The number of adults who self-neglect and thus fall under the aegis of local authority adult safeguarding procedures in England has increased substantially since the introduction of the Care Act 2014. The requirement for collaborative working between agencies dealing with these adults in a safeguarding context is explicit in government policy and legislation. Decisions made by the multiplicity of agencies that may work with people who self-neglect are largely guided by the Mental Capacity Act 2005 (MCA). The overall objective of this research was to develop a clearer understanding of how the range of agencies that might typically be involved in the life of a self-neglecting person work together. This article examines how agencies put the MCA into practice in their work with people who self-neglect, and how they understand their own and others’ roles and responsibilities in so doing. This qualitative study took place in two local authorities in England from 2016 to 2017 and informed a wider action research study which was completed in 2019. Non-probability purposive sampling was used to recruit participants from the professional groups who might typically be involved with self-neglect cases. À total of 245 participants from across 17 different professional groups took part in semi-structured interviews, in a group, paired or individual format, decided by their customary working configuration. Data from the interview transcripts was analysed using thematic analysis. Three key themes in relation to how participants understood the MCA and multi-agency working emerged from the analysis of this data set. These were; a lack of understanding of the MCA by participants and other agencies; a reluctance to engage with MCA assessments; and a perception of manipulation of the MCA by other professionals. This study underlines the importance of the informed application of the MCA in working with people who self-neglect, and an urgent need to consider how this could be enhanced if the service user is not to experience intrusive interventions resulting from professional misinterpretation.

Safeguarding Adult Reviews (SARs) can be a valuable source of learning to improve mental health care. In light of the government’s commitment to reform the Mental Health Act 1983, this report summarises the qualitative learning from 77 SARs published across 24 London boroughs covering the period January 2017 to November 2020. The premise of this report is that the reform of the Mental Health Act will also prompt a ‘wake up’ of the entire mental health system in London and the rest of England in which parity of social care with health care becomes the ‘new normal’. The SARs analysed for this report tell the stories of Londoners who experienced mental health problems and came to harm or died as a consequence of their condition despite having been in contact with mental health care services and others. From the rapid analysis of the SARs case clusters emerged, with similarities in the individuals’ stories and outcomes. These clusters show that there might be groups of people who require particular attention when it comes to reforming the Mental Health Act – and with it the mental health social care ‘offer’. The stories of these individuals also raise some concerns around human rights, equality and inclusion with the question: Is enough being done to protect the rights of vulnerable people with mental health problems who receive mental health social care and who may rely on social care to respect these rights? The analysis further suggests that there are two major problem areas across virtually all the cases and clusters – professional knowledge and usage of the Mental Capacity Act 2005 and inter-agency working and communication.

An easy read version of the Law Commission Mental Capacity and Deprivation of Liberty: interim statement.

This Act amends the Mental Capacity Act 2005 in relation to procedures with which a person may be deprived of liberty where the person lacks capacity to consent. It includes amendments of authorising of arrangements enabling care and treatment which give rise to a deprivation of liberty; and Section 42 of the Mental Capacity Act 2005 code of practice in relation to Deprivation of liberty. The legislation provides for the repeal of the Deprivation of Liberty Safeguards (DoLS) and their replacement with a new scheme called the Liberty Protection Safeguards (LPS).

SCIE Guide on practice guidance on the involvement of Independent Mental Capacity Advocates (IMCAs) in safeguarding adults

This video for health and care professionals looks at how the 2014 Supreme Court judgment on deprivation of liberty affects people working in the area of mental capacity. It looks in detail at two real-life case studies.

This practice guidance describes the role of Independent Mental Capacity Advocates (IMCAs) and paid representatives in the Mental Capacity Act Deprivation of Liberty Safeguards (MCA DOLS).

Information about the Deprivation of Liberty Safeguards (DOLS) –
an amendment to the Mental Capacity Act 2005 (MCA).

This resource describes good practice in the management and implementation of the Deprivation of Liberty Safeguards (DoLS; the Safeguards).

This film looks at how the Supreme Court judgement affects people’s working lives in practice, by looking in detail at two real-life case studies.

The purpose of this document is to set out the safeguarding roles, duties and responsibilities of all organisations commissioning NHS health and social care. The framework’s aims include: identifying and clarify how relationships between health and other systems work at both strategic and operational levels to safeguard children, young people and adults at risk of abuse or neglect; setting out the legal framework; promoting empowerment and autonomy for adults, including those who lack capacity for a particular decision as embodied in the Mental Capacity Act 2005 (MCA), implementing an approach which appropriately balances this with safeguarding.

Prompt cards on safeguarding adults for staff within health services. The cover: staff responsibilities; categories of abuse; staff role as alerters; information sharing; capacity and consent; the Mental Capacity Act 2005; and Deprivation of Liberty Safeguards.