2009 Ground Rules To support everyone’s learning: 1.Respect each other’s views 2.Only one person speaking 3.Keeping to time
2009 Introductions 1.Name 2.Who I support 3.The first record I ever bought.....
2009 Aim To provide Shared Lives Carers with an overview of the Mental Capacity Act (2005) and its implications for their practice
2009 Overview 1.What is capacity & lack of capacity 2.An overview of the Act and its principles 3.Who assesses capacity and how it impacts on Shared Lives Carers 4.The Shared Lives Carer’s role in contributing to the making of best interests decisions 5.Adult safeguarding & what constitutes wilful neglect & ill treatment 6.The impact of Lasting Power of Attorney and Advance Decisions/Directives on assessing and supporting people 7.Independent Mental Capacity Advocate - IMCA 8.Court of Protection and the new public official 9.Recording and reporting
2009 Mental capacity is the ability to make a decision, or take action, at the time the decision or action needs to be taken. ‘ Mental capacity ’ simply means our ability to be able to make decisions. What is Mental Capacity?
2009 The Implications for Shared Lives If I were temporarily incapacitated what would I want other people to take into account when making decisions on my behalf? 1.What would be important to me? 2.Who would I trust to make the small decisions? 3.Who would I trust to make the big decisions? 4.How would I want to be treated? 5.How would I not want to be treated?
2009 The Five Core Principles 1.A person must be assumed to have capacity unless it is established that they lack capacity. 2.A person is not to be treated as unable to make a decision unless all practicable (do-able) steps to help them to do so have been taken without success. 3.A person is not to be treated as unable to make a decision merely because they make an unwise decision. 4.An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in their best interests. 5.Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person ’ s rights and freedom of action.
2009 Assessing Capacity - Two Stage Test 1.Is there an impairment of, or disturbance in, the functioning of the person’s mind or brain? If the answer is ‘ yes ’ then the Mental Capacity Act 2005 can be used and we can move on to the second part of assessment. 2. Is the impairment or disturbance sufficient to cause the person to be unable to make that particular decision at the relevant time?
2009 What decisions can I make? 1.What decisions do I make or help people to make? 2.How might I involve them more in making decisions? 3.What concerns do I have about the decisions I make or support people to make? 4.What support might they need to make better decisions? 5.What support might I need to help people make better decisions?
2009 Best Interests Decisions 1.Best Interests Checklist 2.Functional Test: 1.Understand 2.Retain 3.Weigh Up 4.Communicate
2009 Acts in Connection with Care 1.Providing Care and treatment to people who lack capacity 2.The kinds of things SL Carers may support people with 3.The use of restraint 4.Protecting people from ill-treatment & willful-neglect 5.New criminal offence
2009 Deprivation of Liberty Implications for Shared Lives Carers
2009 Lasting Powers of Attorney Two different LPAs to cover a range of circumstances: personal welfare (including healthcare) property and affairs (finance) Who can be an attorney? family Friend professional, eg lawyer An attorney must be over 18 years old An individual can be an attorney for more than one person SL Carers should not normally act as attorneys
2009 The Court of Protection & the Public Guardian The MCA introduces two new bodies: the Court of Protection the Public Guardian
2009 Court Appointed Deputy What is a Court Appointed Deputy?
2009 Advance Decisions Advanced Decisions and implications for Shared Lives Carers Advanced Decisions and the right to refuse treatment
2009 Independent Mental Capacity Advocates (IMCA) IMCAs are a local service to represent the interests of: people lacking capacity when making a serious decision about medical treatment or a move, and in some adult protection cases, and if they have no one else to speak for them other than paid carers, and Their care is arranged by their local authority or NHS The IMCA has a right to information about the person who lacks capacity but is not a decision maker
2009 Research A person who lacks capacity to consent to taking part in research may take part, but researchers need to consult their family or carer, attorney or deputy, and do what they say the person would have wanted SL Carers should refer to the scheme to: make sure that the research has ethical approval stop the research if the person seems unhappy
2009 Safeguarding/Adult Protection Any adult lacking capacity can be considered a vulnerable adult SL Carers should follow the safeguarding/adult protection guidance from their scheme and in No Secrets (England) or In Safe Hands (Wales) and remember that: the lead agency is the local authority all agencies have policies and procedures covering safeguarding/adult protection
2009 Recording & Reporting Decisions about assessment of capacity and the making of best interests decisions must be recorded SL Carers will generally be recording best interest decisions in: The Service User file What kinds of decisions should be recorded?