Mental Capacity (Amendment) Bill [HL]

Written evidence submitted by Carol Wilkinson, Senior Social Worker and BIA, East Sussex (MCAB11)

Comments on the Liberty Protection Safeguards Bill

I am a registered senior social worker and best interest assessor – BIA- working in East Sussex. My comments are my own and do not necessarily represent my employing authority.

I wholeheartedly support the law as it relates to deprivation of liberty and am very proud and positive about my work in this area as a BIA. I visit and listen to the most vulnerable in our society; those cared for in care homes and on wards deprived of their liberty and unable to decide this or to leave without others agreement and help. The work excited me when the original law came in and still does; saying the words ‘freedom’ and ‘choice’ to people living in this way invariably gets a strong reaction from them, despite cognitive impairment and frailty. Liberty affects us all, the people I assess in care home and on wards are an integral part of our community, made invisible if they have no voice and are not listened to. They are our mothers, our fathers, our brothers, our sisters, our children…. us in a future time or accident.

The new law will hopefully mean social workers and others incorporate these words into their own work with asking the views of people who have lost both by their care by others; but I remain unconvinced. Almost all others arranging care, often in crisis for an ill, cognitively impaired person they know or have responsibility for have competing priorities placed upon them. It’s hard to enshrine the importance of freedom and choice when risk to health is involved – but we must- without happiness or a sense of ease and trust for the person as the end result, what has actually been obtained?

I welcome review of the current law to mainstream and streamline practice and ask the House of Commons to consider the following to achieve a better law than now:

1. Wishes and beliefs of the person: Please give this full consideration in the law by requiring the person to be consulted.

2. AMCP: Please consider ensuring the law requires involving these specialist staff when care of the person is highly restrictive, involves covert sedation, or s/he is unbefriended.

3. AMCPS: Ensure others organisations requiring use of local authority (LA) AMCPS or LPS assessors pay the LA to do so, or money is given to the LA’s by the government to ensure no one is denied an assessment due to lack of funds to pay staff to do so .

4. Advocacy of unbefriended persons deprived of liberty to be made a requirement.

5. The person and those representing the person deprived of their liberty to have the right to challenge their deprivation in Court, with the help of a government funded independent advocate and/ or lawyer as now.

6. Renewals: 1 year and then 3 years at a time is fine, if no one is objecting to the care. Objection to care should trigger immediate re assessment.

7. Private hospitals and private care homes as now need an assessor independent of that organisation to assess their deprivation of liberty of the person by their care. This could be an LA professional or LA AMCP as happens now with wider safeguarding responsibilities of LAs.

8. 16 & 17 year olds rights under liberty protection safeguards should be consistent with the rights afforded under the Children Act.

9. Conditions on lesser restrictions by care to be made a part of the authorisation, as now. They work, and those caring for the person find them a specific measurable way to give the person less restrictive, happier care at nil cost. They are a ‘win win’. Please make sure they carry on.

10. Please ensure registered professionals assess liberty protection safeguards. Whether a nurse, a social worker, an OT, we have a track record of duty, care and keeping the person at the heart of what we do , and we are accountable.

11. Please don’t just leave the detail of human rights to a Code of Practice- it’s not the same as a law to protect. And do please involve BIAs in drawing up the Code- we have practised the deprivation of liberty safeguards- DOLS- now for some years and have built up a body of expertise. DOLS needs streamlining and made more accessible, but standards should not slip in doing so.

12. Appropriate Person: They should have contact with the person to speak up for them, be prepared to appeal when appropriate and the responsible body should monitor to check they are carrying out their duties, i.e. seeing the person and speaking up for them.

13. Do give this the time you need to get this law proportionate, protective, and to give a voice to those who have none without it. Liberty safeguards make a huge difference to the quality of often utterly marginalised lives lived in care homes and on wards by people unable to speak up for themselves. They rely on you to get this right. We all do.

Carol Wilkinson, SP, BIA, HCPC registered East Sussex social worker.

January 2019

 

Prepared 15th January 2019