Any of the following decisions that you make may be challenged;
The following persons may raise a challenge;
Disagreements can be;
Informal disagreements include;
Formal disagreements include;
As soon as you are aware that a disagreement exists the Code of Practice expects you to take steps to resolve it at the earliest opportunity and, wherever possible avoid the need to take matters to the Court for a resolution.
Sometimes disagreement can be anticipated during the process of decision making. When this is apparent (or likely) you should;
Decisions that cannot usually be delayed are those relating to;
In order to proactively try to resolve disagreement you should ensure that you have;
If a proactive approach to resolve the disagreement during decision making is not successful you should;
Disagreements that have been raised after the decision is made, but outside of formal complaints channels can often be resolved through;
This can involve;
If an informal approach to resolve the disagreement is not successful you should;
Depending on the nature of the decision and the dispute it may be appropriate to make an application to the Court of Protection to seek a final determination about mental capacity, or what is in the person’s Best Interests.
An advocate can help settle a disagreement by;
If an IMCA or other independent advocate is already involved you should consider the benefit of;
Formal complaints are those complaints made through the formal complaints procedures of a Local Authority or CCG.
If a formal complaint has been made you (or whoever has been appointed to investigate the complaint) should follow processes set out in any local complaints procedure to try to resolve the dispute.
This will normally involve informal discussion between;
If a formal approach to resolve the disagreement is not successful the person making the complaint should be advised of their right to make a formal complaint to the Local Government or Health Ombudsmen.
Depending on the nature of the decision and the dispute it may be appropriate to make an application to the Court of Protection to seek a final determination about mental capacity, or what is in the person’s Best Interests.
If the dispute is bought to the Court of Protection to make a determination about capacity or Best Interests, the Court will;
Sometimes you will be;
If you have concerns you should not ignore them. You should raise them in an appropriate manner, which could be;
When deciding how to raise a concern you should seek the advice of your line manager as required, and refer to any available local processes.
Peter is a social worker who was consulted as part of a Best Interests decision about medical treatment for Eva. The Decision Maker is a consultant at the hospital where Eva is admitted and she has subsequently made a Best Interests decision to proceed with major surgery.
Based on the information provided to Peter about the process of decision making, he is concerned that the consultant may not have taken adequate steps to involve Eva. Eva has no family, limited verbal communication and needs time to digest information. Peter knows that the consultant has visited her on one occasion only, and that she was asleep for most of this visit. He feels that the decision should have been delayed, an advocate should have been arranged and that Eva should have been given more time to express her wishes and feelings.
Peter expresses his concerns through a professional discussion with the consultant but feels that these are disregarded without justification.
Peter seeks the support of his line manager before putting his concerns in writing and making a formal complaint through the hospital’s complaints process.
John lives in a care home and has previously been found to lack capacity to make decisions about some of his daily care routines, such as what to eat, wear or how to spend his time. Ellen is a community nurse and was involved in agreeing how John should be supported to be involved in these choices by carers.
During a visit to the care home, Ellen observes 2 different carers making choices for John without involving him at all. Ellen is concerned that the manner in which the Best Interests decision is being implemented. She talks privately to the Registered Manager of the care home, who confirms that the Care Plan has not been altered and that John’s wishes and feelings should be sought prior to carers making any decisions on his behalf.
It transpires that both the carers involved have only recently been employed by the care home, and their understanding of John’s Care Plan and the Mental Capacity Act is limited. Ellen agrees a plan with the Registered Manager to address this and plans to review things when she next returns.
Sometimes you will be involved in, or aware of a decision that has been made by a Deputy or a Donee of a Lasting Power of Attorney.
Unless there is evidence that any of the following apply, you cannot challenge a decision made by a Deputy or Donee, even if you disagree with it;
If any of the above applies you must take steps to report concerns to the Office of the Public Guardian. The OPG is responsible for monitoring how Donees and Deputies make decisions, and it will investigate all complaints about the practice of registered Donees and Deputy’s.
All Deputy’s and Donees have a duty ‘not to delegate’. This means they cannot delegate their decision making responsibilities to another person without the permission of the Court to do so.
If a Deputy or Donee is declining to make a decision that they have responsibility for, or has asked another person to make the decision on their behalf you must take steps to;
tri.x procedures