Court of Protection - learning briefing
Safeguarding adult reviews
Under the Care Act 2014, Safeguarding Adult Boards are responsible for undertaking a review of cases that involve adults with care and support needs where:
- an adult has died or suffered serious harm
- abuse or neglect is known or suspected to be a factor in their death
- there is concern that partner agencies could have worked more effectively to protect the adult.
SAR Ben context
Ben had a history of risks relating to self-neglect. He did not follow medical care and treatment in relation to diabetes management. The care home raised concerns about this and his deteriorating physical health.
Ben’s behaviour was becoming more challenging. He began to refuse mental health medication. He also refused treatment for a deteriorating heel ulcer with a risk of gangrene.
The care home considered a referral to the Court of Protection, but did not submit one.
Read the full report on SAR Ben.
Learning point
The challenges of non-engagement with adults experiencing self-neglect
Ben didn't follow his care, support and treatment plan. Care staff didn't always know the right way to get him more help.
Risk assessments did not include the risks from his physical health needs and the significant impact these could have on his future health.
Recommendation
Health and social care staff need to be more aware of the role of the Court of Protection and how to obtain legal advice regarding complex cases.
Where services seek legal advice independently on the same case, they should coordinate any decision making through multi-agency risk management meetings.
Making an application to the Court of Protection
Follow your organisation's guidelines and processes on Court of Protection applications. If you think you may need to apply to the Court of Protection, discuss this with your manager.
Contact your legal services team to get advice about how to make the application, and what evidence you may need.
It is possible to apply to the Court of Protection in extreme emergencies. Ask your legal services team for help to make an urgent application. You may need to safeguard the adult while the legal team makes an application to the court. For example, for out-of-hours urgent decisions.
Make an urgent or emergency application to the Court of Protection | GOV.UK
Examples of good practice
Putting DoLS into practice | SCIE has examples of good practice on Deprivation of Liberty Safeguards.
Case example – Mavis
The local authority is taking steps to protect Mavis, a woman with dementia who lives at home with her husband. They are worried that her needs are not being met because her husband is refusing help. They think her husband might have a mental health problem that is not being treated.
Mavis was assessed as not being able to decide where to live, but she clearly wants to stay at home. The local authority thinks it would be best for Mavis to move to a care home. They also think Mavis would need a lot of restrictions in the care home to get the right care.
Because moving would go against the wishes of Mavis and her husband, they apply to the Court of Protection to make a decision about what is best for Mavis. If the court says Mavis can move to the care home, the care home will apply for authorisation from the Court of Protection to restrict Mavis' freedom.
Case example – Fred
Fred has advanced throat cancer. He had capacity to make the decision about starting chemotherapy to treat his cancer. But when his condition progressed, he was assessed as lacking capacity to decide whether to continue with this treatment.
The medical staff believe that further chemotherapy is not in Fred‘s best interests. His prognosis is not good. Also, to receive the treatment they would have to restrain him, causing him a great deal of distress. His son and daughter disagree. They say that their father would want the medical staff to do everything they could to treat his cancer. The NHS trust responsible for Fred‘s treatment applies to the court for a decision.
