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Support for RPRs

Supporting capacity with augmentative communication aids

An RPR is a vital role under the Mental Capacity Act (2005), supporting an individual’s inclusion and rights around their Deprivation of Liberties (DoLS). This role is often filled by an unpaid family-member, friend or partner. However, if a family-member, friend, or partner cannot be identified, the supervisory body is required to refer for independent advocacy to complete this role as a paid (professional) RPR.

When I started work as a professional RPR, I was provided with shadowing opportunities, signposted to study resources and had regular supervisions until my skillset was secured. This was supported by my education and training within the healthcare field. But what help is available for family, friends and partners assigned to the role of RPR? What training or information are they provided?

In this blog, we look at what an RPR does in practice, recognising the support available to unpaid RPRs, while also signposting resources and providing general good practice guidance for taking on this important role.

RPR in practice

The practical responsibilities of an RPR are to:

  1. Ensure the relevant person is aware of their rights; to listen to their voice and recognise their wishes; to promote their inclusion in decisions around areas of deprivation.
  2. Monitor any areas of deprivation or restrictions, checking they are the least restrictive option in line with best interest, asking questions or raising concerns if needed. This may include checking appropriate Mental Capacity Assessments and Best Interest Decisions have been completed, requesting that they are carried out if required.
  3. Request a DoLS review then raise a 21a CoP case if there is either a clear and consistent objection or a reasonable belief of objection regarding the care and treatment arrangements from the relevant person, helping them access legal support as required. Note that (at the time of writing) Legal Aid is still available for those raising a CoP 21a challenge.
  4. Request a care review if there is observed to be a change in need.
  5. Raise safeguarding concerns if needed.

To complete these tasks, an RPR should be in regular contact with the relevant person, taking time to engage with them on a meaningful level, grading communication as required and supporting their voice. Ideally, these contacts should be face-to-face rather than online.

An RPR should further have a basic understanding of DoLS and a person’s rights, including their own rights in being able to access information and knowledge, and the  appropriate people to contact and liaise with if required. This includes access to the relevant person’s care plans, behavioural charts and DoLS paperwork, as well as speaking with care staff who work alongside the relevant person.

Most of all, an RPR needs to put aside their own personal outlook on what they feel would be best for said person. This includes raising any challenges to the authorisation if an objection is raised, or even if there is a reasonable belief that the individual objects.

Support for unpaid RPRs

In a standard DoLS authorisation where the individual has an unpaid RPR in place, a section 39D Independent Mental Capacity Advocate (IMCA) can be assigned to support the RPR with their role. This can be done on request, or if the supervisory body feels that this would be of benefit. From which a 39D IMCA is then instructed to work alongside the RPR, building their knowledge, confidence and skills around this role for a set period of time.

There are many benefits to having a 39D IMCA assigned to a case. The IMCA can be particularly useful for someone new to the role of RPR to ensure they are aware of their rights in terms of accessing information, what they need to discuss with their relevant person and the placement, as well as what to look for in terms of deprivations and objections. It can also be of assistance if their relevant person is objecting in any way to their care and treatment, working alongside them to request a DoLS review and escalating to the Court of Protection (CoP) if required.

Online resources

In addition to the support of an IMCA there are also a range of useful resources available online that provide guidance around the role of an RPR. These include:

  • Social Care Institute for Excellence – a range of resources that give a very informative overview of the Mental Capacity act, including the role of an RPR and IMCA.
  • Department of Health and Office of the Public Guardian Guide – perhaps one of the more detailed yet accessible guides that looks at the whole role of an RPR in context.
  • Stop adult abuse – a larger, friendlier, easy-read guide that supports explanation of the RPR role, identifying rights and responsibilities. This can be useful to use alongside the Relevant Person to explain their Rights and your role.
  • Research in Practice for adults – a very useful guide explaining what is a RPR and gives practical advice.
  • Simply Social Work – a summary of what an RPRs responsibilities are, linking to case law guidance in accessible points. When the writer refers to ‘P’, this is a both a legal and healthcare short hand for the relevant person, the individual at the centre of care.

Forthcoming changes to the role of RPR

The role and responsibilities of an RPR are a statutory requirement under the Mental Capacity Act (2005). However, there will soon be a new MCA Code of Practice (date as yet unconfirmed). When the Code is finally published, DoLS will be replaced with Liberty Protection Safeguards (LPS). Under these updates, the RPR role remains, but will be renamed as the Appropriate Person. This will not include an option for a paid Appropriate Person if none can be identified. Rather, under the new Code of Practice, a full IMCA will be appointed to fill this role, providing a higher level of advocacy input during an authorisation. 

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