We have just been briefing Shared Lives schemes who are NAAPS members about an important High Court ruling on a case which will have wide implications for Shared Lives carers and other kinds of care and support services.
This was reported on the BBC at http://www.bbc.co.uk/news/uk-england-manchester-10822432 and Community Care magazine at http://bit.ly/bXr3xe. The court criticises a council for breaching both the Mental Capacity Act and the Human Rights Act by removing a young man from his Shared Lives arrangement and placing him in residential care without any legal authority and in breach of Deprivation Of Liberty Standards and the Mental Capacity Act. This happened because of safeguarding allegations which later proved unfounded.
Safeguarding concerns are probably the most complex and troubling challenges faced by people working in care and support and the practices that were criticised in this instance as “deplorable” are not unique to that particular council. It has not been unknown for adults to be arbitrarily removed from their Shared Lives arrangements against their wishes when an allegation is made against their carers. Sometimes other people in the arrangement are also removed. It is understandable that social workers want to move swiftly when there are concerns, but this court judgement makes it clear that there is a proper legal process for making life-changing decisions about people who lack the capacity to make those decisions for themselves. That process is designed to balance the need to manage risks swiftly with the need to respect people’s right to family life, whatever form that family life takes.
One aspect of this case that is far from unique is that the Shared Lives carer is described as providing care in very challenging circumstances for someone with very complex needs. The judge questions whether the advice and support given around safeguarding issues such as the use of restraint were adequate. The judge felt that the Shared Lives carer could have been given advice on restraint which conflicted with social workers’ understanding of council rules, which were themselves very hard to establish with any certainty.
Something that has come up repeatedly for me as I’ve been talking to people involved in Shared Lives is that people who use Shared Lives services do not always have access to advocacy, which is completely independent of their family and paid or unpaid carers. Shared Lives carers do their best to be advocates for the people for whom they care, but many feel uncomfortable when they are the only person in this role. In the case in question, the complaint about the person being moved was made on their behalf by a relative who was closely involved in their care. Not everyone has someone close to them to help fight their corner.
At the Scotland committee meeting the other week, I heard that some Shared Lives schemes have workers who focus entirely on empowering users of Shared Lives. We were having an interesting discussion about the potential of peer mentoring and befriending schemes to play an ongoing part in helping people who use Shared Lives services to find their voices and make sure that they are heard. Approaches like these are a really important part of helping people who use Shared Lives to express their views and to have the confidence to raise any concerns.
If people are really going to have ‘choice and control’ and to live independent lives, fully independent advocacy cannot be an optional extra.
All forms of care and support involve risks. Shared Lives has a really good track record around safeguarding, but this case and others like it show that we are some way from a world in which people with disabilities have access to all of the respect, rights and choices which we should all be able to take for granted.