A Digital Approach to Liberty Protection Safeguards


 

 

 

The Proposal


To undertake an agile discovery approach to the new Liberty Protection Safeguards (LPS) legislation, mapping the differences to the current Deprivation of Liberty process and optimising ways of engaging all stakeholders and then develop a digital solution that works for all partners.

 

New legislation – the Mental Capacity (Amendment) Act – will change the Deprivation of Liberty Safeguards (DoLS) process in every local authority and is due to come into force in October 2020. As such every council will need to engage with partners – particularly care homes, CCGs and hospitals – to support them with the changes that LPS will bring in terms of process, training and rigour.

 

This project will be a collaboration of local government business analysts and technology solution specialists and five co-funding local authorities, supported by the Local Government Association’s Social Care Digital Innovation Programme (SCDIP). The project will be undertaken in two phases - discovery and development/implementation - with Social Care Programme Board approval post the discovery phase.

 

Project Background


This project has been prioritised alongside the core Social Care Digital Innovation Programme (SCDIP) as there is a clear need across local government to swiftly accelerate transformation and take-up in this area. The project has been identified not only due to the potential for sector led co-design and collaboration, but because the results will have real and immediate value to all councils.

 

As such the LGA has agreed to part fund this project alongside their wider SCDIP programme and is keen to see a group of councils work together with a relevant technology partner to progress the work. The project will report into the SCDIP Board as it progresses and be independently evaluated by the Institute of Public Care.

 

Project Context


Under the current Deprivation of Liberty process, local authorities are the “supervisory” body for all cases. When the new Mental Capacity (Amendment) Act comes into force, providers and settings with little experience in this area will need to understand the business process and apply the new legislation. As such there is an opportunity to define new roles and responsibilities, and put a new digital solution and business process in place.

 

Mental Capacity (Amendment) Act proposes amendments to the process for authorising a deprivation of liberty in the following ways:

 

  • It will apply in any setting in which a person may be deprived of their liberty, not just care homes or hospitals, as with DoLS;
  • The “responsible body”, which would sign off the authorisation, differs by setting. Under LPS, NHS hospital managers will be the responsible body for cases in their own settings, CCGs will be responsible body for continuing healthcare cases and local authorities will be responsible body for all other cases including people’s own homes;
  • Responsible bodies may give care home managers responsibility for overseeing cases in their settings, which would involve arranging the required assessments, consultation and reporting back to the responsible body, so that a decision can be made on whether the authorisation conditions have been met;
  • The LPS scheme applies to those aged 16 or over, rather than 18 or over, as it was with DoLS;
  • While LPS authorisations, like DoLS cases, would have an initial limit of 12 months, they would be renewable, unlike with DoLS, where a fresh authorisation is required after one expires. While the first renewal would have a limit of 12 months, subsequent renewals could be for up to three years.

Project Aims


  • To explore the most effective ways for local government to support providers and the NHS with the proposed changes;
  • To work collaboratively with providers and NHS services in managing the change whilst best supporting providers and stakeholders;
  • To explore how the process can be made transparent and accessible to non-professionals involved in a case;
  • To explore how the client, their family and carers can most effectively have their voices heard in the new process;
  • To fulfil the duty to provide information related to LPS and through the provision of information to empower individuals as soon as there is a challenge;
  • To explore solutions and make recommendations in advance of the new Legal Framework and accompanying Code of Practice;
  • To identify and address the issue of the “backlog” of cases that have not been authorised through a legal process;
  • To ensure sufficient scrutiny of practice within the context of reduced Local Authority resources;
  • To set up a database that identifies the qualifications, skills and training of individuals practicing as Mental Capacity Assessors and Approved Mental Capacity Professionals.

Business Case


The DoL caseload in a large number of councils across England has increased significantly over the past few years and in many there is also a backlog of cases awaiting authorisation. This situation means that often DoLS cannot be put in place within the statutory timeframes. Current estimates show there is a current national backlog of DoLS - yet to be authorised - of 125,000.

 

With the situation as it is and the impending change in legislation, there is an immediate need across the local government sector to co-ordinate how it responds. Caseload and workflow modelling strongly suggests that frontline savings can be made by deploying a digital solution to improve the process between care homes, hospitals, CCGs and the council and reduce the time taken on each LPS. A solution will also facilitate simpler engagement, help reduce the backlog as well as reduce risk.

 

Non-Financial Benefits

  • Deeper and more timely engagement of family members throughout the process
  • Reduction of duplication by adhering to the ‘Tell Us Once’ principal
  • Could lead to a national database of individuals practicing as Mental Capacity Assessors and Approved Mental Capacity Professionals
  • Speeding up the process and reducing the backlog
  • Opportunity to establish a common approach to a shared challenge
  • Pro-actively working to reduce the risk of poorly thought out/last minute change implementation
  • Increased transparency & reduced bureaucracy and complexity
  • Use technology to positively engage care partners and providers
  • Address the LPS ‘renewal process’, which is different to the DoLS process
  • Improvement to the quality of care planning and support of care homes in this process
  • Scrutiny improvement

Discovery Phase


  • Carry out wide-ranging business analysis, working across all co-funding councils and their representative providers, the NHS and service user stakeholders;
  • Identify the main challenges in the process, what is most important to stakeholders in designing the new local processes and where ‘digital’ can help, improve and speed up the process;
  • Work with stakeholders to co-design the new local processes, considering opportunities to streamline existing processes and minimising complexity for the user;
  • Developing blueprints and prototyping of solutions;
  • Modelling costs and solution options for the development phase;
  • Develop detailed proposals for implementation;
  • Monitor further developments as more detail becomes available via the Code of Practice and Regulations , adjusting the scope of the discovery and delivery phases accordingly.

Development Phase


  • Develop the agreed co-funded solution in an agile manner;
  • Implement the solution in each of the co-funding council/partner settings;
  • Evaluate the solution with all stakeholders.

Financial Requirements


 

* £15,000 in MVP phase with a further £35,000 for the implementation phase subject to NHS Digital/SCDIP Board approval.

 

Time-frames