Mental Capacity Implementation Programme Mental Capacity Act 2005 Dora Jonathan Regional Programme Lead CSIP West Midlands

Who Is Affected? Mental capacity could affect anybody Over 2 million people in England and Wales lack mental capacity to make some decisions for themselves: learning disabilities, dementia, mental health difficulties, brain injury Up to 6 million family carers, carers, health and social care staff

Principles of the Act (Section 1) Assume a person has capacity unless proved otherwise Do not treat people as incapable of making a decision unless you have tried all you can to help them Do not treat someone as incapable of making a decision because their decision may seem unwise Do things or, take decisions for people without capacity in their best interests Before doing something to someone or making a decision on their behalf, consider whether you could achieve the outcome in a less restrictive way

What the Act does I Sets out a framework for assessing capacity – decision specific – a functional test – no discrimination based on age, condition, behaviour etc. Sets out a best interests checklist Integrates current common law into statute Protects those who do an act in connection with care or treatment from liability if in best interests of the person lacking capacity.

What the Act does II Permits restraint / restriction to prevent harm within certain constraints. Creates a) personal welfare and b) property and affairs Lasting Powers of Attorney Creates new Court of Protection – that can make declarations, single orders and appoint a) personal welfare and b) property and affairs deputies Creates new Office of the Public Guardian to register attorneys and supervise deputies Creates new criminal offence

What the Act doesn’t do Permit deprivation of liberty Abolish existing EPA’s – they continue Abolish existing receivers – they automatically convert to deputies

Planning ahead whilst you have capacity You can create 1. Lasting powers of attorney 2. Advance decisions to refuse treatment 3. But also by making your wishes and feelings known decision makers will have to consult with those “caring for the person or interested in his welfare” as part of best interests checklist

Research – DH responsibility Act sets out new safeguards for many types of research involving people who lack capacity Act balances desire for people without capacity to benefit from properly conducted research with the need for strict safeguards Act says the interests of the person are more important than the interests of science and society

The Independent Mental Capacity Advocate (IMCA) - DH responsibility Extra safeguard for particularly vulnerable people in specific situations Who? - People with no-one to consult (other than paid carers) When? – serious medical treatment; care home moves Duty on LA’s or NHS bodies to provide this service To be commissioned by LAs with PCT partners – included in published consultation response (April 2006) - commissioning guidance issued – seven pilot sites

Key Forthcoming Dates / Action Points Consultation on the code ended in June – to be laid in Parliament in October - other Parliamentary processes e.g. LPA forms Consultation on the Court rules now and fees later in 2006 Consultation on research regulations now IMCA regulations were laid two weeks ago Inspection and monitoring post implementation – revision of NMS Implementation of MCA from April 2007 Amended MH Act will include the Bournewood solution – an amended MCA that permits deprivation of liberty from April 2008?

Implementation structures 150 x local implementation networks 8 x regional CSIP implementation leads – not London yet Creation of a National Advocacy Qualification – CSIP Development Manager Training funds via implementation networks for all local statutory / voluntary / independent sector services (2006 / 08) Bidding process for non-statutory sector national organisations and representative bodies to produce guidance / support implementation via events and conferences (2006 /07)

Implementation tools Newsletter Self assessment tool – imminent dissemination Code of Practice Materials to complement Code - replacing of “Making Decisions” booklets – new information booklets Production of training materials via SCIE / UCLAN - available electronically and in hard copy from November 2006 Further commissioning guidance issued this week via IMCA webpage on DH website

CSIP leads’ primary roles Assist in the commissioning and provision of advocacy Raise awareness Assist in training the trainers and the dissemination of the training materials Informal survey of the use of self assessment tool Meet with chairs of local networks to create and sustain a regional network of chairs Sign off local implementation networks’ plans (to ensure they retain the money) Work to agreed regional plans