Jo Join int Ch Child ildren's & & Adult’s Sa Safeguardin ing Annual l Conference th October 2019 29 th 29
Welcome Gil ill l Frame In Independent Ch Chair ir SS SSCP CP & S SSAB
In Introduction Mark Fit itton - Dir irector of f Adult lt Servi vices Anit ita Rolf lfe - Executi tive Dir irector of f Nursi sing and Quality ty - Stock ckport t CCG Chris is McL cLoughlin - Servi vice Dir irector - Chil ild Safeguarding & Prevention Servi vices
Our vision for the future Vision statement for ASC: “To help the people of Stockport live their best lives possible through promoting independence within our com m unities, w orking w ith our partners and em pow ering our staff to use an asset-based approach to provide high quality support for residents that is appropriate for their level of need.” “ W e w ill do this through: Reclaiming the identity of Adult Social Care for our staff, partners and customers 1. Being outcome-focused, using an asset-based approach in all our interactions with 2. customers Utilising our resources in cost effective and efficient ways to the benefit of our 3. residents Creating and maintaining a service that our workforce is proud of, providing and 4. commissioning the right services to meet local need “ Valuing the contribution of our partners 5. Nurturing and supporting our workers to work differently, maximising their skills 6. and ambitions for the future Adopting the SMBC values 7.
Our new custom er pathw ay The end to end future Adults customer pathway describes how a customer will flow through the various offers of support within ASC. Designed using a strengths and assets based approach, so that staff consistently have “different conversations” with customers based on assets, strengths and community resources and have no presumption that the offer of services is the end goal. 5
Achie ievements 2018-19 19 • Representation at the safeguarding partnership groups • Contributed to the development of the Multi-Agency Domestic Abuse Training • Enhanced front door offer and all safeguarding is triaged to ensure a timely response • Taken an active role in the Daily Risk Meetings at the MASSH – this received a GMP Borough Commander Award • Permanent Adult representative at MARAC
Prio riori ritie ies for r 2020 • All staff attend Domestic Abuse Training • Our assessment staff to be confident to conduct a DASH Risk Assessment • Review of the Multi Agency Safeguarding Policy & Procedure • Implementation of LPS by October 2020 – across both Children & Adult Services in conjunction with colleagues from health • Ensure the adult offer around vulnerable adults is explored across the system and influence future commissioning
Anit ita Rolf lfe - Execu cutive Dir irector of f Nursi sing and Quality ty - Stock ckport t CCG
Chris McLoughlin Se Servi vice Dir irector Ch Child ild Sa Safeguardin ing & P Preventio ion Se Servi vices
Mental Capacity Act t (M (MCA) and th the Li Liberty Protection Safeguards (L (LPS) Steven Richards
Adult t health h and soci cial l ca care - starts ts with CON ONSENT ENT informe formed d consen onsent = the e person son was info formed rmed + under nderst stood: ood: the Na Natu ture re (what) + • Montgomery v the Purpose pose (why) + • Lanarkshire the Con onseque sequences nces of treatment/care Health Board • AND the consent was freely given (not coerced) [2015] UKSC 11 When a person cannot consent, the Mental Capacity Act can be applied (16+ and impairment/ disturbance of mind/ brain) Assessment ssment of Capaci city ty Best Inter terests ests * * * * * * * * * * Restrai aint nt Definition : use or threat of force to make a person do something they resist or restriction of liberty of movement, whether or not the person resists. Criteria: Lack capacity + Best Interests + prevent harm to person + Proportionate act Deprivati ivation on of of Liberty: rty: DoLS LPS
Who ho? Where? ere? Anyo yone: e: aged 16 and over Anyw ywher ere in England and With an impairment or disturbance of Wales mind or brain home, hospital, GP, care This his inc nclu ludes: des: dementia, learning home, day centre, dental disability, brain injury, mental illness, practice, on the street – no autism, confusion, concussion, physical boundaries. alcohol or substance misuse, Men enta tal l unconscious Capaci city ty When en? ? Act ct Why? y? A person is not able to consent It provides the authority (make decisions about) (defence) when working healt ealth h or social cial care re or finances: nances: with people (care or personal care, going out, nursing care, treatment or finances) who housing support, contact with others, cannot give consent/make medical treatment, allied health decisions. therapies, emergency care, dental care Nine ne reall lly y impor porta tant t reasons sons why hy you ou shoul ould d use the e MCA
1. I want to deliver excellent care October 2019: A nursing home in Somerset for 70 older people. ‘The provider did not protect the rights of people living in the home in line with the Mental Capacity Act 2005.’ ‘Records of best interest decisions were not always decision specific or were incomplete and did not always ensure decisions were truly in person's best interest.’ September 2019: domiciliary care agency in Northumberland ‘There were no mental capacity assessments in people's care records. Staff followed instructions from some people's relatives about how their care should be delivered and in some cases these relatives did not have a lasting power of attorney in place to make these decisions lawfully on their family member's behalf.’ Breach of Regulation 11 (Need for consent) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
2. . I wa want t to sa safe feguard guard ad adults lts eff ffectively ectively March 2019 : Peterborough City Council (17015817) ‘..when following safeguarding duties all professionals must work in line with the MCA (Sections 14.55 to 14.61, Care and Support Statutory Guidance).’ ‘The safeguarding process, while it can be used to mitigate risk to a vulnerable adult, does not remove the Council’s (or other professionals’) need to act in accordance with the MCA.’ Failure to assess capacity = fault leading to injustice 3. I w I want to sa save e li lives.. s.. March 2013 228 LD deaths reviewed. 42% of these deaths were assessed as being premature (compared to a non LD adult of similar age, illness). “..professionals in both health and social care commonly showed a lack of adherence to and understanding of the Mental Capacity Act 2005, in particular regarding assessments of capacity, the processes of making ‘best interests’ decisions...” This work continues via the Learning Disability Mortality Review Programme (LeDeR)
4. . I wa want t to pro rotect tect Hu Human man Rights ghts NHS Trust v Mr and Mrs Y [2017] EWHC 2866 (QB) Mrs Justice O’Farrell: considering the withdrawal of CANH to Mr Y who was in a minimally consciousness state. “The MCA was introduced to create the legislative framework so that the fundamental rights , including Article 2 rights, of persons who lack capacity, could be protected. The principles in section 1 of the MCA are intended to ensure that the rights of vulnerable persons are protected .” 5. . I wa want t to ac act lega gally lly ‘ It is not sufficient for the Defence to establish simply that an officer acted ted honest estly ly and d in good d faith th....For my part I am satisfied that where the provisions of the Ment ental al Capac apacity ity Act apply ly, the common law defen fence e of f nece cessi sity ty has no o appli licat atio ion. n. ’ ZH v Police for the Metropolis [2012] EWHC 604 A man with autism + public swimming pool + police. Trespass to the person, assault and battery and false imprisonment.. £28,250 ,250 damages
3. Just because I make odd or 1. Just because I have dementia, 2. You have to help me as unwise decisions (or disagree learning disability or mental much as possible when with you) you cannot say I health problems you cannot say I you assess my capacity. lack capacity. lack capacity to make my own Section 1(3) duty to take Section 1(4) unwise decisions decisions. practicable steps Section 1(2) the assumption of capacity 4. When you assess my capacity you have to provide My legal rights the information in simple and 9. You cannot say I lack basic terms and in a way under the capacity now and always appropriate for me. will do. I have the right to Mental Capacity Act Section 3(2) understand regain capacity and be relevant information assessing capacity re-assessed. Section 2(1) time specific 5. I only have to remember the information long enough to 7. You cannot say I lack make a decision. 8. You cannot generalise and capacity based solely on Section 3(3) retain information say I lack capacity to make all my age, appearance, decisions. You have to assess behaviour or condition, my capacity to make 6. I can communicate my decision in You have to assess my individual decisions. anyway recognised, not just verbally. capacity via the Act. Section 2(1) decision specific Section 3(1d) communicate Section 2(3)(a) & (b) 6 . I w ant to ensure the legal rights of m y clients are respected
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