The Mental Capacity Act 2005 Conference ‘a decade on, what’s right & what’s wrong’ On Thursday 30th March 2017, Local Authority DoLS & Safeguarding Adults Teams, Healthcare Professionals, carers and users of services from across the UK attended an informative and thought provoking Conference which addressed relevant aspects of the Mental Capacity Act 2005 ‘a decade on’ from the act coming into force on the 1st April 2007.

We are very concerned, by what we heard about safeguards. The evidence suggests that tens of thousands are being deprived of their liberty without the protection of the law. Worse still, in some cases the safeguards are being willfully used to oppress and force decisions upon individuals – Rt Hon Lord Hardie QC

Inside this edition  A decade on

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Speakers The conference which was jointly hosted by The Edith Ellen Foundation and Sponsored by Leigh Day Solicitors. The Conference brief along with the identified work streams is focussed on the delivery of responsibilities under the Mental Capacity Act and Deprivation of Liberty Safeguards. With an aim to utilise understanding to enhance service user and carer experience, complement existing service provision and provide sustainable outcomes across the local health and social care economy.

Conference Outcomes

The Conference was facilitated by The Edith Ellen Foundation who believe that the provision of outstanding care should be the objective of every provider; the receipt of outstanding care should be the right of every individual who needs it. The team of volunteers, are passionate about delivering training through drama and bringing subjects to life enabling positive change through the sensitive, sensible presentation of difficult issues. The Edith Ellen Foundation are passionate about the live experience, and so training goes beyond traditional presentation methods, bringing subjects to life for proven, measurable results. Throughout the drama delegates were encouraged to reflect on what was happening to service users and carers in each of the scenarios through discussion and questioning of the characters used.

Key Outcomes

Conference Theme Section 44 The Mental Capacity Act 2005

What is Right & What is Wrong? 5 Principles of the MCA The Law Commission IMCA Summary Summary & Evaluation Conference Photobook

Speakers Rt Rev David Bennet, Former Director of Trauma Centre UK delivered the opening address and welcomed the 200 plus delegates all of whom were Local Authority employees, NHS employees, Health Practitioners, IMCA’s, Carers and users of services from across the UK.

The Edith Ellen Believes  That there is no better way to understand the choices made by individuals faced with difficult circumstances than by seeing their stories unfold before your eyes.

Rt Rev David Bennett Introduced to the delegates to all the speakers, all of whom are at the forefront of their careers, working closely with the Mental Capacity Act and Court of Protection. Judge Anselm Eldergill – Court of Protection Judge – Residing over Court of Protection Cases such as “Shoah survivor who ‘felt like a prisoner’ in care, allowed home” and “Former Labour politician with dementia wins right to live at home”

Lynne Phair – Independent Nurse Consultant – Lynne is an Independent Consultant Nurse and Expert Witness for Older People. She has worked in the NHS, at the Department of Health and in the Independent Sector. She is the professional advisor for three care home companies, Specialist Advisor for CQC, Best Interest Assessor, Visiting Lecturer University of Worcester, Quality & Service Director for Abbeyfield South Downs, Consultant to the Crisis Prevention Institute and member of the Editorial Advisory Board of the Journal of Dementia Care and Journal of Adult Protection David Sheppard – MHA & MCA – Dave trained as a social worker and worked for 17 years in the social work departments of both inner city and rural local authorities – including 12 years as a Mental Welfare Officer and Approved Social Worker. He left social work practice in 1989 and worked for the next 3 years in the Legal and Parliamentary Unit of MIND before becoming a freelance trainer and consultant. In 1992 Dave co-founded, with Peter Edwards, a solicitor, the Institute of Mental Health Law which, for the next 20 years, was a major provider of specialist mental health law training.

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Len Lawrence – Medically Retired Airline Pilot - the harrowing story of one pilot, who was discharged by his airline as being mentally unfit and placed under a restraining order and medicated to the extent that he lost mental capacity. He was for nearly 18 months regarded as a mentally ill patient without access to the Court of Protection. A harrowing story of incompetence by the medical profession, who lacked knowledge of the symptoms following exposure to neurotoxins and the unfairness of the legal profession in not allowing him to see data concerning his own personal records in their reluctance to tackle those culpable. Mervyn Eastman – Dr Eastman is currently Chair of Positive Ageing in London, a member of the Development Group of the Age Action Alliance, a member of the Board of Trustees of Age UK London and of Age Concern City of London. Mervyn is also Co-Founder and Society Secretary of Change AGEnts Network UK Co-operative and Co-Founder and President of the Practitioner Alliance for Safeguarding Adults (PASA). Dr Eastman began his career in the late 1960s as a welfare assistant in East London. In the early 1970s he trained in social work (CQSW) and has worked in all fields of social care, much of which specializing in issues related to age and ageing. In 1997 he co-founded, and is now President of PASA, and following early retirement from the post of Director of Social Services for a north London Borough,

he became in August 2001 UK Director of the Government Programme, Better Government for Older People (BGOP), a post held until May 2009. Dr Rainer Kurtz - a Chartered Psychologist specialising in assessment. Rainer worked in Research & Development roles for leading test publishers since completing his MSc in 1990. His PhD dissertation was on enhancing the validity and utility of ability testing. Rainer developed 50+ psychometric tests and conducted pioneering research into computer-based assessment, leadership and competencies. He authored more than 100 papers, posters, articles and book chapters. At the BPS, he is the Science & Practice Convener of the DOP and a member of the Committee on Test Standards. Rainer has been investigating a chilling ‘Child Smuggling’ case since 2012. He has also supported other victims of overzealous child snatching by authority representatives where odds are completely stacked against protective biological parents. He has made more than 15 presentations on trauma, dissociation and healing as well as the politics of abuse and cover-up. Emma Jones - Emma Jones is a partner in the Human Rights team at law firm Leigh Day. She specialises in human rights and negligence claims including human rights claims arising out of treatment and care that individuals received in hospitals, care homes, detention centres or education settings and the abuse of elderly individuals, false imprisonment and assault claims and public law challenges. In 2009 to 2012 she worked on human rights claims arising from the Stafford Hospital scandal representing over 200 alleged victims at Stafford hospital. Emma joined Leigh Day in 2000 and qualified as a solicitor in 2002. She joined the mental health charity Mind in 2007 as their head of legal before returning to Leigh day in 2009. Emma is an accredited APIL litigator, a member of the Human Rights Lawyers Association, Association of Personal Injury Lawyers, a member of the Child Abuse Special Interest Group (SIG) and the NAS legal network group. Craig Hayes – Craig is a retired Veteran who built up his consultancy Training in bespoke Training Courses having worked for the MOD and IBM, Craig also brings the experience of running training for The Leonard Cheshire Foundation promoting a More Caring Approach. Craig brings to the Foundation over 26-years’ experience in Training and Consultancy and a vast understanding of bespoke Training from the Business and Care Industries.

Conference Outcomes The outcome of the event was to insight discussion, through a critical look at the Mental Capacity Act 2005 – a Decade on.

“Thank you for finding such compassionate speakers, who I believe were excellent in helping to convey their messages. I admit that when I attended the Conference I believed I had a good understanding of care and felt I could not learn anything I did not already know. I was wrong and it was your choice of speakers that opened my eyes. We need more Conferences like yours, not only to help our older people, but all of our most vulnerable

We believe that Leigh Day and The Edith members of society to get the care and the love that they deserve” Ellen Foundation achieved this objective, by helping Professionals to not only see through their own eyes but also through those of the Patients Forum, whereby the application of the Mental Capacity Act 2005 may not have been in the persons “best interest”.

We also looked into the Court of Protection, and how it has been used by professionals. Most importantly we learnt that there is not one standard to follow, each Local Authority is subject to its own understanding of the Act.

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A more professional approach is needed, throughout – a More Caring Approach.

Conference Themes

The Edith Ellen Foundation MCA Conference  The Edith Ellen Foundation, both educated and empowered delegates by delivering real life scenarios based on the following aspects of the Mental Capacity Act 2005 o

Key principles of the Mental Capacity Act o Lasting Powers of Attorney o Making Advanced Decisions o Assessing Capacity

The conference allowed open discussion about the Human Rights Act and the part this important legislation plays when applying the Mental Capacity Act 2005.   

To promote the Mental Capacity Act as it was intended to be used. To educate those who use the Mental Capacity Act and to promote “Best Practice” To celebrate the hard work of our professionals through their knowledge and skills and by sharing “experiences” to learn from “to provide engaging and interactive sessions that allowed for independent reading and conclusions.”

The Mental Capacity Act 2005 in its entirety and applied correctly provides a robust legal framework in England and Wales for decision making on behalf of people aged 16 or over who cannot make decisions themselves. It also sets out the law for people who wish to make preparations for a time in the future when they may lack capacity to make decisions.

Section 44 of the MCA From 13 April 2015, section 20 of the Criminal Justice and Courts Act 2015 applies to individuals such as doctors, dentists and nurses and it states: "It is an offence for an individual who has the care of another individual by virtue of being a care worker to ill-treat or wilfully to neglect that individual."

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the offence will apply to:  all formal healthcare provision for adults and children in both the NHS and private sector. It will not apply to some children’s settings and services which are subject to existing safeguards  all formal adult social care provision, in both the public and private sectors, including selffunded care  people and organisations paid to provide or arrange for the provision of these health and adult social care services, but the offence for organisations will be formulated in a different way to the offence for individuals The offences will not apply to:  the provision of any non-health children’s services (eg children’s social care)  informal caring arrangements where the care is not given as part of paid work  situations that are the result of a genuine accident or error

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any areas other than health care or adult social care health care provided for children or adults in some specified settings or services, such as schools or children’s homes

An individual may owe a duty of care to one another, to ensure that they do not suffer any unreasonable harm or loss. If such a duty is found to be breached, a legal liability is imposed upon the tortfeasor (the person that unfairly causes someone else to suffer loss or harm) to compensate the victim for any losses they incur.

The Mental Capacity Act During the day delegates were able to learn more about some of the difficult decisions and choices they as either carers or users of services may face. The scenarios provided delegates with an understanding of the key principles of the Act along with their rights to make advance decisions and Lasting Powers of Attorney. The use of group discussion and appreciative inquiry encouraged delegates to interact with each other and share personal and often emotional experiences.

“Very engaging and interactive that allowed for independent reading and conclusion, good atmosphere and stimulation of debates. The use of group discussion and appreciative inquiry encouraged delegates to interact with each other and share personal experiences”

Key Outcomes from the Day The Key Outcomes on the day highlighted divergence amongst NHS and Health Professionals and other Practitioners when applying MCA. There was a defined consensus of a need for:  Simpler Rules and Fast Track Procedures*  Improved Integrated Blending and Approaches to ensure consistent trust and safety in systems and procedures  Improved Enhanced and Robust Knowledge to protect the healthcare practitioner and patient care  Training and Clearer Standard Procedures to Understanding all the Principles of the MCA.  Openness in procedures and systems.  A more humane caring approach. To have trust, quality assurance and consistency at the forefront of any legal submissions and evidence based case information there should be a standard format for providing and agreeing all relevant information to the Courts of Protection; a clear audit trail and Barcode Systems on all documentation to clearly acknowledge people have been taken into protection.

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Families should be kept informed at all times where their loved ones are placed under the Courts or Protection for their own safety. Assessments should be maintained to a standard format which places an emphasis on enabling the individual person, and which shows  An honest and realistic appraisal of the individual case from all involved in preparing case evidence and the relevant documentation  Improved personal attendance and involvement

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Evidence each person touched by the MCA received all the relevant information necessary for the decision to be considered safe If they had a choice, evidence of what alternative information was given

More Awareness that there is a National Register for Police Specialists handling MCA Cases and National Trauma Criteria for Police Authorities to follow when dealing with MCA A belief in a more structured process for auditing the MCA Outcomes across all the different principles, including financial managements through the Courts. One to really understand whether it is working well for everyone Regarding outcomes from LPA should they be measured against the level of family satisfaction obtained in the process? Without exception, permission must be obtained for all decisions for Withdrawal of Treatments, (including DNR/CPR) from those that have the legal power to agree and consent must be formally witnessed by a third party.

“Information on any Advance Refusals of Treatment must be shared amongst all relevant integrated services and practitioners. Improved systems, procedures and guidelines introduced to record and agree the wishes of people were carried out.” There is an urgent need to raise more awareness through improved MCA communications which provide a timely knowledge of the updates with contents that are clearly structured for everyone to be able to understand. The lack of information on the pathways to follow shows clear guidelines should be considered to address how people in care and their families might be able to obtain their individual protection under the Court of Protection. Each case brought before the Court is complex, time consuming and costly, and some cases might be prevented if families were more closely embraced by care providers and health care practitioners as part of an acknowledged involvement in their loved ones’ care. As the Court of Protection is the final arbiter in relation to matters arising under MCA, it should be mandatory that where there is disagreement in decisions regarding withholding or withdrawal of artificial nutrition and hydration from patients and people in care in a persistent vegetative state or minimally conscious state, all cases are brought before the Courts. Care homes should have a duty of care to relatives as well as residents. “Should the Law not consider if residents in care homes should have a Tenancy Right Agreement similar to those who pay rent for any other type of accommodation?” With £557, 113, 627.24 being held on deposit for patients who were subject to the court of Protection, should the capital interest gained on secured money in the Courts of Protection not be used for better purpose- for those that would genuinely benefit from Legal Aid?

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Considered Discussions as viewed by Judge Eldergill on the day included: 1. Review issues of race and culture 2. Legally-qualified Solicitor to the Court and team leaders to improve case and file management techniques (OS model) 3. Appoint more specialist judges with relevant experience in the area 4. Consider case for transferring non-contentious work to the OPG

5. Consider dove-tailing CoP and MHT into a single Mental Health Court or provide transfer regulations. 6. Utilise the Mental Health Panel of Solicitors 7. Mental Health Commission in place of CQC Quote Dave Shepherd MHA&MCA Law: The Law Commission beliefs:  A compelling case for replacing DoLS.  There is a widespread agreement that the DoLS was over complicated and legalistic and offer failed to achieve any positive outcomes for the person concerned or their families  Article 5 must be practical and effective; it is not acceptable to continue with the current system under which many people’s rights have been theoretical and illusionary. The Law Commission Report recommended that  DoLS should be repelled and a new scheme introduced as a matter for pressing urgency.  The Bill that was drafted and attached to the Report recommended a replacement schemethe Liberty Protection Safeguards.  This Draft Bill would also amend other parts of the MCA to provide increased protection for people whose rights to their private and family life under Article 8 of the ECHR are at Risk, whether or not they are being deprived of their Liberty.

What is Right & What is Wrong with the Mental Capacity Act? Throughout the Conference the Theme was “What Is Right and What Is Wrong with The Mental Capacity Act 2005”, all discussions centred on the point that The Court of Protection sets out to ensure Justice prevails throughout all the various sections of the MCA and acts to safeguard the best practice interest of people who need robust justice and protection against themselves, or from people that might otherwise wish them harm when in care. Which we can all agree is What is Right with the Mental Capacity Act 2005 when used correctly and with the intent it was meant for. “The Principles of the Act which, when applied safely, correctly and consistently promotes MCA as a Standard Code of Practice which ensures protection for our most frail and vulnerable in society and gives them, and their loved ones, a voice.”

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During the Peer Discussion, it was established that the following is What is Right: Peer Discussions already taken place in the public domain have agreed a need to focus on further improvements in the MCA process, its documentation and outcomes which, if followed through will result in benefits for everyone. 1. Relevant section or detention papers not being seen or examined 2. Medical records not being examined, or no evidence to support the assertion that they had been examined Keeping up to date – MHA & MCA Law Ltd Issue 165 – October 2016 28 3. No evidence of written advice specifically tailored to the client’s situation; that is complete reliance on standardised correspondence 4. No evidenced attempt to check the Tribunal decision for legality 5. Where there is a conflict of interest demonstrated on a file, for example by acting for a party opposing discharge as well as for an applicant patient seeking discharge 6. In cases where the Nearest Relative had the power to discharge the client from section where no attempt had been made: a) To identify the Nearest Relative with the client b) Discuss with the client the Nearest Relative’s powers c) To seek the client’s consent to contact the Nearest Relative

Advanced Decisions One of the greatest successes of the MCA is the number of people taking advantage of Lasting Powers of Attorney. Giving families the legal right to Act in respect of Financial Affairs and their Personal Welfare, when their loved ones have lost Capacity. Advanced Statements of Care, which, going forwards, sets out the type of care individuals would wish to receive. Although not legally binding, this must be taken into account by anyone making decisions about other people’s care when interpreting their best interests, and is used as evidence of acting on behalf of their wishes values and beliefs. Advance Decisions and Powers- Restricted to Advance decisions that comply with the Code of Practice for people to refuse treatments before Mental Capacity is lost. Although Advance Decisions can be written or oral, Advanced Refusal will only be applied to life-sustaining treatment where it is signed and witnessed and contains a statement that it is to be apply even when life is at risk Section 44 Section 44 Gives families in care over 16 years the right to turn to the Courts for protection against any ill-treatment or wilful neglect of their loved ones in care, whether or not they have Capacity. “Key benefits - The new offences will benefit individuals in receipt of health and adult social care services by ensuring they are equally protected from ill-treatment or wilful neglect. It will also ensure that those responsible for the worst failures in care can be held accountable the associated sanctions may also act as a deterrent, reducing the number of incidents and leading to improved safety and quality of services for all.” The Court of Protection carries out much good work on a daily basis. It is the Care Order from the Court of Protections which defines the best interests where someone in care lives or not, or whether quality of care is being delivered. Human Rights Human Rights Act puts a legal duty on public bodies and officials to respect and protect the rights of individuals. Article 8 of the Human Right Act- A right to respect for One’s private and family life. Families may not be banned from a care home unless a Court Order has been obtained. Deprivation of Liberty Safeguards Megyeri Case: Detained patients are entitled to take court proceedings ‘at reasonable intervals’. The procedure must have a judicial character and provide guarantees appropriate to the deprivation. They should have access to a court and the opportunity to be heard in person or, where necessary, by representation. They cannot be required to take the initiative in obtaining legal representation before having recourse to a court. They should receive legal assistance.

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“Every effort should be made in both commissioning and providing care and treatment to prevent deprivation of liberty. If deprivation cannot be avoided it should not be for longer than necessary”. The Court of Appeal recently considered the issue of deprivation of liberty in the context of conditional discharge and compulsory treatment orders under the Mental Health Act 1983 in The Secretary of State for Justice v MM and Welsh Ministers v PJ. Its long awaited decision provides clarity on the role and powers of the tribunal and responsible clinicians to place conditions on a patient. -Article 5 European Convention on Human Rights provides a fundamental right to liberty, which cannot be removed without a clear authority. The MHA provides no power for a tribunal to detain a patient or deprive them of their liberty outside of a hospital. Where patients are consenting to supervision in the community, there is no power to impose a DoLS outside of a hospital. The court identified that the

MHA provides safeguards for a patient, that are compatible with the ECHR. Further, the court was clear that any challenge to the legality of a CTO should be made by way of a judicial review.

The conference also discussed What is Wrong, to enable a full open and honest discussion by comparison to What is Right. “In the main, as with any Legislative Act and appropriate Guidelines it is very detailed and sometimes even the professionals using the Law find it difficult to apply with consistency because of the Human Factor involved.” Setting out to protect frail and vulnerable people Making a Best Interest Decision can be emotive and difficult if it is not always communicated in an appropriate way, or in an appropriate place, or insufficient time is given to people to make them feel at ease. Assessments might be carried out without taking into account the recognition that a person’s Mental Capacity may fluctuate and their impairment might only be temporarily. Decisions can be taken in haste when they might have been deferred to see whether the person can make the decision at a later time when circumstances are right for them As there is no consistent process in the Courts of Protection for recording the number of people, or those being monitored of people in the Courts of Protection at any time, and it would appear little comprehensive analysis of effective outcomes, Regulation of the Court of Protection might be seen as ineffective. “Judges rely on information being provided in individual case notes as there is no official documentation to automatically show people have been placed under protection custody.” Judgement in any Court relies highly on the accuracy of the information being given in the individual cases. However, a study by Professor Jane Ireland, a forensic psychologist, for the Family Justice Council examined 126 psychological reports trawled at random from family court documents. It found that two thirds of them were “poor” or “very poor” in quality. Poor practices by over-zealous therapist can potentially damage incorrect evidence given to the Court, particularly in highly sensitive cases like sexual abuse, as they might induce false memories in people when they have been abused. It is difficult to redress any actions where professionals have failed to discharge their duties appropriately. There are no clear pathways for people to follow and anyone who has now recovery their Mental Capacity, are not always able to see their files, or to be in a position to recover their secured financials. Concerns that LPA are a loose translation with no real safeguards, Transparency is needed and a more robust approach taken by all Local Authorities, using one standard. 66% of DNR/CPR forms across the UK are signed off without consent of people with Mental Capacity or from their Legal Guardians. Without such involvement, Advance Decisions might be perceived as a fine line to refusing basic care for loved ones.

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It would appear in emergency situations, some Health Practitioners, (particularly First Responders and Ambulance Crews), might experience a conflict of people’s interest when faced with need to apply DNA/CPR if it may not be the kinder option for that particular individual.

It would appear that some Health and Social Care Practitioners are not always kept up to date on changes within the MCA. It was felt that Updates on the MCA were not always received in timely bulletins which aids a clear understanding of the Key Issues and changes. Pathways for individual people looking to access redress in the Court of Protection can be confusing for themselves and their families. It can be difficult for people to know where to start and what the process will be. When cases are brought into the Court of Protection, it is a difficult decision to make, when everyone has an opinion on what is the best level of individual care for that person. There is, however an element of mistrust by families that they are not listened too when they raise concerns their loved ones are not being safeguarded or when their loved ones are issued with a ”Notice To Quit” by a care home. Although a Criminal Act for Prosecution if people are ill-Treated or Wilfully Neglected it would appear that not everyone is aware of Section 44 and the Involvement and the responsibilities of The Court of Protection when outcomes cannot be resolved by other means. It might be seen that so far it has not been possible to quantify the benefits of Section 44. An appropriate right to protection only applies to Public Body care but does not provide for families that are cared for under Private care companies. It unfairly precludes protection for those individuals that are struggling to meet part funding care cost. There is inconsistency in the way public money for legal representation is allocated and equality of arms under the current legal aid system. When people are faced with detainment under the Courts, Access to pathways which would benefit people’s involvement in their own Court cases are limited if people are expected to find their own costs and court fees in order to speak.

The Law Commission Mental Capacity and Deprivation of Liberty Presented to Parliament pursuant to section 3(2) of the Law Commissions Act 1965 Ordered by the House of Commons to be printed on 13 March 2017. In response to the Consultation paper the DolS was criticised as an administrative and bureaucratic nightmare. It also confirmed that DoLS was not capable of dealing with the number of people considered to be deprived of their Liberty following Cheshire West. A number of responses from families described how destressing and confusing the process had been for their loved ones. Hospital clinicians believed the process delivered no tangible benefits to patients care plans, particularly in intensive care units, or at end of life care.

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Consultants generally described the language adopted by DoLS best as unhelpful, and felt it out of kilter with the empowering philosophy of the MCA. NHS Bodies and Local Authorities pointed to the financial and practical out comes from Cheshire West such as increased backlog of cases; referrals for authorisations being left unassessed; the legal timescale for authorisations being frequently breached and shortage of people qualified to perform roles under DoLS provision. thus, the Commission believed that any notion of DolS being patched up, even in the short term is unrealistic.

Many Local Authorities are not even considering applying for authorisation of Deprivation of Liberty in cases outside of hospitals or care home settings, or involving 16-17 year olds where the DoLS does not apply.

Additional Support for Social Care Users: Independent Mental Capacity Advocates Summary The Mental Capacity Act provides for a role of Independent Mental Capacity Advocate (IMCA). The IMCA provides an independent safeguard to support: o

particular vulnerable people who lack capacity to make important decisions AND

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who have no-one to appropriately consult regarding certain decisions.

Best practice for IMCA is to remember that people come first – for the Norfolk area we have POhwer. POhWER has been working in Norfolk since 2003, and in the last year alone have supported over 1300 clients in the county, they work in partnership with Age UK and Equal Lives to support people in Norfolk. Additional IMCA’s can be found here for your area http://www.scie.org.uk/mca/imca/find/ IMCAs are a safeguard for people who lack capacity to make some important decisions. The IMCA role is to support and represent the person in the decision-making process. Essentially, they make sure that the Mental Capacity Act 2005 is being followed. The IMCA service that is used is generally the one covering the area in which the person is currently staying (including if they are in hospital).

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IMCAs can only work with people who meet the criteria set out in the Mental Capacity Act (MCA) and the Expansion Regulations. They cannot start working with individuals until they have been instructed by an appropriate person as set out in the MCA, (for example, a doctor who has to make serious medical treatment decisions). For this reason, IMCA services can only accept referrals from specific people. However, if you feel someone should be referred to an IMCA, do contact your local IMCA provider who may be able to help

Reminder of the 5 Principles of The Mental Capacity Act Delegates were given “sna-fooz” puzzles with all 5 principles of the Act on. Delegates worked together to complete the puzzles during one of the workshops which they took away as a reminder from the day. Feedback and comments from delegates included requests for further literature for future reference. This was responded to and circulated to all who attended. By way of a reminder reference from the Code of Practice and the 5 principles are detailed below........

Section 1 of the Act sets out the five statutory principles—these are the values that underpin the legal requirements in the Act. The Act is intended to be enabling and supportive of people who lack capacity, not restricting or controlling of their lives. It aims to protect people who lack capacity to make decisions, or to participate in decision making as far as they are able to do so. (Mental Capacity Act 2005 Code of Practice)

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 steps to help him to do so have been taken without success 3. A person is not to be treated as unable to make a decision merely because he makes 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 his 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

“As a service user, I learned today that the MCA can be used by me to advocate for my choices, before today I assumed it was something to be used against me”

“Very engaging and interactive sessions that allowed for independent reading and

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conclusions”

Delegates enjoyed the excellent aid memoire puzzle on the 5 Principles of the Mental Capacity Act, additional puzzles are available to purchase for £3.00 http://edithellenfoundation.blogspot.com/2017/03/5-principlesof-mental-capacity-act-puzzle.html Each side holds a description on the 5 Principles and is suitable for sitting neatly on your desk.

Summary and Evaluation Delegates were invited to leave a feedback form from the day with comments. In addition to this a guest book was used to gather user and carer feedback, some of which are included in this newsletter. The comments and feedback will be invaluable when planning future events and services so thank you to all who took the time to leave feedback and comments. In conclusion based on the feedback received the day was a huge success with positive and constructive comments received from delegates in attendance. Furthermore, this success will be complemented through the delivery of locality based Mental Capacity Act awareness training for care professionals during 2017 and beyond. These sessions aim to provide those who assist people in making decisions with an awareness of their legal duties in line with the Mental Capacity Act and justify their decisions to best practice standards. For more information about the Mental Capacity Act, roles and responsibilities please visit http://www.justice.gov.uk/about/opg For copies of the Conference Handouts, from the speakers please visit The Dementia Mummy Blog, our volunteer Run Blog https://edithellenfoundation.blogspot.co.uk/ copies of the handouts will be available under the Quick Links: Handouts or Mental Capacity Conference 2017 Additional copies of the Consent Poster are available to purchase at a cost of £17.99 details are from [email protected] poster is A2 Additional Snafooz (puzzles) with the 5 principles of the Mental Capacity Act are also available at a cost of £3.00 details from [email protected] The conference was using #MCA17 on Twitter a Twitter “moments” has been created here: https://twitter.com/i/moments/847908096357924865

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Thank you to all who attended and for all the feedback provided we hope to see you at future events The Edith Ellen Team

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Conference Photobook