The training continues – it’s a fairly robust one as far as it goes and although it might not be apparent, despite the density of content, I am finding the substance interesting.
As promised on the first day of the training, more of the bits and pieces are fitting together as we progress and a better idea of how exactly the assessments will be conducted is forming somewhere in my head.
Generally, I have found the Mental Capacity Act (2005) very helpful in my work to date. It has codified a lot of ‘common law’ practice and provides a much stronger system of safeguards to both those who are affected by it through the lack of capacity – either temporary or permanently.
It also includes safeguards for those who work with people who lack capacity.
Yesterday among lots of other things a couple of issues jumped out from the course. Firstly that when there is a call to authorise deprivations of liberty there will be two types of orders that can be made.
Standard orders which need to be completed within 21 days and can be completed prior to the deprivation of liberty taking place. These are what we will be concerning ourselves with – there is some leeway just this April to manage backlogs and the timings will be slightly more generous – but these are the assessments which will require the ‘6 tests’ (Age, Mental Health, Mental Capacity, Best Interests, No refusals, Eligibility (phew, I did that all without looking – something must be getting through to the brain!)) by at least two people (the Mental Health part of the test has to be completed by a doctor and the Best Interests part has to be completed by a Best Interests Assessor).
In some ways though, the Urgent orders were more curious. These orders can be made for ‘up to 7 days’ and can be made by the managing authority which would be a hospital or a care home.
On the training with me, were some AMHPs who are based in general hospitals in liaison teams – so this perspective was coloured a little by their experiences – and, to put it lightly, I expect liberal use of urgent orders over the next few year or so.
On the course, the trainer referred to ‘sectioning’ under the Mental Capacity Act – by which these orders were considered. And come to think of it, it is an authorisation of a deprivation of liberty that is not so very different from the sectioning process that is currently undertaken under the Mental Health Act. Of course, there are many substantial differences but it is still a significant action and power – being able to make judgements and compelling orders requiring someone to be in a particular case. Of course, capacity (or rather the lack of it) might purvey a less draconian impression but ordering people around is not something to be taken lightly.
The other curiosity was the discussions regarding conditions that can be attached to orders regarding the deprivation of liberty. Again, a few eyes (and mine included, I have to say) lit up at the prospect of being able to attach conditions to care homes and hospitals – a way, perhaps, of solidifying rights and promoting better care. I have attached conditions to a Guardianship which has specified that a person has access to local community amenities to ensure she is not ‘held’ in the care home or hauled back every time she tries to leave. A condition, for example, that Mr T can be deprived of his liberty for up to a year on condition that he has given frequent access to the local community.
We have been forewarned though about attaching conditions to which any cost may be attached. I am assuming this will be something that will be shaped over time and in practice.
So I have a break in the training now – we have some more days to attend next week as well as some written work, a presentation and a legal test (and hopefully – although this is something I am yet to negotiate – some study time from work).
Our ‘homework’ task is to, within our localities, find out exactly what and how our employers are prepared and to come back with a knowledge of the details of how assessments will be managed by the local PCTs and Councils and how they will be distributed amongst BIAs (Best Interests Assessors).
I am quite looking forward to getting my teeth into that one. Not least because I am desperate to know the answers!
And in other, completely non-related news, I completed a job application form for the first time in, well, a few years. Haven’t sent it yet though. I am sure I’ll get around to commenting on it over the next week or so..