We helped the Greater Manchester Integrated Care Board ensure legal compliance, improve patient care, safeguard individual rights, and reduce administrative burden, all while maintaining transparency and accountability in decision-making through the Court of Protection and Deprivation of Liberty framework.

Background 

NHS Midlands and Lancashire (ML) Court of Protection Service was approached by NHS Greater Manchester Integrated Care Board (ICB) (Oldham locality) to undertake a number of CoPDoL applications, supporting the ICB with their statutory responsibilities under the Mental Capacity Act and Human Rights Act. Central to this specialist and complex work, and of paramount importance to the ICB, was ensuring that any risk to individuals undergoing a CoPDoL application process was managed safely and effectively.

Each case had to fully comply with the Mental Capacity Act 2005 and the European Convention on Human Rights (ECHR), providing assurance to the ICB, the individual, and their representatives that every decision made to deprive someone of their liberty in the community was in the individual’s best interests.

The ICB needed to be confident that they were partnering with an organisation that fully understood the legislative responsibilities, best practices, and court processes applicable to the CoPDoL procedure. This partnership helped to minimise risk both to individuals and the ICB when considering deprivation of liberty in the community.

Action 

Our Personalised Healthcare Commissioning team completed CoPDoL applications on behalf of the ICB, which included:

1. Assessment of capacity – Assessing individuals’ capacity to make decisions regarding their care and accommodation. 

2. Consultation – Identifying relevant individuals to consult with regarding best interests decision making. 

3. Multi-disciplinary review – Assisting multi-disciplinary teams in reviewing restrictive practices and identifying the least restrictive approaches to the individual’s care. 

4. Quality assurance – Conducting quality assurance of care plans, risk assessments, and medication charts. 

5. Court documentation – Completing all necessary court documentation. 

6. Court application submission – Conducting quality assurance of court applications and submitting them directly to court, reducing legal fees for the ICB. 

Impact 

For individuals subject to the CoPDoL process: 

1. Patient satisfaction and safety – Individuals felt they were treated with dignity, respect, and were central to the care they received. 

2. Greater Understanding – The process provided clarity that the ICB was accountable for its actions.

3. Improved care planning – Scrutiny of care plans encouraged care providers to critically evaluate the care being provided, ensuring it was tailored to the individual’s needs while balancing autonomy and safety. The process also improved monitoring and oversight, ensuring care providers and public bodies could justify restrictive practices. 

4. Legal protection – The completion of a CoPDoL application ensured that any deprivation of liberty was legally authorised, safeguarding against breaches of human rights and preventing unlawful or arbitrary restrictions. 

5. Advocacy and support – Individuals received advocacy support through a Rule 1.2 Representative, ensuring their voice was heard and their rights were upheld. 

6. Best interests’ decisions – All care decisions were formally documented and evaluated, ensuring the least restrictive option was chosen in the individual’s best interests. 

For the ICB: 

1. Legal compliance – Completing these CoPDoL applications ensured compliance with the Mental Capacity Act 2005 and the ECHR, protecting the ICB from potential legal challenges or accusations of unlawful deprivation of liberty. 

2. Improved accountability – A clear paper trail demonstrated that the ICB followed due process, valuable for internal audits, reviews, and external inspections by regulatory bodies.

3. Transparency in decision making – The process promoted transparency and accountability in the decision to deprive someone of their liberty. 

4. Targeted interventions – Completing the application process allowed the ICB to identify when more intensive interventions were required and when less restrictive measures would suffice, optimising resource allocation. 

5. Reduced risk of financial damages – By adhering to the Mental Capacity Act and Human Rights legislation, the ICB reduced the risk of legal breaches and associated financial penalties. 

6. Improved public image – The process helped public bodies maintain a positive public image, improve confidence in their services, and demonstrate a commitment to safeguarding vulnerable individuals and upholding their rights.

By working with the ML CoPDoL team, NHS Greater Manchester ICB (Oldham) now has complete assurance that these individuals are receiving appropriate care in the right environment. The ICB is confident that all legislative processes were followed and can demonstrate full compliance.

Feedback

“The Court of Protection Service has played a crucial role in mitigating risk within our Court of Protection Deprivation of Liberty provisions, with the team demonstrating high level of expertise and knowledge, responsiveness to our needs and efficiency in delivering timely results.”

Kristy Atkinson | Designated Professional Safeguarding Adults | Oldham, NHS Greater Manchester