the liberty protection safeguards - hc-uk · 2019. 9. 19. · the road to the lps … o 2004...
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the Liberty Protection
Safeguards
Tim Spencer-LaneSeptember 2019
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the road to the LPS …
o 2004 – Bournewood judgment: the rejection of legal informality
o 2009 – DoLS introduced
o 2014 – critical House of Lords PLS report
o 2014 – Cheshire West judgment: expands meaning of deprivation of liberty
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The “Acid Test”P v Cheshire West & Chester Council, P & Q v Surrey CC [2014] UKSC 19
Constant / continuous
supervision & control
not free to leave
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The impact of Cheshire West
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the critical balance
Human rights
protection
Efficient & streamlined
scheme
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6
Implementation date:
1st October 2020
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Authorising arrangements
arrangements can be authorised for enabling the care or treatment of a person (aged 16+) that give rise to a deprivation of liberty
can be in any setting & multiple settings
can include means & manner of transport
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Who is the responsible body?
• if arrangements mainly carried out in an NHS hospital, the “hospital manager” (eg the NHS trust)
• if arrangements mainly carried out in an independent hospital , the local authority
• If arrangements are mainly via CHC, the CCG
• otherwise, the local authority (ie the council meeting the person’s needs or in whose area the person is ordinarily resident)
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The “conditions”
capacity assessment
• person lacks capacity to consent to the arrangements
medical assessment
• person has a mental disorder
necessary & proportionate
• necessary to prevent harm to person, & proportionate to likelihood & seriousness of such harm
• must have regard to person’s wishes and feelings
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consultation with …
• the person
• any named person
• carer or anyone interested in the person’s welfare
• any deputy or attorney
• IMCA or appropriate person
Main purpose is to ascertain person’s wishes and feelings about the arrangements
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Pre-authorisation review
No objections
• person reviews the information
• determines if reasonable for RB to conclude conditions are met
Objection or independent
hospital
• AMCP reviews the information & determines if conditions met
• meets with the person & consults others
reviewer cannot be involved in day-to-day care or providing any
treatment
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Care home arrangements
responsible body decides which
pathway applies
(1) the care home manager leads the
process, or
(2) the responsible body arranges the
authorisation
Applies to those aged 18+
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Key safeguards
• rights to information
• duty to provide care plan (authorisation record)
• rights to regular reviews
• rights of legal challenge to the Court of Protection
• duty on CQC to monitor & report on the LPS
• rights to IMCA or appropriate person …
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Interim & emergency DoL
• D can deprive P of liberty in 3 cases:
o while the court decision being sought
o pending assessment under LPS, or
o in an emergency
• must be reasonable belief in lack of capacity & DoLmust be necessary to deliver life-sustaining treatment or carry out a vital act
Replaces urgent authorisations
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Adverse possessionMental Health Act interface
• LPS cannot be used if a patient is detained in hospital under the MHA
• LPS cannot be used if the person is objection to admission to hospital for psychiatric treatment
• LPS can be used alongside one of the community powers of the MHA (eg CTO or Guardianship)
This largely maintains the existing interface between
DoLS and MHA
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Next steps
• Start date: 1st October 2020
• Code of Practice & Regulations - consultation later this year, laid in Parliament Spring 2020
• Alongside this - consultation on main Code of Practice
• Training and workforce strategy
• Revised impact assessment
• Transitional arrangements - existing DoLS authorisations to remain in place for up to a year