Transcript Mental Capacity Act Deprivation of Liberty Safeguards Update

Mental Capacity Act
Deprivation of Liberty Safeguards Update
Adult Social Care Provider Forums
April 2010
Simon Purdy – MCA/DoLS Co-ordinator
DoLS – One Year On
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Urgent authorisations by managing
authorities – 109
Standard Authorisations requested alone – 2
Authorisations granted – 53
Authorisations not granted – 58
DoH projections – 1:4 assessments will result
in an authorisation
NHS Lincolnshire approx 15 requests
DoLS One Year On
East Mids third in table
nationally.
Lincolnshire second in table
regionally
DoLS One Year On
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Majority of authorisations relate to older
people, in residential homes, with dementia.
Learning disabled/autistic service users are
second most likely group to be authorised.
Average authorisation in Lincolnshire is six
moths.
Only one unauthorised deprivation of liberty –
this resulted in an authorisation once due
process followed.
When can you lawfully deprive a
resident of their liberty?
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In the residents ‘best interests’;
If it is a proportionate response to the
liklihood and seriousness of the harm
and
There is no less restrictive option.
Deprivation of Liberty –
the essentials
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Over 18 years old and assessed as lacking capacity to
consent to care and treatment in a residential or
nursing home;
Did the person consent to their move into your
service provision – or did their relatives ‘consent’ for
them?
Is restraint used (chemical, environmental, physical,
emotional)?
Is discharge to alternative accommodation being
refused – by the case manager or the care provider?
Deprivation of Liberty –
the essentials
 Is the person under continuous supervision and control –
ie ?? minute obs, 1:1 support, cannot go out unescorted etc.
Does the person lack insight into the risks of harm they
represent to themselves?
Has the person been ‘persuaded’ to move into the home?
Does the person make regular/repeated requests to go
home?
Does the resident make attempts to leave the home
What to Include in an Authorisation
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Patience – until you become familiar with the
forms, they appear quite intimidating. Take a
deep breath and/or ring or mail Simon, take
your time.
Bullet point the restrictions/restraints and
why they are necessary. Include summary of
what has been tried before.
Cross reference to care and risk plans and
send a copy.
Restraint – Don’t get tied up in
(k)nots.
It is not illegal, or a breach of human rights, to use restraint, however
you must know what restraint is.
“The use, or the threaten to use, force to make a person do
something that they are resisting or restrict a person’s movement,
whether they are resisting or not”. Code of Practice 2.8
Restraint is appropriate to prevent a person, who lacks capacity, from
coming to harm.
Restraint must be a proportionate response to the risk of that harm
and the likelihood and seriousness of that harm.
And Finally:
Don’t Panic Mr Mannering
The Deprivation of Liberty Safeguards are an important addition to the way
in which we protect very vulnerable adults. These are not without criticism,
but it is the best legal process we have and frames the use of restriction
and restraint, where appropriate, to manage complex care regimes.
‘If you think you may be depriving a person of their liberty……………… then
grant an Urgent Authorisation, and/or request a Standard Authorisation.
The assessment process is independent, does not cost you anything and
provides evidence that you have considered the complexities of the persons
care needs. If it not authorised, it has still not cost you anything, but you
have recorded evidence that you have been complaint with the Mental
Capacity Act 2005’. Paul Gantley – DoH National DoLS lead
Useful organisations and
websites
Lincolnshire County Council – Mental Capacity
Department of Health – Mental Capacity act Deprivation of Liberty
Safeguards – procedure, forms, guidance, resource materials
Social Care Institute for Excellence training materials, updates etc
Social Care Information and Learning Services – discussion, advice,
updates
[email protected]
Simon Purdy MCA/DoLS Co-ordinator– 01522-554205