The LGSS & Cambridgeshire County Council Mental Capacity Act and Deprivation of Liberty Safeguards Training Offer

The LGSS & Cambridgeshire County Council Mental Capacity Act and Deprivation of Liberty Safeguards Training Offer September 2017 September 2018 Author - James Codling - Mental Capacity Act Training and Development Manager Document type Training Strategy Review Date March 2018 1

CONTENTS SECTION CONTENT PAGE 1.0 PURPOSE OF THE STRATEGY 3 2.0 INTRODUCTION 3 3.0 TRAINING FRAMEWORK 3 4.0 QUALITY ASSURANCE FOR COMMISSIONED SERVICES 4 5.0 FREQUENCY OF MCA AND DOLS TRAINING 4 6.0 SUGGESTED MCA AND DOLS TRAINING PROGRAMMES 5 7.0 TRAINING COURSE PROGRAMME 11 8.0 ADDITIONAL LEARNING RESOURCES / WORKSHOPS & SUPPORT 15 9.0 FROM TRAINING TO GOOD PRACTICE 16 10.0 CONTACT DETAILS AND LINKS 17 APPENDIX 1 TRAINING STANDARD: MENTAL CAPACITY ACT 18 2

1.0 PURPOSE OF THE STRATEGY This document sets out LGSS & Cambridgeshire County Council s (CCC) Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) Training Offer. The aim is to offer professionals across Cambridgeshire (and beyond) a comprehensive learning and development programme that will enable all individuals to access appropriate training to meet their needs. This document provides information on the courses and support currently available for professionals working for Cambridgeshire County Council, Commissioned Services within Cambridgeshire & Peterborough, health professionals working across Cambridgeshire and Peterborough, and professionals operating outside of Cambridgeshire. 2.0 INTRODUCTION As the Governments 2014 Post Legislative Scrutiny Committee and CQC Report on DoLS identified: The evidence presented to us concerns the health and social care sectors principally. In those sectors the prevailing cultures of paternalism (in health) and risk-aversion (in social care) have prevented the Act from becoming widely known or embedded. The empowering ethos has not been delivered. The rights conferred by the Act have not been widely realised. The duties imposed by the Act are not widely followed. A fundamental change of attitudes among professionals is needed in order to move from protection and paternalism to enablement and empowerment. Professionals need to be aware of their responsibilities under the Act, just as families need to be aware of their rights under it (Mental Capacity Act 2005: post-legislative scrutiny). It is these findings along with local and national guidance, case law and the feedback we have received from professionals over the past year that has formed the basis of our 2017-2018 MCA and DoLS Training Strategy. 3.0 TRAINING FRAMEWORK This MCA and DOLS training programmes are mostly underpinned by the following resources: Mental Capacity Act, 2005 Code of Practice Deprivation of Liberty Safeguards, 2007 Code of Practice Human Rights Act, 1998 Care Act, 2014 3

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Department of Health Knowledge and skills statement for social workers in adult services British and Irish Information Institute (BAILII) Mental Health Law Online Department of Health Social Care Institute for Excellence Resources General Medical Council Resources As a training and development team we strive to support all professionals meet their learning and development needs, in order to ensure that best practice is applied and mistakes others have made are not repeated. Given the varied and complex nature of the MCA and DoLS, all of the courses we provide can be tailored to meet the individual needs of our customers. 4.0 QUALITY ASSURANCE FOR COMMISSIONED SERVICES Many commissioned services in Cambridgeshire have their own training strategies which will identify the level of training their staff need in accordance with their roles / responsibilities with regard to the MCA and DoLS. Naturally, these may vary across organisations and they may develop and deliver their own training tailored to the needs of that organisation. Nationally, there are no specific standards identified for content of either MCA or DoLS training. Nonetheless, we strongly advise that both MCA and DoLS Codes of Practice are used as a benchmark in identifying what content/level may be appropriate across different roles/specialisms/organisations. The recommended standards on Cambridgeshire MCA and DoLS training are laid out in Appendix 1. Where an organisation chooses to commission MCA and DOLS training from an independent training consultant/provider, they must ensure the training course meets the standards identified in Appendix 1 as a minimum. 5.0 FREQUENCY OF MCA AND DOLS TRAINING Currently there is no national guidance in terms of how often professionals should refresh their MCA and DOLS knowledge and repeat the training. Our recommendations in this strategy are based on: The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Department of Health Knowledge and skills statement for social workers in adult services The Safeguarding Adults: Roles and competences for health care staff With this in mind, we recommend that professionals refresh their knowledge on a 2-yearly basis and attend courses that are appropriate to their professional responsibilities. It has been agreed that Cambridgeshire County Council professionals working in Locality Teams 4

should arrange in-house training sessions every year and where this is not possible, attend one of our community based sessions. 6.0 SUGGESTED MCA AND DOLS TRAINING PROGRAMMES The following MCA and DoLS training programmes are designed to guide professionals to the courses they need and have been split up into 4 key areas, which include: Social Care this training programme is for Cambridgeshire County Council professionals who tend to be working in locality teams which consist of social workers, adult support co-ordinators and other supporting professionals. These courses would also be appropriate for social care and mental health professionals working in Cambridgeshire and Peterborough Foundation Trust (CPFT) and Drugs and Alcohol Services. It also provides guidance on the training available for Children s Disability Services, and wider Children s teams. Commissioned Services this programme is tailored towards not only CCC internal providers but all of the PVI sector as well. Primary Health This training programme is targeted towards professionals working in or with Cambridgeshire and Peterborough CCG or who are part of the CPFT physical health workforce. Outside Agencies This programme is for all organisations, local authorities and CCG s outside of the scope of LGSS (Cambridgeshire and Northamptonshire), who may wish to purchase any of the training we offer. 6.1 SOCIAL CARE Target Audience: Professionals working in Cambridgeshire County Councils Children s / Families & Adults (CFA) locality teams, this may include; Social Workers, Adult Support Co-ordinators (care managers), therapists, nurses, psychiatrists and psychologists. This training is also available for CCC professionals working in CPFT. Training Format: The MCA and DoLS Training and development team will be putting on 8 bespoke training sessions across Cambridgeshire for all Adult Social Care staff based in Locality Teams (CFA). The 8 available sessions will cover both the MCA and DoLS at an Advanced level in 1 day, and all staff will be expected to attend one of these sessions on a yearly basis. 5 sessions tailored to working with young adults will also be made available for professionals working in Children s Disability Services. Professionals working in other Children s services who may be affected by the MCA or DoLS can book shorter tailored 5

sessions within their teams on request or send a representative onto the 5 planned sessions. The responsibility for ensuring that all staff working in Adult Services or Children s Disability Services attend these sessions sits with team managers, with overall accountability sitting with the appropriate Head of Service. Training Offer Note: It is strongly recommended that Social Workers (including locums) & Adult Support Co-ordinators (ASC s) looking to complete the Supported Decision and Best Interest Record (ASC 1708) should not do so until they have attended one of the available sessions in the year. Where this needs to be done urgently, professionals can, as a last resort, attend both the MCA and DoLS Advanced courses that we arrange in the community. Courses: The Mental Capacity Act & Deprivation of Liberty Safeguards Advanced Practice Workshop (8 available sessions for Adult Services & 5 for Children s services) Delivery: Community based sessions accessed every year. Additional Sessions (accessed as and when required) Course: Deprivation of Liberty and the Re X Procedures Delivery: Community based session bi-annually. This session can also be arranged in-house. For further information contact adultsafeguardingtraining@cambridgeshire.gov.uk or janet.tudor@cambridgeshire.gov.uk Course: Case Law Discussions and 1:1 support/mentoring Sessions Delivery: The training team can attend Locality Team Meetings or offer office based support sessions, arranged as and when required. To arrange attendance at a team meeting or to arrange a 1:1 meeting with one of the training team contact james.codling@cambridgeshire.gov.uk 6.2 COMMISSIONED SERVICES Target Audience: The following courses are tailored towards not only CCC internal providers (for example reablement and shared lives services) but all of the PVI sector as well. 6

Senior Staff The following suggested training programme would be appropriate for all senior staff working in any social care commissioned service setting (including nurses working in these settings), who have responsibilities which may include but are not limited to: Writing care plans Writing risk assessments Completing capacity assessments Documenting best interest decisions Completing the DoLS Form 1 Informing the local authority in community based setting (not registered care homes or nursing homes) of any potential DoL that may need an application made to the Court of Protection. Courses: The Mental Capacity Act: Advanced The Deprivation of Liberty Safeguards: Advanced Delivery: Community based or in house training completed bi-annually. Interim year: All professionals should ensure that on the year they don t have formal training that they back up their knowledge, by completing either; e-learning, arranging update sessions or by undertaking further reading in this area. Frontline Staff This suggested training programme would be appropriate for all: health care assistants, support workers, administrative staff, personal assistants, befrienders and any other staff who engage with or support people and/or families on a day to day basis. Course: The MCA and DoLS: An Introduction Delivery: Community based or in-house training completed every 2 years. Interim year: All managers of those supporting these individuals should ensure that staff back up their knowledge, by completing either; e-learning, arranging update sessions or by undertaking further reading in this area on a yearly basis. Purchasing In-house training Many commissioned services should always consider purchasing their MCA/DoLS training inhouse where you have a staff team of 6 or more who would benefit from accessing the training mentioned above. This will offer the following benefit to your service: 7

Accessing the courses in house will be more cost effective as the training programme can be reduced from a day and a half in the community to a single days training for senior staff, and for frontline staff you would be able to arrange 2 half day sessions in 1 day, which could potentially mean you will be able to train 40 staff in one day (depending on the size of the training room you can offer). As part of the training offer we will be able to discuss in greater detail the difficulties and issues you face on a day by day basis and make it personalised to the work you do. The Training & Development team are also happy to review any of your current forms used to record consent, capacity and best interests, and will offer advice and guidance on these, and this is all part of the training offer and will not incur any further costs. Breakdown of course charges Course The MCA and DoLS: An Introduction Charges per person when accessing In-house Training Charges community based sessions 25 400 the cost remains the same whether you access one or two sessions on the one day. MCA Advanced 50 400 DoLS Advanced 25 400 MCA & DoLS Advanced Combined 1 day course Not Available 400 we would recommend that care providers who have responsibilities for the MCA and DoLS/Community DoL access the combined course Note: Responsibility for arranging the training venue for in house courses sits with the organisation commissioning our training, and the training venue/room must be an appropriate size to facilitate the session. 6.3 PRIMARY HEALTH The following training programme is targeted towards Primary Health professionals working in or with Cambridgeshire and Peterborough CCG (CPCCG) or CPFT (physical health workforce). These sessions are funded by CPCCG and NHS England and are free for all primary health professionals to access. These sessions are only available to arrange inhouse. Target Audience These sessions are targeted towards doctors (GP s), nurses, therapists, HCA s and other physical health professionals. These sessions can also be accessed by hospital staff, but depending on the hospital department there may be a charge depending on the training requested. 8

Courses: An Introduction to the Mental Capacity Act and Deprivation of Liberty for Health Professionals Supported Decision Making and the MCA in Clinical Practice Delivery: In house Training completed every 1-2 years. To arrange an in-house training session contact: adultsafeguardingtraining@cambridgeshire.gov.uk Interim year: All professionals should ensure that on the year they don t have formal training that they back up their knowledge, by completing either; e-learning, arranging update sessions or by undertaking further reading in this area. There is free e-learning accredited by the Royal College of General Practitioners available to access here. 6.4 OUTSIDE AGENCIES All the training we offer in LGSS is available to purchase for all organisations, local authorities and CCG s outside of the scope of LGSS (Cambridgeshire and Northamptonshire). Available Courses The courses we offer include: Training for Social Care Professionals The MCA and DoLS: An Introduction The Mental Capacity Act Advanced The Deprivation of Liberty Safeguards Advanced Training for Health Professionals An Introduction to the Mental Capacity Act and Deprivation of Liberty for Health Professionals Supported Decision Making and the MCA in Clinical Practice For more information on course content visit our training course programme. Our Training Offer Our team prides itself on tailoring all our in-house training to the needs of every individual service we work with. Before we deliver any training we will always agree all course content (training booklets and presentations) with the person requesting the training, and ensure that where you use specific forms or guidance s that these are embedded into the sessions we deliver. How will our training offer benefit you? 9

We have a dedicated and experienced training team who have worked in the area of MCA/DoLS for over a decade. The course content, the length of courses and the preferred training format will be led by you As part of the training we will be able to discuss in greater detail the difficulties and issues you face on a day by day basis and tailor it to your specific requirements. We offer competitive prices Breakdown of course charges All our courses purchased in-house are priced at 400. If delivering outside of our local area there may be additional expenses, but these will be negotiated as part of the training package. 10

7.0 TRAINING PROGRAMME Course Title Target Group Learning Objectives Course Length Delivery Method The MCA & DoLS : An It is intended for all frontline Understand and/or Apply: 3 hours Community based Introduction support staff or health care MCA and links to Human Rights sessions or in-house assistants who assist people Duties/responsibilities regarding consent in day to day decisions, The principles of the MCA across social care, private and voluntary sectors Involving and supporting people in decision making Capacity tests and best interests decisions The MCA and planning for the future Independent Mental Capacity Advocate (IMCA) service Restraints & Restrictions and the less restrictive option What constitutes a deprivation of someone s liberty as per the acid test The Mental Capacity Act : It is intended for staff who Understand and/or Apply: Whole day Community based Advanced may be required to The importance of human rights regarding MCA sessions or in-house complete or support formal Duties/responsibilities regarding consent assessments of capacity, be Legal responsibilities and practice implications NB: In-house sessions can involved in establishing best interests decisions, or writing care plans How MCA principles apply in decision making and use of frameworks for supporting and involving people in those decisions also include The Deprivation of Liberty Safeguards : Advanced in Decision/time specific nature of mental capacity a whole day session Recording and completing process of decision making and mental capacity assessments Supporting and recording best interests decisions MCA and recording/planning for the future The role of IMCA s Managing and recording issues associated with restrictions and restraints 11

Course Title Target Group Learning Objectives Course Length Delivery Method The Deprivation of Liberty As a detailed overview of Understand and/or Apply: 3 hours Community based Safeguards : Advanced DoLS, it is suitable for nursing, health care and Key relationships between MCA, DoLS and Human Rights sessions or in-house support staff, working in any Limits on power/control in health care settings NB: In-house sessions can health or social care setting Legal responsibilities and practice implications also include The Mental Restraints/restrictions and the importance of less restrictive option Capacity Act : Advanced in a whole day session What constitutes a DoL as per the acid test Applying the acid test to identify a DoL in health and care settings Authorising a DoL in care homes, hospitals and in the community DoLS assessment processes The Mental Capacity Act It is intended for CCC Understand and/or Apply: Whole day Community based and Deprivation of Liberty professionals working in Importance of human rights to health/social care sessions Safeguards : Advanced locality teams or children s Duties and responsibilities regarding consent Practice Workshop services staff only, and offers a bespoke training Legal responsibilities and practice implications under the MCA and Care Act package relevant to your role and professional responsibilities How MCA principles apply in decision making and use of frameworks for supporting and involving people in those decisions Decision/time specific nature of mental capacity Recording and completing process of decision making and mental capacity assessments Assessment in practice and case law Inter-agency policies and procedures in relation to case law judgements Supporting and recording best interests decisions MCA and recording/planning for the future The role of IMCA s Managing and recording issues associated with restrictions and restraints The relationship between MCA & DoLS Practice implications/legal responsibilities and 12

Course Title Target Group Learning Objectives Course Length Delivery Method The Mental Capacity Act local authority responsibilities under DoLS and Deprivation of Liberty What constitutes a DoL as per the acid test Safeguards : Advanced Practice Workshop (cont) Applying the acid test in a health and care setting to identify a DoL Authorising a DoL in care homes, hospitals and in the community Deprivation of Liberty and It is intended for statutory Understand and/or Apply: 3 hours Community based the Re-X Procedures services. Specifically, social The Re-X process sessions workers, nurses, Purpose(s) of Re-X psychiatrists, care managers Identify when Re-X applies and other registered Who initiates the Re-X process professionals who have responsibility in the completion of the CoP DoL forms Completion of the CoP DoL forms An Introduction to the It is intended for health care Understand and/or Apply: 2-4 hours Only available to access Mental Capacity Act and staff that assist people in Human rights, clinical practice and the MCA in-house for registered Deprivation of Liberty Safeguards for Health day to day clinical decisions Duties and responsibilities regarding consent in clinical care health professionals and any supporting health Professionals Duties and responsibilities under the MCA staff (HCA s) Applying the five principles of the MCA in clinical practice Decision/time specific nature of mental capacity Assessment of capacity and standard for best interests decisions Sharing information and patient consent recent case law developments When to apply for an Independent Medical Capacity Advocate (IMCA) Use of and evidence for restraints and restrictions and less restrictive option Court appointed deputies/lasting power of attorney and clinical practice implications What constitutes DoL as per the acid test 13

Course Title Target Group Learning Objectives Course Length Delivery Method Supported Decision It is intended for health Understand and/or Apply: 2-4 hours Only available to access Making and the MCA in Clinical Practice professionals who have knowledge of the theory of Supported decision making patient and clinicians making decisions together in-house for registered health professionals and MCA, i.e. have previously attended a training course Recording consent/refusal of treatment where capacity could be in question any supporting health staff (HCA s) and who would like to Applying the five principles in practice develop their knowledge in the practical application of Undertaking and documenting capacity assessments MCA Recording best interests decisions How and when to apply for an IMCA The aim of the course is to Identifying and evidencing restraints/restrictions provide a practical and skills and less restrictive options based approach to capacity Making decisions regarding covert medication assessments, best interests Court appointed deputies, lasting powers of decisions and how to use attorney, advanced decisions to refuse treatment the legislation in practice and practice implications When a Coroner s investigation is needed for a person deprived of their liberty e-learning: The Mental Capacity Act and Deprivation of Liberty Safeguards Intended for health care professionals to understand: - What the MCA is - What they need to know - How it affects them - How it affects their patients - How to apply this in their practice Module 1 : An introduction to the Mental Capacity Act Module 2 : The five principles of the MCA Module 3 : Supportive decision making and completing mental capacity assessments Module 4 : Making best interests decisions Module 5 : Planning for the future Module 6 : Deputies and the Court of Protection Module 7 : Independent Mental Capacity Advocates and serious medical treatments Module 8 : Restraint and covert medication Module 9 : Deprivation of liberty in health and social care N/A Accredited by the Royal College of General Practitioners However, we recommend locally that all GP practices also access the free face to face training. To access the e-learning, click here 14

8.0 ADDITIONAL LEARNING RESOURCES / WORKSHOPS & SUPPORT In addition to the core training programmes listed above, other MCA and DOLS support and resources are currently being developed and will become available in 2017/2018. All of our resources and/or information on how to obtain them is available on our website or alternatively, contact james.codling@cambridgeshire.gov.uk for further information. E-learning LGSS are currently developing new MCA and DoLS e-learning packages, to be made available in the Autumn of 2017, for all health and social care professionals across Cambridgeshire. We hope that as we move into 2018, we will be able to develop further bespoke e-learning packages, tailored to the needs of different health and social care professionals. The MCA and DoLS online forum In 2016 we introduced an online forum for social care professionals. This is in the process of being revamped and we hope that by the end of 2017 we will be able to launch a bespoke online forum that focuses on sharing best practice, offering regular updates and answering questions from professionals. We plan to have designated forums for all CCC social care professionals and a separate site for commissioned services later in 2018. In service case law workshops & team discussions These workshops are tailored to your needs and serve as a targeted method to help you deal with practice dilemmas. Whilst the sessions are not a replacement for face to face training, these can be used to keep you up to date with the latest developments in all relevant MCA and DoLS case law. These sessions are free for all agencies to access and we hope to continue to work closely with colleagues across the whole of the health and social care workforce. 1:1 Mentoring Whilst this free support is available for all agencies to access, priority is given to Cambridgeshire County Council staff and will also depend on our availability. Whilst these sessions are not a replacement for face to face training, they are there to offer additional coaching when dealing with practice issues. Depending on your need, these sessions will either be provided by the LGSS MCA & DoLS Training and Development Team or the CCC MCA & DoLS Team. The MCA/DoLS Quarterly Newsletter For a number of years we have produced a very successful MCA/DoLS Newsletter which serves to update all social care and health professionals on the changing landscape of the MCA/DoLS. 15

The LGSS 6 Monthly MCA/DoLS Legal Podcast By Christmas 2017, we will launch a new MCA and DoLS Legal Webinar jointly hosted by the LGSS MCA/DoLS Training & Development Team and the CCC MCA/DoLS Team. The aim of the webinar is to offer all professionals a quick summary of any legal changes and national developments that professionals need to be aware of. This online webinar will be available for participants to engage with on the day or download as a podcast and will be available free of charge for all professionals. 9.0 FROM TRAINING TO BEST PRACTICE The LGSS MCA/DoLS Training & Development Team believes that putting training into practice to improve service delivery is a joint responsibility. This responsibility should be shared equally between the training provider, the participants and their respective managers/employers. Our training courses are designed with the variety of participants learning needs in mind. We will endeavour to check training application forms to ensure that participants are placed on the most appropriate training course suited to their learning needs, role and level of responsibility. However, we also suggest that the participants and/or their managers take a proactive approach to this selection process and enquire about our training courses prior to booking. Our trainers will ensure that the training is relevant, current, engaging and presented in different learning styles to suit the variety of learning needs of participants. Each training session will begin with a brief assessment of participants current knowledge and objectives. These will be informally assessed by the trainer in the course of the training sessions through the use of an activity/case study/quiz etc. Any issues and/or concerns will be reported to their respective managers/employers so that participants receive additional support as required. At the end of the session the trainer will ask participants to complete a course evaluation form. These are used to continuously assess course content and presentation and improve as necessary. The participants responsibilities are to actively engage in the course of the training session through group work and discussions, and to provide the trainer with a completed course evaluation at the end of the session. Any subsequent post-training needs, regarding the MCA and DOLS, can be discussed with the trainer. However, we strongly recommend that participants have broader and more extensive discussions with their managers to explore how their professional development needs could be met. We recommend that managers should undertake knowledge checks with staff subsequent to training and ongoing, as part of the supervision process. We are currently developing a knowledge check form to support managers to proactively support their staff. It is important that participants and their managers discuss whether or not all of the learning objectives have been met and how the new/refreshed knowledge may be implemented in practice. 16

10.0 CONTACT DETAILS AND LINKS For any type of training inquiry you may: call us on 01223 706757 email us at mca.training@cambridgeshire.gov.uk Alternatively you can speak to the MCA/DoLS Training Development Manager by: emailing james.codling@cambridgeshire.gov.uk calling 07584 490 240 To visit the Cambridgeshire County Council MCA/DoLS Homepage click here. 17

Appendix 1 Training Standard: Mental Capacity Act This mandatory training standard describes the learning outcomes which must be delivered to staff working under Cambridgeshire County Council contracts or staff working for Cambridgeshire County Council. Who must have this training? All staff working in a care and support role. The Level of training required is dependent on the role/level of responsibility. This training standard is in place to enable providers and their staff, meet regulations 8, 10, 11 and 13 outlined in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to the MCA. When must the training be taken and when must it be refreshed? Within 12 weeks of a new care worker being in post, thereafter every year, as case law implications should be considered in practice. If a specific knowledge gap is identified or there are changes in service need, then a full refresher will be required as soon as possible. How must the training be delivered? We recommend that initial Induction training should be face to face, as issues of capacity and consent can be complex and all staff working in care/support roles need to have an understanding of supportive decision making and recording standards. If face to face training can be accessed, we would further recommend a blended approach, using a range of teaching methods (e-learning, discussions etc) which should be followed up in regular supervisions and team meetings. Who is qualified to deliver the training? If delivered in a classroom the Trainer should have a minimum of PTTLS or Level 3 Award in Education and Training together with subject expertise. All trainers must evidence subject specific Continual Professional Development / Refresher training and train others only to the level at which they have expert knowledge and experience. 18

Timescale Required Learning Outcomes Additional information for designated persons Within 12 weeks of joining the organisation. The Learner must know and understand: What is the Mental Capacity Act and the duties and responsibilities under the Act The five key principles of the Mental Capacity Act and how these apply to health/care decisions. The 3 elements of valid consent The importance of helping and supporting people to make decisions for themselves The decision/time specific nature of mental capacity The 2 stage assessment of capacity How to make best interest decisions The issues associated with restraint in line with the Act When and how to record a decline in a person s decision making processes The importance of recording decisions made on behalf of a service user How people can use the MCA to plan for the future, and how these legal arrangements can affect day to day care. These learning outcomes and are relevant to all frontline staff not expected to complete formal capacity assessments or best interest decisions. Competent persons/line managers must ensure that their staff member has learned from their training. This can be achieved by asking relevant questions and observation of staff practice. A record of this must be kept in the staff members file. 19

Before you are required to complete or support formal assessments of capacity and establishing best interest decisions As above plus Understand the difference between informal and formal assessments of capacity How to complete a formal assessment of capacity and best interest decision How to identify and record the use of restraint The role of Independent Mental Capacity Advocate service An understanding of the relevant case law decisions that inform day to day practice when using the MCA An understanding of the link between the Mental Capacity Act and Deprivation of Liberty Safeguarding These learning outcomes are relevant to all senior staff and managers who may/will undertake formal assessments of capacity and best interest decisions. The standards in this document comply with the following Legislation/Regulations: Mental Capacity Act 2005 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Suggested resources MCA Code of Practice, SCIE website; Making decisions: A guide for people who work in health and social care http://www.justice.gov.uk/protecting-the-vulnerable/mental-capacity-act 20

Training Standard: Deprivation of Liberty Safeguards This mandatory training standard describes the learning outcomes which must be delivered to staff working under Cambridgeshire County Council contracts or staff working for Cambridgeshire County Council. Who must have this training? All staff working in a care and support roles. The Level of training required is dependent on the role/level of responsibility. This training standard is in place to enable providers and their staff, meet aspects of regulations 17, 18, 9 and 11 outlined in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to the MCA. When must the training be taken and when must it be refreshed? Within 12 weeks of a new care worker being in post, thereafter every 2 years as case law implications should be considered in practice. If a specific knowledge gap is identified or there are changes in service need then a full refresher will be required as soon as possible. How must the training be delivered? Initial Induction should be face to face. Issues of capacity and consent can be complex and all staff working in care/support roles need to have an understanding of supportive decision making and recording standards. Subsequent refreshers: face to face, e-learning or team workshops. We would recommend a blended approach to the learning in this area, which should be followed up in regular supervisions and team meetings. Who is qualified to deliver the training? If delivered in a classroom the Trainer should have either; a minimum of PTTLS or Level 3 Award in Education and Training and a detailed understanding of the MCA, DoLS and the relevant case law. All trainers must evidence subject specific Continual Professional Development / Refresher training and train others only to the level at which they have expert knowledge and experience. 21

Timescale Required Learning Outcomes Additional information for designated persons Within 12 weeks of joining the organisation. The Learner must know and understand: Characterise the importance of Human Rights to health and social care and the MCA and DoLS These learning outcomes are relevant to all frontline staff not expected to complete formal capacity assessments or best interest decisions. Before completing a DoLS application What are the Deprivation of Liberty Safeguards and the duties and responsibilities under the Act How Deprivation of Liberty applies to your work setting The link between Best Interest Decisions (MCA) and DoLS Know what constitutes a deprivation of liberty as per the acid test Recognise the what constitutes restraint/restriction and importance of a less restrictive option As above plus Explain the limits on power and control in health/care settings Know the relevance/significance of the Supreme Court ruling and it s implication in practice for Managing Authorities Identify duties and responsibilities under the Act Complete a combined (Urgent/Standard Authorisation form) Competent persons/line managers must ensure that their staff member has learned from their training. This can be achieved by asking relevant questions and observation of staff practice. A record of this must be kept in the staff members file together with the certificate of training attendance. These learning outcomes are relevant to all senior staff and managers who may complete a DoLS authorisation form.. 22

Identify other DOLS forms that may be necessary to complete as well as the CQC notification form Understand the current constraints on the Local Authority as the Supervisory Body The standards in this document comply with the following Legislation/Regulations: Mental Capacity Act 2005 Deprivation of Liberty Safeguards 2009 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Suggested resources DoLS Code of Practice http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/en/publicationsandstatistics/publications/publicationspolicyandguidan ce/dh_085476 Identifying a Deprivation of Liberty: A Practical Guide https://www.lawsociety.org.uk/.../deprivation-of-liberty---a-practical-guide/ MCA Code of Practice, SCIE website; Making decisions: A guide for people who work in health and social care http://www.justice.gov.uk/protecting-the-vulnerable/mental-capacity-act Version Control Version Created on Participants Changes Next Review Date Version 1 October 2015 James Codling, MCA Training and Development Manager CCC & Multi-agency Training Standards Group. September 2016 23