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England and Wales Court of Protection Decisions |
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You are here: BAILII >> Databases >> England and Wales Court of Protection Decisions >> AJ (Deprivation Of Liberty Safeguards) [2015] EWCOP 5 (10 February 2015) URL: http://www.bailii.org/ew/cases/EWCOP/2015/5.html Cite as: 18 CCL Rep 158, (2015) 18 CCL Rep 158, [2015] Fam 291, [2015] 3 WLR 683, [2015] WLR(D) 64, [2015] COPLR 167, [2015] EWCOP 5 |
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IN THE MATTER OF THE MENTAL CAPACITY ACT 2005
AND IN THE MATTER OF AJ (DEPRIVATION OF LIBERTY SAFEGUARDS)
Strand, London, WC2A 2LL |
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B e f o r e :
____________________
IN THE MATTER OF THE MENTAL CAPACITY ACT 2005 AND IN THE MATTER OF AJ (DEPRIVATION OF LIBERTY SAFEGUARDS) AJ (by her litigation friend the Official Solicitor) |
Applicant |
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- and - |
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A LOCAL AUTHORITY |
Respondent |
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Michael Dooley (of the Local Authority Legal Unit) for the Respondent
Hearing dates: 20th and 21st May 2014
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Crown Copyright ©
THE HONOURABLE MR JUSTICE BAKER:
INTRODUCTION
BACKGROUND
PRELIMINARY ISSUE – RESTRAINT
GENERAL STATUTORY PROVISIONS CONCERNING DEPRIVATION OF LIBERTY
"Everyone who is deprived of his liberty by arrest or detention shall be entitled to take proceedings by which the lawfulness of his detention shall be decided speedily by a court and his release ordered if his detention is not lawful.
The ECHR was incorporated into domestic law by the Human Rights Act 1998, s. 6 (1) of which provides that "it is unlawful for a public authority to act in a way which is compatible with a Convention right".
"(5) An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in his best interests.
(6) Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action."
Section 4 identifies the factors to be taken into account when determining what is in P's best interests.
"(1) This Act does not authorise any person ("D") to deprive any other person ("P") of his liberty.
(2) But that is subject to–
(a) the following provisions of this section, and
(b) section 4B [concerning life-sustaining treatment].
(3) D may deprive P of his liberty if, by doing so, D is giving effect to a relevant decision of the court.
(4) A relevant decision of the court is a decision made by an order under section 16(2)(a) in relation to a matter concerning P's personal welfare.
(5) D may deprive P of his liberty if the deprivation is authorised by Schedule A1 (hospital and care home residents: deprivation of liberty)."
DOLS
"in the vast majority of cases, it should be possible to plan in advance so that a standard authorisation can be obtained before the deprivation of liberty begins. There may, however, be some exceptional cases where the need for the deprivation of liberty is so urgent that it is in the best interests of the person for it to begin while the application is being considered."
It is in these circumstances that the managing authority of the hospital or home may give an urgent authorisation. Under paragraph 78 of Schedule A1, the duration of an urgent authorisation given by the managing authority of a care home of hospital pending the grant of a standard authorisation must not exceed seven days. In certain exceptional circumstances, if the request for a standard authorisation has not been disposed of within that period, the supervisory body at the request of the managing authority may extend the duration of the original urgent authorisation by no more than seven further days.
"(1) This section applies if either of the following has been given under Schedule A1–
(a) a standard authorisation;
(b) an urgent authorisation.
(2) Where a standard authorisation has been given, the court may determine any question relating to any of the following matters–
(a) whether the relevant person meets one or more of the qualifying requirements;
(b) the period during which the standard authorisation is to be in force;
(c) the purpose for which the standard authorisation is given;
(d) the conditions subject to which the standard authorisation is given.
(3) If the court determines any question under subsection (2), the court may make an order–
(a) varying or terminating the standard authorisation, or
(b) directing the supervisory body to vary or terminate the standard authorisation.
(4) Where an urgent authorisation has been given, the court may determine any question relating to any of the following matters–
(a) whether the urgent authorisation should have been given;
(b) the period during which the urgent authorisation is to be in force;
(c) the purpose for which the urgent authorisation is given.
(5) Where the court determines any question under subsection (4), the court may make an order–
(a) varying or terminating the urgent authorisation, or
(b) directing the managing authority of the relevant hospital or care home to vary or terminate the urgent authorisation.
(6) Where the court makes an order under subsection (3) or (5), the court may make an order about a person's liability for any act done in connection with the standard or urgent authorisation before its variation or termination.
(7) An order under subsection (6) may, in particular, exclude a person from liability."
CASE LAW
(1) "There is a positive obligation on the state to protect the liberty of those within its jurisdiction. Otherwise, there would be a sizeable gap in the protection from arbitrary detention, which would be inconsistent with the importance of personal liberty in a democratic society. The state is therefore obliged to take measures providing effective protection of vulnerable persons, including reasonable steps to prevent a deprivation of liberty of which the authorities have or ought to have knowledge": Stanev v Bulgaria at paragraph 120.
(2) The procedure required by Article 5(4) must have a judicial character and be independent of the detaining authority: X v United Kingdom, supra, para 53, MH v UK, supra, para 77(c).
(3) Article 5(4) guarantees a remedy that must be accessible to the person concerned: MH v UK, supra, para 76.
(4) The state has an obligation to ensure that a mentally incapacitated adult is afforded independent representation, enabling them to have their Convention complaints examined before a court or other independent body: Ivinovic v Croatia, supra, para 45.
(5) Special procedural safeguards may be called for in order to protect the interests of persons who, on account of mental disabilities, are not fully capable of acting for themselves. Where a person lacks the capacity to instruct lawyers directly, the safeguards required may include empowering or even requiring some other person to act on that person's behalf: Winterwerp v The Netherlands, supra, para 60, MH v UK, supra, paras 77(e) and 92.
(6) Article 5(4) may not be complied with where access to a court is dependent on the exercise of discretion by a third party, rather than an automatic entitlement. Where the third party supports the deprivation of liberty, reliance on the third party to initiate proceedings may not satisfy the requirements of Article 5(4): Shtukatarov v Russia, supra, para 124.
(7) An initial period of detention may be authorised by an administrative authority as an emergency measure provided it is of short duration and the individual is able to bring judicial proceedings speedily to challenge the lawfulness of any such detention including, where appropriate, its lawful justification as an emergency measure: MH v UK, supra, para 77(a).
(8) The likelihood of the judicial hearing leading to release from detention is irrelevant. Article 5(4) is first and foremost a guarantee of a fair procedure for reviewing the lawfulness of detention – an applicant is not required, as a precondition of enjoying that protection, to show that on the facts of his case he stands any particular chance of success in obtaining his release: Waite v UK, supra, para 59.
"… there is an obligation on the State to ensure that a person deprived of liberty is not only entitled but enabled to have the lawfulness of his detention reviewed speedily by a court".
"What the Convention requires is that P be able to participate in the proceedings in such a way as to enable P to present their case "properly and satisfactorily": see Airie v Ireland (1980) 2 EHRR 305 para 24. More specifically, "it is essential that the person concerned should have access to a court and the opportunity to be heard either in person or, where necessary, through some form of representation, failing which he will not have been afforded the fundamental guarantees of procedure applied in matters of deprivation of liberty": Winterweerp v Netherlands [1979] 2 EHRR 387 para 60. P should always be given the opportunity to be joined if they wish and whether joined as a party or not must be given the support necessary to express views about the application and to participate in the proceedings to the extent that they wish. So long as that demanding standard is met, and in my judgment it can in principle be met without P being joined as a party, there is no need for P to be a party."
THE ISSUES
(1) It should have sought a DOLS authorisation or a court order authorising a deprivation of liberty on or around 17th May 2013 when it was known that AJ was to be moved to a residential care home against her wishes.
(2) It ought not to have appointed Mr. C as RPR at all, or at least not without ensuring that he would bring proceedings under s.21A in the light of AJ's known objections, or alternatively, having appointed him, replaced him when it became apparent that he was not going to facilitate a speedy review of her detention.
(3) Although Mr. R was appointed as IMCA under s.39D of the Act, the Official Solicitor raises the question whether, in the circumstances of this case, the local authority was in fact under an obligation to appoint an IMCA at all. If, in all the circumstances, it was not under an obligation to appoint an IMCA, it should nonetheless have taken steps to assist AJ in exercising her rights. Alternatively, having appointed an IMCA, it remained under an obligation to monitor how the IMCA was acting in furtherance of those rights, and should have ensured that funds were available to enable the IMCA to obtain legal advice and act as litigation friend.
(4) Ultimately, if neither the RPR nor the IMCA were able or willing to issue proceedings promptly, it should have issued proceedings itself.
THE INITIAL AUTHORISATION PROCESS
Submissions
Discussion
ISSUES CONCERNING THE RPR
Statutory provisions, regulations and guidance
"The supervisory body must appoint a person to be the relevant person's representative as soon as practicable after a standard authorisation is given."
Paragraph 140 provides:
"The selection of a person for appointment under paragraph 139 must not be made unless it appears to the person making the selection that the prospective representative would, if appointed,
(a) maintain contact with the relevant person;
(b) represent the relevant person in matters relating to or connected with this Schedule, and
(c) support the relevant person in matters relating to or connected with this Schedule".
"5. Selection by the relevant person
(1) Where the best interests assessor determines that the relevant person has capacity, the relevant person may select a family member, friend or carer.
(2) Where the relevant person does not wish to make a selection under paragraph (1), regulation 8 applies.
6. Selection by a donee or deputy
(1) Where
(a) the best interests assessor determines that the relevant person lacks capacity to select a representative; and
(b) the relevant person has a donee or deputy and the donee's or deputy's scope of authority permits the selection of a family member, friend or carer of the relevant person,
the donee of deputy may select such a person.
(2) A donee or deputy may select himself or herself to be the relevant person's representative.
(3) Where a donee or deputy does not wish to make a selection under paragraph (1) or (2), regulation 8 applies.
7. Confirmation of eligibility of family member, friend or carer and recommendation to the supervisory body
(1) The best interests assessor must confirm that a person selected under regulation 5(1) or 6(1) or (2) is eligible to be a representative.
(2) Where the best interests assessor confirms the selected person's eligibility under paragraph (1), the assessor must recommend the appointment of that person as a representative to the supervisory body.
(3) Where the best interests assessor is unable to confirm the selected person's eligibility under paragraph (1), the assessor must (a) advise the person who made the selection of that decision and give the reasons for it, and (b) invite them to make a further selection.
8. Selection by the best interests assessor
(1) The best interests assessor may select a family member, friend or carer as a representative where paragraph (2) applies.
(2) The best interests assessor may make a selection where
(a) the relevant person has the capacity to make a selection under regulation 5(1) but does not wish to do so;
(b) the relevant person's donee or deputy does not wish to make a selection under regulation 6(1) or (2); or
(c) the relevant person lacks the capacity to make a selection and (i) does not have a donee or deputy, or (ii) has a donee or deputy but the donee's or deputy's scope of authority does not permit the selection of a representative.
(3) Where the best interests assessor selects a person in accordance with paragraph (2), the assessor must recommend that person for appointment as a representative to the supervisory body.
(4) But the best interests assessor must not select a person under paragraph (2) where the relevant person, donee or deputy objects to that selection.
(5) The best interests assessor must notify the supervisory body if they do not select a person who is eligible to be a representative."
9. Selection by the supervisory body
"(1) Where a supervisory body is given notice under regulation 8(5), it may select a person to be the representative who
(a) would be performing the role in a professional capacity; (b) has satisfactory skills and experience to perform the
role;
(c) is not a family member, friend or carer of the relevant person;
(d) is not employed by, or providing services to, the relevant person's managing authority, where the relevant person's managing authority is a care home;
(e) ….
(f) is not employed by the supervisory body.
Regulation 9(2) makes provisions as to criminal records which do not arise here.
"(1) The offer of an appointment to a representative must be made in writing and state
(a) the duties of a representative to (i) maintain contact with the relevant person; (ii) represent the relevant person in matters relating to, or connected with, the deprivation of liberty, and (iii) support the relevant person in matters relating to, or connected with, the deprivation of liberty, and
(b) the length of the period of appointment.
(2) The representative must inform the supervisory body in writing that they are willing to accept the appointment and that they have understood the duties set out in sub-paragraph (1)(a).
(3) The appointment must be for the period of the standard authorisation.
(4) The supervisory body must send copies of the written appointment to (a) the appointed person; (b) the relevant person; (c) the relevant person's managing authority; (d) any donee or deputy of the relevant person; (e) any IMCA appointed in accordance with ss 37 to 39D of the Act, involved in the relevant person's case, and (f) every interested person named by the best interests assessor in their report as somebody the assessor has consulted in carrying out the assessment."
Regulation 13 is headed "Termination of representative's appointment" and provides that "a person ceases to be a representative if
(a) the person dies;
(b) the person informs the supervisory body that they are no longer willing to continue as representative;
(c) the period of the appointment ends;
(d) a relevant person who has selected a family member, friend or carer under regulation 5(1) who has been appointed as their representative informs the supervisory body that they object to the person continuing to be a representative;
(e) a donee or deputy who has selected a family member, friend or carer of the relevant person under regulation 6(1) who has been appointed as a representative informs the supervisory body that they object to the person continuing to be a representative;
(f) the supervisory body terminates the appointment because it is satisfied that the representative is not maintaining sufficient contact with the relevant person in order to support and represent them;
(g) the supervisory body terminates the appointment because it is satisfied that the representative is not acting in the best interests of the relevant person, or
(h) the supervisory body terminates the appointment because it is satisfied that the representative is no longer eligible or was not eligible at the time of appointment to be a representative."
"The role of the relevant person's representative, once appointed, is
- to maintain contact with the relevant person, and
- to represent and support the relevant person in all matters relating to the deprivation of liberty standards, including, if appropriate, triggering a review, using an organisation's complaints procedure on the person's behalf or making an application to the Court of Protection.
This is a crucial role in the deprivation of liberty process, providing the relevant person with representation and support that it independent of the commissioners and providers of the services they are receiving."
"It is up to the best interests assessor to confirm whether any representative proposed by the relevant person, a donee or a deputy is eligible. If the best interests assess decides that a proposed representative is not eligible, they must advise the person who made the selection and invite them to make a further selection."
"If neither the relevant person, nor a donee or deputy, selects an eligible person, then the best interests assessor must consider whether they are able to identify someone eligible who could act as the relevant person's representative."
"In making a recommendation, the assessor should consider, and balance, factors such as:
- Does the relevant person have a preference?
- If they do not have the capacity to express a preference now, is there any written statement made by the relevant person when they had capacity that indicates who they may now want to be their representative?
- Will the proposed representative be able to keep in contact with the relevant person?
- Does the relevant person appear to trust and feel comfortable with the proposed representative?
- Would the proposed representative be able to represent the relevant person effectively?
- Is the proposed representative likely to represent the relevant person's best interests?"
Paragraph 7.17 adds: "It should not be assumed that the representative needs to be someone who supports the deprivation of liberty.".
Evidence on the selection and appointment of the RPR
"I spoke to him at length about the importance of an appeal and the RPR's role in making an application to the Court of Protection. Mr. C advised me that he understood the responsibilities of the RPR and would approach the Court if he were asked to, either directly by AJ or if he felt this were necessary. He told me he understood the role, and also the conflict that he and others must face where the RPR's wish to protect a loved one sits in incongruity with the relevant person's wish for liberty. To support him as RPR, I suggested that in [this county] BIAs would automatically appoint an IMCA-39D [to] help in managing this tension. When I asked Mr. C if he would accept IMCA support, he readily agreed, telling me that this would be helpful to him."
"she declined this, asking instead to speak to Mr. and Mrs. C first. AJ did not appear to understand the relevant information about the appeal process, and specifically that she is subject to DOLS."
"… while [Mr. C] does not have a view on whether this was a correct or incorrect decision, the reasons for not assisting the appellant to exercise her right to review by the court was because he was aware of the complete background to the case, the extensive medical professional involvement and the outcome of a multi-disciplinary best interests meeting; the conclusions of all being that AJ required significant care despite her likely objection. Although [Mr. and Mrs C] absolutely agree to the right of an individual to challenge any deprivation of liberty, it would appear that bringing this case gave no consideration to the personal medical needs of AJ but rather based itself upon the view of an individual who had no knowledge of AJ and has visited her on only four occasions. Indeed, [Mr. and Mrs C] stated from the very outset that AJ would object to being in care but it would appear that these considerations were not given credence."
Submissions
Discussion
ISSUES CONCERNING THE IMCA
In what circumstances does the duty to appoint an IMCA under section 39D arise?
"(1) The responsible authority must make arrangements as it considers reasonable to enable persons ("independent mental capacity advocates") to be available to represent and support persons to whom acts or decisions proposed under section 37, 38 and 39 relate or persons who fall within sections 39A, 39C or 39D.
(2) The appropriate authority may make regulations as to the appointment of independent mental capacity advocates. "
Section 36(1) enables the passing of regulations as to the functions of IMCAs. Section 36(2) stipulates what such regulations may cover, including requiring an advocates to take such steps as may be prescribed for the purpose of providing support to P so that he may participate as fully as possible in any relevant decision. The regulations passed under section 35(2) and section 36(1) are the Mental Capacity Act 2005 (Independent Mental Capacity Advocates General) Regulations 2006.
"(1) This section applies if—
(a) an authorisation under Schedule A1 is in force in relation to a person ("P"),
(b) P has a representative ("R") appointed under Part 10 of Schedule A1, and
(c) R is not being paid under regulations under Part 10 of Schedule A1 for acting as P's representative.
(2) The supervisory body must instruct an independent mental capacity advocate to represent P in any of the following cases.
(3) The first case is where P makes a request to the supervisory body to instruct an advocate.
(4) The second case is where R makes a request to the supervisory body to instruct an advocate.
(5) The third case is where the supervisory body has reason to believe one or more of the following—
(a) that, without the help of an advocate, P and R would be unable to exercise one or both of the relevant rights;
(b) that P and R have each failed to exercise a relevant right when it would have been reasonable to exercise it;
(c) that P and R are each unlikely to exercise a relevant right when it would be reasonable to exercise it.
(6) The duty in subsection (2) is subject to section 39E.
(7) If an advocate is appointed under this section, the advocate is, in particular, to take such steps as are practicable to help P and R to understand the following matters—
(a) the effect of the authorization;
(b) the purpose of the authorization;
(c) the duration of the authorization;
(d) any conditions to which the authorization is subject;
(e) the reasons why each assessor who carried out an assessment in connection with the request for the authorization, or in connection with a review of the authorization, decided that P met the qualifying requirement in question;
(f) the relevant rights;
(g) how to exercise the relevant rights.
(8) The advocate is, in particular, to take such steps as are practicable to help P or R—
(a) to exercise the right to apply to court, if it appears to the advocate that P or R wishes to exercise that right, or
(b) to exercise the right of review, if it appears to the advocate that P or R wishes to exercise that right.
(9) If the advocate helps P or R to exercise the right of review—
(a) the advocate may make submissions to the supervisory body on the question of whether a qualifying requirement is reviewable;
(b) the advocate may give information, or make submissions, to any assessor carrying out a review assessment.
(10) In this section—
'relevant rights' means—
(a) the right to apply to court, and
(b) the right of review;
'right to apply to court' means the right to make an application to the court to exercise its jurisdiction under section 21A;
'right of review' means the right under Part 8 of Schedule A1 to request a review."
"Sections 37(3), 38(3) and (4) and 39(4) and (5) do not apply if there is
(a) a person nominated by P (in whatever manner) as a person to be consulted in matters affecting his interests;
(b) a donee of a lasting power of attorney created by P;
(c) a deputy appointed by the court for P, or
(d) a donee of an enduring power of attorney (within the meaning of Schedule 4) created by P."
As drafted under the amendment, the section now reads:
"(1) The duty imposed by section 37(3), 38(3) or 39(4) or 39A(3), 39C(3) or 39D(2) does not apply where there is -
(a) a person nominated by P (in whatever manner) as a person to be consulted on matters to which that duty relates,
(b) a donee of a lasting power of attorney created by P who is authorized to make decisions in relation to those matters, or
(c) a deputy appointed by the court for P with power to make decisions in relation to those matters
(2) A person appointed under Part 10 of Schedule A1 to be P's representative is not, by virtue of that appointment, a person nominated by P as a person to be consulted in matters to which a duty mentioned in subsection (1) relates."
It will be seen that the effect of the amendment was, first, to insert the new statutory duties under section 39A to D within the exceptions set out in section 40, but, secondly, to narrow the scope of those exceptions.
"In these regulations, references to instructions given to a person to act as an IMCA are to instructions given under sections 37 to 39 of the Act or under regulations made by virtue of section 41 of the Act."
Furthermore, regulation 6, which sets out the functions of an IMCA, including the duty to determine in all the circumstances how best to represent and support P, is limited by regulation 6(1) and (2) to cases where an IMCA has been instructed by a person who is required or enabled to instruct an IMCA under sections 37 to 39, or by regulations made under section 41. (Section 41 enables the making of regulations to expand the role of IMCAs. Regulations have been made pursuant to this power but are not relevant to the present case.)
"192. Under the MCA an independent mental capacity advocate (IMCA) must be appointed in specified situations to support and represent particularly vulnerable people who have no family or friends or others whom it would be appropriate to consult. Sections 40 of the MCA provides some limited exceptions to the requirement to appoint an IMCA in these circumstances.
193. Section 49 [of the Mental Health Act 2007] substitutes a new version of section 40, to limit the exceptions to the duty to instruct an IMCA. The amendment ensures that there will still be a duty to instruct an IMCA (for health and social care issues) for someone who lacks capacity even if they have someone to represent them on different issues, for example financial issues. There is no such duty if they already have someone to represent them on the same issue."
(2) Did the duty to appoint an IMCA arise here?
(3) Did the appointment of the IMCA absolve the local authority from further responsibility to ensure that AJ rights under Article 5(4) were respected?
CONCLUSION
"as AJ's friends of thirty years or more and people who have been involved in her care, we felt helpless and disappointed that we were now letting her down as there was nothing we could do to help her. She had no voice of her own and no one else to fight her corner. We had been told that because we are not related to her, there was nothing we could do."
(1) That the Respondent local authority has unlawfully deprived AJ of her liberty and thereby infringed her rights under Article 5(1) of ECHR by placing her between 13th and 20th June 2013 in a residential home in circumstances which amounted to a deprivation of liberty without first either (a) granting any authorisation for such deprivation, pursuant to Schedule A1 of the Mental Capacity Act 2005, or (b) obtaining an order of this Court authorising such deprivation;
(2) That the local authority, knowing at all material times that AJ did not wish to reside at Y House, infringed AJ's rights under Article 5(4) of ECHR between 5th June and 18th November 2013 by
(a) wrongly appointing Mr C as AJ's relevant person's representative when it knew or ought to have known that he would not represent or support AJ in challenging the standard authorisations granting by the local authority under Schedule A1;
(b) failing to terminate Mr C's appointment as relevant person's representative when he failed to take any or adequate steps on AJ's behalf to challenge the said authorisation; and
(c) failing to take adequate steps to ensure that AJ's challenge to the deprivation of her liberty was brought before the Court expeditiously.