During the course of undertaking Advocacy Quality Performance Mark assessments, we review an organisation’s policies and procedures to help us assess whether that organisation meets QPM standards. A number of organisations are being required to update policies to show that the work that they do with people who lack the mental capacity to make certain decisions about how their advocate works with them, are working in line with the Mental Capacity Act 2005. We thought we’d let you know what assessors are looking for to help you prepare your QPM submissions.
We need to see that advocates are using the MCA 2005 to make Best Interest decisions in the course of their advocacy relationship. For example,
- If a person lacks the mental capacity to consent to their advocate sharing information with others, or to consent to the advocate discussing their issues with others, how does the advocate decide who to talk to and what information to share?
- if a person lacks the mental capacity to consent to the advocacy relationship, how do you decide if it’s in the person’s best interest to have an advocate?
- If a person lacks the mental capacity to decide which advocacy issues their advocate should support them with, how does the advocate decide what would be in their best interests to work with the person on?
- If the person lacks the capacity to instruct their advocate how does the advocate decide which model/s of Non Instructed Advocacy to use?
When we are reviewing policies, your assessor needs to see what your organisations approach and process is for dealing with these types of scenarios. We need to see that advocates are using the best interest decision making frameworks of the MCA to inform their practice and to make good Best Interest decisions in the course of the advocacy relationship.
This isn’t about advocates making best interest decisions that other should be making, e.g. whether to move to home A or home B – it’s purely about how the advocate works with the individual and makes decisions when the person lacks the mental capacity to decide or consent. It’s ensuring that advocates uphold people’s rights as set out in the MCA.
We absolutely believe that advocates should be directed by the people they are working with – so taking into account a person’s past and present wishes, feelings, beliefs and values, however they are expressing these, is absolutely fundamental when making best interest decisions.
The policies that this most often impacts on are:
- Non Instructed Advocacy Policy
- Confidentiality and Data Protection Policies (with regard to sharing information and the inherent breach of sharing information without consent where someone lacks capacity to decide if that information should be shared)
- And at times, Safeguarding polices, depending on your organisations approach to making safeguarding alerts and breaching confidentiality.
- Supervision – it’s important that any non-instructed advocacy is discussed at every supervision. For QPM, we want to see that this is happening
We aren’t suggesting that there needs to be onerous processes in place – the MCA is all about proportionality – but we do need to see that polices support advocates to be mindful of people’s rights under the act and that advocates are working within the law.
It’s a tricky subject – we spend a lot of time telling decision makers “Advocates don’t make Best Interest decisions!!” and that’s true, advocates don’t make Best interests decisions that are other people’s responsibility – however, we might, at specific times in the course of the advocacy relationship have to make Best interest decisions about how we work with someone, if we are also going to uphold people’s rights in the same we expect others to. It is about how we as advocates work with people in an empowering and lawful way.
We’ll be running a NIA and MCA masterclass – so for further info sign up!
NDTi also deliver MCA awareness training that covers the basics of capacity tests and best interest decision making – for more information, contact the NDTi Office on 01225 789135.