The Mental Capacity Act in practice.
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.
The Mental Capacity Act (2005) provides two options to help us plan for the future and provide clear documented decisions in the case of deteriorating health.…
I’ve been involved with the field of Mental Capacity for many years now, both as an assessor and an advocate. In this time, I’ve encountered a whole range of common errors and mistakes that come up time and time again.
These errors can have a major impact on a person’s quality of life, and ability to make decisions for themselves. Not only that, but they also leave open the risk that if the Mental Capacity decision is ever to be challenged, then it will quickly be dismissed and overruled by governing bodies such as the Court of Protection.
However, thankfully, most of these errors are easily avoidable and simple to resolve with adequate reflection, preparation and the correct training.
There is surprisingly little information available on precisely how to complete a Mental Capacity Assessment. Having attended many courses on Mental Capacity in my time, it still surprises me just how many courses fail to set out what to ask, how much to record, what information is relevant and what to do next.
We often hear the words least restrictive practice, which we often associate with physical or medical restraint. However, an often overlooked area of least restrictive practice is placement, which is more easily thought of as where someone lives and the restrictions placed upon them.
The Mental Capacity Act (2005) provides protection to any individual who is deprived of their liberties in order to safeguard their health and wellbeing. It does this by establishing that all support be the least restrictive option; that any restriction in place must be proportionate to the need of keeping the individual safe, necessary in terms of all other lesser options have been attempted multiple times and lawful. By this, it must be justifiable if needed to be defended in front of the Court of Protection.
We all have a large amount of underlying assumptions or associations in all elements of our lives, which we are encouraged as working professionals to stop and reflect on in order to reduce the impact of these on our daily practices. Without this professional conduct we risk being biased, unprofessional, incur misunderstandings or cause offence. Whether it is surrounding age, gender, health conditions, political outlook, faith, religion, education or appearance.
From talking to colleagues, team members from different settings and other professionals across the board about the topic of the Mental Capacity Act and its Assessment, one of the most common stumbling blocks reported appears to be – where to start with an assessment, closely followed by the contents of completed assessments. It can leave some people feeling really overwhelmed and unsure of themselves, while others are thriving at the challenge, identifying ways to establish a “standard” for their own working environment.
When I first started working in healthcare there was very little said about capacity yet there was a lot of emphasis said about consent, especially that of informed consent. Consent to treatment, consent to an intervention, consent to support with personal care, consent to speak to a family member, consent to take photos, consent to store information or share with the GP. The list is quite endless and is a staple of not just the health care system, but our society as a whole that has grown in importance over the years.