Improving Enforcement in Adult Care Homes

Another week, another consultation.  The Department for Business, Innovation and Skills (DBIS) are holding a review of regulatory enforcement in the adult social care sector.  The website says:

In this review, we are asking anyone involved or interested in the adult care home sector to let us know their views and experiences on how current enforcement of regulation in this sector is working. This is part of an initiative to drive up standards and enable providers to achieve the highest standards of care, while removing confusing bureaucratic requirements that divert carers from meeting the needs of residents.

Pigs in clover

I am happy as a pig in clover this morning, as those lovely folks at Emerald Journals let me have a peek at the latest edition of The Journal of Adult Protection, which is entirely given over to discussing the Mental Capacity Act 2005 (MCA).

Like water dripping on stone

Image by Hans

The CQC published its State of Care Report today.  In it, on pages 104-5, is a sneak preview of a brilliant piece of work they're doing on restrictive practices in health and social care institutions.  Restrictive practices were one of the concerns which emerged from CQC's thematic study of learning disabilities services, conducted over the last year in the wake of Winterbourne View.  In these reports CQC describe the following concerns about restrictive practices in care services:

Liberty call for overarching inquiry into the adequacy of safeguards under the Mental Capacity Act 2005

A while back I had a little whinge about how few disability and human rights NGO's were campaigning about the paucity of safeguards under the Mental Capacity Act 2005 (MCA) and the shocking problems with the deprivation of liberty safeguards (DOLS) in particular.  Behind the scenes, I think there is growing concern about the MCA and the risk of unchecked decision making powers it affords under the 'general authority' (now called the 'general defence').  I only just spotted this, so apologies for the delayed response, but Liberty have written to the Joint Committee on Human Rights and called upon them to open an 'overarching inquiry' into the MCA - and in particular to its paucity of safeguards.  They have also drawn attention to the direction of travel of DOLS case law, and expressed concern at the narrowing of the definition of deprivation of liberty.  I fervently hope that the JCHR will consider taking up this call, and would encourage other individuals and organisations who are concerned about the inadequacy of safeguards for decisions made under the MCA and the serious problems with the DoLS to consider writing letters in support of Liberty's proposal.

We were right to be worried about Worcestershire

I'm afraid this is a rather short, but depressing, post to bring to your attention the decision of Worcestershire County Council to pass its maximum expenditure policy (MEP).  I wrote about the policy previously here, the grass roots Spartacus campaign produced a report on the proposal called Past Caring, available here.  Following the publication of Past Caring Worcestershire decided to extend the consultation, and information which the report criticised Worcestershire for not putting on the consultation website was subsequently added.*  Worcestershire's response to Past Caring does not address the concerns about human rights at all, although it's recent cabinet documents (here) state that they see no conflict with Article 8 (Article 5 is simply not discussed).  The response also says that the Council will provide more details on what 'exceptional circumstances' it will depart from the policy in, but I can't see anything on the consultation portal which mentions this.  I've tried to find this policy for older adults online elsewhere on their website, but with no success, so we're still none the wiser as to what kinds of exceptional circumstances WCC might increase expenditure above the value of a residential care placement.  In any case, this information was not presented as part of the consultation.

The Great Escape (a schematic)

Greetings from deepest, darkest, thesis land.  I am in the thick of "writing up", and barely have time to get dressed let alone write a blog post.  But here is small offering in lieu of a proper post - an attempt to schematise how you might try to get out of detention using Schedule A1 of the Mental Capacity Act, otherwise known as the dreaded DOLS (Deprivation of Liberty Safeguards).  It includes a few other regulations and bits and bobs that tie up some (but not all) of the loose ends in the Great Escape.  Obviously my reasons for posting it here are entirely selfish - this figure (or a jiggled around version of it) will be going in the thesis as an appendix, so if you spot any mistakes please let me know!  You can download the pdf from here.