Care home staff excluded from assessments of residents facing move to supported living, peers told

Councils are moving learning disabled people out of care homes into supported living without adequate assessment or support, care home leaders have warned.

The claim came from the National Care Association’s chief executive and chair, Sheila Scott and Nadra Ahmed, in evidence to the House of Lords committee examining the impact of the Mental Capacity Act 2005 earlier this month.

Scott said social workers in some areas were not consulting care home staff during assessments of residents, often people with learning disabilities, whom councils would like to move into supported living.

Scott suggested this lack of consultation applied to assessments of the person’s capacity to decide whether to move into supported living and of best-interests decisions made about people who lacked the capacity to decide.

While she said care homes had a duty to support young adults to move towards independent living but sometimes they required greater protection than was allowed for in council assessments and support plans.

Ahmed cited the case of two young women with learning disabilities who were moved into supported living from a care home run by a learning disability provider of which she was a trustee.

‘Care home’s views not taken into consideration’

“We had our reservations, but they were not taken into consideration,” she said. “These two young ladies went to the local pub for a drink in the evening, got chatted up and handed over their address and phone numbers. That night, we got a very panicky phone call in the middle of the night from one of the girls because there were these lads hammering on the door.”

Ahmed added: “We are not against supported living, because for some people it is absolutely great and it is right and they are living very happily, but when you do an assessment you have to take into consideration why somebody is stable in [the care home],” said Ahmed. “They may be stable because of the support that they are getting around them during the time that they are there. If you take that support away from them, what will the impact be on them when they are living alone?”

Scott and Ahmed agreed to provide the committee with further instances of cases where they claim local authorities have moved people from into supported living without consulting staff at the care home from which they moved.

Scott also raised concerns about the level of initial training care staff were getting on the Mental Capacity Act 2005 through the common induction standards all are required to undergo.

Inadequate induction training

While the CIS requires care staff to understand the importance of balancing risk with promoting independence and of empowering people to take decisions about their care and support, it does not mention the MCA by name.

However, Scott said that it should be “part of that basic fundamental training that nobody can work unsupervised until they have had”. She said the government’s plan to require care staff to obtain a “care certificate” before practising unsupervised provided an opportunity to address this gap.

Scott also admitted that she was surprised at the number of Deprivation of Liberty Safeguards applications that had been made and granted to care homes, since the introduction of Dols in 2009. This is contrary to the common view that the number of Dols authorisations is too low and that in some areas people are being detained in care homes or hospitals without the protection of the safeguards.

Scott suggested that in some areas councils were expecting Dols applications to be made when they were not necessary. She said more clarity was needed about what constituted a deprivation of liberty, for example for a person with dementia in a care home.

Enhance your practice

Get the latest case law, policy updates and practice advice on the Mental Capacity Act and the Deprivation of Liberty Safeguards at Community Care’s conference on the topics in London on 19 March 2014. Register now for a discounted place.