The Department of Health has published the new statutory guidance on the Care Act 2014. I had a number of concerns about the draft safeguarding guidance (I think the phrase “recipe for human rights violations” was the description I gave it at the time), so I quickly raced through to look at the new and revised guidance. I appreciate that the Department had around 4000 responses to the consultation, and only a few months to consider and digest them all, but I can’t help but feel they should have waited longer and got it right. There are some absolutely howlers in here.
I could moan on about the ungrammatical sentences that have crept in, the incorrect table of contents, the shoddy referencing* (if somebody could tell me what Bury Council’s homepage has to do with the Court of Protection – see paragraph 7.26 and footnote 124 on page 119 – I’d be interested to know), the lack of clear guidance on the limits of what can be done in the name of ‘best interests’ without seeking court authority, but it’s this sentence from page 135 of the safeguarding chapter that really stood out:
14.22. Financial abuse is the main form of abuse by the Office of the Public Guardian both amongst adults and children at risk
Just. I mean. I’ve got no words. This is simply incredible. Surely they can’t leave it like this?!
[Update (five minutes later) – looks like the DH are on the case…]
*Actually, I will have a little moan about referencing. It’s really bad practice to use URLs instead of proper references. Very important documents like No Secrets and the Mental Capacity Act Code of Practice are referenced simply by name and URL or even just by URL. Yet if those URLs cease to work, how will people know what document is being referred to? And why should you have to follow a URL to know that the source being referred to is, for example, the MCA Code? It’s much better to include the author, year of publication and full title, to ensure that people a) know what you’re referring to without having to look it up, and b) when the government or whoever hosts the link (inevitably) shuffles their URLs around in years to come, it can still be located.
Ahem:
Department of Health and Home Office (2000) No Secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse, London.
Lord Chancellor’s Office (2007) Mental Capacity Act Code of Practice, TSO: London.
The Small Places 
I think the whole of what comes out of the DoH reflects badly on both the government and the skills/ quality of those employed to effectively pull together complex material from a variety of relevant sources. We had swine flu pandemic…then we didn’t after expensive stacks of vaccine were procured. I was one who refused to be vaccinated.
The more nebulous MCA and its ramifications on the social and health care machinery are clearly a challenge to the DoH staff. What is interesting is the idea that 4000 people / responses is deemed representative of anything. Social /health care affects millions, but there seems to be very little in the way to getting a true consensus. Most of the responses come from ‘vested interest staff / organisations’. I have undertaken focus groups and the manner in which sensitive or complex subjects are approached may change the responses from service users / carers to the questions put to them. Most government funded focus groups are very limited in their approach.
I also note that the DoH seems to ignore / misinterpret responses that do not support the ‘professional vested interests’ in keeping things in their ‘court’, rather than being truly client centred. The latter might mean accepting risk which can backfire on them. A double edged sword for those in the ‘blame culture’. as they say Rien change… Nothing will actually change with this legislation- I can guarantee this as a veteran of the health and social care system over decades….. The public, who are not part of the public sector, are so disenchanted with the systems we have that we effectively face a difficult society.
Oh dear – not a great surprise! I have frequently moaned about the lack of proper referencing in Government reports. Their favourite trick is to refer obliquely to research projects but provide little in the way of clear title, author, date, publisher etc – not even a URL, and certainly no bibliography. Even our first year students know better!
The funny thing is, that parts of the guidance are really good on referencing – the research on personal budgets, for example, is all correctly referenced. But it is surprising to see mistakes in government guidance that undergraduate students couldn’t get away with…
I’ve read some of the parts that relate directly to my role as a DoLS Coordinator and already I have been pulling my hair out in frustration. The Annex on Ordinary Residence makes no reference to the commonplace situation of a person undergoing an acute episode of care in a hospital. The practice example offers some helpful guidance on the issue of determining ordinary residence when the patient is discharged from hospital but glosses over without comment the fact that the host authority for the inpatient episode, and not the authority of origin, has granted the standard authorisation!
This tied in with an issue raised with us by a hospital that had been told by another Local Authority that they should divert all of their inpatient DoLS requests to the local Supervisory Body, irrespective of where the patients came from.
So where was the simple unambiguous statement that the Supervisory Body will be the Local Authority where the person is ordinarily resident? Certainly not in the ordinary residence guidance in the Care Act Guidance. We found it eventually, in the amendments to Schedule A1 made by the Health and Social Care Act 2012 but only after realising that the Schedule A1 on http://www.legislation.gov.uk is woefully out of date and did not reflect the end of the PCTs as hardly anything does.