on the adult social care system.

Community Care notes: “In 2013-14 councils received 8,455 requests for Dols assessments; since April this year they’ve already had 32,988 referrals. The figures mean average monthly referrals have risen from 713 in 2013-14 to 6,643 in 2014-15. The effect of the dramatic rise in cases is clear. Last year 2.2% of cases breached timescales; so far this year 50% of cases were not completed in time.”

The investigation also found “that the shortage of trained staff in councils means local authorities have already spent £1.4m on independent BIAs (business impact analysis) in 2014-15. That’s almost three times the £550,000 spent across 12 months in 2013-14.”

Predictably, the chorus of complaint is one of more resources required. I know that the teams have had to divert much of their safeguarding resource to getting as many fulfilled in the times scales as they can. In some areas that means they are having to priotise.

However the Department of Health has not passed this message onto CQC who feel that it is there duty to punish Care Homes very severely if they have not put everyone through for a DoLS that they can. We talked to the DOH when we saw them in January and asked them to help CQC understand the problem.

It seems it is understandable for local authorities to fall behind with their timescales but not care homes!