1. Care Act 2004
1.1. Section 1- The general duty for local authorities is to promote individuals well being
1.1.1. well-being in regards to individuals means that individual's well-being so far as relating to what are called the 'nine domains'.
1.1.1.1. Personal dignity
1.1.1.1.1. This applies to Miss Shepherd- you would establish a respectful relationship and a equitable relationship through person centred practice (rogers, 1961 cited by sanders and Joseph, 2016) and by using person centred tools, which will give more of an holistic approach, with the result of hopefully building that relationship.
1.1.1.2. Physical and mental health and emotional well-being
1.1.1.2.1. Miss Shepherd comes across as displaying difficulties within her mental health and emotional well-being. For example, her lack of confidence in herself, which eventually will need addressing, however a capacity assessment may be needed if there is a refusal of intervention.
1.1.1.3. Protection from abuse and neglect
1.1.1.3.1. Physical Abuse
1.1.1.3.2. Sexual Abuse
1.1.1.3.3. Psychological Abuse
1.1.1.3.4. Exploitation
1.1.1.3.5. Financial or material abuse
1.1.1.3.6. Neglect and acts of omission
1.1.1.3.7. Discrimination abuse
1.1.1.3.8. Institutional abuse
1.1.1.3.9. Self Neglect
1.1.1.4. Participation in work, education, training and recreation.
1.1.1.4.1. Miss Shepherd doesn't show any issues at the moment and aren't individual in any. However it might be worth the discussion into whether or not she would like to access any of these.
1.1.1.5. Social and economical well-being
1.1.1.5.1. It needs to be found out if Miss Shepherd is managing financially as there isn't much information in regards to this, other than the fact she is selling goods in the middle of Camden. From a social perspective it is seen that Miss Shepherd is happy in the way in which she is living.
1.1.1.6. Control by the individual over daily life
1.1.1.6.1. Miss Shepherd says that she has a gods given right in which is guided through the virgin Mary, which shows that she has choice and control over her life, however she could be putting herself at risk by living the way she does.
1.1.1.7. Domestic, family and personal relationships
1.1.1.7.1. Who Miss Shepherd has contact and relationships with should be discussed throughout the assessment, and as well of people she would like to stay in contact with or reconnect with. However possible risks need to be considered, for example her brother.
1.1.1.8. Suitability of living accommodation
1.1.1.8.1. With Miss Shepherd being fine with her living accommodation, the social worker doing the assessment needs to make sure that they are being respectful and sensitive in this matter. If Miss Shepherd understands the risks she is putting herself under by living in the van, that Miss Shepherd needs are being met then unless they use the power under the Mental Capacity Act, there is nothing they can do to make Miss Shepherd out of her current living accommodation.
1.2. Section 9- Assessment of need
1.2.1. In order to establish whether or not Miss Shepherd has needs for care and support, the social worker will need to build a relationships with her, which can be supported by Trevithick (2012) Lexicon of skills.
1.2.1.1. If she does have needs, what are they? just in regards to assessment.
1.2.1.2. The aim of the assessment if for Local Authority to gain the knowledge of what Miss Shepherd wants as outcomes in order to achieve in day to day life.
1.3. Section 13 - Eligibility
1.3.1. The local authority must consider is Miss Shepherd is eligible through looking at if her needs are due to physical impairment, mental impairment, illness, also if Miss Shepherd is able to take basic care for herself for example personal care and eating. The local authority must also see whether or not Miss Shepherd is able to meet such takes; will this affect her well-being significantly.
1.4. Section 18- Duty to meet needs
1.4.1. If there has been needs which were identified in section 13 in regards to Miss Shepherd, the Local Authority has a duty to care and meet those needs.
1.5. Section 42- Making Enquiries
1.5.1. This is when the Local authority/social worker has reasonable cause to think that Miss Shepherd is either: Has need for care and support, is at risk or being subjected to abuse or neglect, as a result of needs found.
1.5.2. Local authorities must make the enquiries it thinks are necessary to be able to make a decision whether or not any action should be taken in an adults case.
1.6. Section 43-45 (safeguarding boards)
1.6.1. S43.1- each local authority must have a safeguarding adults board (SAB)
1.6.1.1. S43 (2)- the point of the SAB is to help and protect service users that have been described in section 42 (1) within: understanding information, retaining information, communicating her individual views, wishes or feelings, using information as part of the process of being involved. If any of these are met then she would meet the threshold.
1.6.1.1.1. If Miss Shepherd meets the threshold then the advocate would be there to assist her understanding the information give to her, support her in order for her voice to be heard, and to make sure her rights are respected.
1.7. Care and support statutory guidance
1.7.1. it is a guide in which gives you support on how to intergrate the Care Act into intervention.
1.7.2. Identifies who is at risk and how? Miss Shepherd would be considered at risk.
1.7.3. Settings - are the settings appropriate for her, including the van?
1.8. The six principles of safeguarding
1.8.1. Empowerment ( presumption of person led decisions)
1.8.2. Prevention (it is better to take action before harm happens)
1.8.3. Proportionailty (proportionate and a least intrusive response appropriate to the risk presented)
1.8.4. Protection (support and representation for those in greatest of need)
1.8.5. Partnerships (local solutions through services working with their communities)
1.8.6. Accountability (accountability and transparency in delivering safeguarding)
2. Mental Capacity Act 2005
2.1. The Mental Capacity Act is also there to support individuals with capacity to be able to make decisions in regards to their care plan.
2.2. Primary aim is to support individuals in which lack capacity in order to protect and empower individuals
2.3. Section 1
2.3.1. Capacity must be presumed until it is proven that they do not have capacity through assessment
2.3.2. Service users should be supported in making their own decisions
2.3.3. all decisions made by professionals should be in the persons best interests
2.3.4. individuals are allowed to make their own decisions even if professionals feel like the decisions isn't the best thing to do
2.3.5. The option which is least restrictive should always be considered
2.4. The Mental Capacity Act also empowers individuals who have accessed or have previously been actively part of health and social care services to assess capacity themselves.
2.5. The Mental Capacity Act also incorporates 5 statutory principles which are a basis and must be able to be linked to all decisions or interventions made.
2.5.1. Least restrictive and pushing independnace
2.5.1.1. Miss Shepherd should be treated lawfully and safely, without the need to detain her.
2.5.2. Empowerment and involvement
2.5.2.1. Miss Shepherd should be involved in decisions made, even if she is detained, still has a voice.
2.5.3. Respect and dignity
2.5.3.1. Miss Shepherd should be treated with respect and dignity, including respecting wishes
2.5.4. Purposeful and effective
2.5.4.1. All care/treatment should be appropriate to Miss Shepherd and made clear so she understands what is being explained.
2.5.5. Efficiency and equality
2.5.5.1. Refers to organisations providing quality, which wouldn't affect Miss Shepherd directly
2.6. Part 1 (s2+4) assessing capacity
2.6.1. In relation to Miss Shepherd, it is likely she would say that she understands her life style and consequences of her decisions
2.6.1.1. A capacity assessment would need to be done to see if she has capacity especially in relation to welfare, well- being and finances
2.6.1.1.1. 2 stage test done. 2 questions:
3. Human Rights Act (1998)
3.1. Article 8- having the right to respect, having private+ family life+home
3.1.1. Private life includes autonomy, personal dignity and an individuals interventions. This would apply to Miss Shepherd as she doesn't share her private life with anyone.
3.1.2. Family life includes close family ties such as parents/siblings. In regards to Miss Shepherd, there would need to be more exploration into Miss Shepherd's family life as not much known.
3.1.3. Home includes not having someone's home interfered with, example: unlawful surveillance and entry.
4. Equality Act (2010)
4.1. The Equality Act (2010) legally protects Miss Shepherd from discrimination within society, these include things such as disability, age, race and sex
5. Theory and practice
5.1. Attachment Theory
5.1.1. It was defined by Bowlby (1969) as having three measures which are:
5.1.1.1. Stranger Anxiety
5.1.1.2. Seperation anxiety
5.1.1.3. Social referencing
5.1.2. This relates to Miss Shepherd as she has an attachment to things such as her van and other aspects.
5.2. Person centred practice
5.2.1. Person Centred tools
5.2.1.1. One page profiles
5.2.1.2. Perfect week
5.2.1.3. Good/bad day
5.2.1.4. Important to/ important for
5.2.1.5. The doughnut
5.2.1.6. Relationship circle
5.2.1.7. learning log
5.2.1.8. communication chart
5.2.2. Miss Shepherd has many positives such as her skills within music, these should be recognised and supported.
5.2.3. Is she able to identify her own needs? building on her existing capabilities.
6. Health and Social Care Act (2012)
6.1. The Act discusses the designing of care and/or treatment that meets individuals preferences.
6.2. Miss Shepherd should possibly benefit from this approach as she was described in the film as 'cantankerous' in a number of reviews of the film including Bradshaw (2019)
6.3. Regulation 10
6.3.1. It ensures that individuals are being treated with respect and dignity
6.4. Regulation 4
6.4.1. It says that the need of the individual by a service has to be given by an appropriate person or the organisation has to be registered with the care quality commission.
6.5. Regulation 9
6.5.1. It is around person centred care, in which states that the care and treatment of service users must meet the needs of them as well as taking in their preferences
6.6. Regulation 12
6.6.1. It makes sure that safe care and treatment is given, if Miss Shepherd wants it
6.7. Regulation 13
6.7.1. It ensures that service users are protected against abuse or bad treatment wherever possible
7. Safeguarding and Personalisation
7.1. Personalisation is about enabling and allowing people to make choices and take risks, however safeguarding is preventing individuals from harm
7.1.1. This could be argued that these are contradicting aspects
7.2. There are many ethical dilemma's when ensuring personalisation for an individual, where as safeguarding in the past has been much more risk averse.
7.3. Risk is often perceived as a negative, therefore safeguarding prevents negative risk. Personailsation however is a positive as it is empowering people to make risks which are positive.
8. Mental Health Act ( 1983) amended in 2007.
8.1. The Mental Health Act (1983) over rides the Mental Capacity Act (2005) if the needs are met
8.2. Chapter 1
8.2.1. Code of practice highlights, guiding principles are designed to inform every decision which is taken under the Mental Health Act (1983/2007)
8.3. Section 2
8.3.1. Is utilised when the individual is not really known to services like Miss Shepherd. It ensures that an assessment is completed within the time frame of 28 days
8.3.1.1. When the assessment is being completed, the Local authority needs to take into account and respect Miss Shepherd's wishes and feelings. The local authority needs to avoid any unlawful discrimination and provide effective treatment, which acts upon any views of carers as well as paying attention Miss Shepherd's safety as well as the public's.
8.4. Section 135/136
8.4.1. May relate to Miss Shepherd, if when she is assessed it comes out that she is at significant risk and therefore will need moving to a place which is safe for herself and which keeps members of the public safe.
8.5. Before changes to the Mental Health Act 2007, individuals were not admitted if they wee considered as 'not treatable', which is not the case from the 2007 amendment
8.5.1. Miss Shepherd therefore would not have been admitted to hospital if needed, as she would have been seen as 'non treatable' however now with the 2007 amendment, she would be able to be admitted in order to prevent her symptoms worsening.