Describe the relevant legislation and frameworks which govern the work with individuals with dementia

• Health and Social Care
• Further Education (Key Stage 5)

Unit 16: Supporting People with

Dementia

Assignment 3 - Lesson

P4 - Describe the relevant legislation and frameworks which govern the work with individuals with dementia

What is the Mental Health Act 1983?

The Mental Health Act 1983 is the law in England and Wales which was updated in 2007. It tells people with mental health problems what their rights are regarding:

• Assessment and treatment in hospital
• Treatment in the community
• Pathways into hospital, which can be civil or criminal

Many people who receive inpatient treatment on psychiatric wards have agreed to go into hospital as informal patients, also known as voluntary patients. But over half are in hospital without their agreement as formal patients. This is because they have been detained under the Mental Health Act, also known as being sectioned.

If you're a formal patient you lose certain rights, including the right to leave hospital freely, so if you're in this situation it's really important to know your rights under the Mental Health Act.

What is the Mental Health Act 1983?

1. A law in England and Wales regarding mental health rights
2. A guideline for physical health treatment
3. A policy for educational institutions
4. A financial regulation act

What happens to formal patients under the Mental Health Act?

1. They are not allowed any visitors
2. They can leave the hospital freely
3. They lose certain rights, including the right to leave freely
4. They are given more rights than informal patients

What is another term for being detained under the Mental Health Act?

1. Being hospitalized
2. Being counselled
3. Being released
4. Being sectioned

What does the Mental Health Act 1983 cover?

1. Only treatment in the community
2. Assessment and treatment in hospital, treatment in the community, and pathways into hospital
3. Only pathways into hospital
4. Only criminal pathways into hospital

What does the Mental Health Act cover?

• Detained in hospital against your wishes 
• Detained in hospital and also part of the criminal justice system
• Offered treatment while detained 
• Leaving hospital, including having your section lifted and care planning

What does the Mental Health Act cover?

Detained in                  against your 

Detained in hospital and also part of the                  system

Offered                       while detained

Leaving hospital, including having your                 lifted and                planning

hospital

wishes

criminal justice

treatment

section

care

What are my rights under the Mental Health Act?

You still have certain rights when you're in hospital, and when you've left hospital. These usually include rights to:

• Have information about your section and what it means to be in hospital
• Appeal to a Mental Health Tribunal against your section
• Get support from an advocate
• Meet with the hospital managers
• Make a complaint
• Vote in elections
• Write to people and have visitors, as well as some telephone access
• Receive care after you've left hospital

What right do you have regarding information about your section under the Mental Health Act?

1. You have no right to any information
2. You have the right to have information about your section and what it means to be in hospital
3. You can only receive information after leaving the hospital
4. You must request information through a solicitor

Which of the following is a right you have to challenge your section under the Mental Health Act?

1. You can only appeal through a family member
2. You must wait until you are discharged to appeal
3. You cannot appeal your section
4. You can appeal to a Mental Health Tribunal

What type of support can you receive while under the Mental Health Act?

1. You can receive support from a financial advisor
2. You can receive support from an advocate
3. You can only receive support from hospital staff
4. You cannot receive any support

Human Rights Act 1998

Human rights are basic rights and freedoms which we all have. 

They cannot be taken away, although they can be restricted in certain circumstances.

In the UK, our human rights are protected by law. This law is called the Human Rights Act 1998.

The Human Rights Act 1998 sets out the fundamental rights and freedoms that everyone in the UK is entitled to. 

In some instances, individuals have had their rights limited, diminished, or abused. 

Historically, individuals with dementia have often had their rights

and freedoms limited or restricted and there have been times when these individuals have not been heard, have been ignored, and/or denied choice. 

There have also been instances where medication has been used to control behaviour or where people have not been treated with dignity and respect. 

The core principles which lie at the heart of our human rights legislation are essential for the support and care of people with dementia, but also to enable their exercise of full citizenship and their ability to participate, have

voice and gain control – all of which the rest of us demand and expect and often take for granted.

Individuals with dementia should have equal human rights.

Absolutely agree, it's essential

Disagree, capacity determines rights

Healthcare providers should prioritize dementia patients' rights.

Yes, they deserve special consideration

No, equality means all patients are equal

What is the Equality Act 2010?

• The Equality Act 2010 is the law that protects you from discrimination. 
• It also gives you the right to challenge discrimination.
  
• You're protected by the Equality Act if you have certain protected characteristics. 
• Disability is one of these protected characteristics. 
• Mental health problems may be considered a disability. 

00:16

How many of the protected characteristics can you name?

00:24

Individuals who are married have more legal rights than those who are in a civil partnership

TRUE

FALSE

00:25

What is the difference between marriage and civil partnership?

01:25

Write down an example of direct discrimination in a health and social care environment

01:46

Write down an example of indirect discrimination within a health and social care setting

02:57

Write down TWO examples of adjustments that can be made within a health and social care setting to support those with protected characteristics.

The Equality Act 2010

• Lack of capacity can make people with dementia vulnerable to discrimination and treatment that contravenes their human rights. For example, people with dementia can be excluded from discussions about their care and support and lack the capacity to challenge this exclusion. 
• People with dementia can face discrimination and treatment that contravenes their human rights for three key reasons:

1. Ageism
2. The stigma and discrimination associated with the condition
3. Lack of capacity to challenge and report incidents that occur

• The Equality Act 2010 makes it illegal for people to be treated less favourably because of their age, disability, gender, race, religion or belief and sexual orientation or transgender.

Mental Capacity Act (2005)

Mental capacity legislation has a role in enforcing rights for people with disabilities who are cognitively impaired.

The Mental Capacity Act is based on five principles:

• A person has the right to make decisions for themselves.                                                                                                                                             You must assume that someone is able to make their own decisions, unless it is shown that they can’t do this.
• A person should not be treated as being unable to make a decision unless they have been given all reasonable help and support to make and communicate their own decision.
• A person should not be treated as being unable to make a decision just because other people think they have made a bad decision.
• If a person lacks capacity, any decisions that other people make for them must be in the person’s best interests.
• If a person lacks capacity, the people making the decision for them must consider the option that is the least restrictive to the person’s rights and freedoms.

It is essential that you follow the Mental Capacity Act Code of Practice when making your assessment, which says:

• The person must be assumed to have capacity unless it is established that they do not have capacity
• The person must not be treated as unable to make a decision unless all practicable steps to help them do so have been taken without success
• The person is not to be treated as unable to make a decision simply because they make an unwise decision
• Any decision made for a person who lacks capacity must be in their best interests
• The decision must be made in the way that is least restrictive of the person’s rights and freedom 

What is the fundamental assumption about a person's capacity according to the given principles?

1. A person is assumed to lack capacity until proven otherwise
2. A person is assumed to have capacity unless it is established that they do not
3. A person is assumed to have capacity only if they make wise decisions
4. A person is assumed to lack capacity if they make an unwise decision

What must be done before treating a person as unable to make a decision?

1. Assume they cannot make decisions if they are elderly
2. Take all practicable steps to help them make a decision
3. Make decisions for them immediately
4. Consult a legal professional first

How should decisions be made to respect a person's rights and freedom?

1. In the most restrictive way possible
2. In the way that is least restrictive of their rights and freedom
3. By consulting with their family only
4. By following a strict legal protocol

Deprivation of Liberty and Safeguards (2009)

Deprivation of liberty is when a person has their freedom limited in some way.

It occurs when the person is:

• under continuous supervision and control 
• not free to leave l
• acks capacity to consent to these arrangements

Deprivation of liberty is common for a person with dementia receiving care who may have:                                                                            

• decisions made for them or on their behalf
• limitations on where they are allowed to go
• their routine decided for them

DoLS are a set of checks that aim to protect the person with dementia.

These checks are made via a specific DoLS assessment which aims to make sure that any care that limits a person’s liberty

is done in the least restrictive way and is in the person’s best interests.

Deprivation of liberty is when a person has their freedom limited in some way.

It occurs when the person is:

- under continuous                              and control

- not free to                       

- lacks capacity to                        to these arrangements

Deprivation of liberty is common for a person with dementia receiving care who may have:

-                         made for them or on their behalf

-                          on where they are allowed to go

- their                         decided for them

supervision

leave

consent

decisions

limitations

routine

The Care Act 2014

Purpose

The Care Act 2014 is comprehensive legislation focusing on the wellbeing of individuals needing care and support, including those with dementia.

Key Provisions

• Wellbeing Principle: The Act places an emphasis on individual wellbeing, including personal dignity and control over day-to-day life.

• Carer’s Rights: Recognises and supports the rights of carers by assessing their needs and providing support.

• Safeguarding: Introduces statutory safeguarding duties to protect adults at risk, which includes many individuals with dementia.

Impact on Dementia Care

Legislation ensures that individuals with dementia receive person-centred care that focuses on their holistic well-being. Carers also get the support they need, enhancing the overall care quality.

Carers’ rights under the Care Act 2014

• The Care Act is great news for carers as it gives equal importance to the wellbeing of the carer as to that of the person with care needs. 
• It places a duty on local authorities to promote and maintain wellbeing, both of people with care needs and of carers. 
• Wellbeing includes physical and mental health, emotional wellbeing, personal dignity and control over day-to-day life. 
• The Care Act also gives carers, for the first time, the right to have their assessed eligible needs met.

What is the primary focus of the Care Act 2014?

1. Financial support for healthcare providers
2. Wellbeing of individuals needing care and support
3. Infrastructure development for care facilities
4. Technological advancements in healthcare

How does the Care Act 2014 impact dementia care?

1. It reduces the funding for dementia care
2. It ensures person-centred care focusing on holistic well-being
3. It limits the rights of carers
4. It prioritises technological solutions over personal care

What duty does the Care Act 2014 place on local authorities?

1. To increase taxes for healthcare funding
2. To promote and maintain wellbeing of people with care needs and carers
3. To build more care homes
4. To provide free transportation for carers