Category Archives: Advice

Advice Challenging Behaviour

Mental Capacity Act ‘not working’

When the Mental Capacity Act, 2005 was introduced its prime intention was to empower and protect vulnerable adults. However, a recent House of Lords Committee report found that in thousands of cases, those who oversee the care of such adults – for instance social workers or health professionals – are failing to correctly implement the legislation and in many cases are barely aware of the Act and the requirements it makes of them.

The Act is underpinned by five key principles: (i) that adults have the capability to make decisions for themselves until it can be proved otherwise; (ii) that a person must be given all practical support to make decisions before it can be shown that they lack said capacity; (iii) that just because a decision may be judged to be ‘unwise’ it should not be seen as evidence that the individual lacks capacity to make it; (iv) that any act or decision made on behalf of a person lacking capacity to decide for themselves, must be in the individual’s best interests, and (v) that any decision made on behalf of an individual who lacks capacity, must be that which least restricts their essential rights and freedoms.

Whilst Lord Hardie, Chair of the Committee, states that, ‘The Act is good and it needs to be implemented;’ he goes on to say, ‘The evidence suggests that tens of thousands of people are being deprived of their liberty without the protection of the law, and without the protection that Parliament intended… Worse still, in some cases the safeguards are being wilfully used to oppress individuals and to force decisions upon them, regardless of what actions may be in their best interests.’

The case of a 21-year-old, Steven Neary of Uxbridge, has been cited as an example of what is going wrong. Mr Neary’s father, Mark, whilst unwell, sought three day’s respite. However, after this period Hillingdon Council, concerned by Steven’s behaviour and weight, took the decision to transfer him to a behaviour unit. It was nearly a year before Steven was allowed to return home. In the interim, Steven’s father felt, ‘helpless,’ and that, ‘I had let him down, lost my own son.’

Hillingdon Council later issued an apology, stating that whilst, ‘Staff were genuinely committed to ensuring that we did the right thing… we need to improve our processes.’

The House of Lords report has recommended that Government needs to ‘draft replacement provisions that are easy to understand and implement, and in keeping with the style and ethos of the Mental Capacity Act.’

Further recommendations include giving the Act a higher profile in training, standards and inspections; that an increase in resources for the Court of Protection would enable non-controversial cases to be handled more speedily; that Government reconsiders the provision of non-means tested legal aid to those who lack capacity, especially in cases of deprivation of liberty and; that the Government review the criminal law provision for ill-treatment or neglect of a person lacking capacity to ensure that it is fit for purpose.

Finally, the Committee has recommended that the Government report back in a year’s time to show how it has responded to the above recommendations.


Advice People Handling

Need to Know – 10 useful things to know if you have low back pain

  1. Ice therapy Putting ice on the painful area can be really useful in the first 24 to 48 hours after an injury because it can help reduce the inflammation. Even though the gut reaction maybe to keep a painful area warm and this certainly feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice — take it off after about 20 minutes to give your skin a rest.
  2. Keep moving. Our spines are like the rest of our body — they’re meant to move. You should not refrain from doing your usual daily activities. Continue to do the housework, walk the dog, and drive the kids to school. Once you’re feeling better, regular aerobic exercises like swimming, yoga, cycling, and walking can keep you — and your back — more mobile. Just don’t overdo it. There’s no need to run a marathon when your back is painful.
  3. Stay strong. Once your back pain has receded, you can help avert future episodes of pain by working the muscles that support your lower back, including the back extensor muscles. Having strong hip, pelvic, and abdominal muscles also gives you more back support. Seek advice about the best exercises to do as some exercises can actually put more strain on your back.
  4. Stretch A lot of us undertake jobs that require us to occasionally adopt poor posture. You should get into the habit of stretching in the opposite direction every 20 minutes through your day to relieve the possible discomfort. Many people get relief from their back pain by doing a regular stretching routine, this also helps build up your muscle strength as well.
  5. Think ergonomically. Design your workspace/home space so you don’t have to hunch forward to see your computer monitor or sit twisted to watch your TV. Use a desk chair or home sofa that supports your lower back and allows you to sit as comfortably as possible.
  6. Watch your posture. Be especially careful of your posture when lifting heavy or awkward objects. Never bend over from the waist. Instead, bend and straighten from the knees keeping your spine it its natural alignment.
  7. Wear low heels. Exchange your four-inch shoes for flats or low heels (less than 1 inch). High heels create a more unstable posture, and increase pressure on your lower spine. According to research, nearly 60% of women who consistently wear high-heeled shoes complain of low back pain.
  8. Kick the habit. Smoking can increase your risk for osteoporosis of the spine and other bone problems. Osteoporosis can lead to compression fractures of the spine. One study found that smokers are about a third more likely to have low back pain compared with non-smokers.
  9. Watch your weight. Use diet and exercise to keep your weight within a healthy range for your height. Being overweight puts excess stress on your spine.

10. Try an over-the-counter pain reliever. Anti-inflammatory drugs and some pain killers can help reduce back pain. Be sure to check with your G.P. or pharmacist about any interactions over-the-counter pain relievers may have with other medications you are taking. People with a history of certain medical conditions (such as ulcers, kidney disease, and liver disease) should avoid some medicines.


Finally if your low back pain persists contact your G.P. for advice.

Advice News

Changes to the Disclosure and Barring Service

The Protection of Freedoms Act 2012 merged the functions of the Criminal Records Bureau (CRB) and the Independent Safeguarding Authority (ISA) into one body: the Disclosure and Barring Service (DBS). The DBS covers England and Wales with Disclosure Scotland and Access Northern Ireland fulfilling the same role elsewhere in the UK. The role of the DBS is to enable organisations from public, private and voluntary sectors to identify potential employees who may not be appropriate to work in certain roles with particular emphasis on those working with children or vulnerable adults. The new body became effective on the 1st December 2012.

Around a quarter of the working population of the United Kingdom work in circumstances that fall within the DRB’s remit.

Previously the DBS produced certificates listing an individual’s entire history of convictions regardless of when they occurred or the significance of the crime or misdemeanour. The recent upholding by the Court of Appeal of a complaint that such a blanket approach risked breaching peoples’ right to privacy has required a change in policy and, since the end of May 2013, some convictions will be filtered.

Convictions can now be excised from the record if they meet the following three criteria: firstly, that at least eleven years have elapsed since the date of the conviction; secondly, that it is the individual’s only conviction and thirdly, that said conviction was not punished with a custodial sentence.


Furthermore, candidates are not obliged to inform potential employers of convictions which would not be appear on a DBS certificate. An employer taking such a conviction into account would risk prosecution uner the Rehabilitation of Offenders Act, 1974.

Advice Moving and Handling News

Breakthrough for Sufferers of Chronic Back Pain

€lterer Mann hat Probleme mit seinen BandscheibenRecent research conducted by the University of Southern Denmark has turned much of the established thinking about chronic lower back pain on its head. Over a period of ten years the Danish team have studied tissue collected from sufferers and found that nearly half of the samples were infected, most often by Propionibacterium acnes more generally known as the cause of acne.

When a vertebral disc prolapses or ‘slips’ the body attempts to repair the damage by growing tiny blood vessels into the disc itself. Rather than helping, this actually allows the offending bacteria, which usually enters the bloodstream as a consequence of people brushing their teeth, to infiltrate the disc resulting in painful inflammation and damage.

Around £480 million is spent in the UK each year conducting surgery on the human spine, the largest part of this treatment is in tackling back pain. Prolapsed vertebral discs pressing against the spinal cord are often simply cut off to reduce or remove the pressure and, therefore, the pain. However, in light of the new research, many patients will be able to avoid surgery and simply take a 100-day course of antibiotics. The researchers found that in as many as 80% of cases where damaged vertebrae had been identified and pain suffered for a period greater than six months, it was alleviated by antibiotics.

Peter Hamlyn of University College London Hospital commented, ‘We are talking about probably half of all spinal surgery for back pain being replaced by taking antibiotics. It may be that we can save £250 million from the NHS budget by doing away with unnecessary operations. The price of the antibiotic treatment is only £114. It is spectacularly different to surgery.’

Of course, over-use of antibiotics is currently of significant concern to the health services as antibiotic-resistant bacteria present ever-greater problems and challenges to the successful treatment of infections. Further research is needed to ensure that drugs are targeted effectively, the number of patients responding grows and the duration of suffering reduced. Dr Hanne Albert, one of the researchers, pointed out that currently many patients were treated with ineffective surgery instead of the drug treatment that could effectively address their condition.