When a person lacks the mental capacity to make decisions about the care or treatment they need, it is sometimes in their best interests to deprive them of their liberty. The Mental Capacity Act 2005 Deprivation of Liberty Safeguards (MCA DOLS) exists to ensure that no one is deprived of their liberty without good reasons. It is the right of every person deprived of their liberty under MCA DOLS to have a relevant person’s representatives (RPR). This booklet is designed to help relevant person’s representatives understand and fulfil their statutory role under the MCA DOLS legislation.

This document describes the work that has taken place to raise awareness and understanding of the Mental Capacity Act (MCA) across the health and care system in response to the recommendations of the House of Lords Select Committee on the Mental Capacity Act in 2014. Using case studies, the report outlines the progress made in a range of areas, including: national governance, monitoring progress, increasing awareness and implementation, digital resources, professional training, system design and partnership, system regulation, care planning, the Office of the Public Guardian, Independent Mental Capacity Advocates (IMCAs), and Deprivation of Liberty Safeguards (DoLS). The report shows that many localities have seized the opportunity to make real strides forward. With the establishment of the new National Mental Capacity Forum, an opportunity now exists to accelerate progress.

The key messages from the The Chief Social Worker’s Mental Capacity Act (MCA) Seminar on 13 March 2015. Key themes included: a push on awareness; the importance of local networks and the importance of identifying people and services.

Following the March 2014 Supreme Court judgment in the case of ‘Cheshire West’ clarified an ‘acid test’ used to determine whether someone should be assessed under the Deprivation of Liberty Safeguards (DoLS) scheme, the Department of Health provided a oneoff contribution of £25m in July 2015 to local authorities to support their DoLS work. This document reports on how local authorities spent/intend to spend their allocation.

A case study focusing on the tender process for new provider of Mr J’s supported living accommodation and the role played by the IMCA in ensuring the selection of the provider from the shortlist was done by the families of the residents with support from the Council’s commissioning unit. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, to show how IMCAs can act as a powerful support to people who may lack capacity.

A case study focusing on a patient for whom an inadequate capacity assessment was carried out. Following IMCA intervention, it was discovered that lack of capacity had been assumed and the IMCA set about undertaking an accurate capacity assessment. The patient, however, passed away before this could be completed. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, and aims to show how IMCAs can act as a powerful support to people who may lack capacity.

A case study focusing on a care home resident needing improvements to their accommodation, explaining how after intervention by an IMCA the decision was made to go ahead with the repair work. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, and shows how IMCAs can act as a powerful support to people who may lack capacity.

A case study focusing on a patient with an acquired brain injury, needing a best interests decision made as to whether she should have a PEG feed inserted. The case shows how the correct application of the principles of the MCA ensured the least restrictive option was explored and the patient was able to make improvements in eating and drinking so the PEG was no longer needed. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, to show how IMCAs can act as a powerful support to people who may lack capacity.

A case study describing how a decision had to be made about the permanent care arrangements for a service user temporarily placed in a care home, which appeared to be against her wishes. With IMCA intervention the resident was able to return home with a care package which she was more amenable to. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, showing how IMCAs can act as a powerful support to people who may lack capacity.

A case study focusing on a patient with cognitive impairment, showing how the intervention by an IMCA ensured she was able to return to live at home with her dog instead of being admitted to a care home that did not allow dogs. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, and shows how IMCAs can act as a powerful support to people who may lack capacity.

A case study focusing on patient decision to require representation in deciding whether she should be resuscitated and the intervention by an IMCA. It has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, showing how IMCAs can act as a powerful support to people who may lack capacity.

A case study focusing on patient due to be discharged from hospital while there was disagreement amongst family members about where she should go. It shows how an IMCA intervention ensured that a decision could be made for the patient to be discharged to a 24-hour residential care placement, which was the only place where her complex needs could be met. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, and shows how IMCAs can act as a powerful support to people who may lack capacity.