by Professor Keith Brown, director of the national centre for post-qualifying social work at Bournemouth University
Best interests assessors (BIAs) are currently in huge demand – with an investigation by Community Care published last week suggesting that 50 per cent of requests for Deprivation of Liberty Safeguards (Dols) authorisations are not being carried out within the legal deadlines.
Since the Supreme Court’s ‘Cheshire West’ ruling in March, which widened the scope by clarifying the definition of deprivation of liberty, the floodgates have opened.
One local authority told me that they had seen a 1,200% increase in the number of requests for assessments.
Best interests assessors
by Andy McNicoll, Community Care
Best interests assessors, who are mostly specially trained social workers, play a vital role under the Dols. The Dols process involves six assessments. BIAs carry out the most significant of these – the best interests assessment. This assessment determines whether a person is being, or will be, deprived of their liberty and, if so, whether this is in their best interests and necessary to protect harm to them. Each assessment requires the BIA to visit the person, undertake a detailed analysis of care plans and records, speak to individuals involved in the case and complete detailed paperwork. There is currently a national shortage of BIAs, meaning that those that are in local authorities are under increasing strain.
There’s been a huge increase in demand and local authorities are under pressure. They don’t have enough BIAs to deal with requests, they are having to train employees as BIAs, each assessment takes time, and all of this costs money.
But, if you take the view that the Mental Capacity Act 2005 and the Dols are there to protect the liberty of the most vulnerable people in our society, it’s the one thing that we absolutely must do – and do properly.
So, how do we ensure that the training of all these people as BIAs is of sufficient quality? Because what I certainly don’t want, and I don’t think anyone in the sector wants, is different standards being applied up and down the country.
You need confidence that somebody who’s been assessed as appropriate to do this work has met standards that have been agreed and have been applied all over the land – so you don’t go to a certain course or region to train, for example, because it’s easier.
The College of Social Work was asked by the Department of Health to pilot an endorsement scheme for BIA training programmes, and we agreed to participate in their pilot.
The inspection process was very rigorous. We were visited by two people and had to provide a great deal of evidence – our books, our materials, our CPD, our links, our work. They met with students and ex-students, spoke to employers from across the country, and took references to check the quality of our delivery.
I think it was a robust system and I think it’s the right way to do it. Because, when there’s demand to train thousands of people as BIAs, you don’t want private training companies who lack robust quality assurance and external scrutiny of the assessment process popping up and saying they’ll run it.
Neither, in my view, do you want a local authority saying they’ll train their own people – because, if you’ve had a 1,200% increase in applications, there’s a pressure to get your staff trained and you might not have that rigour.
We are talking about some of the most vulnerable citizens in our society here, and so it needs to be rigorous, it needs to be appropriately assessed, and needs to be externally moderated.
So I think the endorsement scheme is right, and I would like to see the College of Social Work move quickly to get the scheme out and running with national benchmarking so there’s greater confidence in the system; you know that everybody is working to the same standard and has been assessed as appropriate to do that, protecting those vulnerable people.
We can’t delay on that – there is a lot of pressure out there with people saying ‘we can’t do the job, we haven’t got enough BIAs’, but we need to ensure the standards remain high.
We’ve got to do that because, at the end of the day, it could be your relative who is at risk, and we need to make sure that their interests are being met and that people aren’t being detained or restricted because it suits the care home or hospital.
But, currently, with 50% of people not having their deprivation of liberty assessments undertaken within the proper time and thousands of people on the waiting list for them, we don’t even know that the standards of training are equal across providers.
If we don’t get it right, we could be waking up to yet another scandal for people who lack capacity.