We have a gentleman who accesses a day time opportunity in a horticulture setting from 9 to 4 and then returns home. Lately, behaviours have come to light that he will attack staff and run out of the cabin that he uses into the garden part of the service where there are tools which he has used to chase and throw at staff.  I, as the area manager for the service, have been asked if we can lock the door to stop the person coming out and also lock the windows because he had also climbed out of the window. We have approached the Social Worker for guidance and have been told DoLs does not come into this scenario as the Mental Capacity Act would come into play regarding making decisions in his best interest.  Am I right to be wary of this? advice.

Answered by Sheila Scott

Dear P

Thank you for your email. This is a risk. There are some areas I would suggest you look at. You say you have approached the social worker for guidance but, if you haven’t already asked, I would suggest you request a mental capacity assessment. You say this behaviour has just come to light. I wonder if this is as a result of a deterioration in his mental health or if it is caused by another underlying health condition that is triggering the behaviour that challenges. It would be helpful for you to find out from staff if they can identify when they think this behaviour started and if there are any triggers. You may also want to involve the GP and arrange a consultation. This may be more challenging because of COVID but I would emphasise to the GP, the risk he is posing not only to staff but also to himself. I would also carry out a risk assessment, consider the risks to the residents, to staff and other residents or visitors. If you can’t carry out the risk assessment, ask if the day time opportunity provider carry one out. In terms of best interest decisions, you need to know if the resident has the mental capacity or not to make a decision for himself and if he hasn’t, you need to involve a multidisciplinary team to make a best interest decision. Where you asked about DoLs, if this is about stopping him leaving to go to his horticultural activity by locking doors then you need to speak to the DoLs team at your local authority. You can also seek guidance from the safeguarding team as he is putting himself and possibly others,  at risk of harm.