A step by step guide to help decide which legislation to use when making decisions about admission to a care home/remaining in a care home. The process outlined in the diagram applies only to patients who are 16 years or older – different arrangements are in place for under 16s.

This flowchart sets out the steps that need to be taken to ensure compliance with MCA, the MHA and the DoLS when admitting patients to hospital or preventing them from leaving hospital.

Guidance relating to advance decisions to refuse treatment (ADRTs) and the Mental Health Act 1983.

The focus of this report is on the MHA and its interface with the MCA, Deprivation of Liberty and the implications of the Supreme Court judgment (P v Cheshire West and Chester Council and P and Q v Surrey County Council [2014] UKSC 19). The latter has made it clearer and easier for providers and decision makers to identify where a person is being deprived of their liberty but has also led to a considerable increase in the numbers of people in England and Wales who are considered to be deprived of their liberty for the purposes of receiving care and treatment. The paper summarises the findings from a survey on the court judgment impacted on AMHP practice and service delivery. They show that there has been significant impact on AMHPs and service providers, but the situation appears to be more challenging for certain local authorities where a large proportion of their Best Interests Assessors for DoLS are drawn from the AMHP service. Landmark changes impacting AMHP practice and the local authorities on behalf of which the professionals act have been made as result of the Cheshire West judgement but there remain barriers and challenges in fully implementing these changes arising from the complex and bureaucratic DoLS framework. The Law Commission has been tasked to look for a framework that is simpler, while still protecting the rights of vulnerable people with mental health problems and those who lack capacity, with final report and draft legislation due to be published in summer 2017.