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Comment on legislation, case law, and relevant stories relating to Mental Capacity and the care of vulnerable people.

Mental capacity assessment: female professional assessing elderly gentleman

Reflecting on changes to the MCA Code of Practice (Part 1)

The UK Government has launched an open consultation around changes to the MCA Code of Practice and implementation of the LPS. The consultation document is available for anyone to access and can be downloaded in a number of different formats, including a draft version of the new Code. Professionals are encouraged to read the document(s) as appropriate and feedback via online forms. There is no requirement to study the complete set of proposals in order to take part.

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Consent to treatment: patient preparing for an MRI scan

Using LEGO to support capacity and enable informed consent

LEGO has launched a new kit designed to help ease children’s anxieties around using an MRI scanner. This fantastic toy helps bridge the gap in understanding around what is going to happen, putting the process of an MRI scan in terms that a child can understand, facilitating their comprehension and thereby reducing anxiety around the whole process.

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Supporting capacity with augmentative communication aids

Supporting capacity with augmentative communication aids

There are many different forms of communication, both verbal and non-verbal in nature. While many of us will take communication for granted, others need a little more support. Thankfully there are a range of relatively low-tech aids available to support those with complex communication needs. These include Makaton, PECS and Talking Mats – all of which are put to good use across education and healthcare settings to promote inclusion and person-centred care.

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Isolation and seclusion: old man looking out a window

Covid ‘isolation’ or seclusion: Are we in breach of Human Rights?

  • Comment

It has been a trying few years for everyone with the impact of Covid and related restrictions. During this time, I have been privileged to see some incredible person-centred care. For example, one of the homes I have worked with went above and beyond to ensure that an isolating gentleman with learning disabilities, who had tested positive, had a staff member at his door throughout the day to engage with him and give him someone to talk to. They also supported him by doing activities at a distance and he had thrice-daily supported access to the gardens to get fresh air and a change of scene.

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Central Middlesex Hospital, part of London NW University Hospital Trust

Patient dies as NHS Trust fails to comply with the MCA

On the 29th December 2021, Jenny Kitzinger and Celia Kitzinger shared a challenging and troubling case on the website Open Justice Court of Protection.  This case demonstrates the lack of knowledge and application of the Mental Capacity Act (2005) by London North West University Healthcare NHS Trust, who continue to be rated as ‘Requires Improvement’ by the Care Quality Commission

In this case, the patient, Mrs W had her nasogastric tube removed by medical staff on 10th November 2021. Mrs W had previously assigned the role of Lasting Power of Attorney (LPA) for Health and Welfare to her children. However, her children were not consulted in this process, and the clinicians declined to reinstate the feeding tube when challenged. The Trust then proceeded to withdraw hydration from Mrs W as well.

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Holding hands

What is a Relevant Person’s Representative (RPR)?

A Relevant Person’s Representative (RPR) is a necessary and essential role under the Deprivation of Liberty Safeguards (DoLs). It is the role of the RPR to maintain regular contact with the relevant person who has been deprived of liberty, and represent them in all relevant matters. This can include: appealing against a DoLs authorisation, requesting a review, ensuring least restrictive practices are in place or raising a complaint.

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Lady with emotional disabilities using pet therapy

Impact of LPS on supported living

  • Comment

In recent years, the Courts have recognised the growing number of areas to which Deprivation of Liberty Safeguard (DoLS) should apply, with the result being that Community Orders have been added to the DoLS process. Yet still there has been gaps where people have not had capacity to consent to their placement and care, yet not had an authorisation requested or considered.  

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