When mental capacity assessments must delve beneath what people say to what they do | Community Care

I disagree as each have their own important skills which should be used in tandem, for one is using the ‘social model’ while the other is using the ‘medical model’, when really it should be a mixture of both.

For example, my wife was in hospital last year and the consultant formed the opinion, that she needed to be on 24/7 oxygen when she was discharged and he assumed, wrongly, that my wife would mention this to me.

But she has a memory problem sometimes, while showing confidence and strength in her manner.

What she did mention to me was that the Consultant was considering 24/7 oxygen at home and thought he would discuss this with me.

A week went by and I had no such discussion, so I enquired what was happening after the week had gone by when I made my daily visit, to be informed that the process had been concluded.

But, to me no home assessment had been done, so they did not know we had 24/7 care for our daughter, who lives at home with us, I had not informed my house insurers or anyone else.

While I was visiting my wife the oxygen supplier tried to deliver the oxygen, which was, rightly refused by our daughters carers.

I then found out that the Home assessment had not been done, so this was done on my next day visit and I agreed to the oxygen delivery.

I would mention that my wife had mentioned for them to discuss this with me, which they saw fit to ignore.

I was given no consideration and left completely in the dark.

I was my not only my wife’s husband, but also her carer and therefore was the person who took responsibility for the management of the oxygen as my wife relied on me for everything, her choice.

But choice is also something that is ignored by hospitals as well as carers and with COVID-19 carers are going to be more evident than they were previously in their number and their responsibilities.

Hospitals need to consider ‘person-centred ‘care instead of ‘institutional’ care.

The care team is not just hospital personal, but everyone within the caring of a person, including the person themselves, which who at times is seen as an object and an inconvenience to some hospital staff.

I am not blaming the staff, but the system, as the staff do their best within the constraints of the system.


Source: When mental capacity assessments must delve beneath what people say to what they do | Community Care

Mandatory Autism And LD Training After Teen’s Death

While I agree that Learning Disability and Autism training should be mandatory, so should Training on Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (Dols) and the forthcoming change of Dols to LPS (Liberty Protection Safeguards) effective from October 2020.

However, in this instance, while Learning Disability and Autism was relevant, surely the adherence to the policy on allergies is also relevant as this should be an underling principle for any organisation, especiallywithin health.

Same Difference

Readers, for a few days, I will only be posting links with relevant titles. This is due to not having access to a computer. I will still do my best to bring you content.


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Key change made to rights to information under LPS : Community Care

Individuals who may be deprived of their liberty under the Mental Capacity Act (MCA) would not be informed of their rights until the deprivation has been authorised, under government changes to the bill to replace the Deprivation of Liberty Safeguards (DoLS) with the Liberty Protection Safeguards (LPS).

The amendment to the Mental Capacity (Amendment) Bill, which passed narrowly last week by a committee of MPs scrutinising the bill, would see the cared for person, and any appropriate person or independent mental capacity advocate (IMCA) supporting them, given key information regarding the process and the person’s rights as soon as practicable after an authorisation were given.

More on the Mental Capacity (Amendment) Bill:

This includes the responsible body – the agency which authorises the deprivation of liberty, ensuring the cared-for person, and any IMCA or appropriate person -understand the effect of the authorisation, the circumstances under which an advocate would be appointed and their rights to request a review and to challenge any authorisation in court.


Source: Key change made to rights to information under LPS : Community Care

Lords approves DoLS replacement bill following significant changes to boost safeguards for those detained | Community Care

The bill to replace the Deprivation of Liberty Safeguards (DoLS) with the Liberty Protection Safeguards (LPS) has been approved by the House of Lords after peers made significant changes to the government’s original proposals.

The majority of changes made to the Mental Capacity (Amendment) Act were designed to address concerns that the original bill failed to provide sufficient safeguards for people deprived of their liberty or sufficiently consider the wishes and feelings of people and their families.

With the bill due to have its first debate in the House of Commons tomorrow (18 December), we review the major changes agreed by the Lords.

Reducing role of care home managers

One of the main sticking points of the original proposals was the significant role given to care home managers under LPS in cases in their homes

It was originally proposed that care home managers would be responsible for arranging assessments to decide whether the three conditions for a deprivation of liberty authorisation had been met: that the person lacked capacity to consent to their care arrangements and had a mental disorder, and that the arrangements were necessary and proportionate.

Managers were also tasked with confirming with the responsible body – which in the case of care homes would be the local authority – if the authorisation conditions had been met, if an independent mental capacity advocate (IMCA) should be appointed and if the person were objecting to their care arrangements. This is significant because anyone who objected would be entitled to have their case reviewed by an approved mental capacity professional (AMCP), a practitioner with specialist training in the Mental Capacity Act (MCA) similar to the best interests assessor (BIA) under DoLS.

Concerns over managers’ skills and knowledge  

Peers challenged the initial proposals, questioning whether care home managers would have the required skills and knowledge to carry out what would be, in effect, the responsibilities performed under DoLS by BIAs, who have specialist training in the MCA.

They also questioned why these responsibilities would not be carried out by local authorities in their responsible body capacity, as proposed by the Law Commission in its 2017 report on reforming deprivation of liberty law that forms the blueprint for the government’s proposals.   

Professionals also expressed significant concern about this aspect of the bill. A survey of over 900 people conducted by Edge Training and Community Care found that 86% of respondents disagreed with proposals to make care home managers responsible for conducting or delegating assessments.

In addition, giving managers the responsibility to alert local authorities if they judged an IMCA was required also worried peers, who warned that care home managers would act as gatekeepers and people entitled to advocates would not have access to them.

Local authorities given a choice

In response to these concerns, the government brought forward amendments to give local authorities the option of giving these responsibilities to the care home manager or undertaking the responsibilities themselves. This would act as a check to ensure that the care home was suitable to oversee the process.

The bill was also changed so that managers would no longer be responsible for notifying a local authority if an IMCA should be appointed.

Instead, the amended bill specifies IMCAs would be automatically appointed where there was no appropriate person – an informal advocate who would represent and support the cared-for person but would not be involved in their care, such as a family member – unless it would not be in the person’s best interest to appoint an IMCA.

Conflict of interest

Another government a


Source: Lords approves DoLS replacement bill following significant changes to boost safeguards for those detained | Community Care

Government pledges new Mental Health Act following review : Community Care

The government has committed to introduce a Mental Health Bill to transform care for detained patients after an independent review recommended new legislation that placed people’s rights, choices and dignity at its heart.

Following today’s publication of the final report of the Independent Review of the Mental Health Act 1983, the government accepted two of its recommendations:

  • to replace the nearest relative role, in which a patient is allocated a relative to be involved in decisions about their care, with that of a nominated person that they would choose;
  • to allow people to make statutory advance choice documents setting out their preferences for inpatient treatment, which clinicians must honour unless there are compelling reasons not to.

Both of these will be in the Mental Health Bill and the government will give more detail on the legislation and its response to the review in the New Year.

Four principle recommendations 

The review’s recommendations are designed to transform the law on the detention and compulsory treatment of people with serious mental health problems around four principles:

  • Choice and autonomy – ensuring people’s views and choices are respected.
  • Least restriction – ensuring the act’s powers are used in the least restrictive way.
  • Therapeutic benefit – ensuring people are supported to get better so they can be discharged from the act.
  • The person as an individual – ensuring people are viewed and treated as rounded individuals.

Unlike the current “guiding principles”, which are set out in the code of practice under the MHA, these principles would be on the face of the new act and professionals would be required to have regard to them.


Source: Government pledges new Mental Health Act following review : Community Care

Social workers ‘too often’ failing to apply Mental Capacity Act properly, says watchdog

One in five social care complaints made to the ombudsman last year involved concerns about the Mental Capacity Act or DoLS

Source: Social workers ‘too often’ failing to apply Mental Capacity Act properly, says watchdog

Five key steps to assessing capacity | Community Care

The process of assessing a person’s mental capacity is often misunderstood by social care practitioners as they seek to apply the principles of the Mental Capacity Act 2005 (MCA) and the lessons from case law. But help is at hand with the launch of a set of resources which aims to support practitioners improve their …

Source: Five key steps to assessing capacity | Community Care