Morgan Davies - Complex Needs Assessment
📋 Basic Information
- Name: Morgan Davies (they/them)
- Age: 24 years old
- Location: Specialist care home, Powys, Wales
- Legal Status: Under consideration for DoLS authorisation
- Ethnicity: Mixed heritage (Welsh/Caribbean)
- Gender Identity: Non-binary
🏥 Primary Diagnoses
- • Autism Spectrum Condition (high support needs)
- • Learning disability (moderate)
- • Complex PTSD (childhood trauma)
- • Episodic psychosis (under review)
- • Type 1 Diabetes (requiring monitoring)
📖 Background & History
Morgan experienced significant childhood trauma including neglect and emotional abuse within foster care placements in England before moving to Wales aged 16. They have had 17 placement breakdowns since age 12, with patterns of escalating distress during transitions.
Originally from Birmingham, Morgan was placed in Welsh children's services at 16 due to a specialist autism placement becoming available. This cross-border move has created ongoing complexities regarding their care coordination, with some services still based in England.
Morgan identifies as non-binary and has experienced discrimination in previous placements regarding their gender identity. They have a strong cultural connection to their Caribbean heritage through their birth mother, which has not always been supported in previous settings.
Six months ago, Morgan experienced a significant mental health crisis involving psychotic symptoms. There was consideration of detention under the Mental Health Act 1983, but this was not pursued. The interface between MHA and MCA remains an ongoing consideration.
✅ Morgan's Expressed Wishes
- • Wants to stay in current placement ("feel safe here")
- • Wishes to maintain contact with birth mother in Birmingham
- • Wants more independence with managing diabetes
- • Prefers female or non-binary support workers
- • Wants to attend local LGBTQ+ youth group
- • Dislikes being touched without warning
⚠️ Current Concerns
- • Self-injurious behaviour during distress
- • Absconding attempts (3 in past month)
- • Refusal of diabetes medication at times
- • Aggression towards specific male staff
- • Sleep disturbance affecting daytime functioning
- • Recent weight loss and reduced appetite
🔗 Multi-Agency Involvement
Wales-Based:
- • Powys County Council Adult Social Services (lead)
- • Powys Teaching Health Board
- • Community Learning Disability Team
- • Welsh Ambulance Service (frequent caller)
England-Based:
- • Birmingham Children's Trust (historic)
- • NHS England funding panel
- • Court of Protection (previous proceedings)
Identifying Restrictions
Select all measures that constitute a restriction of Morgan's liberty. Consider what a person of similar age without disabilities might experience.
📊 Your Selection Analysis
Analysing Impact of Restrictions
For each restriction, consider its specific impact on Morgan given their individual circumstances, history, and intersecting identities.
Best Interests Determination
Work through the key considerations for Morgan's best interests assessment under the Mental Capacity Act 2005.
1. Morgan's Past & Present Wishes
How should Morgan's expressed wishes influence this assessment?
2. Beliefs & Values
What beliefs and values are relevant to this decision?
3. Views of Others to Consult
Who should be consulted and what weight should their views carry?
4. Less Restrictive Options
What less restrictive alternatives have been considered?
⚖️ Key Tension: MHA vs MCA
Given Morgan's episodic psychosis, how do you navigate the interface between the Mental Health Act and Mental Capacity Act?
Your Assessment Decision
Based on your analysis, make your recommendation for Morgan's DoLS assessment.
Authorise DoLS
The deprivation of liberty is in Morgan's best interests and should be authorised with appropriate conditions.
Do Not Authorise
The restrictions are not proportionate or necessary; less restrictive options should be pursued.
Refer for MHA Assessment
The primary purpose appears to be mental disorder treatment; MHA may be more appropriate.
Request Further Information
Insufficient information to make a decision; specify what additional assessments or consultations are needed.