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Home » Reflecting on changes to the MCA Code of Practice (Part 8)

Reflecting on changes to the MCA Code of Practice (Part 8)

Monitoring body: healthcare professional writing report at computer

In the eighth part of our ten-part blog series, we examine proposed changes to the MCA Code of Practice surrounding the monitoring and reporting powers to promote safeguarding of those under the Act.

Monitoring and reporting on the LPS

Under proposals in the draft Code of Practice, organisations such as CQC, OFSTED and Health Inspectorate Wales are to be referred to as Monitoring Bodies, and have a statutory duty within the LPS process to monitor and report in order to reduce risks of misuse, neglect and abuse.

Responsible Bodies must update the Monitoring Body on a regular basis when an LPS is triggered, and must report whether an authorisation was granted, including relevant related details. Specific timeframes are suggested with a six-month starting basis on implementation, moving to a quarterly review within initial government shared information, however this does not appear to be clear in the proposed Code of Conduct.

Under the new system, Monitoring Bodies have the power to visit locations where an individual is being held, meeting with the person under authorisation as well as those who care for that person, as well as access to associated records to review. These visits will be carried out alongside normal inspections, following the same periods of notice etc.

As well as providing a much-needed extra layer of protection for individuals who have been deprived of their liberty, the Monitoring Bodies will also publish annual reports on the LPS, including trends that develop over time. It is hoped that this reporting will help improve the process over time, and will help identify key areas for improvement.

Unanswered questions

As professionals, it is good practice to critically reflect upon our work, both formally and informally, ensuring standards are consistent and best practice is upheld. With additional formal monitoring by external bodies, it may well prompt further preparation, research and application of the MCA and LPS, which should (in theory) lead to better outcomes. It should also hopefully reduce risks of abuse that appear all too frequently in the news.

However, this does raise the question of just how other settings will be monitored and supported in their application of the Mental Capacity Act. This includes those settings that don’t already have regular reviews by Monitoring Bodies, such as perhaps private hospitals, shared living, or individuals’ private homes. It is implied it may be the Local Authority, however I do not feel this is clear.

Questions include:

  • What safeguards are in place to support them?
  • Will an IMCA and AMCP definitely be allocated to support and protect?
  • Will other schemes be introduced?
  • How quickly will these wider settings be supported to apply the LPS appropriately?

I have already included these questions in my own detailed feedback to the Code of Practice consultation, and encourage readers to also share their views.

Training and support

The Mental Capacity Act and supporting Code of Practice are both detailed, complex documents, and we cannot cover everything in the space of a few short blogs. If you have any questions, we are more than happy to discuss any of the issues here in more detail. We can also provide training, consultancy and assessments to support you in your application of the MCA in practice.

In the final two blogs in our series, we will look at the new wider age range the LPS will apply to, and will look finally at the other legal tests of capacity.

As ever, your thoughts and feedback are more than welcome.

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