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Mental Capacity Act: a view from the CQC from Rachel Griffiths at the Deprivation of Liberty conference

Rachel GriffithsRachel Griffiths

Rachel Griffiths talks today at the Deprivation of Liberty conference and discusses the CQC response in the short term by acknowledging that supervisory bodies are under strain.

And that providers will be assessed as compliant with the MCA if where appropriate they are doing their best to seek authorisation. They are in discussion with supervisory bodies and commissioners and are doing all they can to minimise the need for deprivation of liberty – can care or treatment be given in a less restrictive way?
There is some concern among inspectors that delays are lengthening.
Anecdotal reports from providers that they are being told not even to put in requests

The House of Lords made the following recommendation to Cqc which the Cqc accepted Chief Executive promised  the HoL Committee in evidence that he would “ensure that mental capacity is built into the way that we conduct our inspections – whether of hospital services, community healthcare services or adult social care services”.

Ongoing actions include:
Advanced training has created an Action Learning Set of staff with growing knowledge to train and advise
New inspector training / intermediate MCA training is longer and more focused than it was, and being rolled out also to existing staff
Intranet and internet resources being improved
Specific MCA KLOE with prompts – the same over all sectors we regulate (adult social care, acute hospitals, primary and community medicine).
Five questions: is a service safe, effective, caring, responsive and well led?
MCA under the ‘Effective’ domain, linked to the new regulation on consent.
Reflected in the new ratings system: ‘outstanding’, ‘good’, ‘requires improvement’ and ‘inadequate’.
See handbooks for each sector on CQC website.

What good looks like:
People are supported to make decisions and, where appropriate, their mental capacity is assessed and recorded.
The process for seeking consent is appropriately monitored. The use of restraint is understood and monitored, and less restrictive options are used where possible.
Deprivation of liberty is recognised and only occurs when it is in a person’s best interests, is a proportionate response to the risk and seriousness of harm to the person, and there is no less restrictive option that can be used to ensure the person gets the necessary care and treatment.
The Deprivation of Liberty Safeguards, and orders by the Court of Protection authorising deprivation of a person’s liberty, are used appropriately.

DoLS effective and creative as a powerful force for good, to challenge thoughtless or overly risk-averse restraint, and to help find less restrictive ways to provide services.

DoLS are part of the Mental Capacity Act, and a great protection: the unprotected people are those where it isn’t even recognised they might be deprived of their liberty.

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Events of interest:


Adult Safeguarding under the Care Act 2014
Monday 17 November London

Delivering a High Quality Elder Friendly Service
Wednesday 10 December London

Undertaking Adult Safeguarding Investigations & Serious Case Reviews
Thursday 11 December London

Download: Rachel Griffiths Presentation

13 October 2014


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