Fourth annual report into the use of the Mental Capacity Act published
Checks on implementation of the Mental Capacity Act (MCA) will become a routine part of hospital and care home inspection, the Care Quality Commission (CQC) reports today.
In its fourth annual report into the Deprivation of Liberty Safeguards (DoLS), CQC says these checks will become an integral part of its new approach to regulation, as it implements its fresh strategy Raising standards, putting people first.
The strategy underlines CQC’s commitment to strengthening its focus on the Mental Capacity Act (MCA), which includes the DoLS.
The MCA sets out how people in vulnerable circumstances should be cared for and how to strike the balance between respect for rights to liberty and independence and the need to protect people when they lack the capacity to make decisions.
The report into how the Deprivation of Liberty Safeguards have been applied during 2012/13, published today, cites concern that the MCA is still not understood and implemented consistently across health and social care services. Findings include:
· People in care homes and hospitals may continue to be subject to restraint and possible deprivation of liberty without legal protection
· People’s experiences of the DoLS are mixed – our case studies show how the system can work well for people
· There has been a significant increase in the number of applications for the use of DoLS to protect the rights of people aged over 85
· Application rates continue to vary by region – but the reasons for this are unknown
· Around two thirds of care homes and hospitals are failing to notify CQC of the outcome of DoLS applications as required by law
The report also recommends that NHS England should include an expectation on the effective use of the DoLS into the standard contract for providers.
CQC chief executive David Behan said: ‘We expect more focus on reducing the restraint and restriction of vulnerable people lacking capacity.
‘We want to ensure people who are unable to consent to treatment because they lack capacity receive high quality care as a fundamental part of health and care services. While there has been an increase in the use of DoLS there is still much more that needs to be done to ensure people are appropriately cared for.
‘This year, CQC is strengthening its approach to monitoring this legislation and we will be working more closely with local authorities to support them in their roles as supervisory bodies.’
For the first time, CQC surveyed local authorities on their monitoring of the MCA. Of 118 of 152 local authorities:
· Knowledge of the Deprivation of Liberty Safeguards system generally appears to be good. Most had appropriate structures and processes in place to operate the system effectively
· Some did not actively encourage people’s representatives or their Independent Mental Capacity Advocates to enable people to challenge authorisations