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Rachel Griffiths gives an updated on ensuring effective use and compliance in practice monitoring the DoLS from the CQC

Rachel Griffiths Mental Capacity Act Policy Manager Care Quality Commission an updated on ensuring effective use and compliance in practice monitoring the Deprivation of Liberty Safeguards from the CQC at today’s conference. In her presentation Rachel discussed:

  • DoLS: ensuring compliance
  • findings from the Care Quality Commission Fourth annual report into the use of the Mental Capacity Act
  • improving understanding of DOLs and reducing the restraint and restriction of vulnerable people lacking capacity
  • moving forward: strengthening monitoring

Rachel Griffiths full presentation is available for download at the end of this page.

In her presentation Rachel outlined the changes in practice brought about both by the report of the House of Lords MCA Post-Legislative Scrutiny Committee, and by the Supreme Court’s clarification to how to recognise when people are deprived of their liberty.

In looking at findings from the CQC’s fifth annual report monitoring use of the Deprivation of Liberty safeguards, Rachel compared their usage before the Supreme Court judgement with the current position.

Rachel also outlined how the CQC now inspects against the MCA, and how in particular it regards providers of health or social care, in care homes or hospitals, who are affected by the delays in assessing requests for authorisation under the Deprivation of Liberty Safeguards, caused by the huge increase in numbers of applications.

During her presentation Rachel stated:

“The Mental Capacity Act is the essential framework for balancing FREEDOM (wherever possible) with PROTECTION (when essential, and the lightest possible touch) in the person’s best interests.”

“Great changes to the landscape of health and social care

  • DH, CQC, NHS England, ADASS, Court of Protection,  the medical Royal Colleges, Law Society, Law Commission, OPG and others all acting collaboratively to improve implementation
  • Providers applying in unprecedented numbers to seek authorisation for deprivation of liberty”

“Acknowledging that supervisory bodies are under strain. Providers will be assessed on compliance with the MCA where appropriate:  re deprivation of liberty, we check that

  • They understand the key points of the Supreme Court ruling and they are doing their best to seek authorisation
  • In discussion with supervisory bodies and commissioners
  • Doing all they can to minimise the need for deprivation of liberty – can care or treatment be given in a less restrictive way?”

“DoLS fit inside MCA which fits inside human rights law”

Recommendation for CQC:

“The standards against which the CQC inspects should explicitly incorporate compliance with the Mental Capacity Act, as a core requirement that must be met by all health and care providers”.

“MCA Key Line of Enquiry - 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
  • MCA part of the descriptors in the new ratings system: ‘outstanding’, ‘good’, ‘requires improvement’ and ‘inadequate’.”

“Two main MCA routes:

Best interests decision-making in accordance with the MCA: in practice or by Court of Protection; or

Ourselves - any of us can make Advance Decisions to Refuse Treatment or give Lasting Powers of Attorney for health and welfare decisions”

Rachel Griffiths’ Biography:

Rachel is the Mental Capacity Act policy manager for the Care Quality Commission. 

In this role, she works widely both inside the CQC and with colleagues in other agencies to embed the MCA among all health and social care providers in England, and also, more specifically, to enable the CQC to meet its strategic aim to make the MCA a central part of all its activity.

Formerly, she was the Mental Capacity Act implementation manager for the Social Care Institute for Excellence (SCIE).  

Her background is as a social worker in mental health and learning disabilities: she is a former Approved Mental Health Professional.

Forthcoming events of interest:

Improving Mental Health Crisis Care
Thursday 30 April 2015, London

Masterclass: Mental Health Pathways
Monday 11 May 2015, London

Stronger Code: Better Care Implementing the Changes to the Mental Health Act Code of Practice
Tuesday 12 May 2015, London

Masterclass: The Mental Capacity Act and Advance Decisions
Wednesday 13 May 2015, London

Psychosis & Schizophrenia in Adults
Monday 8 June 2015, London

Implementing the national objective to end Prone/Face Down Restraint: Examining Restraint Positions in Practice
Tuesday 22 September 2015, London

Masterclass: Deprivation of Liberty Safeguards
Friday 13 November 2015, London


Download: Rachel Griffiths" Presentation

25 March 2015

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