Case Study on BIA Module Assessment Help

 

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  • Number of Words: 2500

 

Case Study on BIA Module

 

Scenario 1

 

All names in the case study are pseudonyms.

 

Mr Jones was born in 1980 in Greyhurst, Greyhurstshire.  He was born with Downs Syndrome and an associated learning disability.  He has lived his entire life with his parents in their home.  As an adult he has regularly attended a day centre/care home close to his parent’s home.  He has been trained to use public transport and takes a bus three times a week from his home to the day centre and returns at the end of the day.  He has in the past had regular periods of respite care in the care home when his parents have gone away on holiday which he enjoys. He usually stayed for approximately a week at a time up to 6 times a year.  Mr Jones had previously been deemed to have capacity to consent to staying at the care home.

 

In 2010 when Mr Jones was 30 he met and married his wife Cecelia and they lived with the agreement of his parents, together, in his parents’ home.  In 2015 Mr Jones and his wife sought fertility treatment from the local hospital, during which time a consultant psychologist concluded that Mr Jones lacked capacity to consent to sexual relations.   Mr Jones and his wife were informed of the outcome of the capacity assessment.  Mrs Jones was advised that she must abstain from sexual intercourse with Mr Jones as that would, given his incapacity to consent, be a serious sexual offence under the Sexual Offences Act 2003.  Mrs Jones was informed that she should move out of their bedroom and reduce any expression of affection towards him so not “to give him the wrong message”.   She was told that if she failed to comply, safeguarding measures would be taken to remove either Mr Jones or herself from Mr Jones’s parents’ home.

 

Mrs Jones complied with the request but Mr Jones was very upset about his wife moving out of their bedroom and not showing him the same affection he was used to and he became very distressed.  Mrs Jones spoke to the consultant about this.

 

The consultant psychologist was concerned about whether Mrs Jones was following advice and raised a safeguarding concern to the local authority inferring that Mr Jones was at risk of sexual abuse at the hands of his wife.

 

A senior social worker in the central referral unit received the concern and immediately called the police.  Arrangements were made by the local authority and the police to attend Mr Jones’s house as a matter of urgency.  Mr Jones was alone in the house when they arrived, his wife was out, and his parents had popped into town to do some shopping.

 

Mr Jones was said by the local authority to have “left the house willingly” with the police and social services and he was taken to the care home where he had previously enjoyed respite.  He was informed that this temporary arrangement had been “agreed” by his wife and parents.

 

Once at the home Mr Jones was assessed as not having capacity to keep himself safe or to agree to stay at the care home, and the social worker informed the registered manager that he “should be kept at the home to keep him safe” as he was at risk of sexual abuse and he should be “dolled” immediately.

 

The registered manager was unhappy about what she had been told and decided that she ought to seek an urgent authorisation from the local authority and completed the appropriate forms and sent them off along with a standard application.

 

Mr Jones became increasingly distressed about being in the care home and being told he was unable to leave or see his wife, and a GP was called and asked to prescribe him “something to calm him down” as his behaviour had become “challenging”.

 

Mr Jones’s wife and parents came home to find Mr Jones missing and called the police who did not inform them of his whereabouts for 12 hours.  Mrs Jones was told to refrain from seeing her husband in light of the allegations of abuse.  Mrs Jones was extremely distraught and upset about the allegations because as far as she could see she had done nothing wrong.

 

Once Mrs Jones found where her husband was being kept she rang the local authority stating that she thought her husband had been “kidnapped” and was “being held against his will” and that threatened that “they were ruining her family life and someone would pay”.

 

The local authority on hearing from the registered manager that Mr Jones was “trying to leave” decided the best thing was to issue an application to the Court of Protection for a declaration that it was in Mr Jones best interests to reside in the care home and for a deprivation of liberty order.

 

The local authority commenced a section 42 enquiry under the Care Act 2014 at the same time as issuing an application to the Court of Protection.

 

Scenario 2

 

All names in the case study are pseudonyms.

 

Mrs Smith was born in Loam in Loamshire on 3/8/35.  She is the youngest of three siblings and the only survivor.  She had three children with her first husband who died.  Her children are Alan, Brian who lives in the South West and who is paralysed from a motor accident, and Clara who lives in the USA.  Mrs Smith’s second marriage lasted for some 6 years before her husband left her, but he is still alive.  Mrs Smith is described by her friend Trevor as having been a ‘fiercely independent woman’. She was a Senior Civil Servant for 20 years. Since retirement she had run a business from home. She was involved with voluntary work.  She taught artwork at the local college. She was involved with various charitable organisations. According to her friend Margo she was a regular attendee at her local church. She attended a local bridge club every month and a ‘singles lunch’ twice monthly. These activities and interests were curtailed by her failing health.  Mrs Smith had lived in the same home for some 30 years surrounded by her all her hobbies, her belongings and precious things.  For the last 4 years her son Alan had lived in her home caring for by her. Alan had financial difficulties running his business and left his home and business to care for Mrs Smith and he continued to do so for 3 years.

 

Mrs Smith was diagnosed with vascular dementia, of a moderate type approximately 7 years ago. In a mental health assessment some 2 years ago Mrs Smith was described as having ‘cognitive deficits, confusion, disorientation to time place and person’ and a week later diagnosed with severe dementia and as a consequence found to lack capacity to make decisions regarding residence, care and contact.

 

Over the last two years there have been several safeguarding concerns raised to the local authority.  The first concern involved redness around the right eye and bruising to her upper arms, the next concern, some two months later was a cut to the right side of the back of her head, several weeks after that she sustained bruising to the left side of her mouth and jaw.  A week after the last concern was raised Mrs Smith was removed from her home by Loamshire Council.  The concerns were raised to Loamshire Central Safeguarding Team and a contact officer made a decision that the concerns did not meet their threshold for an enquiry to be made.  None of the safeguarding concerns were investigated by Loamshire’s safeguarding team.

 

A further safeguarding concern was raised on the same day of Mrs Smith’s removal from her home.   A newly qualified social worker employed by Loamshire considered in all the circumstances it was in Mrs Smith’s best interest that she was removed to a place of safety whilst an enquiry took place. The incident was also to be reported to the police.

 

The newly qualified social work and her immediate superior, a senior social worker, attended Mrs Smith’s property.  Her son was not at home and Mrs Smith was unable explain how she had sustained the injuries. Mrs Smith is said to have ‘willingly left her home’ and she was taken to a Care Home.  Mrs Smith’s son was not informed of his mother’s whereabouts for nearly 3 weeks after her removal.  Loamshire had not sought an urgent authorisation for Mrs Smith’s removal from her home and residence at the Care Home. A standard authorisation was requested about a month after Mrs Smith arrived in the care home and was not granted for another month.    Loamshire made an application to the Court of Protection a few days later for a declaration that it was in Mrs Smith’s best interests to reside in the care home and for a deprivation of liberty order.

 

Loamshire were not convinced the injuries Mrs Smith sustained were caused by the son and if he did not cause the injury she should stay at the care home until a care plan was in place.  Loamshire were reluctant to fund a package of care in the community as it felt the care home was appropriate for her needs.

 

Loamshire did not complete the enquiry for nearly a year.  The outcome of the enquiry was a finding that Mrs Smith had been neglected by her son and should not be returned to his care.  The care home is aware of the safeguarding concerns and has been told by Loamshire to restrict contact between Mrs Smith and her son.

 

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