“However the Act applies more generally to everyone who looks after or cares for, someone who lacks capacity to make particular decisions for themselves. This includes family carers or other carers. Although these carers are not legally required to have regard to the Code…, the guidance given in the Code will help them to understand the Act and apply it. They should follow the guidance in the Code as far as they are aware of it.”
“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.”
“What does the Act mean when it talks about ‘best interests’?”
“5.1 The best interests principle underpins the MCA. It is set out in section 1(5) of the Act…The concept has been developed by the courts in cases relating to people who lack capacity to make specific decisions for themselves, mainly decisions concerned with the provision of medical treatment or social care. 5.2 This principle covers all aspects of financial, personal welfare and health care decision-making and actions. It applies to anyone making decisions or acting under the provisions of the Act, including • family carers, other carers and care workers • health care and social care staff • attorneys appointed under a Lasting Power of Attorney or registered Enduring Power of Attorney • deputies appointed by the Court to make decisions on behalf of someone who lacks capacity, and • the Court of Protection.” • family carers, other carers and care workers • health care and social care staff • attorneys appointed under a Lasting Power of Attorney or registered Enduring Power of Attorney • deputies appointed by the Court to make decisions on behalf of someone who lacks capacity, and • the Court of Protection.”
“5.8 Under the Act many different people may be required to make decisions or act on behalf of someone who lacks capacity to make decisions for themselves. The person making the decision is referred to throughout this chapter and in other parts of the Code as the “decision-maker”, and it is the decision-maker’s responsibility to work out what would be in the best interests of the person who lacks capacity. • For most day to day actions or decisions, the decision-maker would be the carer most directly involved with the person at the time. • Where the decision involves the provision of medical treatment, the doctor or other member of health care staff responsible for carrying out the particular treatment or procedure is the decision-maker. • Where nursing or paid care is provided the nurse or paid carer will be the decision-maker. • If a Lasting Power of Attorney (or Enduring Power of Attorney) has been made and registered, or a deputy has been appointed under a court order, the attorney or deputy will be the decision-maker, for decisions within the scope of their authority.” • For most day to day actions or decisions, the decision-maker would be the carer most directly involved with the person at the time. • Where the decision involves the provision of medical treatment, the doctor or other member of health care staff responsible for carrying out the particular treatment or procedure is the decision-maker. • Where nursing or paid care is provided the nurse or paid carer will be the decision-maker. • If a Lasting Power of Attorney (or Enduring Power of Attorney) has been made and registered, or a deputy has been appointed under a court order, the attorney or deputy will be the decision-maker, for decisions within the scope of their authority.”
“(6) He must consider, so far as is reasonably ascertainable (a) the person’s past and present wishes and feelings (and in particular any relevant written statement made by him when he had capacity), (b) the beliefs and values that would be likely to influence his decision if he had capacity, and (c) the other factors that he would be likely to consider if he were able to do so. (7) He must take into account, if it is practicable and appropriate to consult them, the views of (a) anyone named by the person as someone to be consulted on the matter in question or on matters of that kind; (b) anyone engaged in caring for the person or interested in his welfare, (c) any donee of a lasting power of attorney granted by the person and (d) any deputy appointed for the person by the court, as to what would be in the person’s best interests, and in particular, as to the matters mentioned in sub-section (6). … (9) In the case of an act done, or a decision made, by a person other than the court, there is sufficient compliance with this section if (having complied with the requirements of subsections (1) to (7)) he reasonably believes that what he does or decides is in the best interests of the person concerned.”
“6.1 Every day, millions of acts are done to and for people who lack capacity either to • Take decisions about their own care or treatment, or • Consent to someone else caring for them. Such acts range from everyday tasks of caring (for example, helping someone to wash) to life changing events, (for example, serious medical treatment or arranging for someone to go into a care home). In theory, many of these actions could be against the law. Legally, people have the right to stop others from interfering with their body or property unless they give permission. What happens if someone lacks capacity to give permission? Carers who dress people who cannot dress themselves are potentially interfering with somebody’s body without their consent, so could theoretically be prosecuted for assault. A neighbour who enters and cleans the house of a person who lacks capacity could be trespassing on the person’s property. 6.2 Section 5 of the Act provides “protection from liability”
“8.3 In most cases concerning personal welfare matters, the core principles of the Act and the processes set out in chapters 5 and 6 will be enough to • help people take action or make decisions in the best interests of someone who lacks capacity to make decisions about their own care or treatment, or • find ways of settling disagreements about such actions, or decisions. But an application to the Court of Protection may be necessary for: • particularly difficult decisions • disagreements that cannot be resolved in any other way (see chapter 15), or • situations where ongoing decisions may need to be made about the personal welfare of a person who lacks capacity to make decisions for themselves. 8.4 An order of the court will usually be necessary for matters relating to the property and affairs (including financial matters) of people who lack capacity to make specific financial decisions for themselves, unless: • their only income is state benefits… or • they have previously made a Enduring Power of Attorney or Lasting Power of Attorney to give somebody authority to manage their property and affairs…” • help people take action or make decisions in the best interests of someone who lacks capacity to make decisions about their own care or treatment, or • find ways of settling disagreements about such actions, or decisions. • particularly difficult decisions • disagreements that cannot be resolved in any other way (see chapter 15), or • situations where ongoing decisions may need to be made about the personal welfare of a person who lacks capacity to make decisions for themselves. • their only income is state benefits… or • they have previously made a Enduring Power of Attorney or Lasting Power of Attorney to give somebody authority to manage their property and affairs…”
“8.27 In some cases, the court must make a decision, because someone needs specific authority to act and there is no other route for getting it. These include cases where: • there is no EPA or property and affairs LPA in place and someone needs to make a financial decision for a person who lacks capacity to make that decision (for example, the decision to terminate a tenancy agreement) or • it is necessary to make a will or to amend an existing will, on behalf of the person who lacks capacity to do so. 8.28 Examples of other types of case where a court’s decision might be appropriate include cases where: • there is genuine doubt or disagreement about the existence, validity or applicability of an advance decision to refuse treatment (see Chapter 9) • there is major disagreement regarding a serious decision, (for example, about where a person lacks capacity to decide for themselves where they should live) • a family carer or a solicitor asks for personal information about someone who lacks capacity to consent to that information being revealed (for example, where there have been allegations of abuse of a person living in a care home) • someone suspects that a person who lacks capacity to make decisions to protect themselves is at risk of harm or abuse from a named individual (the court could stop that individual contacting the person who lacks capacity).” • there is no EPA or property and affairs LPA in place and someone needs to make a financial decision for a person who lacks capacity to make that decision (for example, the decision to terminate a tenancy agreement) or • it is necessary to make a will or to amend an existing will, on behalf of the person who lacks capacity to do so. • there is genuine doubt or disagreement about the existence, validity or applicability of an advance decision to refuse treatment (see Chapter 9) • there is major disagreement regarding a serious decision, (for example, about where a person lacks capacity to decide for themselves where they should live) • a family carer or a solicitor asks for personal information about someone who lacks capacity to consent to that information being revealed (for example, where there have been allegations of abuse of a person living in a care home) • someone suspects that a person who lacks capacity to make decisions to protect themselves is at risk of harm or abuse from a named individual (the court could stop that individual contacting the person who lacks capacity).”
“8.31 Sometimes it is not practicable or appropriate for the court to make a single declaration or decision. In such cases, if the court thinks that somebody needs to make future or ongoing decisions for someone whose condition makes is likely they will lack capacity to make some further decisions in the future, it can appoint a deputy to act for and make decisions for that person. A deputy’s authority should be as limited in scope and duration as possible…”
“8.32 It is for the court to decide who to appoint as a deputy. Different skills may be required depending on whether the deputy’s decisions will be about a person’s welfare (including healthcare) their finances or both (the court will decide whether the proposed deputy is reliable and trustworthy and has an appropriate level of skill and confidence to carry out the necessary tasks. 8.33 In the majority of cases, the deputy is likely to be a family member or someone who knows the person well. But in some cases the court may decide to appoint a deputy who is independent of the family (for example, where the person’s affairs or care needs are particularly complicated). This could be … a professional deputy…”
“We need to be able to handle E’s affairs and make decisions as to his welfare with minimal intervention from the local authority. We want to be able to get on with our lives in a way which gives us some independence from both the local authority and the Official Solicitor.”
“I would like to be E’s deputy, along with F. I have had this explained to me and understand fully what is involved. I think it should be up to me and F to make best interests decisions with regards to E’s future care and welfare. The sole reason why I brought this case in the first place was because I wanted to play an important role in making the decisions that were significant for my brother’s life as I didn’t think the authorities involved in his care were acting in E’s best interest. I think that the best people to make decisions are those people who are personally involved with E’s care and understand the world he lives in.”
“to put it bluntly, I’m E’s big sister. I’ve cared for him since I was six and I want to carry on for as long as possible. It [i.e. being appointed deputy] would give me a strong sense of being responsible.”
“7. The court has before it an application by the parents and sisters of DP to be appointed as his deputies in respect of all welfare and financial matters, in other words to be appointed in such a way as to make all the necessary decisions indefinitely into the future in relation to those matters which he himself cannot decide. It is accepted that, whether it be the court or whether it be a deputy, any decision made on behalf of a person lacking capacity, must be made in his best interests and the statutes sets out in section 4 the principles that must govern the exercise of a judgment in relation to best interests.”
“8. A provisional reading of those principles might be thought to sit rather uncomfortably with the concept of appointing deputies at all. Since the principle of appointing deputies is fundamental to this part of the Act, it must be appreciated that section 16(4) has to be read in the context of the fact that, ordinarily, the court will appoint deputies where it feels confident that it can. It is perhaps important to take one step further back even than that, and for the court to remind itself that in a society structured as is ours, it is not the State whether through the agency of an authority or the court, which is primarily responsible for individuals who are subject or citizens of the State. It is for those who naturally have their care and well being at heart, that is to say members of the family, where they are willing and able to do so, to take first place in the care and upbringing, not only of children, but of those whose needs, because of disability, extend far into adulthood. It seems to me at least that the Act ought to be read subject to that overriding policy aim. 9. Therefore, the court ought to start from the position that, where family members offer themselves as deputies, then, in the absence of family dispute or other evidence that raises queries as to their willingness or capacity to carry out those functions, the court ought to approach such an application with considerable openness and sympathy.”
“since the principle of appointing deputies is fundamental to this part of the Act, it must be appreciated that section 16(4) has to be read in the context of the fact that, ordinarily, the court will appoint deputies where it feels confident that it can…”
“The authors of ‘Mental Capacity: A guide to the new law’ (second edition) rightly noted, in my judgment, the application of the principle in section 16(4)(a) ‘suggests that there is little scope for the appointment of deputies on a general basis effectively to act as if they were donees of a general power under an LPA.’ Later, they continued that ‘it is expected that a deputy will be appointed to take personal welfare decisions in only the most extreme cases and the court will usually seek to make an order in respect of a decision, rather than confer an ongoing power on a deputy.’ That, I have concluded, is a proper summary of the position and reflects the desirable approach. Section 16(4) seems to me to be intended specifically to minimise the scope and duration of control. Specific decisions of the court are to be preferred to the ongoing appointment of a deputy and when a deputy must be appointed it is to be for the narrowest scope and the shortest time reasonably practicable in the circumstances.”
“ (1) The court may make an order appointing (a) the Official Solicitor; or (b) some other person to act as his litigation friend. (2) The court may act under paragraph (1) (c) either on its own initiative or on the application of any person; but (d) only with the consent of the person to be appointed (3) An application for an order under paragraph (1) must be supported by evidence. (4) The court may not appoint a litigation friend under this rule unless it is satisfied that the person to be appointed satisfies the conditions specified in rule 140 (1). (5) The court may at any stage of the proceedings give direction as to the appointment of a litigation friend.”
“(1) It is G who had to issue this application and who has consistently adopted the stance that E was detained (a matter not immediately acknowledged by either the local authority or the Official Solicitor) [and] must return home, which is now known to be correct. (2) It is only at a very late stage that the Official Solicitor argued that E should be returned home (presumably because they did not have the background knowledge that G had). (3) If the order of Ryder J did authorise lawful detention [at the hearing on8 December 2009 – see my earlier judgment of26 March 2010 at paras 47 and 92-96] (which is not admitted, this being one issue on which leading counsel has advised an application to the Supreme Court should be made) it was the Official Solicitor which removed E’s claim for damages by consenting to that order (if consent order it was, which is not accepted for the reasons previously given). Accordingly if E cannot claim damages for this period he has a cause of action in negligence against the Official Solicitor. (4) Alternatively, the Official Solicitor agreed to E for whom they acted, being detained at an organisation which was in breach of theCare Standards Act 2000 and so were negligent in failing to satisfy themselves that E was detained in an organisation which was authorised to detain. It was G who had to point out the “tenancy” was invalid. (5) The Official Solicitor failed to secure proper contact for E. There were problems and delays even after the various court orders directing contact… (6) The Official Solicitor have [sic] failed to protect E’s money [i.e. during his stay at Z Road in the care of X Limited]… Accordingly it will be necessary to seek to claim monies back from X Limited. (7) The Official Solicitor have [sic] failed to protect E’s possessions [some of which, it is alleged, have not been returned by X Limited or returned in a poor condition]. (8) The Official Solicitor failed to ensure that E was properly cared for [i.e. by X Limited]. (9) The Official Solicitor have [sic] failed to raise the issue of [a] serious case review, a matter repeatedly raised by G.”
“(1): The court may make an order appointing (a) the Official Solicitor or (b) some other person to act as a litigation friend.”