Agenda item

To consider a report of the Service Director (Adult Social Care)

This report will set out the background to the introduction of the Deprivation of Liberty Safeguards, their implications and challenges with implementation.

This report had been requested by the Scrutiny Committee at its meeting on 27 May 2015.

Officer contact: Mark Warren, 0161 474 4401, mark.warren@stockport.gov.uk

Representatives of the Service Director (Adult Social Care) submitted a report (copies of which had been circulated) setting out the background to the introduction of the Deprivation of Liberty Safeguards (DoLS), their implications and challenges with implementation. The Scrutiny Committee had requested this comprehensive report following concerns raised about the impact of the implementation of the 2014 Supreme Court Judgement on families of those subject to a DoLS and the increased pressure on public services.

Representatives of the Service Director (Adult Social Care) were in attendance at the meeting to provide an overview of the situation and to answer questions from the Scrutiny Committee.

The following issues were highlighted:-

·         Operationally, the DoLS requirements were extremely resource intensive and were having a significant impact on the capacity of the adult social care service.

·         The DoLS requirements were also having a significant impact on vulnerable people, and particularly those subject to DoLS who die and were consequently considered to be in ‘State Detention’.

·         Over time the process for reviewing an individual’s DoLS assessment would get more, rather than less, intensive.

·         There were potentially a significant number of deprivations taking place in the community that were not yet known to Adult Social Care.

·         As case law around DoLS grew the Council was having to revisit its assessments and this was increasing the time and cost.

Ann Coffey MP, who had raised concerns about DoLS during an adjournment debate in Parliament on 17 June 2015, also attended the meeting. She highlighted the following issues:-

·         The matter had been raised in Parliament after she had been approached by constituents upset by the ‘state detention’ status given to their relatives. The Minister for Community and Social Care had responded positively about the concerns raised.

·         DoLS in themselves were a good means to safeguard vulnerable people but the 2014 Supreme Court judgement had lowered the bar for assessment, leading to the problematic ‘unforeseen consequences’.

·         The Law Commission Review would be a review of the law, rather than the practice, and it needed to be borne in mind that as well as the 2014 judgement the guidance issued by the Chief Coroner had resulted in those dying subject to DoLS being considered as having been in state detention. The Review had been brought forward by the Government following pressure from Parliament, but it was unlikely that any legislation would be enacted before 2017.

·         Locally, partners should be encouraged to develop protocols to streamline processes to minimise the burden of DoLS, including working with the Coroner to take a proportionate response, and working with local care providers to ensure applications for DoLS were appropriate as many providers were concerned about negative consequences of inspections if applications had not been made.

·         She had arranged for a meeting with the CQC, Coroner, Stockport Adult Social Care and large care providers to discuss ways to improve the local situation.

·         She had approached the Chief Coroner in relation to her concerns and he had agreed to revisit his guidance.

The Executive Councillor (Independence & Wellbeing) (Councillor John Pantall) attended the meeting and raised the following issues:-

·         The impact on individuals and their families was the primary cause of concern.

·         The problems experienced with care homes and DoLS had echoes of the difficulties experienced with improving end-of-life care, and would need to be addressed in part by changing the culture within these settings, as well as using contractual mechanisms. Ensuring residents had clear care plans should encourage only appropriate applications, and more could be done through contractual arrangements to require plans.

·         Greater clarity was needed by providers on the role of DoLS, and more generally on safeguarding, particular on what needed to be prevented.

·         Ensuring independent advocacy was built into Council process and activity was important to ensure the aims of DoLS were achieved.

The following general comments were made/ issues raised:-

·         Given the population profile in Stockport, as well as the relatively high concentration of care homes, it was likely that approximately 150 people per year would be in the DoLS process, and that given the likely timetable for legislative change this could be the case for some time.

·         It was confirmed that the Council would be responding to the Law Commission Review. Revised guidance from the Chief Coroner in the shorter term would also be welcomed. It was stressed that for staff within Adult Social Care the Mental Capacity Act and the rights of individuals were at the forefront of their work, but that what was needed was a more proportionate approach to DoLS.

·         It was suggested that despite the Government bringing forward the timetable for the Law Commission Review it was unlikely the process could be speeded up any further, given the complexity and sensitivity of the issues involved. It was also emphasised that services would continue to undertake its duties while at the same time seeking to work with partners to improve processes.

·         Concerns were expressed about the impact of the DoLS processing on the workload of staff who might already be working in stressful circumstances. Concerns were also expressed about how this would impact on the delivery of other core activity.

·         It was commented that DoLS requirements were proving challenging to a range of public services, including the NHS and hospitals in particular.

RESOLVED – (1) That the report be noted.

(2) That Ann Coffey MP be thanked for her attendance and contribution to the meeting, and that the Scrutiny Committee welcome her efforts to address the challenges associated with the Deprivation of Liberties Safeguards.

(3) That the Democratic Services Manager, in conjunction with the Chair, write to the Chief Coroner, LGA and AGMA outlining the concerns expressed by the Scrutiny Committee during the course of the meeting and previous meetings in relation to the unforeseen consequences of the 2014 Supreme Court judgement on the Deprivation of Liberties Safeguards and to ask that these organisations and individuals seek to address these concerns.