“In the circumstances you will not be surprised that we can have little confidence in any of the documentation which accounts for the care package which P receives. We believe that it is therefore necessary for an independent social worker expert to be instructed to report to the court on the issue of P’s best interests in relation to his residence, the care he should receive and the manner of its delivery, and contact with other individuals.”
“… minimal intervention by his support team has always been envisaged and planned for in order to further P’s best interests. There appears to have been a great deal of confusion in this case on all sides regarding the issue of restraint. Such confusion seems to have stemmed from the use of language regarding that issue: In particular, whether the local authority has “no restraint policy” or whether it has “a no restraint policy”
“With regard to the instruction of an independent social work expert, we agree with Baker J that this case does not require such a report. Such costs would be disproportionate and unnecessary.”
“Using protective clothing, one staff member is to hold P’s hand and ask him to open his hand. If P is uncooperative, one member of staff must open his fist, remove the contents and clean his hand, to prevent him from throwing, smearing or ingesting it. The second member of staff should ask, coax and direct in assisting P to change his pads/clothing and freshen up. In the highly unlikely circumstance that P does not cooperate, depending on the circumstances, the members of staff will have to decide whether this needs to be done (a) in a location where the incident has arisen or (b) in another location. If it is decided that another location will be preferable (such as a bathroom or lavatory) the member of staff will have to establish whether P is willing to go to that location, and if not, whether restraint should be used to achieve that end. The decision whether a change of location is required, and, if so, whether restraint is necessary to achieve it should be taken having regard to (a) the risk of harm to P (b) the risk of harm to others, including members of staff, and (c) P’s dignity and personal autonomy.”
“Sadly, this case has had a detrimental impact on those working at Z House as support staff seem to think that physical restraint is somehow “a bad thing” that should be avoided. This in part is due to a confusion of language between the Court and care staff. They perceive physical intervention as an action to prevent someone from hurting themselves or others as part of the wider care and support plan. The Court seems to me to define it more broadly as any hands on care. The staff have all been trained in personal care routines in safeguarding, and moving and handling training, and I would want to reassure the Court that despite staff having a heightened sense of anxiety they continue to meet P’s needs in a professional and respectful manner. One of the key lessons learnt is that the local authority needs to ensure that those working with incapacitated adults presented with challenging behaviour are reassured that a proportion of restraint is perfectly lawful. The legal terms “deprivation of liberty” and “restraint” unfortunately invoke negative connotations in lay minds when they are intended to promote a person’s best interests… I want the court, however, to be reassured that all staff working with such service users will receive training in the new… policy. To this end, the council has agreed to employ an appropriate external trainer to provide practical training in the new policy.”
“In conclusion, there is no doubt the previous guidance was not strong or comprehensive enough, often with an emphasis on managing aggressive or violent behaviour, as opposed to guidance on physical interactions in relation to promoting the care and safety of service users. Specific issues are managed, as in P’s case via the risk assessment process. Whilst full risk assessments and action plans will remain important, the clear gap re a lack of guidance to staff re physical intervention will now be closed through the new policy.”
“Everyone has the right to liberty and security of the person.
“Where the proceedings concern P’s personal welfare, the general rule is that there will be no order as to the costs of the proceedings or of that part of the proceedings that concerns P’s personal welfare.”
“(1) The court may depart from rules 156 to 158 if the circumstances so justify, and in deciding whether departure is justified, the court will have regard to all the circumstances including (a) the conduct of the parties; (b) whether a party has succeeded on part of his case, even if he has not been wholly successful; and (c) the role of any public body involved in the proceedings. (a) the conduct of the parties; (b) whether a party has succeeded on part of his case, even if he has not been wholly successful; and (c) the role of any public body involved in the proceedings. (2) The conduct of the parties includes (a) conduct before, as well as during, the proceedings; (b) whether it was reasonable for a party to raise, pursue or contest a particular issue; (c) the manner in which a party has made or responded to an application or a particular issue; and (d) whether a party who has succeeded in his application or response to an application, in whole or in part, exaggerated any matter contained in his application or response…”
“The work carried out by the local authorities and other public bodies such as NHS Trusts in this important field cannot be underestimated. Thousands of dedicated professionals and support staff devote their lives to helping people with learning disability, for long hours and low salaries. All public bodies face very difficult times as they struggle to come to terms with the implications of the cuts in public expenditure recently announced. The Court of Protection must work with these professionals under the collaborative philosophy underpinning the MCA and its Code of Practice ….”
“That does not mean, however, that local authorities, or any other public bodies, can be excluded from liability to pay costs in appropriate cases. The rules about costs must be applied fairly to all litigants, regardless of who they are. In this case, all the costs of litigation will be borne by the public purse. The Legal Services Commission is an equally hard-pressed public agency and the Commission – and the taxpayers who fund it – are entitled to look to the Court to apply the costs rules impartially and ensure that there is a level playing field. Gone are the days when it is appropriate for a court to dismiss applications for costs on the basis that it all comes out of the same pot. Such an approach would undermine confidence in the courts and distort public administration and accountability …. Of course, it is right that the Court should follow the general rule where appropriate. Parties should be free to bring personal welfare issues to the Court of Protection without fear of a costs sanction. Local authorities and others who carry out their work professionally have no reason to fear that a costs order will be made. The submission that local authorities will be discouraged from making applications to the Court of Protection if a costs order is made in this case is a thoroughly bad argument. The opposite is, in fact, the truth. It is only local authorities who break the law, or who are guilty of misconduct that falls within the meaning of rule 159, that have reason to fear a costs order. Local authorities who do their job properly and abide by the law have nothing to fear. In particular, the Court of Protection recognises that professional work in this very difficult field often involves very difficult judgments and decisions. The Court is not going to impose a costs burden on a local authority simply because hindsight demonstrates that it got those judgments wrong.”