Agenda item

6.1  The Chair stated that in the past the Commission had considered briefings on Deprivation of Liberty Safeguards (DoLS) and the system is now being replaced with Liberty Protection Safeguards (LPS) and the purpose of this item is to understand the changes being made and the impact it will have on the Council and on service users.

6.2  He welcomed to the following

Dr Godfred Boahen (GB), Principal Social Worker, Adult Services, AHI

Georgina Diba (GD), Director of Adult Social Care and Operations, AHI

Helen Woodland (HW), Group Director, Adults, Health and Integration

6.3  Members gave consideration to 2 briefing notes:

LPS implementation - cover sheet

Liberty Protection Safeguards - Briefing to HiH

6.4  HW introduced the report explaining that this was another piece of legislation brought in and with implementation postponed repeatedly.  The report gives the timeline and the work being done to prepare Hackney for it.

6.5  GB explained that this went to the heart of how society looks after people who need care or support and protection but do not have the mental capacity to consent and so safeguards are required. DoLS changed the legal framework around depriving  people of their liberty. Then an important Supreme Court Judgement in 2014 clarified what constitutes a DoL which then made the sector realise that the thresholds were lower than previously thought and this led to expansion of referrals and the system was then seen as overly bureaucratic and in need of simplification.  The Law Commission made proposals which became the LPS.  It increases the settings where safeguards apply, it expands the function to other Responsible Bodies and it includes 16-17 yr olds for the first time.  A final Code of Practice is still subject to consultation so they are awaiting that before the date for implementation is known. So the Council has had to plan amidst this uncertainty and all this within the context of workforce shortages. There is a need to consider the needs of all the relevant partners involved locally so that a seamless transition can be enacted.  They have done a number of consultations with staff to develop the model and they have also worked with trusts, the ICB and Children and Families Service.  The LPS needs to be underpinned by principles and values and the recognition that the demography of Hackney requires an LPS model that must respond to the cultural needs of residents.  The local model also is being co produced and they are taking a whole systems approach.  Between Jan and Mar ‘23 they will work with providers and advocates to finalise the local model. They also need to train the work force and to scale them up to deliver the care and support. They are already working with partners to develop clear care pathways to enable a seamless transition.

6.6  Members asked detailed questions and the following points were noted:

a) The Chair asked that with the expansion of the Responsible Bodies to be involved, what risk was there when responsibility lines were changed and wasn’t there a danger of people falling through the net.  He also asked why a resource strapped NHS trust should volunteer to undertake this responsibility when it could be done by the Council. On the expansion of settings he asked how the expansion of DoLS from just institutional settings to home settings would operate and if it was the case that an individual would have greater freedom of movement but, for example, might have less liberty to make decisions over banking etc.  GB explained that they were taking a whole system approach and so were developing clear pathways which would capture movement from one system or organisation to another. The ‘new’ Responsible Bodies would want to take it on as it will be part of their statutory duties and there will be expectations on them to fulfil these responsibilities.

b) The Chair gave an example of a patient at the Homerton where doctors had concerns and would the Homerton be the RB in that case.  GB replied it would and that one advantage of LPS is that careful planning of pathways is done and the authorisation would be portable so there would be no need for other bodies to duplicate or replicate the assessment and care plans. On the home environment issue the details of the precise application of the LPS are being finalised and the Code of Practice is not yet available but they hope the details will be forthcoming once the consultation is completed.

c) Members asked how the extension to 16-17 yr olds will operate. GB replied again that there will be a need to keep a close eye on the guidance as it emerges.  Up to now the process was to bring a request to the Court of Protection, a process which can be adversarial, time consuming and costly. Now the partners have to work with the Children and Families Team to enable them to fully understand the implications of the new LPS. They will do an audit now to gauge how it might impact on their caseloads to get a better sense of when it might apply. GD added that under current arrangements families/carers would be involved in the decision making and within LPS that will remain. She explained that when they make ‘best interests’ decisions around those who lack capacity, they always work with the family/carer and this will not change. But the advent of LPS moves it out of the court arena and is a better environment to work with parents in a different way and really help to strengthen relations. In all it will be more of a partnership approach with the young person at the centre.

d) The Chair commented that previously with 16-17 yr olds it was a was mandatory Court of Protection process whereas with LPS it’s at first stage a non judicial process but a 16 or 17 yr old themselves or through an advocate would still be able to challenge the process through a court or tribunal, so one way of seeing it was that we are getting less legal protections but another way is that it is being taken out of the adversarial courtroom environment.  GD added that it won’t reduce the work being done in advance and there are a huge number of safeguards nor it is reducing the ability of the person to challenge with an advocate beside them. 

e) The Chair commented that on implementation we don't yet have a code of practice and we don’t have a date but the Council is as far ahead with the preparation work as officers think it can be.  He asked why officers think that LPS will just increase “slightly”  the demands on the Council’s resources.  GB replied that it would be difficult to say as present as we don’t have final details and we have to assume at the initial stage, because of the need to train the workforce, there would be additional resource implications but this can be seen as an investment in  having a better system overall.

f) Members asked about the monitoring of LPS orders by gender and ethnicity as historically black communities were over represented in mental health services and what is being done to tackle this. GB replied that there are a number of monitoring requirements embedded in the LPS system as well as regular reporting but added that the focus now is on how can we ensure that our practice takes a more preventative approach so we don’t get to the stage of needing more LPSs. The focus needs to be on having a less restrictive approach with LPS being the final part, if required. They need to be used in a positive and not a negative way.

6.7  The Chair thanked officers for all the work that is being done on this and asked that when LPSs are being implemented and when the new system is up and running that Members might receive an update to provide reassurance on the level of interplay between the different organisations as well as on the reduction of duplication and whether it represents a marked improvement on the old system.

ACTION:

Future update on the implementation of LPS once the system is bedded in to be added to the work programme.

RESOLVED:

That the report and discussion be noted.