Specialising in Mental Capacity Assessments and Social Work Services.
Mental Capacity Assessments from a qualified, experienced, compassionate independent social worker.
About Me
Tilly Baden - Founder of Chesil Social Work Services
Tilly is a qualified and independent Social Worker, Best Interests Assessor, and Team Manager with over a decade of experience in social work. Tilly predominantly works for a Local Authority and manages a Mental Capacity Act Team, but also completes a range of independent mental capacity assessments and training related to mental capacity, human rights, leadership and management.
Tilly has substantial experience across social work settings. She has worked in community, hospital, and safeguarding teams and has experience working with adults with a range of needs, including people with learning disabilities, mental health conditions, dementia, acquired brain injuries, physical disabilities, forensic histories, and substance misuse issues.
Tilly is a regular columnist and features writer for the popular Social Work News media platform.
Tilly is an Associate Fellow at Bournemouth University and regularly delivers guest lectures for social work students on the legal systems, social policy, human rights, mental capacity and adult social work.
Tilly has been recognised nationally for her excellent social work practice and was a finalist for the National Social Worker of the Year Awards in 2019.
Tilly lives and breathes social work and is committed to promoting lawful and ethical practice which improves the lives of the citizens she works with.
What is the Mental Capacity Act?
Overview
The Mental Capacity Act (MCA) is a law that protects the rights of people aged 16 and over. It enables them to make their own decisions wherever possible.
It also adds a safety net for those who are unable to make a specific decision due to a mental disorder.
This can be decisions about:
- minor things like what food to buy or what to wear
- more serious things like whether to move to a care home or have major surgery
Decisions for a person aged 16 or 17 cannot automatically be made by their parents or guardians.
The MCA has 5 key principles that everyone must follow. These are:
- A person must be assumed to have capacity unless it is established that they lack capacity.
- A person is not to be treated as unable to make a decision unless all practicable steps to help them to do so have been taken without success.
- A person is not to be treated as unable to make a decision merely because he makes an unwise decision.
- An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done or made, in his best interests.
- Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action.
For a person to make a decision, they need to be able to:
- understand the information relevant to the decision
- remember the information long enough to make a decision
- work out what they think about it. This includes weighing up the advantages, disadvantages and likely consequences
- communicate their decision to others
A person has a lack of capacity to make a particular decision if they are unable to do:
- one or more of the 4 steps above
- this due to a mental disorder such as (but not limited to) dementia, a brain injury or a learning disability
If someone is unable to make a specific decision, then the decision will need to be made in their best interests.
Sometimes, a person will have:
- made a Lasting Power of Attorney
- made an Advance Decision
- a Court Appointed Deputy who can make the decision on their behalf
Anyone who makes a best interest decision must abide by the law and follow the Code of Practice.
The person must still be involved in the decision, even if they lack capacity. Their wishes and feelings should be taken into account.
Others involved in the person's life should also be spoken with. They should be given the opportunity to share their views. That includes:
- family members
- friends
- carers
- other professionals
- their advocate (if relevant)
If a best interest decision cannot be reached, an application may be made to the Court of Protection. This means a judge will make the final decision.
No one can make decisions on another person's behalf about consent to sex or marriage.
What are Deprivation of Liberty Safeguards?
Overview
Some people are prevented from leaving care in hospitals and care homes for their own safety.
This is called 'deprivation of liberty'.
A person may be 'deprived of their liberty' if they:
- lack capacity to consent to their care and treatment
- are under continuous supervision and control
- are not free to leave a care home or hospital
Deprivations of liberty are judged on a case by case basis.
If a person is deprived of their liberty, it is important that the person has legal protection to ensure:
- that their human rights are not breached
- there is a way for them to challenge this deprivation of liberty through court
This legal protection is called the Deprivation of Liberty Safeguards (known as DoLS).
DoLS assessments are carried out by 2 professionals:
- a specially trained doctor that will assess the person's mental disorder
- a second professional called the Best Interest Assessor (BIA)
They will spend time talking to the person and anyone involved in their life, such as:
- carers
- family members
- other professionals
A DoLS Standard Authorisation is only granted once the doctor and BIA are satisfied that the deprivation of liberty is lawful.
During the DoLS assessment, a representative for the person must be selected. They are known as the Relevant Person's Representative (RPR). The RPR keeps in touch with the person and supports them to challenge the DoLS Standard Authorisation if they object to:
- their care
- their accommodation
- restrictions in their life
There are rules about who can be appointed as an RPR.
If the person or their RPR disagrees with the standard authorisation, then they can challenge us in the Court of Protection. This is called a Section 21A challenge. There is non-means tested legal aid available along with full advocacy support for this process.
A judge will then decide:
- what care and treatment is in that person's best interests
- where they should stay
The DoLS process only applies to those in a hospital or care home. If a person is deprived of their liberty in their own home or a supported living environment, then the Local Authority or NHS Trust will apply to the Court of Protection for a judge to agree this. This is often known as a "Community Deprivation of Liberty" or referred to as the "Re. X procedure".
Contact details
Contact
Email: tilly@chesilsocialwork.co.uk
Telephone: +44 7790066694
Follow Tilly on Twitter: @tilly_anya
Read Tilly's latest articles written for Social Work News here.
Charitable Partnerships
Lendwithcare.org
At Chesil Social Work Services, we are passionate about giving back to the community, promoting empowerment, and advocating for personal autonomy.
We have started working with Lendwithcare, an initiative run by CARE International UK, one of the leading aid organisations. It aims to fight poverty by supporting people in low-income countries to work their way out of poverty with dignity. Lendwithcare works with local development partners to provide micro-loans to low-income entrepreneurs who are excluded or under-served by formal financial institutions or are at greater risk of being exploited by loan sharks or criminal organisations.
We are currently supporting two entrepreneurs in Rwanda and Ecuador who have small farming businesses and are committed to farming sustainably and supporting local communities.
For more information about the great work Lendwithcare is doing, or to become a Lendwithcare angel, visit www.lendwithcare.org/referral/YSVLJF
