Agenda item

The Director of Adult Social Services submitted a report to inform Members of the implications associated with the implementation in Leeds of the Mental Capacity Act 2005 and it also outlines the requirements of the Deprivation of Liberty Safeguards (DoLS) which are incorporated into the Mental Capacity Act 2005, which also feature prominently in the implementation of the Mental Health Act 2007.

The Chair welcomed the following Officers to the meeting who outlined the report and responded to Members’ questions and comments:-

Dennis Holmes – Chief Commissioning Officer

Dave Shields – Service Delivery Manager (Adults)

Members noted that the Mental Capacity Act 2005 was based on the following five key principles:

(a)  A presumption of capacity.

(b)  Right of individuals to make their own decisions.

(c )   Right not to be treated as lacking capacity merely because of unwise or   eccentric decisions.

(d)  Needs to ascertain what is in the best interests of the individual.

(e)  Least restrictive intervention.

The Board was advised that the Act was a wide ranging piece of legislation potentially affecting the lives of many thousands of citizens in Leeds and the main provisions were aimed at protecting the interests of the most vulnerable people in our community.  The Board was also advised that the main provisions of the Act set out in the report that were introduced since 2007 were:

·  Independent Mental Capacity Advocacy (IMCA) Service becoming operational.

·  Two new Criminal Offences are introduced of ill treatment and wilful neglect.

·  Capacity Defined, the Act sets out the criteria for assessment, and codifies existing Common Law it also sets out a clear decision specific test.

·  Best Interest Checklist – the Act provides a checklist that decision makers must work through in deciding what is in the person’s best interests and how to decide this.

·  Acts in connection with Care/Treatment (‘Section 5 Acts’).  For the first time there is law to protect carers, healthcare and social care staff from liability when acting in connection with care or treatment for those who lack capacity under Section 5.

·  Lasting Powers of Attorney (LPA’s) appointed in advance by someone if s/he should lose capacity – able to make health and welfare decisions as well as property and affairs if authorised.

·  A new Court of Protection  - the new court will have jurisdiction relating to the whole Act so its remit includes social are and health decisions when appropriate.

·  A new Public Guardian – who will supervise Court of Protection deputies and powers of attorney, and work with all agencies in relation to any concerns with these roles.

·  Court Appointed Deputies (to replace receivership’s) – this structure replaces current receivership and deputies are able to make welfare, financial and most health decisions as authorised by the Court.

·  Advance Decisions (formerly known as Advance Directives or Living Wills) – there will be statutory rules with safeguards and strict formalities so that people can make an advance decision about refusing medical treatment.

·  Research Issues – there are very clear guidelines that protect the person who lacks capacity.

·  Deprivation of Liberty Safeguards (DoLS)which are incorporated into the Mental Capacity Act and which also feature prominently in the implementation of the Mental Health Act 2007.  The safeguards create two new legal entities:

-  Managing Authority (Care Homes/Hospitals) who provide care and must request authorisation to deprive the liberty of an individual who

  may be deemed lack of capacity.

-  Supervising Bodies who may organise assessments and issue   authorisations if assessments require them to do so.  Leeds Adult   Social Services will undertake both functions which will require   appropriate processes, governance, management and operational   arrangements to be put into place to assure the independence of decision making. 

A brief overview of the key points detailed within the report was provided and the main areas of clarification and discussion were as follows:-

·  The process for deciding that a vulnerable person is in need of support.  In response, the Officer reminded the meeting that anyone applying for support would automatically be referred to the ‘Best Interest Assessment Unit’ who work on behalf of the person in need of support.  The assessment tests are far more thorough and cases are now better recorded and regularly reviewed as individual circumstances are known to change frequently. 

·  The process when vulnerable people are in need  of assistance in handling their finances. 

  In response, the Officer reminded the meeting that there are new Powers   of   Attorney and care protection governing finance and other aspects of   care. 

·  The need for accredited training on the Mental Capacity Act 2005 and clarification on when the local authority would implement this training.

In response, the Officer informed the meeting that a whole range of training was being implemented and supported by Adult Social Care.

Arrangements were also being made for training within various partner organisations such as Leeds PCT and the Police Authority, including the use of e-learning packages. 

·  How the general public would be made aware of the implications of the Mental Capacity Act 2005. 

·  In response, the Officer informed the meeting that there have been an extensive range of materials provided by the Department of Health (DoH) which can be accessed through the Council’s website.  Members were also advised that raising public awareness was a longer-term issue and would include a range of service user/ carer events.  A specific government grant to help to raise awareness had also been made available.

·  Implications of the Act on locked doors/wards in Care Homes and Hospitals.  In response, the Officer referred to the Deprivation of Liberty Safeguards and informed the meeting that under the Act all patients would receive an individual assessment to determine their capacity to maintain their safety.  The Board was advised that the safety of patients  was of paramount importance rather than the smooth running of and individual hospital or care home.

·  Assurance that the local authority will be ready and the necessary requirements in place when the Mental Capacity Act becomes effective in April 2009.  In response, the Officer informed the meeting that the Adult Social Services Department already had an Implementation Plan and work to implement the conditions of the Act was on-going.  It was also stressed that full implementation was dependent on the cooperation of partners and effective partnership working. 

·  Whether any general training had been arranged with Member Development for Members of Council to attend briefing sessions or seminars regarding the implications of the Mental Capacity Act 2005. 

·  In response, the Officer informed the meeting that to date there had not been any specific sessions arranged for Members of Council, but was something that might usefully be arranged for the early part of 2009.

The Chair thanked officers for their attendance.

RESOLVED - 

(a)  That the content of the report, specifically  the progress made to date in implementing the Act and the plans being progressed to raise greater awareness among the public of its provisions and implications, be noted. 

(b)  That any outstanding issues referred to above be dealt with by those   Officers now identified within the minutes and reported back to Board   Members.

(c)  That a further report detailing progress in implementing the requirements of the Act be presented to the Board meeting in March 2009.

(Note:  Councillor E Taylor declared a personal interest in the above item in her capacity as a nurse who works for Leeds Community Mental Health).