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News from todays Decision Making and Mental Capacity - A practical guide to best practice

How can we better support and involve people who lack capacity?
Jan Sensier
, Deputy Director of Strategy and Corporate Services, The Office of the Public Guardian
Pre event abstract
The Office of the Public Guardian (OPG) has a clear purpose. We work to promote decision making and the right to choose. Where someone lacks capacity, we support those who empower people to make good decisions and we strive to provide high quality services.
How can we better support and involve people who lack capacity?
OPG has a duty to make sure that anyone who comes into contact with someone who may be vulnerable due to lack of capacity knows the action they may take.
The vulnerable person may have chosen someone to support them in their decision making; someone may be legally empowered to take care of their affairs if they’re not able to. In case of a diagnosis that may impact mental capacity, the practitioner needs to know the patient may need to consider putting lasting powers of attorney (LPA) in place.
In July 2017 we conducted research among those who have contact with vulnerable people.
We asked about practitioners’ knowledge of OPG and their understanding of LPAs and deputyship orders – documents that give people legal authority to support someone’s decision making, or even act for them.
Would they be confident checking their validity? Who would they refer a concern to?
From the 1736 responses received we saw we have much work to do.
There was low recognition of the role of attorneys and deputies, and common misconceptions around the documents themselves. For example, few knew to check with OPG that documents had been registered – a prerequisite to their use.
Since conducting the research we’ve been working with participants to see how we can get messages out through their channels.
We’re also working with stakeholders in NHS England and Wales to explore opportunities in primary care and in acute trusts.
The importance of planning for the future
Our population is getting older and we’re living longer with illnesses likely to impact our mental capacity. From in-depth analysis we know that lack of future planning has wider societal impact. If people don’t plan for the future and need support in their decision making it’ll have a direct impact on public services.
For example in an NHS Scotland report 58% of patients occupying a hospital bed past 6 weeks were doing so as a direct consequence of not having the correct powers of attorney in place.*
We’ve seen in England and Wales that in areas of deprivation where you’re most likely to have a diagnosis of dementia, you’re least likely to find people who have an LPA.
To address this, we’ll be rolling out a campaign in pilot areas to raise uptake of LPAs with under-represented groups and we’ve had offers of support from a number of Clinical Commissioning Groups.
Moving forward
We’re looking forward to 2025 and how we develop OPG to respond to the changing needs of society, better protect and empower the vulnerable and create high quality services that are accessible and affordable.
Key to this will be greater digitisation of our services, so that we continue developing safeguards to protect our vulnerable clients and better assist those acting in roles supporting others.
Our partners in the health sector will play an important role in our future.
Full powerpoint presentation

The Mental Capacity Act – Key Principles and Big Issues 
Andy Butler
, Principal Social Worker (Adults), Surrey County Council
Pre event abstract
Decision Making and Mental Capacity – A Guide to Best Practice: Key Principles and Big Issues!
‘It is not possible to work effectively in Health or Social Care in 2018 without being confident and competent in supporting people who have a degree of cognitive impairment or a condition that may result in compromised mental capacity. In particular professionals need to have an applied knowledge of the Mental Capacity Act’ - Butler 2018
Full powerpoint presentation

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The Mental Capacity Act Masterclass
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14 September 2018


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