Skip to content
Home » Comment » Page 5

Comment

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

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.

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.

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.  

Elderly couple sat together looking out to sea

Least restrictive practice: What does the Mental Capacity Act say?

If someone were to say “we can’t go out there at the moment, shall we have a cuppa we wait” or  “sorry, it’s dark outside so garden’s not open until to 8am”, be provided with a medication to sedate or calm as a medical restraint such as promethazine or lorazepam, be secluded to a certain area to keep their dignity if undressed or be restrained in their best interest once all other alternatives have been trialled repeatedly, these are all forms of restrictive practices and restraint. No matter how cooperative or accepting of the support provided. They are different forms, different levels, but all restrictive, affecting a person’s freedom of movement and choice through limiting access, provision of sedative medication, seclusion or restraint.

Mental Capacity: Elderly lady watching video supported by nurse in mask.

Accessibility in a digital age

  • Comment

Equal access for all has been a standing call for social inclusion and disability rights activists for many years. Ramps have been custom built for venues, alternate access routes established, consideration of visual distinguishment on steps for those who are visually impaired added, contrast colours established on posts and lifts put in amongst many other elements to ensure everyone can physically move as freely as possible.