DoLS Assessment: Communication & Restrictions Exercise

Interactive Case Study for Best Interest Assessors

Learning Objectives

Apply Principle 2 of the Mental Capacity Act in practice
Identify practicable steps for effective communication
Recognise reasonable adjustments for individual needs
Understand AAC (Augmentative & Alternative Communication) applications
Evaluate appropriate use of TEC (Technology Enabled Care)
Complete 2 of 6 possible scenarios with feedback

Select Scenario Set to Begin

Each activity involves completing 2 scenarios with 3 tasks each

Case Study

Meet Jordan (They/Them), Age 24

Background: Jordan is a young transgender person of mixed heritage (Welsh-Jamaican) living in a specialist care home in Cardiff. They have a learning disability, autism, and complex PTSD following historical trauma and family rejection.

Communication Profile:

Uses AAC (augmentative and alternative communication) tablet with symbols and text-to-speech
Becomes non-verbal when anxious or overwhelmed
Requires processing time and visual supports
Has sensory sensitivities (particularly to bright lights and loud noises)
Communicates through drawing and music when distressed

Cultural & Identity Considerations:

Strong connection to LGBTQ+ community and Black British culture
Experienced discrimination and misgendering in previous placements
Values autonomy and self-determination highly
Finds comfort in chosen family and peer support networks

Current Situation: Jordan is subject to a DoLS authorisation. You are conducting a review as the Best Interest Assessor.

Scenario 1 of 6

Task 1: Identify the Restrictions

Select all measures that constitute restrictions on this person's liberty:

Scenario 1 of 6

Task 2: Communication Plan & Practicable Steps

Match the communication need with the appropriate practicable step:

Scenario 1 of 6

Task 3: AAC, TEC & Alternative Communication

Match each communication challenge with the most appropriate technology or method:

Scenario Complete!

Key Points for This Scenario

Restrictions must be clearly identified and proportionate
Communication support must be individualised and multi-modal
Technology should empower, not control
Cultural identity and community connections are vital

Exercise Complete: Overall Performance

Key Takeaways

AAC (Augmentative & Alternative Communication): Essential for supporting non-verbal communication and giving voice to individuals
TEC (Technology Enabled Care): Can promote independence while respecting dignity, when used proportionately
Person-Centred Assessment: Must consider all aspects of identity, culture, and communication preferences
Practicable Steps: Going beyond standard approaches to truly enable participation in decisions
Intersectionality: Understanding how multiple identities interact to shape experiences and needs

Recommended Next Steps

Review Welsh Government guidance on DoLS and communication support
Explore AAC training resources and technology options
Consider how TEC can support rather than restrict individuals
Reflect on unconscious bias in assessment practice
Engage with advocacy organisations for diverse communities