How do we help our brother as a Nearest Relative ?

My brother’s mental health has been deteriorating for over a year, and he is now becoming paranoid. He lives alone after kicking out his girlfriend and kids. Despite numerous attempts by mental health professionals and the police to help him, he has refused assistance. He believes our mum is out to destroy him. How can his family (especially our mum) help him? We want to be involved in his care and have his GP involved. Is my mum the nearest relative (NR) by default? Can he object to her being the NR? What other routes can we take to be involved in his care?