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.
Why is this role important?
“This is a crucial role in the deprivation of liberty process, providing the relevant person with representation and support that is independent of the commissioners and providers of the services they are receiving.”
Code of Practice (2008)
An RPR is assigned to be an impartial, independent voice for the individual who is under a DoLS. The RPR role may include supporting the relevant person to raise objections surrounding their placement, care and restrictions in place, upholding their Human Rights (article 5) and providing a safeguard to reduce risks of unnecessary deprivations, restrictions or restraints.
By supporting the relevant person to raise a objection or make a complaint, the RPR is able to support their right to be heard. It is then down to the DoLS office to review the case following direction of a Form 10, a care review if required and a Court of Protection challenge to be raised by the RPR if they continue to object.
Who can be assigned as an RPR?
At the time or writing, and in accordance with the Code of Practice an RPR must be:
- 18 years of age or over.
- Able to keep in contact with the relevant person.
- Willing to be appointed.
The person must not be:
- Financially interested in the relevant person’s managing authority
- A relative of a person who has a financial interest in the relevant person’s managing authority
- Be employed by, or providing services to, the care home in which the person relevant person is residing.
It is the responsibility of the Supervisory Body to ensure this role is assigned, often being a part of the Best Interest Assessor’s role, working with the relevant person (if they are able) to select them. If there are none available or said person(s) decline, then a paid RPR may be brought in through a local advocacy organisation.
Note: the role or RPR is an addition to the Next of Kin, Nearest Relative or Lasting/Enduring Power of Attorney.
Choosing an RPR
The Code of Practice provides the following questions to help decide who should be allocated as RPR:
- Does the relevant person have a preference?
- If they do not have the capacity to express a preference now, is there any written statement made by the relevant person when they had capacity that indicates who they may now want to be their representative?
- Will the proposed representative be able to keep in contact with the relevant person?
- Does the relevant person appear to trust and feel comfortable with the proposed representative?
- Would the proposed representative be able to represent the relevant person effectively?
- Is the proposed representative likely to represent the relevant person’s best interests?
Within these questions, the Code highlights the fact that the RPR needs to be able to complete the role effectively and in the relevant person’s Best Interests. However, it is also important that the RPR does not let their own judgement sway their decisions. Indeed, the RPR should put aside their personal thoughts or opinions on a matter and look at a situation from the relevant person’s perspective, taking into account any voiced, behavioural or observed objections they may make.
What does an RPR do?
An RPR is responsible to make regular contact with the relevant person under authorisation, as well as liaising with those who are responsible for their care and support. An RPR should discuss and review their levels of support considering proportionate least restrictive practices across all areas of daily living, while further searching for any presentation that indicates objection.
Objections to DoLS
If any objection is identified (whether verbal, physical or behavioural) then a Form 10 should be submitted to the DoLS office who will complete a review, alongside requesting a Care Review if no recent review has been conducted. After which, if no change in objection is noted, then a Challenge 21 to the Court of Protection is initiated. As Lady Hale observed within the Cheshire West case, “A gilded cage is still a cage”, and each person, no matter their cognitive or functional ability has the same rights as another. Therefore, whether in late stage dementia or cognitively impaired following a brain injury, if they are politely voicing or screaming incoherently and rattling the doors, these are both legitimate signs of objection and should be treated as thus whether or not the placement is a “good fit” and has a Best Interest assessment in place.
Challenges to the Court of Protection
Misconceptions I have heard over the years regarding a 21a challenge to the Court of Protection, have included concerns that it might be a judgement on the placement and support or will most certainly result in a placement change with family worrying over the implications. Rather, a challenge to the Court of Protection is Best Practice, to ensure the relevant person has their active voice heard within this process, to ensure their Rights are upheld and the least restrictive practices are in place, safeguarding them and the decisions that have been put in place. The Court of Protection will explore all reasonable, proportionate alternatives, in a rigorous and thorough process.
This challenge may result in a number of outcomes from change of placement to a small change in the care plan, increased 1:1 support to facilitate de-escalations or community access, or even just a recognition that all alternatives have been tried and that the current placement is the most appropriate option at the time. Whatever the outcome, it is best practice to follow this process, keeping positive professional communication with all relevant parties throughout.
Other tasks
Alongside making challenges to the Court of Protection, an RPR should be vigilant for any areas of need that other services should be signposted to, whether for a care review, other advocacy services, a specific care requirement, or need for safeguarding. These are all part of an RPR’s duty of care.
Useful resources
There are a number of useful resources available that explain the role of an RPR in different formats. These may be of use to help explain the process to the relevant person, family and friends, care homes or other relevant professionals:
- Deprivation of Liberty Safeguards Code of Practice (CQC)
- Deprivation of Liberty Safeguards (ageuk.org.uk)
- IMCA and paid RPR roles in the Mental Capacity Act Deprivation of Liberty Safeguards (scie.org.uk)
- DoLs: A guide for RPRs (Stockton-on-Tees Borough Council)
You can also see our blog post: Support for RPRs.
Changes with the Liberty Protection Safeguards
According to the government’s online factsheet, once the new Liberty Protection Safeguards (LPS) come into force, replacing DoLS, the RPR is to be known as the Appropriate Person, whose role is key “in securing the person’s views, wishes and feelings about their care, treatment and support.” This implies a widening of the responsibilities of the Appropriate Person, overlapping with roles under the Care Act and Mental Health Act. It remains a role that will normally be fulfilled by a family member or through a volunteer from the third sector organisation.
Government guidance around the LPS also specifies that an Independent Mental Capacity Advocate (IMCA) can be assigned to support the Appropriate Person if required or take on this role if no other Appropriate Person can be identified. It goes on to stipulate that there will be “a presumption that an IMCA should be appointed if there’s no appropriate person”, who must be referred to by the Responsible Body (placement of residence).
From a professional perspective, this is highly encouraging, as it will help put in place safeguarding measures to uphold the person’ rights, supporting their voice in their placement and care, showing good practice. It then ensures the most appropriate person is allocated with support of an IMCA if required.
For further updates, please refer to the UK government website.