Mental Capacity Act Key Principles

Question 1

The main reason for the enactment of Mental Capacity Act 2005 was to empower and protect individuals with the inability to make important health decisions due to their disability or illness status, or due to drug-related mental illness. Based on the current case study, the mental capacity assessment for Callum would have been conducted based on the six principles of Mental Capacity Act (2005), which would allow for a valid ascertainment of whether he is capable of making sound decisions or not. The first principle (s. 1(2)) requires that the physician should assume the patient to have sound mental capacity unless proven otherwise. The second principle, as stated in s.1(3), is that the person should not be assumed to be incapable of making sound decisions unless all the efforts made to assist him in doing so have failed. On the other hand, the thirst principle stipulates that making unwise decision should not be the basis for considering the person unable to make sound decision (s. 1(4)), while the fourth principle stipulates that all the decisions for, and on behalf of the person who lacks the capacity to make sound decisions should consider their best interest. The last principle states that the caregivers must take the least restrictive action when making decisions for or on behalf of individuals believed to lack the capacity of making sound decisions.

Following the recommendations by section 2 of the Mental Capacity Act occurs as the best regulatory principle to adopt when assessing Callum’s mental capacity. In doing so, the practitioner, if in doubt of Callum’s mental ability, will need to conduct a two-stage test by asking whether (i) Callum has an impairment that renders him unable to make sound decisions, and (ii) whether Callum has a disturbance that renders him unfit to make sound decisions. Nonetheless, it is essential to take note that Callum may need other forms of support to make sound decisions, based on the diagnosed cause of his inability to make decisions, which could be Down’s syndrome or other learning disabilities (GOV.UK, 2019). Furthermore, the support may be needed based on the essence of the decisions being made and the specific time within which that decision should be made. The practitioner could also adopt section three of the Mental Capacity Act 2005 in case Callum is unable to decide at that particular time. Section 3 of the Mental Capacity Act 2005 requires that to ascertain that the person is not capable of making sound decision; the practitioner should ensure that he/she cannot understand information about the decision at hand, cannot read it, and is unable to evaluate or communicate it back. According to Brammer (2015), all these ascertainment are made to ensure that the person is given enough support to make the necessary decision.

Question 2

Section two of the Mental Capacity Act 2005 (3) (a) (b) behavior age, medical health condition, or appearance should not be used as the basis for declaring Callum unfit to make sound decisions. Furthermore, section two of the Care Act 2014 requires that Callum should be classified as part of the vulnerable person to protect him from any form of abuse. Nonetheless, the practitioner should take an individualized approach in assessing Callum by considering his gender, culture, race, age, disability level, and personal preferences.

Guidelines by the Social Care Institute of excellence advocates for the protection of adults declared to be at high risk of abuse (Scie.org.uk, 2019). Based on the Care Act 2014, the guidelines require caregivers to follow six fundamental principles, namely:

(i) Empowerment: Any decisions concerning Callum should be made on his interest and after receiving informed consent from him,

(ii) Proportionality: all decisions concerning Callum should follow the least intrusive or restrictive approach,

(iii) Prevention: caregivers should focus on prevention any harm to Callum before they occur,

(iv) Protection: Callum should be given all the support and protection from the abuse he needs

(v) Collaboration: there should be a multi-agency collaboration between the practitioners, family, friends, and social workers targeted at offering holistic care to Callum

(vi) The Local Authority should be accountable and transparent to Callum, and his family to ensure that he receives quality care services.

Any safeguarding alert raised by Callum or his family should be followed by a quick response. This can be achieved by establishing a safeguarding committee where strategies of care are formulated, and investigations are carried out on any arising safety issues before reporting them to the Local Authority and other key stakeholders. The Local Authority should then carry out an inquiry into the issues and find out whether they might affect Callum. The investigations should then lead into the formation of a multi-disciplinary committee formed to deliberate on the issues and prevent Callum from any abuse, or to prevent James from any abuse – because he is also vulnerable. Particularly, these multi-disciplinary committees are to develop a protection plan for all the vulnerable adults (i.e., Callum & James) by developing and implementing safeguarding strategies as required by the Care Act 2014 S. 34. In the case study, inquiries revealed that both James and Callum could give consent to sexual activity, even though they were not supposed to engage in the sexual activities within the daycare center. Thus, it was the duty of the Local Authority, in collaboration with the multi-disciplinary team of professionals, to support James and Callum through education and sensitization about sexual activities and the health risks that accompany them. Based on the Local Authority guidelines, a review of the safeguarding strategies would take a multi-agency approach by ensuring effective communication of all the necessary information to all the parties involved. The committee would investigate and inform the Local Authority of the homophobic comments made against James, as well as the act of Valerie stopping Callum from attending the daycare. The committee would also notify the Local Authority about Callum’s resultant behavior deterioration characterized by increased hostility. Section 43 of the Care Act 2014 would then require the Local Authority to protect Callum from unfair restriction and any other abuse or neglect. The reported restrictions were enough to inform the local authorities of the repressions he was facing. Hence, section 2 of the Care Act 2014 provides essential guidelines for protecting and supporting Callum. However, it is important to note that after implementing the appropriate measures to safeguard Callum, the Local Authority should also arrange for an advocate who would support and represent Callum in case no one is available to offer such support.

Question 3

Valerie, a 65-year-old lady, has been diagnosed with depression. Her mother, whom she stays with, is also involved in caring for disabled children. Whereas Valarie had voluntarily admitted herself to the hospital 20 years ago, she is currently using some medications to manage her depression. However, she recently developed a mental health crisis attributable to poor adherence to the medicines. Hence, it is the duty of an approved mental health professional (AMHP) to assess her and arrange compulsory hospital readmission as guided by the Mental Health Act 1983. Ideally, before the mandatory readmission, the practitioner would interview her based on the guidelines under the Mental Health Act S.13 to ascertain whether the readmission is necessary. Upon satisfactorily determining that Valerie needs hospital readmission, the AMHP would then use section 2 of 3 of the Mental Health Act to admit Valerie or apply for guardianship while considering the wishes of Mike and other relatives (Eekelaar, 1986). Section 13 of the Mental Health Act 1983 also indicates that it is the AMHP’s responsibility to respond to the suggestions and requests made by Valarie’s close relatives. Hence, Valerie’s husband (i.e., Mike) should be informed of the mandatory admission or when requesting a guardianship. However, the AMHP must ascertain the identity of all the relatives because it would also be illegal to inform the wrong people about such decisions.

In the case of sought guardianship, section 7 of the mental health act requires the AMHP to act as Valerie’s guardian. However, if mandatory admission appears to be the best option, the AMHP should examine Valarie through an interview to ascertain that the admission would be the best way of treating her. The examination would be targeted at the social causes of mental health issues to ensure that she receives the best community care services offered in the most non-restrictive way. Due to Valerie’s deteriorating mental health and suicidal ideation, the examination would be based on section 2 of the Mental Health Act 1983, which involves a 28-day detention in a mental healthcare facility to identify the presenting type of mental disorder the most appropriate treatment for that mental disorder, and an evaluation of how that treatment will affect her health. However, because Valerie has not been admitted in the hospital for the past 20 years, Section 2 of the Mental Health Act emerges as the most appropriate practice guideline. Conversely, community treatment order would not be appropriate for Valerie due to her non-compliance with medication. Nonetheless, due to the need for the least non-restrictive intervention, it would be good if Valerie agreed to be admitted into as an informal patient. In that case, the AMHP would be responsible for her transportation to the hospital, admission, and accompaniment during her stay in the hospital. Upon Valerie’s discharge, the AMHP would also be responsible for arranging all the aftercare services that she might need, describe their roles to Valerie and inform her of all her rights (Social Care Institute for Excellence, 2019). Alternatively, the AMHP could seek the services of a mental health advocate to help Valerie understand all her rights.

Question 4

The Care Act 2014 was formed as a means of reinforcing the laws related to adult care and support by providing for guidance and support as well as the standards to be followed when giving adult care. Therefore, Section 1 of the Care Act 2014 provides for the delivery of person-centered care to Callum and his parents by ensuring that the practitioner gives priority to their care need and wishes. Because Callum has been diagnosed with Down’s syndrome associated with various learning disabilities, it is Local Authority’s duty tonsure that Callum’s needs are met and that she is not exposed to the risk of neglect nor abuse. The practitioner should also seek support from Valerie and Mike, being that they are Callum’s relatives. Callum’s parents stopped him from attending the daycare after he was found to have engaged in sexual conduct with another service user. However, the parents speculated that Callum was not aware of what he was doing. It is therefore vital, according to section 9 of the Care Act 2014, for the Local Authority to conduct a needs assessment for Callum to ensure that his needs and wishes are heard and supported for purposes of enhancing a positive outcome.

More importantly, the Local Authority needs to respect Callum’s wish to attend the daycare, to move to his own flat and to continue with his relationship with James even if Valerie and Mike handle his daily activities, and although he cannot manage his finances. Nonetheless, it is necessary to conduct a needs assessment to evaluate Callum’s strengths to develop a proper care plan that meets all his fundamental needs based on the requirements of Section 4 of the Care Act 2014. Mike and Valerie should also undergo a care’s eligibility test administered by the Local Authority under section 9 of the Care Acr 2014 to ensure that they both have the ability and resources to provide care. The assessment would also provide an opportunity for Mike and Valerie to interact with the Local Authority for the purpose of knowing the types of services they can seek from the authorities – especially Valerie who suffers from depression. This interaction may also create an opportunity for training on some basic concepts of care that Mile and Valerie may not be aware .

Question 5

Child protection in the UK is guided and promoted by several legislations. With this regard, the Children Ac2004 together with the Children Act 1989 requires all agencies responsible for child protection to collaborate in safeguarding and enhancing child welfare. This is alongside other principles such as the welfare principle stipulated in Section 1 of the Children Act 1989, which states that a child’s welfare should be considered paramount and guarded in every decision made about them. Against this backdrop, Eeakalaar (1986) proposed that child welfare protection can be understood from the perspective of autonomy, basic and developmental needs. Hence, in the case of Suzy’s children, it is the responsibility of the Local Authority to develop a list of matters that the court should deal with, in line with the welfare principle Section 1 Seb-section 3. Section three the Children Act 1989 also bestows Suzy the parental responsibility to take care of her children even though she violated these responsibilities by failing to protect and promote their welfare. Nonetheless, it is crucial to consider that she might have been unable to partake of the responsibility of protecting her children due to the problems associated with mental health and frequent drug abuse.

It is, therefore, the responsibility of the Local Authority to intervene and safeguard Suzy’s children, especially considering the neglect and emotional abuse they are going through. In doing so, the Local Authority will develop a child protection plan after a preliminary investigation on the issues raised by the authorities as Kimberly’s school. Having been classified as ‘needy children,’ Jeremy, Kimberly, and Lennie are entitled to care from the Local Authority in collaboration with other professionals as stipulated in section 17 of the Children’s Act 1989. Furthermore, the Local Authority is supposed to work with Suzy while providing the children with the services they need. This can be achieved by providing Suzy with community or home care services such as family support workers, educational psychologist, as well as rehabilitation services to address Suzy’s drug addiction. Due to the deteriorated nature of Suzy’s home, the Local Authority has the responsibility of constant monitoring and supervising the home to ensure that the children’s welfare is upheld, especially considering the relapse and deterioration of her mental health condition. Through a local children Safeguarding Board, the Local Authority would conduct an assessment of Suzy’s home to ensure that it is safe for the children and share that information with other professionals for purposes of safeguarding the children’s welfare. Moreover, due to the speculations that the children may be harmed, the Local Authority, under section 47 of the Children’s Act, 1989 would investigate to evaluate the possibility of the children suffering further harm.

Also, a multi-disciplinary team consisting of various professionals as well as the Local Authority would be formed to engage in strategic meetings aimed at developing plans of how to safeguard the children. Considering that Suzy’s children have been experiencing physical and emotional abuse, Section 44 of the Children’s Act 1989 requires the Local Authority to invoke an Emergency Protection Order to protect the children out of any form of abuse for between 31 to 91 days.

Question 6

Due to the tragic safety violations, the children have gone through in due to Suzy’s drug addiction, erratic behavior and inability to assume the responsibility of protecting her children, there is an urgent need for professional intervention aimed at protecting the children. As envisaged on Children Act 1989 S. 46, the police are allowed to take custody of the children and keep them on custodial protection for 72 hours upon informing the Local Authority that they have taken custody of the children. The police would make this action as the first emergency action in the rescue of the children. Nonetheless, while addressing children’s wishes, the police should take note that their parents, Suzy and Ken, still hold parental responsibility – although that responsibility may have diminished due to their current circumstances. Conversely, whereas Wesley is capable of caring for his daughter, the police will inform him of the actions, even though he cannot take custody of her because he does not have Authority as a primary carer. That said, placing the children in emergency care will; provide an opportunity for the police to provide the necessary social services to the children while keeping them off any abuse. Based on the concerns raised that Rob is a sexual offender; it is the Local Authority’s responsibility (i.e., under Children Act section 47) to investigate and ascertain these allegations as raised by Kimberly and Lennie. However, considering that all the children are at risk of further harm the Local Authority, through a court order, can apply section 44 of the Children Act 1989 to place the children under emergency care for at least eight days as investigations over the allegations are conducted. A care plan would then be developed to safeguard the health of the affected children.

While under the Local Authority’s care, section 20 of the Children Act 1989 can be invoked to find the children a secure home of accommodation. However, the Local Authority would also develop a medium-term plan under section 31 of the Children Act 1989 to seek shared parental care of the children with Suzy based on the mistreatment they have received from their mother.

Question 7

It is the responsibility of the Local Authority, under section 22 of the Children Act 1989 to take care of Lennie, Jez, and Kimberly. In doing so, the Local Authority should also ensure that the children’s wishes are adhered to by keeping them in contact with their relatives. For instance, the Local Authority would develop plans for Suzy to have supervised visits with the children. Besides, the supervised visits would be extended to other relatives such as Jeremy’s aunt and grandmother, who have been under active contact with the children. Furthermore, it is the Local Authority’s responsibility to look for appropriate relatives known to the children; who would take custody of the children under temporary foster guardianship based on a placement order issued by the Local Authority. This process would involve proper planning whereby the children’s welfare is considered the core focus of any decision made for them. Furthermore, the plan would enable the delivery of health, education, and emotional needs to the children while avoiding any plans to separate them.

If a suitable foster caregiver is found, the Local Authority will conduct an assessment of the caregiver to ensure that they are fit to have the custody of the children. Schedule 2 of the Children Act 1989 also gives the children the right to an independent visitor who would frequently visit the children to advise and brief the children of their rights and other social issues. However, the visits could be terminated if the children objected it, although the frequent visits would play an important role in preparing the children for life after they leave care, or in safeguarding their welfare.

Question 8

As the social worker assigned to Jeremy, my responsibility would be to advocate for his welfare while protecting his rights as prescribed by Code C of the Police and Criminal Evidence Act 1984. I would act as his representative while he is in police custody and ensuring that he is fully aware of the charges labeled against him. Furthermore, as his adult caregiver, I would ensure that his rights are not violated and to ensure that the law on detention is not broken because he is only supposed to be in police custody for 36 hours regardless of the crime with which he is charged. It would also be my responsibility to ensure that Jeremy is well represented and receives adequate legal advice from the solicitor. If possible, I would seek to know the charges labeled against him evidence laid on those charges, as well as all the case files of the crimes he is alleged to have committed. Because Jeremy is still a child under an adult’s care, my duty as a Local Authority representative is to apply for legal aid to take care of all his legal fees (S. 21 of Children Act 1989).

If Jeremy is prosecuted, my duty as a representative of the Local Authority is to give him the necessary support as he awaits trial. In the process, I would write reports and make court presentations as his support officer. However, because Jeremy is charged with serious offenses including possession of class A drugs, possession of a weapon, criminal damage amounting to £25,000, and aggravated bodily harm, the prosecutor would press a charge against him, and bail would be granted. I would work with the YOT, based on the principles of national standards for youth justice, to develop a report detailing the facts about Jeremy’s life circumstances and how such circumstances could have contributed to his participation in the crime. Part of the items outlined in the report would be his family dynamics and the fact that he experiences neglect and abuse. I would use this information to explain to the court why a community rehabilitation based on a conditional discharge would be the most appropriate sentence for him instead of a custodial sentence. I would also submit to the court that with the right support, Jeremy would less likely engage in re-offending and that custodial sentence would harm his life. Ultimately, my focus would be on the argument that a second chance would be an opportunity for Jeremy to change. Moreover, I would also argue that Jeremy is already engaging with professionals at school, and therefore, a conditional discharge would be the most appropriate remedy to his behavior. If he is granted a conditional discharge, I will ensure that Jeremy adheres to all the judgment requirements and report any progress, so that his interactions with the youth justice court is minimized to create an opportunity for best outcomes.

Question 9

Suzy’s children are currently under the parental care of the Local Authority as required by the Care Order section 33. Even though Suzy still holds the children’s parental responsibility, the Local Authority has the responsibility to determine the extent to which Suzy can exercise her parental responsibility on the children. Because Suzy has refused to comply with any assistance to take care of the children, a placement order would be the most appropriate to suspend any existing care order. By the effect of the placement order, the Local Authority would be responsible for adopting the children or seeking any suitable adopter. The Adoption and Children Act 2002 allows the Local Authority to apply for a placement order in case there is a long-term plan to adopt the children. However, the order will not be sought unless it is satisfactorily confirmed that adoption is the best option for the children (Brammer, 2015). Besides, parental responsibility will only be given to the adopting agency if Suzy consents to the placement order. Hence, Suzy will retain her parental responsibility, although the agency has the power to restrict her responsibilities. Furthermore, the adoption order would only be valid if there is consent from both parents.

Being Lennie’s father, Wesley has parental responsibility for her, but he can only gain guardianship after applying for the same under section 14 of the Children Act 1989, which would award him special guardianship of both Kimberly and Jeremy. This arrangement would be the most suitable because Jeremy does not intend to saver his relationship with the grandparents as well as with the mother. He would, therefore, benefit from the arrangement by gaining permanent security of the ‘special guardianship.’ Nonetheless, Jasmine and Jerry, Wesley’s friends, have offered to foster the children in case Wesley has to be hospitalized for surgery.

Question 10

Considering Jeremy’s former ‘looked after child’ status, the Local Authority is responsible for promoting Jeremy’s welfare when he seizes his ‘looked after’ condition. Thus, the Local Authority will assume the role of a corporate parent, which comes with the responsibility of providing Jeremy with quality tertiary education as stipulated by section 25 of the Children Act 1989. Jeremy will be entitled to the Local Authority’s support until he reaches age 21. The Local Authority would also be required to develop a comprehensive plan aimed at ensuring Jeremy’s independence, considering his health, accommodation, education, and any other essential items. Furthermore, the Local Authority can apply for grant support to Jeremy’s educational needs as stipulated in section 24 Children Act 1989.

Question 11

As feedback from the played role, teamwork emerges as a critical contributor to any successful task. Being an aspiring social worker, I intend to develop excellent communication skills that would help me in coordination and collaboration with my colleagues to support my service as a social worker. Collaborative work would ensure that I make use of every team member’s skills to deliver the best quality of care to my clients and to make use of collaborative decision-making in the interest of the client. As Jeremy’s social worker, I was responsible for considering the various circumstances of his life that have contributed to his criminal engagements. My greatest achievement was being able to develop an argument based on relevant legislation to advocate for a lesser sentence for him so that he would have another opportunity for rehabilitation as opposed to incarceration.

Bibliography

Brammer, A. (2015). Social work law. 4th ed. Harlow: Pearson, pp.442-443

Children (Leaving Care)Act 2000 Regulations and guidance. Paras. 21-22)

J. Eekelaar (1986) ‘ The emergence of children’s rights’ 6(6) Oxford journal of Legal Studies p. 161