Daniel used to live alone in his own flat since the passing of his wife. He was diagnosed with Alzheimer’s a year ago and has shown some signs of confusion and short-term memory loss. He would go out often on the bus but was at high risk of falls. He was admitted to hospital a number of times due to falls after experiencing dizzy spells. There were also a number of fires in his home which he could not recall how they started. Neighbours reported they were caused by accidents, for example where Daniel had forgotten he had left pans on the cooker.

The enablement team provided support for Daniel around his house. They reported that he was not able to take good care of himself, he was looking unkempt and not eating very well. When the ambulance crew last visited Daniel, they found a lot of out-of-date food in his home.

On his last hospital stay, Daniel was put on a temporary placement at a care home. This was authorised on the basis that a referral for an Independent Advocate was made to support him with longer-term care decisions. He was referred to POhWER for advocacy support. Lynn, a POhWER Advocate was appointed to represent Daniel. 

A needs assessment was being completed by the social worker and Lynn helped Daniel to communicate his support needs and his views and wishes going forward under her role of Care Act Advocate. 

At the same time, it was decided that Daniel could not make long term housing decisions independently and Lynn, acting in her role of Independent Mental Capacity Advocate (IMCA), supported Daniel to understand and weigh up the options available to him. These were:

1. to return home with a package of care
2. to go to an interim placement until sheltered accommodation could be arranged
3. to remain at the care home. 

Lynn visited Daniel at the care home. He was happy with her explanation of the IMCA role and was pleased to be able to have his say in the matter of where he lives. 

He told Lynn he really liked living at the care home.

She asked, “What do you like about living here over being at home?”
He said “Feeling safe, they look after me well. I get given my meals, I have tea and coffee whenever I want, and I can join in with all the activities that are going on here. Some people here need a lot of help, and they get it. I keep thinking if I am here when that happens to me, I will be around people I trust who will do the best for me.”

Daniel said “I really would like to stay here. I have a good routine, and I am being well cared for. I couldn’t manage at home but kept trying to. Before you come to a place like this you have no idea what to expect and want to keep your independence, it’s a scary thought when you don’t know what it’s like. Some people here really don’t know where they are, and I might be a little bit confused now, but in the future, it could be much worse. Now I am here, I am aware I was at risk being at home on my own. There were 3 fires, and it was very lonely. I would very much like to remain here now. I am settled, they do a great job in making sure I am safe, I have people to talk to. There is a sense of community. I feel useful. I don’t have to cook, and the food is very nice. The staff will help me when I have a shower, if it’s just a wash I don’t need help with that. They give me my meals, drinks, and medication. I would say I need minimal help really but the staff being there if I need them is such a relief.”

The deputy manager told Lynn that Daniel is a very charming man who has settled in well, he is very helpful to the other residents and needs minimal support from staff. He will help the other residents with their activities and will get involved in anything we put on.

Lynn reported the wishes and feelings of Daniel in a report and to the social worker. Lynn also highlighted reasons why she felt that Daniel showed a good understanding of his needs and wishes and asked that the capacity assessment was revisited. 

It was decided that Daniel was able to make the decision for himself, and he would stay at the care home where he felt happy and secure.