By Norman Lamb, minister of state for care and support
There was a time, not that long ago when people with severe and enduring mental ill health and those with learning disabilities and autism were routinely placed into institutional care, hidden away from view, treated as second-class citizens.
Things have, thankfully, improved considerably. The numbers living in institutions are now far lower than in the past. But we must not be complacent. Too many people with learning disabilities and autism are still denied the chance to live in the community, with support. This, for me, is intolerable. It must be challenged. So we recently published a green paper consultation which sets out proposals for transferring power away from institutions to people and their families.
The Mental Capacity Act 2005 (the MCA) provides a key framework for delivering change and I want to ensure that everyone in the health and care system understands how crucial it is in providing good care. We all want to create a culture that values the voices of people with mental health needs and respects their rights and the MCA supports this culture. Over the last year, my department has been working with our key partners to understand what more can be done to realise the benefits of the act, for example through supporting professionals to understand and use the Act in the best way for vulnerable people.
There is still a tendency in some parts of the health and care system to look at someone with dementia or a learning disability in a different way to others.
It is assumed that, simply because of their diagnosis, people with dementia or learning disabilities are automatically less able to be part of their care, automatically less able to tell us what they think and that, care built around their needs is somehow less necessary. This is completely contrary to the Mental Capacity Act.”
Local health and care organisations need to seriously and strongly consider how their services can better implement the Mental Capacity Act – and take actions forward as a matter of urgency.
Unnecessarily restrictive care
Another continuing issue that has caused me great concern since I took over my current Ministerial responsibilities is the temptation in the health and care system to apply unnecessarily restrictive care to an individual with mental health needs – often simply for the convenience of the provider. The law on this could not be clearer – care must be provided in the least restrictive manner necessary to achieve the intended purpose.
We have issued new guidance aimed at significantly reducing the use of restraint and seclusion and this is starting to change the culture in many places. But we must use every tool at our disposal, including the Deprivation of Liberty Safeguards (Dols). Dols help to protect the basic human rights of those who lack mental capacity. They are therefore incredibly important in promoting the wellbeing of people. They can – and do – realise real improvements in individuals’ well-being.
Social workers working tirelessly
Local authorities, best interest assessors, Dols teams and providers have been working tirelessly over the last year delivering the independent scrutiny of Dols to tens of thousands more vulnerable individuals than in previous years. I pay tribute to their great efforts. Now we need to maintain momentum and deliver Dols in a way that protect the rights of thousands more people.
That is why I’m announcing a one-off contribution of £25 million this year for local authorities to support the Deprivation of Liberty Safeguards.
In the current financial climate, this is a real recognition of the importance of the Deprivation of Liberty Safeguards and the real benefits social services teams are delivering. I urge you all to make the most of this opportunity, to help deliver this much needed culture change for a fairer society where everyone gets the care, rights and respect they deserve.