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The impacts of policy delay on client safeguarding and safety

What are the Liberty Protection Safeguards (LPS)?

Introduced in the Mental Capacity (Amendment) Act 2019, the LPS will replace the Deprivation of Liberty Safeguards (DoLS) and deliver improved outcomes for people over the age of 16 who are or need to be deprived of their liberty if it is deemed in their best interests to do so to allow them to receive appropriate care or treatment.

People with dementia, severe autism, or who have learning or behavioural difficulties may lack the mental capacity to make or consent to their care arrangements and in these cases supervisory bodies including local authorities, NHS Trusts, or Care Commissioning Groups make decisions on behalf of vulnerable people.

The decision to deprive someone of their liberty is a major step and one that is often taken without the consent if the individual involved. The current process requires the supervisory body to follow the DoLS process, but decisions can cause upset for relatives and when a sustained objection is made, the Court of Protection is called upon to make decisions as to whether the deprivation of liberty is necessary.

The LPS - changes and delay

The DoLS was launched in 2009 to provide legal authority for supervisory bodies to undertake assessments and to make decisions on an individuals liberty based on the outcome of those assessments. However, critics have labelled it as too complicated and unnecessarily bureaucratic and two high-profile Supreme Court judgments in recent years widened its scope to the extent it became overwhelmed with referrals, which subsequently led the government to initiate a review.

LPS is intended to place the person at the heart of decision-making and to provide a simplified legal framework that protects human rights and is clear and accessible to all stakeholders with a streamlined authorisation process for the deprivation of liberty. The main reforms include;

  • LPS will apply to vulnerable young people from the age of 16
  • Deprivations of liberty will need to be authorised in advance by the supervisory body
  • The assigning of an advocate to speak on behalf of the protected party
  • Frequent reviews by supervisory bodies to assess situation and its ongoing validity
  • Introduction of a maximum initial detention period of one year, with any extensions requiring justification
  • However, if a person’s capacity or condition is unlikely to change, authorisations can be renewed for up to three years
  • Family or friends of the protected party can challenge the measures in the Court of Protection if thought to be excessive of unreasonable

Initially planned for introduction in October 2020, the impact of COVID resulted in the implementation of the LPS being pushed back to April 2022. However, at the end of 2021 this revised timeframe was deemed unrealistic due to the prolonged impact of COVID, with a revised plans for implementation yet to be confirmed.

The impacts of the policy delay

Health and social care workers welcomed the initial delay to the implementation, enabling focus to remain on dealing with the impact of the COVID pandemic. However, with momentum effectively stopped, there is now uncertainty over whether a timeline for implementation exists and if provision for appropriate resources needs to be made.

Supervisory bodies are wasting time and money preparing for the LPS without knowing when it will become valid, whilst neglecting potential improvements to processes for the DoLS in anticipation of it being replaced. Given the significance and scope of the changes, sufficient time to plan the implementation of the LPS is needed to ensure a clear focus on the rights and wellbeing of those that need support.

Vulnerable people who are not yet protected by the DoLS remain at risk during this period of uncertainty and those deprived of their liberty and awaiting reviews face ongoing delays due to crippling resource shortages within the healthcare sector. Protected people and their families must also work with the current complex and bureaucratic framework the LPS is designed to replace until it becomes active.

‘whilst the delay is concerning, we welcome the introduction of these changes with the emphasis being on seeking authorisation prior to care arrangements being made. This will ensure that for those receiving care and intervention, the least restrictive measures for the individual are considered from the beginning and allow for the arrangements for care delivery to be person centred in the best interests of the client. We particularly welcome the amendments which for the first time consider the impact of executive dysfunction on capacity assessments which for those with a brain injury can be crucial in ensuring that the assessment itself is robust.” Jo Wilkins, Head of Care Support Services.

The role of a case manager in protecting vulnerable people

Those that have been deprived of their liberty are among the most at risk people in society and case managers have a critical role in protecting vulnerable clients and ensuring they receive the right care in the right setting. A case manager must have an intimate knowledge of their client’s medical history and personal life, in addition to a comprehensive understanding of their challenges and familiarity with their support structure to deliver successful case management.

Where a vulnerable client has been deprived of their liberty, that protection takes on different challenges, as the case manager may often be required to coordinate complex support services to manage care for an ongoing condition rather than rehabilitation. The fundamental principles of case management remain in that the client remains at the centre of all decisions taken.

The case manager begins by completing a thorough assessment to identify the case needs of the client before formulating a plan, ensuring they work closely with loved ones to provide a long-term solution that safeguards the client’s wellbeing and protects their human rights.

Case Management at Bush & Co

Case management services from Bush Care Solutions are regulated by the Care Quality Commission and support vulnerable young people and adults and others with serious and complex needs as a result of personal injury and clinical negligence. Our team of case managers bring a wealth of experience from several clinical fields and the medico-legal knowledge and expertise to deliver excellent client service.

  • Expertise – a team of more than 115 clinical specialists across the UK with an average of 16 and a minimum of 7 years experience
  • Professional – established relationships across the medico-legal sector enabling flexible commercial terms and efficient response times
  • Client-focused – we are proud to have a 97% overall client satisfaction rate
  • Added Value – access to services including vocational rehabilitation, pain management programmes, and employment support services

Bush & Co have a Clinical Board that oversees clinical risk management and clinical governance to ensure our team of experts always maintain the highest standards in care for our clients.

Contact a member of our team on 01327 876210 or at enquiries@bushco.co.uk for further details of our Case Management and other services