Acts – Key Legal Frameworks

1. Mental Health Act (1983, amended 2003):

• Legal rights of people with severe mental health problems:
  • Right to assessment and treatment under the Act, including the right to choose a second opinion.
  • Right to object to detention or treatment, with safeguards for review and appeal.
  • Right to the confidentiality of their medical records.
  • Right to be accompanied by an independent advocate during assessments and meetings.
• Enabling some patients to be detained in the hospital:
  • Detention can be authorized under specific sections of the Act if deemed necessary to protect the patient from harm to themselves or others, or to prevent serious harm to their mental health.
  • Detention is subject to strict criteria and review procedures.
  • Less restrictive alternatives to detention, such as community treatment orders, should be considered first.

2. Mental Capacity Act (2005):

• Protecting people who cannot make decisions for themselves:
  • Presumes that everyone has capacity to make decisions unless it’s established otherwise.
  • Provides a framework for assessing capacity in relation to specific decisions.
  • If someone lacks capacity, decisions about their care and treatment should be made in their best interests, considering their wishes and values.
  • Depriving someone of their liberty is only lawful if necessary and proportionate to protect them from harm.
  • If the patient lacks capacity to give consent and there is no one suitable to make decisions (family/friends) an Independent Mental Capacity Advocate (IMCA) must be consulted.

3. The Court of Protection:

• Legal body that oversees the operation of the Mental Capacity Act:
  • Makes decisions about people who lack capacity to manage their finances, property, or personal welfare.
  • Appoints deputies or trustees to make decisions on their behalf.
  • Monitors the actions of deputies and trustees to ensure they act in the best interests of the person they represent.

4. Advance Decisions (Advance Directives/Living Wills):

• Legally binding documents outlining treatment preferences in advance:
  • Can specify the treatments someone would or would not want if they lack the capacity to make decisions in the future.
  • Must be made voluntarily and with a clear understanding of the implications.
  • It should be discussed with healthcare professionals and stored in a readily accessible location.

Additional Considerations:

• NMC Code: The Nursing and Midwifery Council’s Code sets out professional standards for nurses, midwives, and nursing associates in the UK. It includes guidelines on respecting patient autonomy, upholding patient confidentiality, and making decisions in the best interests of patients who lack capacity.
• Human Rights Act 1998: The Human Rights Act incorporates the European Convention on Human Rights into UK law, including the right to life, the right to freedom, the right to be free from torture, the right to expression, the right to liberty, and security of person, and the right to respect for private and family life. These rights are relevant to the care and treatment of people with mental health problems.
• Equality Act 2010: The Equality Act protects people from discrimination based on protected characteristics, including disability. This includes discrimination in the provision of healthcare services.
• Medicine Act (1968): It set out the requirements for the sale, supply, and administration of drug.
• Misuse Drug Act (1971)
  • It controls the exports, imports, supply, and possession of dangerous or harmful drugs.
  • Controls the manufacture of CDs
  Class A: Heroin, Methadone, Cocaine, Morphine (most harmful)
  Class B: Amphetamines, Barbiturates, Cannabis, dihydrocodeine, Codeine
  Class C: Benzodiazepines, Steroids, Subutex
• The Human Fertilization and Embryology Act (1990): It regulates the provision of new reproductive technology services and places a satisfactory ban upon the disclosure of information concerning gamete donors and people receiving treatment under the act.
• National Health Service Venereal Disease Regulation. (1974): This states that health authorities should take all steps to ensure that identifiable information relating to persons being treated for sexually transmitted diseases should not be disclosed.
• The Freedom of Information Act (2000): This act grant people’s rights of access to information that is not covered by the Data Protection Act.
• Carers Act/Equal Opportunity Act (2004): It is aimed at helping carers achieve fair access to training work and leisure opportunities. The act ensures assessments to be offered to carers, to consider the needs of carers in relation to leisure, education, training, and work.

 

16. A patient has been assessed as lacking the capacity to make their own decisions, what government legislation or act should
be referred to:
a) Health and Social Care Act (2012)
b) Mental Capacity Act (2005)
c) Carers (Equal Opportunities) Act (2004)
d) All of the above

Ans) b) Mental Capacity Act (2005)

17. Under the Carers (Equal Opportunities) Act (2004) what are carers entitled to?
a) Their own assessment
b) Financial support
c) Respite care
d) All of the above

Ans) d) All of the above

18. How many steps to discharge planning were identified by the Department of Health (DH 2010)?
a) 5 steps
b) 8 steps
c) 10 steps
d) 12 steps

Ans) c) 10 steps

19. The single assessment process was introduced as part of the National Service Framework for Older People (DH 2001) in
order to improve care for this group of patients.
a) True
b) False

Ans) b) False

20. Under the Carers (Equal Opportunities) Act (2004) what are carers entitled to?
a) Their own assessment
b) Financial support
c) Respite care
d) All of the above

Ans) d) All of the above

21. Which law provides communication aid to patients with a disability?
a) Communication Act
b) Equality Act
c) Mental Capacity Act
d) Children and Family Act

Ans) b) Equality Act

22. What law should be taken into consideration when a patient has hearing difficulties and would need hearing aids?
a) Mental Capacity Act
b) Equality act
c) Communication law

Ans) b) Equality act

23. Hearing aids provided to clients come under which act?
a) communication act
b) mental capacity act
c) children and family act.
d) Equality Act

Ans) d) Equality Act

24. Mental Capacity Act 2005 explores which of the following concepts:
a) Mental capacity, advanced treatment decisions, and act’s code of practice
b) Mental capacity, independent mental capacity advocates, and the act’s code of practice
c) Mental capacity, advance treatment decisions, independent mental capacity advocates, and the act’s code of practice
d) Mental capacity and the possible ethical and legal dilemmas in its interpretation.

Ans) c) Mental capacity, advance treatment decisions, independent mental capacity advocates, and the act’s code of practice

25. A patient has been assessed as lacking the capacity to make their own decisions, what government legislation or act should
be referred to:
a) Health and Social Care Act (2012)
b) Mental Capacity Act (2005)
c) Carers (Equal Opportunities) Act (2004)
d) All of the above

Ans) b) Mental Capacity Act (2005)

26. An inquiry was launched involving the death of one of your patients. The police visited your unit to investigate. When interviewed, which of the following frameworks will best help assist the investigation?”
a) Data Protection Act 2005
b) Storage of Records Policy
c) Consent policy
d) Confidentiality guidelines

Ans) d) Confidentiality guidelines

27. Which of the following statements is false?
a) Abuse mostly happens in nursing and residential homes.
b) Abuse can take place anywhere there is a vulnerable adult.
c) Abuse can take place in a daycare center.
d) Abuse can be carried out by anyone – doctors, nurses, carers, and even family members.

Ans) b) Abuse can take place anywhere there is a vulnerable adult.

28. During the day, Mrs. X sits on a chair and has a table put in front of her to stop her from getting up and walking about. What type of abuse is this?
a) Physical Abuse
b) Psychological Abuse
c) Emotional Abuse
d) Discriminatory Abuse

Ans) d) Discriminatory Abuse

29. Michael feels very uncomfortable when the carer visiting him always gives him a kiss and holds him tightly when he arrives and leaves his home. What type of abuse is this?
a) Emotional Abuse
b) Psychological Abuse
c) Discriminatory Abuse
d) Sexual Abuse

Ans) d) Sexual Abuse

30. Anna has been told that unless she does what the ward staff tell her, the consultant will stop her family from visiting.
What type of abuse is this?
a) Psychological Abuse
b) Discriminatory Abuse
c) Institutional Abuse
d) Neglect

Ans) c) Institutional Abuse

31. Christine cannot get herself a drink because of her disability. Her carers only give her drinks three times a day so she does not
wet herself. What type of abuse is this?
a) Physical Abuse
b) Institutional Abuse
c) Neglect
d) Sexual Abuse

Ans) c) Neglect

32. Gabriella is a 26-year-old woman with severe learning disabilities. She is usually happy and outgoing. Her mobility is good, her speech is limited but she is able to be involved if carers take time to use simple language. She lives with her mother and is
being assisted with personal care. Her home care worker has noticed bruising on the upper insides of her thighs and arms. The genital area was red and sore. She told the care worker that a male care worker is her friend and he has been cuddling her
but she does not like the cuddling because it hurts. What could possibly be the type of abuse Gabriella is experiencing?
a) Discriminatory Abuse
b) Financial Abuse
c) Sexual Abuse
d) Institutional Abuse

Ans) c) Sexual Abuse

33. You have noticed that the management wants all residents to be up and about by 8:30 am, so they can be ready for breakfast. Mrs. X refused to get up at 8 am, and she wanted to have a bit of a lie-in, but one of the carers insisted to wash and dress her and took her to the dining room. What type of abuse is in place?
a) Financial Abuse
b) Psychological Abuse
c) Sexual Abuse
d) Institutional Abuse

Ans) d) Institutional Abuse

34. The patient asking for LAMA, and the medical team has concerns about the mental capacity of the patient, what decision should be made?
a) call the police
b) call the security
c) let the patient go
d) encourage the patient to wait by telling the need for treatment

Ans) d) encourage the patient to wait by telling the need for treatment