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Recent updates on website

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  • 18/11/18 (2): CQC MHA report corrections. CQC, 'Monitoring the Mental Health Act in 2016/17 - amendment list' (13/11/18) — The CQC published the following text alongside a full list of corrections to their 2016/17 report: "We are currently amending this document after our analysts found that we had displayed some data gathered by Mental Health Act reviewers on their visits in an inaccurate way. We will publish the updated report in November 2018. An explanation for the amendments: (1) Up until 2015-16, we used ‘Yes/No’ to document whether providers could show evidence of patient involvement in care planning. (2) In 2015-16, we added an option for Mental Health Act reviewers to document this as ‘Requires improvement’. This gave reviewers the option of documenting that the provider had shown some evidence of recording patient information, but it still required improvement. (3) When working on the 2016/17 report, our analysts found that reviewers had been inconsistent in how they had documented this information. Some reviewers had recorded patient involvement just as ‘Yes’ or ‘No’, while others had recorded as ‘Yes’, ‘No’, or ‘Requires Improvement’. (4) In preparing the report, we sought to present the information in the ‘Yes/No’ style to show a trend from past results. However, in doing so we combined the responses of ‘requires improvement’ with the ‘No’ responses, which was inaccurate. As a result, we have amended the report."
  • 18/11/18 (1): CQC MHA report. CQC, 'Monitoring the Mental Health Act in 2016/17' (27/2/18) — Summary from Gov.uk website: "This report sets out the Care Quality Commission’s (CQC) findings from engagement with people subject to the Mental Health Act 1983 (MHA) and review of services registered to assess, treat and care for people detained using the MHA. The report was compiled using information gathered from across CQC activities to report on the quality of care people are receiving while detained. The report also looks at how providers use the MHA to make sure people with a mental health disorder have access to the right care and treatment when their or others’ health or safety is at risk. CQC reports limited or no improvement in the key concerns that it has raised in previous years. In particular, no improvement in evidence of: (a) patient involvement being recorded in care plans; (b) patients’ views about their care being recorded; (c) whether clinicians have considered the least restrictive option for care." See also the corrections here: CQC, 'Monitoring the Mental Health Act in 2016/17 - amendment list' (13/11/18).
  • 17/11/18 (4): Hillgreen case. CQC, 'Statement on CQC's actions in relation to Hillgreen Care Ltd' (27/7/17) — In this response to the Times article of the same date, the CQC's chief executive stated: "Today's coverage in the Times has rightfully challenged the action we have taken in respect of the care provided to the people who were resident at Colne Road. Whilst we did take action that led to the closure of this and two other services run by the Hillgreen Care Ltd, I believe that we could and should have taken action more speedily, both to ensure people were safe and in prosecuting this provider. Consequently, I am commissioning an independent investigation, which will report publicly to the CQC Board and identify what has happened, what we should have done differently and which will make recommendations to strengthen our future work."
  • 17/11/18 (3): Hillgreen case. Andrew Norfolk, 'CQC covered up suspected rape in care home' (Times, 27/7/17) — This article related to a "cluster" of sex alerts at residential homes owned by Hillgreen Care, a private company that specialised in the care of young adults with learning disabilities. It was said that confidential documents revealed that: (a) the deputy manager of one home was a convicted sex offender working in Britain illegally; (b) concerns were raised at other homes over “sexual grooming” of residents, and staff having sex while on duty; (c) care workers were initially told not to inform police of a suspected rape in November 2015 of a severely autistic 23-year-old man who lacked capacity to consent to sexual relations; and (d) potential DNA evidence linked to the incident was destroyed. The CQC said it was "actively pursuing what criminal action can be taken in relation to the failings" at the Enfield home, and had not made any of the concerns public because its desire to be "open and transparent" needed to be balanced alongside a risk of "compromising ongoing investigations".
  • 17/11/18 (1): CQC prosecution. CQC v Hillgreen Care Ltd [2018] MHLO 50Care home provider fined £300,000 for failing in its duty to protect people in its care by failing adequately to monitor a known sex offender.
  • 13/11/18 (2): IJMHCL issue 5. [2018] IJMHCL pages 1-77 — The fifth issue of the International Journal of Mental Health and Capacity Law (volume 24) contains the following: (1) Editorial (Daniel Wang, Alex Ruck Keene, Ruth Fletcher, Catherine Penny, Richard Ashcroft); (2) Letters to the Editor: (a) Rejoinder (Response to article by Christopher Maylea and Christopher Ryan) (Matthew Carroll); (b) Response to Carroll, President of the Victorian Mental Health Tribunal (Christopher Maylea, Christopher James Ryan); (3) The 'Tricky Dance' of Advocacy: A study of non-legal Mental Health Advocacy (Wanda Bennetts, Christopher Maylea, Brian McKenna, Helen Makregiorgos); (4) The Right to Independent Living and being included in the Community: Lessons from the United Nations (Piers Gooding); (5) Psychosocial Disability and Deprivation of Liberty: Reviewing the case of Qatar in the light of the Convention on the Rights of Persons with Disabilities (Patricia Cuenca Gómez, María del Carmen Barranco Avilés, Pablo Rodríguez del Pozo).
  • 13/11/18 (1): IJMHCL issue 4. [2017] IJMHCL pages 84-149 — The fourth issue of the International Journal of Mental Health and Capacity Law (volume 23) contains the following: (1) Editorial (Jill Stavert); (2) Decision-making capacity and the Victorian Mental Health Tribunal Christopher Maylea, Christopher James Ryan); (3) What makes a 'good' conference from a service user perspective? (Sarah Gordon, Kris Gledhill); (4) Why futile and unwanted life-prolonging treatment continues for some patients in permanent vegetative states (and what to do about it): Case study, context and policy recommendations (Jenny Kitzinger, Celia Kitzinger); (5) Review: Melbourne Social Equity Institute, 'Unfitness to Plead and Indefinite Detention of Persons with Cognitive Disabilities'; and Justice, 'Mental Health and Fair Trial' (Kris Gledhill).
  • 12/11/18 (2): Medical treatment case. Leeds Teaching Hospitals NHS Trust v JF [2018] EWCOP 32 — "... N suffered a cardiac arrest in the taxi as she was arriving at Leeds General Infirmary and as a result for some 20 minutes or so ceased breathing and suffered a severe hypoxic injury. In consequence she has suffered a very significant and severe brain injury. The position now and since then has remained that she is essentially unconscious. ... The issues before me have been threefold. First, whether or not the tracheostomy tube should be removed. ... The second issue has rather retreated in significance. I have to consider whether or not N should receive an escalation of invasive care or treatment, in particular vasoactive drugs, renal replacement therapy, ventilation treatment that requires central venous action or CPR. ... That brings me on to morphine, and that is a difficult issue."
  • 12/11/18 (1): Legislation. Mental Health Units (Use of Force) Act 2018 — Preamble: "An Act to make provision about the oversight and management of the appropriate use of force in relation to people in mental health units; to make provision about the use of body cameras by police officers in the course of duties in relation to people in mental health units; and for connected purposes." Royal assent: 1/11/18. The power to make regulations (s16) came into force when the Act was passed, and regulations will set out when the remainder comes into force.
  • 09/11/18 (1): Event. Edge Training: AMHP Conference - London, 7/12/18 — This one-day conference explores issues relevant to AMHP practice. The conference can contribute towards the statutory requirement of 18 hours relevant training for AMHPs each year. Speakers: David Carson (A principled and practical means of tackling The Risk Problem); Simon Foster (Case law update); Louise Blakeney (Exploring Service User experiences of MHA assessments - a research study); Professor Diana Rose; Mark Trewin (MHA Review 2018 - an update); Debbie Martin (Community Treatment Orders - use or abuse of power?). Chair: Christine Hutchinson. Price: £145 plus VAT (£174); 10% discount for groups of 10 or more in one booking. See Edge Training website for further details and booking information
  • 08/11/18 (6): Updated tribunal forms. The T129 (legal representation and tribunal doctor form) and T131-144 (all the report proformas) were updated on 3/10/18 to include GDPR information. Restructured T110 (application) and T111 (referral) forms were published on 19/10/18. See Tribunal forms
  • 08/11/18 (5): Child DOL case. Re D (A Child): Liverpool City Council v AM [2018] EWCOP 31 — "However, an extensive search for a therapeutic placement was undertaken throughout the UK with repeated emails being sent to multiple providers. Unfortunately, due to there being a limited number of placements available and demand being high, no offers of placements were made that were remotely suitable to D's identified needs. The Placements Team contacted commissioners in other Local Authorities, requesting any intelligence concerning potentially suitable placements. I have been told that they obtained a Residential Framework Placement list to ensure that they were contacting every possible provider. The case has been heard by HHJ De Haas QC, the Designated Family Judge for Liverpool and Merseyside whose robust and determined case management is clear from the papers. Having failed, entirely, to achieve a placement, over so many months Judge De Haas, yesterday, in desperation and no doubt exasperation, ordered the case to be transferred to me. I have interposed it into my list to be heard, as it has been throughout, in open Court with, I note, the press in attendance."
  • 08/11/18 (4): Care plan/CAMHS case. Re D (A Child): Liverpool City Council v AM [2018] EWCOP 31 — "However, an extensive search for a therapeutic placement was undertaken throughout the UK with repeated emails being sent to multiple providers. Unfortunately, due to there being a limited number of placements available and demand being high, no offers of placements were made that were remotely suitable to D's identified needs. The Placements Team contacted commissioners in other Local Authorities, requesting any intelligence concerning potentially suitable placements. I have been told that they obtained a Residential Framework Placement list to ensure that they were contacting every possible provider. The case has been heard by HHJ De Haas QC, the Designated Family Judge for Liverpool and Merseyside whose robust and determined case management is clear from the papers. Having failed, entirely, to achieve a placement, over so many months Judge De Haas, yesterday, in desperation and no doubt exasperation, ordered the case to be transferred to me. I have interposed it into my list to be heard, as it has been throughout, in open Court with, I note, the press in attendance."
  • 08/11/18 (3): Family court case. Z v Kent County Council [2018] EWFC B65This family court case - subtitled 'Revocation of placement order - Failure to assess Mother's capacity and Grandparents' - has a detailed consideration of the MCA 2005. Extract: "The law - capacity, presumption of capacity and determining protected party status. This issue is governed primarily by the Family Procedure Rules 2010 Part 15 and Practice Directions 15A and 15B, and by the Mental Capacity Act 2005. Additionally, there is guidance provided by the Department for Children, Schools and Families’ publication 'The Children Act 1989 Guidance and Regulations', and in April 2010 the Family Justice Council published guidance for proceedings and pre-proceedings called 'Parents who Lack Capacity to Conduct Public Law Proceedings' [updated in April 2018]."
  • 08/11/18 (1): Sex case. Manchester City Council Legal Services v LC [2018] EWCOP 30After a circuit judge endorsed a care plan which led to the repeated sexual exploitation by strangers of a young woman with autism and significant learning disabilities (who had capacity to consent to sexual relations but lacked capacity to make decisions on her contact with men), Hayden J provided guidance that 'where issues arise that may necessitate restrictions in areas where adults have capacity, these should be heard by a High Court Judge in the Court of Protection'.
  • 04/11/18 (2): COPUG minutes. Minutes of Court User Group Meeting (17/10/18) — (1) Apologies. (2) Minutes and Action points. (3) Court Manager’s Report: (a) Issue volumes; (b) Disposals; (c) Timeliness; (d) Backlogs; (e) COP 9s; (f) Multiple Points of Entry. (4) Filing of Bundles on time. (5) Delays in dealing with applications and urgent applications. (6) Update on court dress in public hearings. (7) Removal of bundles after Hearing. (8) E-Bundles. (9) Update on Accredited Legal Representatives (ALR). (10) Bonding of Lay deputies. (11) Capacity regarding financial scams. (12) Use of professional visitors. (13) Any other business. (14) Date of next meeting: Tuesday 23/4/19 at 2pm at First Avenue House.
  • 01/11/18 (1): TPC consultation response. TPC, 'Responses to the consultation on possible changes to the Tribunal Procedure (FTT) (HESC) Rules 2008 regarding pre-hearing examinations and decisions without a hearing in the case of references by the hospital or Department of Health' (23/10/18) — One interesting response, of many, is this from an MHT judge: "If cases are decided on papers alone, I can see little point in having those cases referred to the Tribunal. I have done a number of paper hearings and they are unsatisfactory." The TPC noted the following points and in consequence rejected the proposed rule changes: (1) The PHE provides for greater participation in the process by the patient. (2) The PHE reduces stress and anxiety at the hearing for the patient who will not need to be asked distressing questions. (3) The PHE allows the patient to talk about their situation privately to a person not involved in their detention. (4) The PHE allows for information missing from reports to be picked up. (5) The PHE is a lesser cost to the public purse than independent psychiatric reports. (6) The High Court has confirmed that there is no reason why the MM cannot carry out a PHE, provided the findings are disclosed at the outset of the hearing as they are currently. (7) Having a second medical opinion to assist the panel reduces the possibility of the wrong decision being made, thus reducing the risk to both the patient and the general public. (8) The system in England is not comparable to the Scottish system which operates in a fundamentally different way. (9) In Wales PHEs are carried out in every case and there are no current plans to alter that. (10) The outcome of MHTs cannot be measured by the numbers discharged but by whether the patient and their representative are satisfied that the case has been properly scrutinised with all relevant evidence before it. (11) Those who have their cases referred to the MHT are the most vulnerable members of society, often lacking the mental capacity to make an application to the MHT. (12) Disposals without a hearing would mean that the MHT panel would have evidence from only one party. (13) The MHT panel would not have adequate information to decide whether an oral hearing is appropriate. (14) There are a significant number of examples of MHTs reaching a decision on referred cases based on evidence that came out at the hearing and not contained in the reports.
  • 31/10/18 (1): Medical treatment case. University College London Hospitals v KG [2018] EWCOP 29 — "In this case the University College London Hospitals NHS Foundation Trust seeks the court's authority to administer a treatment known as PRN100 to a patient KG. KG is represented by the Official Solicitor. KG, the Official Solicitor on his behalf, his family and the Trust all ask for the court's approval. The matter is before the court because PRN100 has never been tested on or administered to any person anywhere. It is thus a completely novel treatment."
  • 12/10/18 (1): DOL case. Re D (A Child) [2017] EWCA Civ 1695 — "This is an appeal from an order of Keehan J sitting in the Court of Protection dated 15 March 2016, following a judgment handed down on 21 January 2016: Birmingham City Council v D [2016] EWCOP 8, [2016] PTSR 1129. Permission to appeal was granted by McFarlane LJ on 14 June 2016. The proceedings related to D, who was born on 23 April 1999, and was therefore 16 years old when the matter was heard by Keehan J in November 2015. Similar issues in relation to D had been before Keehan J in the Family Division earlier in 2015 when D was 15 years old, judgment (which was not appealed) having been handed down on 31 March 2015: Re D (A Child) (Deprivation of Liberty) [2015] EWHC 922 (Fam), [2016] 1 FLR 142.. In each case, the essential question was whether D was being deprived of his liberty within the meaning of and for the purposes of Article 5 of the European Convention for the Protection of Human Rights and Fundamental Freedoms."
  • 22/10/18 (8): CQC report. CQC, 'The state of health care and adult social care in England: 2017/18' (11/10/18) — "State of Care is our annual assessment of health and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. This year's report finds that most people in England receive a good quality of care. Our ratings show that quality overall has been largely maintained from last year, and in some cases improved, despite the continuing challenges that providers face."
  • 22/10/18 (6): TPC minutes (abandonment of rule change proposal). Tribunal Procedure Committee, 'Minutes' (25/7/18) — Minutes of 25/7/18 meeting, including the news that the proposals to abolish pre-hearing medical examinations and to reduce the number of oral hearings had been abandoned (the context for this included the ongoing MHA review, Rethink's FOI requests and the overwhelmingly negative response to the consultation).

Update archive