Lords introduce care home manager DoLS safeguards

Health and social care minister Lord O’Shaughnessy has attempted to reassure care home managers of proposed safeguards as the Lords debate changes to the mental capacity bill.

In day two of the Lords committee stage of the bill, the health minister tackled concerns raised to date about the potential for the new ‘son of DoLS’ bill to introduce conflict of interest.

On the Deprivation of Liberty Standards (DoLS) pre-authorisation review, he acknowledged that it would be inappropriate for these to be completed by care home managers. Instead, a code of practice would stipulate this as a role for a qualified medical practitioner, nurse, social worker, speech therapist, occupational therapist or other profession.

In addition, there will be a specific exclusion for people involved in the day-to-day care of the person or delivering treatment to them. He said: “That is another safeguard. I hope that is at least one brick in the road towards defining the proper role for care home managers.”

Lord O’Shaughnessy also highlighted the issue of care home managers having to seek permission from a responsible body on every case where there is a previous or equivalent
Assessment. He said: “The role of the care home manager… is critical to avoid duplication and to ensure that cases that are relatively straightforward can be dealt with at a level that is close to the person being cared for, can be integrated into care planning without involving referrals upwards.”
Straightforward assessments could include a lifelong diagnosis such as a learning disability where a previous assessment can be reasonably expected to provide valid and reliable evidence, he clarified.

However, to tackle concerns about the potential for over-reliance on previous assessments, the health minister said there would be opportunity for review of care home managers’ decisions by a responsible body. “If there is an overreliance on past – particularly quite long-dated – assessments in that statement, it will be a flag for escalation to the approved mental capacity professional (AMCP).”

The debate also highlighted the need for care home manager training to support the new DoLS assessment role.


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