Sanctuary Supported Living’s Skelton Court is a residential care home for older people with learning disabilities and complex needs. The Skelton Court team passionately believe in promoting dignity and respect, and they aim to give residents access to the same opportunities, understanding and treatment as anyone else.

This ethos was put to the test when in early April, shortly after lockdown was introduced, a 65-year-old resident with a learning disability and autism was admitted to hospital with respiratory issues which were suspected to be Covid-19. Prior to being admitted to hospital, she had enjoyed an active, happy and fulfilling life, particularly since moving to Skelton Court, and had been physically well with no major health concerns.

However, when Nikki Oakley, the Local Service Manager, contacted the hospital’s Learning Disability Liaison Nurse for an update and to ensure the resident’s communication and care needs were being met appropriately, she was informed that the doctor wanted to place a DNACPR on the resident. Nikki was told that, because the resident had a learning disability, the doctor felt that she had no quality of life.

This was a huge concern for Nikki and her team, and they immediately challenged the decision. They raised concerns that there had been no Mental Capacity Act (MCA) assessment or Best Interest meeting to discuss it. They also explained to the NHS staff who were treating her, that the resident had a good quality of life at Skelton Court and had achieved many positive outcomes since living there, regardless of her learning disability and autism. At this stage, she hadn’t even tested positive for Covid-19 or received a confirmed diagnosis.

Nikki escalated the issue to senior managers within Sanctuary Supported Living, and raised awareness amongst her colleagues, so that they could be prepared in case other hospitals took the same approach with their residents (many of whom have learning disabilities, physical disabilities, mental health needs, autism and other complex needs). In response to her quick actions, the senior managers were able to highlight the issue with NHS England, that people with learning disabilities or autism were being placed on DNACPR, without the use of the frailty scale.

Thanks to Nikki and the team’s hard work and clear understanding of her needs, the resident had a voice and received person-centred care and support during her illness and throughout her stay in hospital. With their support and unwavering advocacy on her behalf, the decision was made to not place her on a DNACPR and she has since fully recovered. She has now returned home to her friends at Skelton Court and is continuing to live her life to the full.