SPECIFICATION FOR
INDEPENDENT MENTAL CAPACITY ADVOCACY SERVICE
AND PAID RELEVANT PERSON’S REPRESENTATIVE SERVICE
TO
CITY OF WESTMINSTER, NHS WESTMINSTER
AND, AS MAY BE REQUIRED BY THE CITY COUNCIL IN ACCORDANCE WITH THE CONTRACT,AS THE CITY COUNCIL’S SUB-CONTRACTOR TO:
ROYAL BOROUGH OF KENSINGTON AND CHELSEA,
LONDON BOROUGHS OF: HILLINGDON, HOUNSLOW, HARROW, HAMMERSMITH & FULHAM, BRENT, EALING, LAMBETH
Interpretation
a)The provisions of this Specification are without prejudice to the Contractor’s obligations under the Contract and in the event of any inconsistency the provisions of the Contract shall prevail. The Contractor shall ensure that all relevant members of staff are also fully familiar with the Contractor’s obligations under the Contract.
b)Non-instructed advocacy where referred to in this Specification means advocacy on behalf of a Service User who is not able to direct the independent mental capacity advocate themselves and who cannot clearly state what they want or need.
c)Words and expressions defined in the Contract shall have the same meaning in this Specification unless otherwise stated.
- INTRODUCTION
1.1Adult Services Departments have responsibilities for the most vulnerable people in the community. These include: people with mental health problems, people with learning disabilities, people with physical disabilities, frail older people and people with other vulnerabilities. The City Council’s Adults Services Department’s function is to ensure that these people receive services appropriate to their needs within the framework of statutory duties and the City Council’s policies.
1.2The overall aim of Westminster Adults Services is to promote and provide a range of high quality, responsive, cost effective services to our Service Users in order to assist them to attain and maintain an optimum quality of life.
- CORE REQUIREMENTS
2.1City Council Access and Liaison
2.1.1The Contractor shall be contactable by the City Council, and the Participating Authorities (if applicable), between the hours of 9.00 am and 5.00 pm Monday - Friday.
2.1.2 The Services will be available to the City Council and the other Participating Authorities and their relevant Partners under the terms of the Mental Capacity Act 2005 (as amended by the Mental Health Act 2007 and any other legislation/regulations) (“the Act”) normally between 9.00 am and 5.00 pm Monday – Friday and in exceptional circumstances outside these hours.
2.1.3 The Contractor should acknowledge to the relevant Instructing Officer the receipt of any Referral within 24 hours of its receipt.
2.2Access to Information
2.2.1 The City Council has an open policy on information held concerning all Service Users, in accordance with the Data Protection Act 1998. The Contractor shall ensure that information held in relation to the Service Users is made available to them in accordance with the legislation.
2.3Confidentiality
2.3.1 The Contractor will recognise the need for confidentiality within the content of a clear operational policy having regard to the Data Protection Act 1998, the Human Rights Act 1998 and any Information Sharing Agreements that the City Council may expect the Contractor to enter into from time to time.
2.4Contractor’s Policies
2.4.1 The Contractor shall have a clear policy to be approved by the City Council on, but without limitation:
Recruitment Procedures
Health and Safety
Grievance and Disciplinary Procedures
Supervision of staff
Training of staff
Complaints
Confidentiality
Equalities and Diversity
Service User involvement
Raising Issues of Concern
Safeguarding Adults
Safeguarding Children
Multi-disciplinary working
2.5Safeguarding Adults and Children
2.5.1The Contractorshall ensure that Service Users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory or institutional abuse, inhuman or degrading treatment, , through deliberate intent, negligence or ignorance, in accordance with written policy and procedures.
2.5.2The Contractorshall have procedures for responding to suspicion, disclosure or evidence of abuse or neglect (including ‘Whistle–blowing’) to ensure the safety and protection of Service Users. In the case of young people the Contractorshall follow the processes outlined in the London Child Protection Procedures 2007
2.5.3The Contractorshall report any concerns or allegations of abuse in relation to City of Westminster’s Service Users as follows:
- Concerns in relation to young people shall be referred to the City Council’s Children’s Services Duty and Assessment team on (020) 7641 7525 who will advise on contacting the relevant placing local authority; and
- Concerns in relation to adults shall be referred to the City Council’s Safeguarding Adults Team on (020) 7641 2176 or by email to , following Westminster’s Safeguarding Adults Policy and Procedures in accordance with the Public Interest Disclosure Act 1998 and Department of Health (DH) guidance No Secrets 2000.
2.5.4The Contractor shall report concerns or allegations or abuse in relation to Service Users of any Participating Authority to the appropriate person as notified to the contractor by the relevant Participating Body.
2.5.5The Contractor shall ensure that Staff who may be unsuitable to work with children or vulnerable adults are referred for consideration for barring from the Independent Safeguarding Authority’s register.
2.5.6The Contractor shall ensure that itsStaff working with vulnerable client groups have been subject to enhanced Criminal Record Bureau checks and have received appropriate training
2.5.7The Contractor shall ensure that it abides by the requirements as set out in the safeguarding adults procedures or child protection procedures which operates in the City of Westminster and in each of the relevant Participating Authorities.
2.6Race Relations (Amendment) Act 2000
2.6.1The Contractor shall ensure that it fully identifies and considers the needs of the black and minority ethnic group Service Users when planning and developing the Service.
2.6.2The Contractor shall monitor the Service to identify any gaps in its delivery to black and minority ethnic group Service Users.
2.6.3The Contractor shall consult and work in partnership with the City Council, the Participating Authorities (if applicable), and relevant black and minority ethnic community groups in order to develop its policies and practices with equality implications for the Project’s Service Users.
2.7Social Inclusion and Recognising Diversity
2.7.1The Contractor shall demonstrate through its policies and practice a commitment to and ability to meet the following principles:
- To treat Service Users as individuals and promote their dignity, independence and social inclusion
- To acknowledge and respect Service Users’ gender, sexual orientation, age, ability, race, religion, culture and lifestyle
- To enable Service Users to maintain their rights associated with citizenship
2.8Civil Contingencies
2.8.1Under the Civil Contingencies Act, the City Council and Participating Authorities are obliged to ensure that their services and contractors who deliver services on their behalf are able to operate effectively at all times in a way that meets the needs of residents and addresses the needs of the workforce in the event of a major civil incident. The Contractor shall ensure that plans and procedures are in place to enable the continued operation of the service during any form of major civil disruption.
2.9Freedom of Information Act
2.9.1The Contractor shall assist the City Council and, if applicable, the Participating Authorities in meeting all their obligations under the Freedom of Information Act 2000.
2.10Legal requirements
2.10.1The Contractor shall at all times during the Contract Period provide the Service in accordance with current Legislation.
- THE SERVICES
3.1The Services which the Contractor shall carry out pursuant to this Contract are in four parts as follows (which together shall be known as “the Services”):
- An Independent Mental Capacity Advocate Service (the “IMCA Service”) as described in paragraph 3.2 below
- A Paid Relevant Persons Representative Service (the “PRPR Service”) as described in paragraph 3.3 below
- Additional Advocacy, as described in paragraph 3.4 below
- Awareness Raising and training, as described in paragraph 3.5 below
3.1.1The Contractor shall provide the Services both to the City Council and, as the City Council’s sub-contractor, to any of the following Participating Authorities who may wish to take up the Service:
The Royal Borough of Kensington & Chelsea
The London Borough of Hillingdon
The London Borough of Hounslow
The London Borough of Harrow
The London Borough of Brent
The London Borough of Hammersmith and Fulham
The London Borough of Ealing
The London Borough of Lambeth
3.2Independent Mental Capacity Advocate Service
3.2.1The role and function of Independent Mental Capacity Advocates (“IMCAs”) are described in the Act, the DoLS Code of Practice and the Mental Capacity Act 2005 Code of Practice(the “MCA Code of Practice”) and the Contractor shall at all times provide the Services in accordance with the Act, the Mental Capacity Act 2005 (Independent Mental Capacity Advocates) (General) Regulations 2006 , the Mental Capacity Act 2005 (Independent Mental Capacity Advocates) (Expansion of Role) Regulations 2006, and any Code of Practice, guidelines or subsequent regulations that may from time to time be enacted or issued by the Secretary of State or the Department of Health or any other relevant body.
3.2.2The Contractor shall support and represent Service Users by:
- obtaining and evaluating relevant information
- Ascertainingas far as possible the Service User’s wishes and feelings, beliefs and values
- Consulting those providing care or treatment for the Service User or those who may be able to comment on the Service User’s wishes, feelings, beliefs or values
- ascertaining the extent of the support provided to the Service User to enable them to participate in the decision-making process
- ascertaining what alternative courses of action are available
- obtaining a further medical opinion where necessary
- providing a full written report to the decision maker in the relevant local authority, or NHS body.
3.2.3The IMCA has a legislative role to help represent any person aged 18 and above who has been deprived of their liberty under the terms of the DoLS Code of Practice and as described in the Act and who has no friend or family member who is willing or eligible to represent them and who is ordinarily resident in the City of Westminster or one of the eight Participating Authorities, and who is accommodated within a hospital or care home which is located in Greater London (“the Relevant Person”). The DoLS IMCA shall assist the Relevant Person and their unpaid representative to understand the authorisation (to deprive the Relevant Person of liberty), and how to appeal against it.
3.2.4If necessary, the IMCA shall also support the Relevant Person and their unpaid representative with an application to the Court of Protectionand/or provide support to trigger a review. The IMCA will have the right to make submissions to the Supervisory Body(the “Supervisory Body”for a Relevant Person in a care home is the local authority for the area in which the Relevant Person is ordinarily resident; the “Supervisory Body” for a Relevant Person in a hospital is the Primary Care Trust (PCT) that commissions the relevant care or treatment, or the host PCT if the care or treatment is not commissioned by a PCT) on the question of whether a qualifying requirement should be reviewed, or to give information, or make submissions, to any assessor carrying out a review assessment.A Deprivation of Liberty IMCA (“DoLS IMCA”)will be called upon to represent the Relevant Person at the assessment stage if it has been identified that there is no other appropriate person to represent them.
3.2.5In addition to the statutory appointment of an IMCA with regards to serious medical treatment and change of accommodation, where required by the referrer or IMCA Lead Officer, the IMCA shall also attend the first care review for any Service User, where the IMCA has been involved in reaching the decision about the care arrangements. This will include where the Service User is placed outside of the City of Westminster or if required, one of the eight Participating Authorities, but within Greater London. Where there is staffing capacity within the Services the IMCA shall also attend the first such carereview where the Service User is located outside of Greater London.
3.2.6Where required by the referrer or IMCA Lead Officerthe IMCA may also be appointed to a Service User who is subject to Safeguarding Adults procedures even where a family member is involved.
3.3Paid Relevant Person’s Representative Service (“PRPR Service”)
3.3.1The Contractor shall provide Paid Relevant Person’s Representatives (“PRPRs”) (as described in the Mental Capacity (Deprivation of Liberty: Appointment of Relevant Person’s Representative) Regulations 2008 and the Act) to any Relevant Person as defined at paragraph 3.2.3 above.
3.3.2Where there is suitable staffing capacity the Paid Relevant Person’s Representative Service shall also be provided to Relevant Persons ordinarily resident in the City of Westminster or if required, one of the eight Participating Authorities, who are accommodated outside of Greater London.
3.3.3The PRPRs shall carry out the role and functionsas described in the Department of Health guide, Deprivation of Liberty Safeguards; A guide for Relevant Person’s representatives, (the “Guide”). The responsibilities of the Paid Relevant Person’s Representative shall include the following:
3.3.3.1To have regard to the Act, the MCA Code of Practice and the DoLS Code of Practice.
3.3.3.2To maintain face-to-face contact with the Relevant Person. Levels and methods of contact will vary depending on the person. The minimum level of contact is one visit to the Relevant Person per month.
3.3.3.3To support the Relevant Person in matters relating to or connected with their deprivation of liberty under the standard authorisation as described Part 4 of Schedule A1 to the Act. This will include:
Working with the Managing Authority (as defined Part 13 to Schedule A1 to the Act) to help the Relevant Person to understand, as much as they are able to, the fact that the Managing Authority has been authorised to deprive them of their liberty and the effect of this on their care;
Finding out the Relevant Person’s views on their care and the restraints imposed on them;
Helping the Relevant Person to communicate their feelings to the Managing Authority and others (eg family, friends, professionals involved) as appropriate.
3.3.3.4To represent the Relevant Person in matters relating to or connected with their deprivation of liberty under the standard authorisation.This will include:
Expressing what has been witnessed of their views and feelings to the Managing Authority and others (eg family, friends involved professionals) as appropriate;
Putting forward the Relevant Person’s views and feelings in the statutory processes (including review and application to the Court of Protection);
Challenging those involved in the Relevant Person’s care if it appears that their care could be improved in their best interests, even if the Relevant Person is not expressing unhappiness with the care.
3.3.3.5To ensure that the Relevant Person’s best interests are safeguarded by:
Bringing to the attention of both the Managing Authority and the Supervisory Body any ways in which the current care of the Relevant Person appears not to be in their best interests.
Requesting a review when necessary (see 3.3.4below).
Applying to the Court of Protection when necessary (see3.3.7below).
Anything else that would protect the Relevant Person’s best interests, eg using the Managing Authority’s or Supervisory Body’s complaints procedure.
3.3.3.6In addition to maintaining contact with the Relevant Person, to undertake the following:
To maintain contact with the key-worker or person within the Managing Authority responsible for overseeing the standard authorisation, involved family or friends, any attorney or deputy;
Periodically (at least every 3 months and whenever the care planchanges) reviewing the care plan for appropriateness;
Attending reviews of their care/multi-disciplinary discharge planning meetings.
Putting forward the Relevant Person’s views and the Representative’sown views on their best interests during any review of the standard authorisation or assessment for a new standard authorisation.
To be available to be consulted by a s39A IMCA who is considering applying to the Court of Protection.
To ensure that an interpreter is available for any visit to or discussion with anyone whose first language is not English and who is not able to or does not want to communicate in English.
3.3.3.7To maintain records of contacts with the Relevant Person and those referred to above and provide copies of these to the Supervisory Body every 3 months.
3.3.3.8The minimum time commitment needed in relation to each Relevant Person will be 3 hours per month (indicative use of time – 1hr visit, 1 ½ hrs talking to others and looking at care plan, ½ hr writing-up), plus 3 hours per review.
3.3.4Requesting a review of the standard authorisation
This will be requested by completing “Deprivation of Liberty Letter 4” as set out in Appendix A of the Guideand returning to the Supervisory Body if:
- It appears to the Representative that the Relevant Person no longer meets any of the qualifying requirements, or
- It appears to the Representative that the reason the Relevant Person meets any of the qualifying requirements has changed, or
- It appears to the Representative that there has been a change in the Relevant Person’s case which means that the conditions of the standard authorisation should be changed.
3.3.5Case closure
The service provided by the Paid Relevant Person’s Representative shall end when the authorisation of Deprivation of Liberty for that Relevant Person ends.
3.3.6Dispute resolution
Wherever possible, concerns about the deprivation of liberty should be resolved informally or through the relevant Supervisory Body’s or Managing Authority’s complaints procedure, rather than through the Court of Protection.
3.3.7Applying to the Court of Protection
The Paid Relevant Person’sRepresentative does not need permission to apply to the Court of Protection. The Paid Relevant Person’s Representative should consider applying to the Court of Protection if they feel it would be in the Relevant Person’s best interests for the Court to rule on any of the below:
a)whether the Relevant Person meets one or more of the qualifying requirements;
b)the period during which the standard authorisation is to be in force;
c)the purpose for which the standard authorisation is given.
d)the conditions subject to which the standard authorisation is given. (s21A (2) of the Act).
3.3.8Sources of support and information for the Paid Relevant Person’s Representative