Vulnerable people being 'let down' by councils and care providers

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Vulnerable people who lack the ability to choose how they are cared for are being "let down" by the very institutions that are charged with their care, an Ombudsman has warned.

The Local Government and Social Care Ombudsman, which investigates complaints about adult social care, raised concerns about how decisions are made on behalf of people who lack mental capacity to choose how they are cared for.

Some people are being forced into situations against their will, without proper checks carried out and safeguards put in place, according to a new report from the Ombudsman.

One case highlighted in the report details how a man with dementia was forcibly moved out of his family home by social workers despite the wishes of his family.

He was placed in a care home 15 miles away - where his wife had to take two different buses in order to see her husband.

The Ombudsman's investigation found the council overseeing his care had decided the man had "no capacity to make decisions" in meetings held to assess his care needs. But there was no indication that a mental capacity or a best interests assessment were carried out, as required by the law.

The council involved also failed to carry out a Deprivation of Liberty Safeguards (DoLS) application - where a care provider can apply to detain patients with mental health issues for their own safety - when the man's wife repeatedly asked that he should be returned home.

Instead she was told that the police would be called if she tried to remove the man from care.

The Ombudsman report also raises concerns about councils and care providers not carrying out - or delaying - assessments to determine whether someone has the capacity to make decisions for themselves, poor decision-making when deciding on someone's best interests, and not involving friends and families in the decision process.

The report also highlights problems with the DoLS system.

Flaws in the system can lead to people having been left in care homes, having not had the proper assessments carried out - and potentially being deprived of their freedom - for many years, the authors said.

In March a Government-commissioned report by the Law Commission concluded that the current system for detaining patients with mental health issues for their own safety should be "replaced as a matter of pressing urgency".

The new Ombudsman report states that of the 1,212 adult social care complaints it investigated in 2016/17, one in five were about DoLS.

It concludes that some councils and care providers do not properly understand the processes for making decisions on behalf of people who lack mental capacity.

"The people who these measures are designed to protect are all too often being let down by poor practice," said Local Government and Social Care Ombudsman Michael King.

"And, while I appreciate the complex emotional and practical decisions social workers need to make, the people they look after are still entitled to be treated fairly, and have their assessments undertaken correctly and in a timely manner.

"People should have the right to make choices for themselves unless they have been assessed as not having capacity. We have issued this report to highlight where things are going wrong, so we can help authorities get things right and improve services for people."

Last year it emerged that applications to local authorities to deprive people of their liberty were at their highest ever level.

DoLS applications in England reached 195,840 in 2015/16, the highest since they were introduced in 2009.

Commenting on the report, Janet Morrison, chief executive of the older people's charity Independent Age, said: "It is the mark of a civilised society that we always look to take decisions in the best interests of those who, due to a lack of mental capacity, can't make these decisions for themselves.

"Unfortunately, the DoLS system is not currently fit for purpose and is failing some of the most vulnerable people it is designed to protect."

Izzi Seccombe, chairwoman of the Local Government Association's Community Wellbeing Board, said: "Councils take the findings of this report very seriously and will seek to establish any lessons that can be learnt.

"We have long warned of the need to overhaul the current DoLS process so that everyone who lacks mental capacity is at the heart of decisions made about their care.

"The current law is not fit for purpose and we are clear on the need for reform, which the recent Law Commission review called for."

Margaret Willcox, president of the Association of Directors of Adult Social Services, added: "The report recognises that DoLS applications in England have soared to unprecedented levels in the past two years, leading to huge delays in processing.

"We hope the Law Commission's plans to introduce new, more efficient DoLS legislation helps to address this and alleviate any further concerns and anxiety for families and individuals involved."