Monthly Archives: June 2017

The Mental Capacity Act – What You Need To Know

The mental capacity act was only introduced in the year of 2005, which was something that has been long overdue. This is a guideline policy designed to empower and protect individuals who may have otherwise been stigmatised, and their choices limited because others may have deemed them as not being capable of making their own choices in life.

Here is the understandable and easy read version of the mental capacity act and it’s principles.

Why was the mental capacity act brought in?

The mental capacity act was introduced in order to remove any grey areas regarding a person’s capacity. Before it was introduced, there has been so many occasions where individuals have been wrongly judged as not having capacity because of a diagnosis.

For example, I worked in the healthcare industry prior to 2005 as a support worker. My speciality at that time was autism and I had the privilege of supporting four young adults, each with their own spectrum of autism. The unfortunate reality at that time is that because these people had a diagnosis of autism, they automatically had some of their rights taken away because it was assumed that they lacked the capacity to do so.

One of the guys we supported always had to have someone with him when he went out in the community because it was assumed that he lacked the capacity to go out on his own, there was nothing to legally protect us if anything happened to him when he went out so we couldn’t take a risk by making the decision to let him go on his own. Can you imagine being followed around 24/7 and never be left alone no matter where you went? Now imagine you had autism, how much worse it must have been for him to handle.

Thanks to the mental capacity act, he has now been deemed to have the capacity, despite the fact that he makes “unwise decisions.” The truism that was obvious to everyone, but nobody could do anything about, was that we all make unwise decisions a lot of the time. Should our right to make those unwise decisions be taken away? 

This is just one example out of millions of cases pre 2005 which needed to be addressed. While there is still a lot of stigma among the public, in the healthcare sector things have changed dramatically. Now people who have been diagnosed with autism, mental health problems, dementia, learning difficulties and much more have been freed from the shackles of assumption.

What if someone is deemed to lack capacity?

If an individual has been tested and does not have the capacity, then a best interests meeting will be held. The aim of this is to determine in which areas the person does not have the capacity in some areas and to support them in a way which is the least restrictive for them. 

Just because someone lacks capacity does not mean that all of their independence should be stripped from them. The main goal now is to find a way to empower them despite their ailments. This could mean concealing medication so that they are getting the help they need pharmaceutically, or it could mean that they are restricted as to where they can go on their own for their own safety.

One example would be someone who has learning difficulties. They may not understand the road signs which makes it dangerous for them to cross the road on their own, in this case, they would have a support worker with them to help them navigate and explore the world safely.

Legally speaking, if a company is responsible for the care of someone who lacks capacity, they have the right to make decisions on their behalf in the area which they need support. This can only be for their welfare and is only specific to the areas where the individual requires support to make decisions.

In other words, if our person with learning difficulties needs support crossing the road safely, that does not mean he needs us to support him and make decisions for him in every other area. He may be very capable when it comes to dressing himself for example so we would promote and encourage that person to dress without support. 

Mental Capacity Advocates

When someone lacks capacity, by law they will need to have an advocate to speak on their behalf. This is to prevent misunderstandings and safeguards that person from being taken advantage of. It is the responsibility of the advocate to ensure that the person who lacks capacity has all of his support needs in place correctly.

They will be liaising with support workers, social workers, health professionals and the council so that the individual has all of their needs met. This includes emotional and physical wellbeing, promoting independence, eating well and having access to the community.

Balancing these needs for the individuals can be challenging but that is why so many people are involved at each time. No matter how severe the person’s lack of capacity is, there is always something that can be done for them so that they can get the best out of life. As long as all of the people involved care enough and can use their creativity to solve problems then there is always a solution.

Working In Domiciliary Care As A Coordinator

By far and away, the most stressful position that I have yet to experience in the health and social care sector is a care coordinator for a large home care company. The pressure is immense. What you have as a care coordinator is an accelerating ageing population matched with bloated rules and regulations.

The healthcare sector is referred to as the hot potato sector because there is just so much liability on the companies/individuals if anything does ever go wrong. We are dealing with people’s lives after all, but you would think that the compensation would match the responsibility…it does not even come close.

So let’s break the job of a care coordinator in the domiciliary sector down a bit by bit. This will help you understand what is involved in the job if you ever wanted to try the job so that you know what to expect when applying.

The Carers

Carers are always a mixed bag. You will never manage to get a team of fantastic carers at all times. For some reason, the law of averages always throws in a few troublesome ones. You can generally tell early on who will be good and who will be a headache to manage, for some the work of a carer comes so naturally that you would think they had been doing it for years.

Other carers will start out making a lot of mistakes, but with the right guidance will eventually make excellent carers and these are the ones who go on to management because they tend to learn new things more quickly and retain the information when taught.

Then there are the carers who will never be good at their job, always miserable, always complaining about the office, always making the same mistakes and never learning from them – because they don’t want to. With the healthcare sector being as it is, you can’t just fire them either, carers are surprisingly hard to come by so you will need to learn how to manage their weaknesses. Mostly you can put them on the runs which you know requires less effort, or you can put them on a double run with an experienced carer to allow for their mistakes. 

Carers are your most important tools for effectively doing your job. Do everything you can to keep them happy, but at the same time make sure that you don’t let them take advantage. If they want a holiday and they haven’t given enough notice then don’t do it if you think they will not appreciate you going the extra mile. Be flexible where you can but only if the carer is willing to be flexible for you when you need them.

The Families

As a care coordinator, you will be working very closely with the families of those under your care. This can be an enormous help for you as the coordinator as most families will do anything for their family members, but it can also be one of the most stressful relationships a coordinator has to do as well.

For many families, a carer will never be able to do the job right no matter how much they try, not because of the carers competency but because the family will simply never be completely happy. 

Some family members you will never see until their mother/father passes away and the inheritance check comes in. This can be a heart-wrenching experience if you have provided care for the individual for so long and you watch on in disgust as their family members come on the scene as vultures tearing away at their whole life savings. 

There are also the family members who are really just appreciative to have the help of a carer. These are the best families to work with as you can get a lot done for the person you are providing care for. 

The Social Workers

Social workers are a funny bunch. Mostly they will spend their time calling you about any changes in care, trying to ask for time specific calls for their clients, relaying the families wishes to you, organising reviews and generally keeping you on your toes while coordinating the elderly clients care packages.

Unfortunately, the job of a social worker attracts a lot of self-righteous individuals who take it upon themselves to dig for dirt, even if it’s not there. They will charge into you with no evidence of wrongdoing or intentional bad care provisions because they can believe they are the saviour of the client. These are the bad social workers, the ones who make your job a lot harder but most importantly have a negative impact on the care being provided. When a social worker’s sole purpose is to try to find the negatives in care being provided, this creates a negative environment for the client.

Carers will not enjoy going into seeing the client because they know every move will be scrutinised and judged. That has a knock on effect onto the client who is then even more complacent about the care being provided, and the self-righteous social worker becomes even more active…vicious cycle!

I should stress that not all social workers are like this. Some social workers are pig ignorant and so appear to be rude because they don’t know what to do to help their client, then there are those who actually do try to do their best.

The good social workers never last long. They either get so frustrated with the social care sector because they begin to realise there is little they can do to influence things, or they get promotions or move on to more senior roles.