Full To Capacity

Today was the latest in the long line of mental capacity assessments that Steven has been put through in relation to the community DoLS. The first one was a year ago and today was the fourth. They’ve never really got out of the starting blocks because, quite frankly, Steven has refused to engage with them. You can always rely on Steven to smell the bullshit a mile off and in his own inimitable way, calls it for exactly what it is.

Anyone with a smidgen of knowledge about the Mental Capacity Act knows that a capacity assessment has to be decision specific. And that has been the stumbling block so far – the process is so nonsensically labirynth, nobody has managed to work out what the question is that they’re meant to be exploring. I’m still not entirely sure but I think the question today was – does Steven have the capacity to agree to his current support arrangements. This is important because the DoLS ship has sailed so far off course that having support around the home and to go out is now seen as a deprivation of one’s liberty. We are now in such DoLS chaos that the very thing that enables Steven’s liberty is viewed as depriving him of it!

I spent the morning with Steven but left before the assessment. Cowardly, I know but I was frightened of inadvertently revealing that the king has got no clothes on. So I left it to the two support workers knowing they’ll give me a full report afterwards.

The social worker brought a male colleague with her. It was a wise move. Steven gets a bit intimidated by her but he took to her chum.

Here are some of the highlights:

Assessor: Where do you live Steven?

Steven: In the Cowley house.

Assessor: Do you live here on your own?

Steven: No. With Mark Neary.

Assessor: Do you like living with Mark Neary?

Steven: Yes.

Assessor: Do you like your support workers?

Steven: Yes.


Assessor: Do you do your food shopping?

Steven: No.

Assessor: Who does your shopping Steven?

Steven: Ranjit or Gary.

Assessor: Are they your support workers?

Steven: No. Ranjit and Gary are Tesco men. Ranjit and Gary bring the shopping on their lorry.

Assessor: Do you go to the shops Steven?

Steven: Yes. Go to Jay’s shop.

Assessor: Do you go to the shop on your own?

Steven: No. Go to the shop on Friday with Alan and Des…. (Steven then ran through each day of the week and who goes with him each time).

Assessor: Why does Des go with you on Fridays?

Steven: Steven Neary carries the crisps. Des carries the massive heavy milk.


Assessor: Do you ever go out on your own?

Steven: No. I don’t. (Then he thought about it and admitted). Steven Neary went to see Uncle Wayne next Friday nighttime. Steven Neary was being a bit silly.


Then, for some reason, the assessor decided on some geography questions:

Assessor: Where is Cowley?

Steven: Here. This is the Cowley living room.

Assessor: Is Cowley near Uxbridge?

At this point the assessment abruptly ended. Steven got upset and ran off to his bedroom saying:

“Don’t want to go back to the Uxbridge house. Want to live in the Cowley house forever and ever”.


This morning, before the assessment, I tweeted some thoughts about and mentioned that I’d like to have a cup of tea with Lady Hale and ask her whether this is what she had in mind when she came up with the idea of the acid test. Steve Broach tweeted back suggesting that she would probably be up for it and that I should drop her a line at the Supreme Court.

So I did.

And I think she will reply.

“Lady Hale. Do you ever leave the Supreme Court on your own? And do you know where Westminster is?”

17 thoughts on “Full To Capacity”

  1. You’re last sentence had me in stitches. My son is being assessed as well, thank you for making sense of the senseless.

  2. Indeed! Quite how you manage to make sense of the senseless with such good humour, I don’t know.
    I hope Steven is OK after the upset. I love his logic, makes perfect sense! Goodness only knows why the powers that be have to make it all so bloody difficult.

  3. Thanks for this Mark. Just superb insight as always and straight to the point. I’ve always been mystified about my siblings DoLS, how it existed to only prolong his torment. There was no safeguarding in practise. With an independent investigation going on I won’t bring up all the dirty details of the damage I believe was carried out by that DoLS other than to say to any family, follow your instinct, it’s all you’ve got and it’s usually always right. Never hesitate and be wary; get help and expert advice, not from the provider or the social worker or BI Assessor for the DoLS (sadly) but independent strong advocacy or an urgent conversation with a strong legal firm that covers civil liberties. The situation could turn into an unforseen catastrophe.

  4. I don’t know whether to laugh or cry. It’s been a hard week – I think I will chose to laugh. So much wrong with these questions, I wouldn’t know where to start 😦

  5. Decision: Can Steven consent to his current care and support arrangements?
    Salient points for stage 2: What help does Steven need each day? What would happen if that help wasn’t there?
    Not relevant: Geography (unless linked to practicalities of support provision ie Dad’s house).

  6. Excuse my language, but why the actual fuck would anybody mention the one place that Steven hates most, where he was traumatised, which terrifies him? Do they not realise the stress every Christmas? His need to know he is never going back to Uxbridge? It’s like out of the blue asking Harry Potter about the agonising way his parents were murdered, while casually chatting over a cup of tea.

    Can they not put something in Steven’s notes saying “for christsake don’t use the word Uxbridge”? I’m serious.

      1. They were both in Uxbridge Flash. Steven is so content and pleased with his Cowley house that the mention of anywhere from the past makes him terrified that he’ll be taken away from his home.

    1. In our case, it would have be “For Christ’s sake don;t mention the word independance”. My daughter may lack capacity in some areas, but she is only too well aware of what THAT word means in Social Care speak

      Since we have been on Direct Payments (after a fashion) and she has had some say in who cares for her and how, she has blossomed into the kind of independance which is a lot more real – but it is perilous, and like Steven she fears it being taken away in some cost cutting exercise. So do I.

      This may not be the right place, but as I am old and becoming unwell, I am more than a bit desperate, could anyone tell me how you GET independent advice/support? Again, like Steven, she has a wonderful and stable support team, but emergency cover can occasionally be
      more than a bit of a problem and I don’t really know where to turn.

      Any advice VERY gratefully recived.

  7. Well, this should be another classic, of how not to test mental capacity.
    A stranger asking stressing questions. There should be meticulous planning with you; the person most trusted and knowledgeable. A trusted person should ask the questions. This is so emotionally loaded.

    Aaaaaaaaaaaaghhhhhhhhhhhhhhh!!!! Are they just of low IQ or are they messing about? They need supervision and recording on video.

  8. So sorry to share latest horror care home story, re an NAS home for 6 people set in beautiful grounds, expensively funded.. delivering abuse and neglect, unmonitored.
    One staff was too busy on his PlayStation and left a person waiting all day, another threw cake at a resident’s head, another gave an onion when a person asked for a biscuit, and God knows what else.
    The NAS didn’t report this until very late.
    Safeguarding board did their job.

    Highbridge’s Mendip House staff ‘engaged in cruel behaviour’

    1. Just read the Mendip House story. The review said “The staff at Mendip House engaged in behaviour that was cruel, far below the standard expected.” I would like to think that ‘cruel’ is completely and utterly intolerable and unforgivable, not just far below the standard expected. It looks like they are all off the hook and free to find work elsewhere?

  9. It seems that when laws are introduced to provide safeguards for vulnerable adults, the powers that be soon manage to find ways to use those laws as weapons against the very people they were brought about to protect. It also seems likely to me the sheer volume of DoLS assessments will lead to it all being outsourced to some private company, with fat cats waiting to line their pockets. And in most cases, it really doesn’t matter what laws or procedures are introduced to protect vulnerable people because laws and procedures are abused by the authorities to create whatever conclusions suit them anyway. Not many people get as far as court and/or exposing their lying and cheating schemes.

    1. I know, Kate.
      And to me, it means that one thing is always true. Never have your loved one out of your sight. Always keep sight of them, and if not every day (as I can’t), most days.
      When paid others see you watching, they tread carefully. Few of them can be trusted. Just like in the military, they must be kept in line.
      Many people are worse than animals.

      Cruelty is completely intolerable and unforgiveable, as you say. The NAS again is a disgrace, that a safeguarding board had to criticise them.

  10. The Code of Practice to MCA clearly states

    ‘a person who lacks capacity’.
    Whenever the term ‘a person who lacks capacity’ is used, it means a person who lacks capacity to make a particular decision or take a particular action for themselves at the time the decision or action needs to be taken’

    So the decision not only needs to be specific it also needs to be at a time the decision is needed, the later requirement appears to be being ignored by courts etc

    If Stephen is happy going out with his carers if the decision does not ‘need to be taken’

    Nor do all the MCA applications to COP by LAs/NHS, if an autistic is happy living at home with their parents.

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