Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-15
Topic: Social Welfare
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, with the leave of the Committee, I shall move Amendment 14B briefly, if the Minister will allow me. I apologise for my error: I claim jet lag, having just come back from Bahrain The amendments in the second group, which are all in my name, are designed to meet the statement and explanation made by the Minister that the care home manager would arrange assessments but not undertake them directly. They attempt to clarify in the Bill the assurance given by the Minister that the care home manager would arrange assessments on behalf of the responsible body. He pointed out that care homes already play a role. They are currently frightened by an increased level of responsibility and believe that they will be conducting assessments rather than having a co-ordinating role. The care home manager will always remain responsible for identifying people where there is a restriction of liberty In this set of amendments, the responsibility for performing assessments is clearly not with the care home manager, who has only an administrative role, making sure that the relevant assessments have been done and forwarded to the authorising body. They must be undertaken as part of care planning. I suggest that this would require pulling together medical assessments of the person’s condition, which may be from the GP in care of the elderly or from other specialist departments where that person has been. Sometimes, medical details may be obtained from people such as rehabilitation teams, where the person had a head injury. That becomes important because some aspects, such as frontal lobe damage, need a highly specialised assessment. You could not have a general practitioner assess some of these people, because it is beyond the scope of most clinicians The capacity assessment must be done by someone who is suitably qualified, and the care plan must consider the person’s wishes and feelings and the type of person they were before the illness struck. To use a simple example, a professional musician’s needs will probably differ greatly from those of an agricultural worker in terms of aspects of liberty that need to be enhanced, such as access to whatever instrument they played before, and how the environment needs to be adapted, such as allowing the agricultural worker to have much more time outside if that is what they need, to protect their ability to live well I have discussed this with a range of concerned stakeholders, and there are genuine concerns that if care home managers were to hold the responsibility to undertake assessments themselves, there could be conflicts of interest. Although some could be trained to a certain extent, others would need extensive training and would probably move on before they were able to undertake that role. There is general agreement that care home managers cannot do the assessments themselves, but they could have a co-ordinating role. Whatever the final pattern of assessment, many care home staff need better training in mental capacity overall. I feel a great burden of responsibility on my shoulders, as I chair the National Mental Capacity Forum In Amendment 30A, I require the assessment to be made by a registered professional who has responsibility for the care plan and appropriate experience and knowledge to lead the care planning process for the cared-for person. We must have a thorough debate about what the Minister was explaining to us on the first day of Committee, which I fear has been poorly understood by many outside this Chamber. In gratitude to the Committee for allowing me to speak to the amendments, I beg to move.