Operationalising the Deprivation of Liberty Safeguards (DoLS) in support of brain injury survivors – views from practice

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jade Scott ◽  
Stephen Weatherhead ◽  
Jill Manthorpe
Keyword(s):  
Decision Making ◽  
Brain Injury ◽  
Social Care ◽  
Legal Framework ◽  
Content Type ◽  
Health And Social Care ◽  
Mental Capacity Act 2005 ◽  
Decision Making Styles ◽  
Tentative Explanation ◽  
Mental Capacity Act

Purpose Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI). Design/methodology/approach A total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed. Findings Three distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted. Research limitations/implications The findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system. Originality/value To the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service.

scholarly journals Assessment of mental capacity: a flow chart guide

2007 ◽  
Vol 31 (8) ◽  
pp. 304-307 ◽  
Author(s):  
Michael Church ◽  
Sarah Watts
Keyword(s):  
Good Practice ◽  
Good Clinical Practice ◽  
Legal Framework ◽  
Mental Capacity ◽  
Flow Chart ◽  
Code Of Practice ◽  
Health And Social Care ◽  
Mental Capacity Act 2005 ◽  
Informal Carers ◽  
Mental Capacity Act

The Mental Capacity Act 2005 provides a new legal framework within which health and social care professionals (as well as informal carers) must act when providing care and treatment for the estimated 2 million people in England, Wales and Northern Ireland who lack the capacity to make certain decisions for themselves. Although the Mental Capacity Act 2005 Code of Practice provides comprehensive advice on good practice in assessing capacity, it does not identify a specific process to be used. Good clinical practice depends on the exercise of clinical judgement within a valid and contestable process. This article outlines a flow chart (Fig. 1) that can be used to guide the process of capacity assessments in more complex cases, in line with the Mental Capacity Act 2005 and the Code of Practice.

Modernising the regulation of health and social care professionals: the Law Commissions’ final report and draft Bill

2014 ◽  
Vol 16 (6) ◽  
pp. 411-420
Author(s):  
Tim Spencer-Lane
Keyword(s):  
Design Methodology ◽  
Social Care ◽  
Legal Framework ◽  
Final Report ◽  
Content Type ◽  
Health And Social Care ◽  
The Law ◽  
Draft Bill ◽  
The Uk

Purpose – The purpose of this paper is to summarise the Law Commissions’ final report and draft Bill on the regulation of health and social care professionals. Design/methodology/approach – To summarise the key recommendations that are relevant to adult safeguarding. Findings – The final report concludes that new legislation is needed to govern the UK regulators of health and social care professionals. Originality/value – The paper sets out the recommended new legal framework.

scholarly journals The Supreme Court and deprivation of liberty: where are we now?

2015 ◽  
Vol 21 (6) ◽  
pp. 417-424
Author(s):  
Nick Brindle
Keyword(s):  
Supreme Court ◽  
Social Care ◽  
Case Law ◽  
Legal Implications ◽  
Health And Social Care ◽  
The Supreme Court ◽  
Mental Capacity Act 2005 ◽  
Low Threshold ◽  
Mental Capacity Act ◽  
Acid Test

SummaryDeciding on where the tipping point between restrictions and deprivation arises in care settings has important legal implications, but until recently case law has not much helped to resolve these challenging issues. An important milestone has been the Supreme Court judgment in the so-called Cheshire West case. This judgment, handed down in March 2014, set a low threshold to apply (the ‘acid test’) in deciding when someone may be being deprived of their liberty and therefore that additional legal authorisation is required. The application of the acid test is not straightforward and its effects are wide-ranging. In this article, I discuss the evolution of the concept of deprivation of liberty in health and social care, the implications of the judgment and the application of the acid test. I also briefly highlight the interface between the Mental Capacity Act 2005 and the Mental Health Act 1983.

Practitioners’ experiences of the mental capacity act: a systematic review

2020 ◽  
Vol 22 (4) ◽  
pp. 227-244
Author(s):  
Jade Scott ◽  
Stephen Weatherhead ◽  
Gavin Daker-White ◽  
Jill Manthorpe ◽  
Marsha Mawson
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Social Care ◽  
Mental Capacity ◽  
Quality Data ◽  
Emotional Impact ◽  
Supervisory Support ◽  
Content Type ◽  
Health And Social Care ◽  
Mental Capacity Act

Purpose The Mental Capacity Act (MCA, 2005) provided a new legal framework for decision-making practice in England and Wales. This study aims to explore qualitative research on practitioners’ knowledge and experiences of the MCA in health and social care settings to inform practice and policy. Design/methodology/approach Four electronic databases and Google Scholar were searched in November 2019 for peer-reviewed, qualitative, English language studies exploring practitioners’ experiences and knowledge of the MCA in health and social care settings. Nine studies were included and appraised for methodological quality. Data were analysed using thematic synthesis. Findings Data revealed both positive aspects and challenges of applying the MCA in practice within five main themes, namely, travelling the “grey line”, the empowering nature of the MCA, doing the assessment justice, behaviours and emotional impact and knowledge gaps and confidence. Practical implications The fundamental principles of the MCA appear to be adhered to and embedded in practice. However, practitioners find mental capacity work remains challenging in its uncertainties. While calling for more training, they may also benefit from further MCA skills development and support to increase confidence and reduce apprehension. Originality/value This is the first systematic review to synthesise qualitative literature on practitioners’ experiences and knowledge of the MCA. Findings offer insight into practice experiences of the MCA and provide a basis for the development of training and supervisory support.

scholarly journals Behind the cloak of competence: brain injury and mental capacity legislation

2019 ◽  
Vol 21 (4) ◽  
pp. 201-218 ◽  
Author(s):  
Sophie Moore ◽  
Rebecca Wotus ◽  
Alyson Norman ◽  
Mark Holloway ◽  
Jackie Dean
Keyword(s):  
Decision Making ◽  
Brain Injury ◽  
Case Managers ◽  
Mental Capacity ◽  
Online Questionnaire ◽  
Content Type ◽  
Hidden Disabilities ◽  
Mental Capacity Act ◽  
Method Approach

Purpose Brain Injury Case Managers (BICMs) work closely with individuals with Acquired Brain Injury (ABI), assessing needs, structuring rehabilitation interventions and providing support, and have significant experience of clients with impairments to decision making. The purpose of this paper is to explore the application of the Mental Capacity Act (MCA) and its guidance when applied to ABI survivors. This research aimed to: first, highlight potential conflicts or tensions that application of the MCA might pose, and second, identify approaches to mitigate the problems of the MCA and capacity assessments with ABI survivors. It is hoped that this will support improvements in the services offered. Design/methodology/approach Using a mixed method approach, 93 BICMs responded to an online questionnaire about decision making following ABI. Of these, 12 BICMs agreed to take part in a follow-up semi-structured telephone interview. Findings The data revealed four main themes: disagreements with other professionals, hidden disabilities, vulnerability in the community and implementation of the MCA and capacity assessments. Practical implications The findings highlight the need for changes to the way mental capacity assessments are conducted and the need for training for professionals in the hidden effects of ABI. Originality/value Limited research exists on potential limitations of the application of the MCA for individuals with an ABI. This paper provides much needed research on the difficulties surrounding mental capacity and ABI.

A response to “A preventable death? A family’s perspective on an adult safeguarding review regarding an adult with traumatic brain injury”

2017 ◽  
Vol 19 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Pete Morgan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Support Services ◽  
Brain Injuries ◽  
Social Care ◽  
Discharge Planning ◽  
Community Support ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose To reflect on the particular case from a professional’s perspective to provide, in conjunction with the original article, a more holistic overview of some of its implications for safeguarding practice and, by definition, for the provision of health and social care support services to individuals with a traumatic brain injury and their families. The paper aims to discuss these issues. Design/methodology/approach A response to an already published article. Findings That a lack of “professional curiosity” on the part of practitioners across a range of professions and agencies led to a failure to initiate safeguarding processes and procedures appropriately, resulting in avoidable damage to the subject of the article, the author’s partner and their families. Practical implications There is a need for a greater awareness and understanding of the implications of traumatic brain injuries across health and social care services: that hospital discharge planning and community support services need to be more flexible in identifying and meeting the needs of patients with traumatic brain injury, that there is no substitute for “professional curiosity” in ensuring that assessments are holistic, and that services are appropriate and multi-agency working is effective. Originality/value This is a response to an existing publication.

Positive risk-taking: from rhetoric to reality

2016 ◽  
Vol 11 (2) ◽  
pp. 122-132 ◽  
Author(s):  
Steve Morgan ◽  
Nick Andrews
Keyword(s):  
Risk Taking ◽  
Mental Capacity ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care ◽  
Mental Capacity Act 2005 ◽  
Legislative Framework ◽  
Mental Capacity Act ◽  
Almost All ◽  
Dementia Services

Purpose – For health and social care services to become truly person-centred requires a fundamentally positive mindset from professionals and care workers, and a willingness to take some risks. The purpose of this paper is to explore how this will apply to delivering dementia services, where almost all of the initial impressions are of deficits, disability and disadvantage. Design/methodology/approach – The co-authors combine their knowledge and experience of supporting and developing staff working in dementia services. The concept of positive risk-taking is explored within the legislative framework of the Mental Capacity Act 2005, Safeguarding and the Care Act 2014. Findings – Practitioners face a range of challenges when it comes to supporting people living with dementia to take risks through exercising personal choices and making their own decisions. However, the concept of positive risk-taking applies equally to people living with dementia who have or who lack mental capacity in relation to their decision making. Originality/value – This paper places positive risk-taking within a context of strengths-based, values-based and relationship-based working. Practical tips are offered for putting positive risk-taking into practice.

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