AC M10 Understand mental capacity and restrictive practices

1.1 Summarise the main purpose and principles of relevant legislation and codes of practice relating to mental capacity and how these principles interact

Determining the mental capacity of individuals under care is grounded in legislation and different codes of practice in adult care. The fundamental purpose of legislation and codes of practice related to mental capacity is to protect individuals who may not be able to make certain decisions for themselves due to cognitive impairments or other disabilities. The Mental Capacity Act (MCA) 2005, later amended in 2007, embodies this ethos with guiding principles that are designed to uphold autonomy while ensuring safety and support where necessary (Department for Constitutional Affairs, 2007).

Firstly, it stipulates that every adult has the right to make their own decisions whenever possible; it’s a presumption of capacity unless proven otherwise. This shifts the focus from what an individual cannot do to what they can do with appropriate support, resonating with the principle of empowerment.

Moreover, a person should not be deemed incapable before all practical steps have been taken without success—a nod towards inclusiveness and reasonable adjustments. The act further asserts that an individual retains the right to make seemingly unwise decisions without automatically being classed as incapacitated—thereby respecting personal self-determination.

Crucially, any decision made on behalf of someone judged lacking capacity must consider their best interests—an overarching standard that threads through all interventions under this act (Hughes & Goodwin, 2016). In essence, ‘best interest’ forms a protective boundary within which decisions are tailored as closely as possible to the wishes and feelings of the person concerned.

Legislation such as the Liberty Protection Safeguards establishes measures against arbitrary detention in care for people who lack capacity—providing legal protections parallel with those available in broader society (House of Lords House of Commons Joint Committee on Human Rights, 2019).

Complementary legal frameworks include the Care Act 2014 which aligns various aspects of care provision into a coherent structure that interacts fluidly with MCA principles by prioritising well-being and person-centred care (Scourfield, 2017). Additionally, the newer amendments through the Mental Capacity (Amendment) Act 2019 refine previous safeguards ensuring contemporary relevance and better alignment with human rights conventions.

The Mental Health Act 1983 recognises psychological health conditions necessitating specific kinds of interventions while maintaining respect for civil liberties; its conjunction with mental capacity legislation introduces layers in social policies distinguishing between mental health needs and capacity issues (Pilgrim & Tomasini, 2012).

Last but critically important is the Data Protection Act 2018 which brings into focus information governance—particularly sensitive when dealing involves people who may lack full capacity—and how personal data must be used respectfully and responsibly within these contexts (Information Commissioner’s Office [ICO], n.d.).

In striving toward protection without paternalism, these legislative statutes construct an ethical framework where dignity thrives alongside safeguarded rights.

1.2 Explain how these principles underpin practice in adult care

In adult care practices, the adoption of key principles affiliated with mental capacity is integral to ensuring that individuals receive appropriate and ethical support. The Mental Capacity Act (MCA) 2005 provides a foundational framework that is essential for decision-making processes relating to individuals who may lack the capacity to make certain decisions themselves (Legislation.gov.uk, 2005). This statute is complemented by the Code of Practice, which offers professionals practical guidance on applying these principles effectively in their work (Department for Constitutional Affairs, 2007).

Firstly, one must acknowledge an individual’s right to make their own decisions wherever possible, affirming autonomy and respect for individuals’ preferences and feelings. The MCA stipulates that adults are presumed to have capacity unless proven otherwise; a presumption of capacity avoids unjust biases against those with mental health conditions or disabilities (Mental Capacity Act 2005). In practice, this means professionals actively engage individuals in decision-making processes to the fullest extent they can partake.

Moreover, identifying less restrictive options and further support systems becomes critical under this legal structure. A decision made on behalf of someone without capacity should be taken in their best interest but also limiting their rights and freedom of action as little as possible – an approach known as “the least restrictive option” principle (Kohn et al., 2013).

There is also a duty on caregivers to enable persons lacking in mental capacity by seeking ways they might regain it or participate more fully in decisions affecting them. This could mean simplifying communication methods or providing information at suitable times when concentration is optimal.

Notably, care practitioners are called on to honour these legal imperatives within complex situations while considering ethical theories such as deontology’s focus on duty and rule-based actions aligning with best practice guidelines issued by professional bodies like the Care Quality Commission (Care Quality Commission, n.d.).

Ultimately, the conscious application of these principles demands skilled judgment whereby practitioners take into account unique circumstances while harnessing empathy and a deep-seated commitment toward upholding dignity in adult care scenarios.

1.3 Explain what is meant by ‘valid consent’

Valid consent, as related to mental capacity in adult care, is a fundamental prerequisite for any form of treatment or care. It echoes respect for the autonomy and dignity of individuals receiving care services (Department of Health, 2001). For consent to be deemed valid, it must tick several important boxes.

Firstly, it ought to be given voluntarily—free from any form of pressure or undue influence (Mental Capacity Act 2005). The individual should have the liberty to make their own decisions without feeling coerced by care professionals, family members, or other external parties.

Secondly, the person giving consent must have full comprehension of what they are consenting to—this encompasses awareness about the nature and purpose of the procedure or intervention in question (General Medical Council, 2008). It’s insufficient for them simply nod along; they need a grasp on possible risks involved and alternative options available.

Thirdly—the individual providing consent must possess ‘capacity.’ According to the law as articulated in the Mental Capacity Act 2005, having capacity means that one can understand information relevant to a decision and its consequences, retain that information long enough to make an informed choice, weigh up different elements involved in making that decision and communicate their wish through any possible means such as speech or sign language.

Crucially though, capacity is not static—it can fluctuate over time (British Medical Association [BMA], 2016). Therefore, assessments regarding capacity should be decision-specific and carried out each time there is a new decision required from someone whose ability to provide valid consent might be in question due to factors like illness or impairment.

Lastly, obtaining valid consent is not merely a one-off event but an ongoing process necessitating continuous communication between care providers and those receiving care—which signifies that even after the initial agreement has been given it may still be revoked at any point if so desired by an individual with capacity (Royal College of Nursing [RCN], 2011).

Ensuring practitioners gain this kind of informed agreement before proceeding with treatment protects both parties legally while simultaneously fostering trust—a keystone in therapeutic relationships. It marks honouring personal choices within adult care contexts where respecting human rights goes hand-in-hand with delivering high-quality health services.

1.4 Describe a range of factors that influence an individual’s mental capacity and ability to express consent

Mental capacity, a vital component in an individual’s autonomy, does not exist in a vacuum and is subject to fluctuation. When assessing an individual’s ability to express consent, it is crucial to recognise that mental capacity can vary daily and is impacted by the decision’s nature (Department for Constitutional Affairs, 2007). The Mental Capacity Act of 2005 outlines a four-step process for decision-making: understanding information, retaining it temporarily, weighing it in the balance to make a choice, and then communicating the decision (Legislation.gov.uk, 2005).

Individual factors such as age-related cognitive decline or health conditions like dementia can affect this process. Psychological stressors also play a part; anxiety or depression may cloud judgment or hinder communication abilities (Szmukler & Appelbaum, 2008). Furthermore, control by others through coercive behaviour dramatically influences the capability of individuals to consent autonomously. It restricts their access to information and freedom to decide (World Health Organization [WHO], 2018).

Communication is another key area—having clear methods aligned with an individual’s capacities ensures meaningful participation in consent processes (Brayne et al., 2010). External elements are equally relevant. An overly noisy space may disrupt concentration while decisions made under time pressure can lead to a diminished ability for thoughtful deliberation.

Ultimately, creating an environment that supports rather than hinders decision-making involves acknowledging these diverse influences on mental capacity—a task challenging but foundational for respecting individual rights and promoting informed consent.

1.5 Explain the relationship between an individual’s mental capacity, consent, choice and safety

Understanding the relationship between an individual’s mental capacity and other factors like consent, choice, and safety is paramount. Mental capacity refers to one’s ability to make informed decisions; when compromised, it directly influences consent validity (Mental Capacity Act 2005). The act stipulates that individuals must be presumed capable unless proven otherwise, ensuring respect for autonomy.

Consent is a dynamic element requiring the active engagement of a mentally capable individual. Without capacity, consent cannot be ethically or legally obtained (Department of Health, 2009), underscoring the need for clear communication and assessment before assuming consent in health and social care settings.

Choice reflects personal preferences and plays a critical role in dignity preservation. Respecting the choices of individuals with full mental capacities fosters their wellbeing (Equality Act 2010), highlighting a delicate balance between autonomous decision-making and protection from harm.

Safety remains pivotal; professionals must judiciously weigh risk against individuals’ right to make potentially unsafe choices (Health and Safety Executive, n.d.). Interventions maintaining safety should be proportionate to potential harm while maximising an individual’s choice scope (Care Quality Commission, 2014).

Mental capacity authorises authentic consent; without which meaningful choice becomes moot. Simultaneously, freedom of choice warrants careful modulation by considerations for personal safety—a guideline enshrined within adult care practices.

2.1 Describe own role and responsibilities in relation to relevant principles, legislation and codes of practice, and upholding individuals’ rights

As a professional in the adult care sector, my responsibilities are diverse and anchored in a commitment to upholding individuals’ rights. My role is directly threaded through with adherence to essential regulations such as the Health and Social Care Act of 2008 and mandates resulting from the Care Quality Commission’s standards.

Ensuring that each individual’s care is person-centred stands paramount. This means I am actively involved in recognising their choice, dignity, privacy, and independence. The aspects of respect and confidentiality cannot be overstated; these principles guide my interactions daily, ensuring consistent compliance with both GDPR guidelines for data protection and individual choices.

Risk management forms another crucial layer of my role. It encompasses vigilant assessment to minimize potential harm while not unduly constraining individuals’ freedoms. The balance struck here requires continual attention to detail and an agile response—a dynamic exercise considering each person’s unique needs.

Effective communication remains my core duty; it keeps the lines open not only between myself and those receiving care but also among family members, other health professionals, and any representatives acting on behalf of the service user. This involves clear articulation about care plans or concerns that might arise, always striving for transparent collaboration founded upon mutual trust.

Compliance training maintains sharpness for this purpose––update sessions are non-negotiable so skills remain current against ever-evolving legislative benchmarks. In essence, embodying these roles is not a static occupation; while it is imperative to stay abreast of current best practices and changing legislations, putting the individuals being supported at the centre of our service remains the primary objective.

2.2 Explain the importance of establishing an individual’s consent when providing care and support

Establishing an individual’s consent is vital in adult care, and central to upholding their dignity and autonomy. When care providers seek consent, they recognise that every person has the right to make informed decisions about their own life and the treatments or support they receive. This respect for personal choice is embedded in legal frameworks, such as the Mental Capacity Act 2005.

Consent is not merely a formality; it forms the foundation of trust between individuals and those providing support. By engaging in dialogue about preferences and concerns, caregivers can tailor their approach to align with the individual’s wishes, thereby enhancing bespoke care delivery.

Recognising that capacity can fluctuate—a person may be able to make certain decisions at one time but not another—regularly reaffirming consent becomes as crucial as obtaining it initially. Doing so not only assures compliance with ethical standards but also prompts continual assessment of an individual’s needs and respects their evolving circumstances.

Without consent, even well-intended actions may cause distress or conflict, potentially leading to a sense of disempowerment or violation of rights for those receiving care. Therefore, honourably requesting and securing consent must be seen as an ongoing commitment—an essential act that validates individuality and promotes harmonious caregiving relationships where people feel valued and understood.

2.3 Give examples of how personal values and attitudes can influence perceptions of:

• different situations

• individuals’ capacity

Personal values and attitudes profoundly influence how one perceives various situations and evaluates individuals’ capacities, especially in adult care settings. For instance, a care worker who places high regard on independence may overestimate an elderly individual’s ability to perform daily tasks without assistance. This perspective could stem from the belief that maintaining one’s autonomy is crucial for dignity.

Conversely, another worker who values safety above all might view the same situation with caution, emphasising the risks associated with unsupervised activities. Such a disposition may lead to underestimating the client’s capabilities or over-paternalism, depriving them of their autonomy and potentially hindering their rehabilitation by not encouraging enough self-reliance.

In practice, I witnessed a colleague who adamantly believed in holistic therapy approaches; this coloured her perception of clients’ capacity for recovery. She often attributed remarkable improvements solely to alternative therapies while underestimating conventional methods’ contribution. This was evident when discussing care plans with families; her personal advocacy would sometimes overshadow clinical evidence which ought to guide decision-making.

This underscores that our interpretations are seldom value-free; instead, they’re filtered through personal beliefs that shape our expectations and judgments about others’ abilities. Recognising these biases is critical in adult care—where varying perspectives can either inhibit or enhance the tailored support needed by each individual client.

2.4 Describe a range of strategies and skills that could be used to maximise individuals’ capacity to make their own decisions

Maximizing an individual’s capacity to make their own decisions requires different strategies grounded in effective communication and strong engagement skills. At the forefront is the tailored use of communication aids. These assistive devices or technologies bridge gaps for those with speech, hearing, or cognitive impairments (Beukelman & Mirenda, 2013).

Furthermore, adapting environmental factors can significantly enhance decision-making autonomy; this might include ensuring a quiet space to prevent sensory overload or arranging furniture to accommodate mobility devices.

Listening is yet another crucial skill. Active listening not only garners essential information but also validates the individual’s concerns and thoughts as legitimate contributions to the decision-making process (Miller & Rollnick, 2012). Equally important is our ability to identify and counteract any coercive behaviours that may influence an individual’s choices. This vigilance ensures that decisions are made freely without undue pressure and align with personal values (Roberts et al., 2004).

Finally, offering information in diverse formats—whether through visual aids, simplified text, large print materials, or digital media—can empower individuals by catering to their unique learning styles and comprehension needs (National Institute on Deafness and Other Communication Disorders [NIDCD], 2018). By implementing these strategies cohesively, we provide solid ground from which individuals can confidently make their own array of choices.

2.5 State own role in identifying when an assessment of capacity may be required

In my professional role as a senior support worker, I am tasked to remain vigilant in recognising signs that may indicate a need for an assessment of an individual’s capacity. The Mental Capacity Act 2005 outlines specific instances when such assessments become necessary, particularly when there’s a doubt about a person’s ability to make informed decisions regarding their welfare or financial matters (Mental Capacity Act 2005). It falls under my purview to observe changes in behaviour or decision-making skills and consider various triggers—like major life events or altered health conditions—that could impair judgment.

Effective communication is pivotal. I engage with the individuals in my care to gauge their comprehension and decision-making aptitude through open-ended questioning, which allows insight into their thought processes (Department of Health, 2014). When inconsistencies arise or there’s noticeable cognitive decline, this serves as a cue for further action.

Collaboration with healthcare professionals is also key; sharing observations ensures we approach capacity concerns comprehensively (Spector et al., 2016). For instance, if I notice someone struggling with personal hygiene decisions that were previously well-managed, I would consult with relevant medical personnel who can thoroughly evaluate cognitive function and provide objective assessments.

Documenting these observations meticulously aligns with legal obligations and reinforces the integrity of any subsequent assessments conducted by qualified professionals (British Psychological Society, 2018). My role centres around this early identification phase—facilitating referrals where necessary—while ensuring dignity and respect remain paramount throughout all interactions.

2.6 Explain the steps to o take if consent cannot be readily established and own role in this

When consent is not easily established, it becomes essential to follow a systematic approach. Firstly, adhering to the core principles of the Mental Capacity Act (MCA) 2005, amended in 2007, ensures we respect the autonomy and rights of individuals who may lack capacity (Department of Health & Social Care, 2019). As a senior support worker within a care home setting, my role involves initially assessing if this difficulty with consent arises due to a temporary or persisting incapacity.

Should the individual lack the ability to make an informed decision at the moment—perhaps due to mental impairment or severe distress—my duty then shifts towards making decisions that reflect their best interests. This pivot involves meticulously documenting observed behaviours and attempted communication efforts that might offer insight into their preferences and wishes.

In parallel, consulting with fellow healthcare professionals and seeking guidance from family members or advocates known by the individual typically ensues (The British Psychological Society & The Royal College of Psychiatrists, 2015). These consultations are insightful as they provide additional context regarding prevailing values and past decisions made by the person in similar situations.

If no resolution emerges from these steps and disputes arise, recourse can be found through legal avenues such as seeking advice from legal experts or applying to the Court of Protection where necessary (NHS England, n.d.). Moreover, liaising with organisational superiors or legal teams during such high-stakes scenarios is imperative.

Throughout this process, my obligations transcend mere procedural compliance; they require active engagement in empathetic listening and compassionate advocacy for those under my care. By striking a balance between legal frameworks like MCA directives and personalised care principles, I uphold both my professional responsibilities and ethical integrity.

3.1 Explain what is meant by ‘restrictive practice’

Restrictive practice refers to the protocols and measures that deliberately limit or restrain an individual’s freedom of movement or personal autonomy. These constraints, intentional or inadvertent, can significantly impact a person’s life and should be applied judiciously, with ethical consideration being paramount.

Physically restraining a person can encompass anything from manual holds to barriers designed to contain movement; both examples sit under the umbrella of restrictive practice (Huckshorn, 2014). Mechanical restraints incorporate devices such as straps or belts—hardware deployed to restrict individuals physically (Mohr et al., 2010). When medication is used to subdue or manage behaviour without therapeutic justification, this is known as chemical restraint. A stark kind of containment that involves confinement away from others is seclusion.

Segregation might take the form of isolating an individual within settings like care homes or hospitals due to behaviour concerns rather than clinical needs. Furthermore, psychological restraint employs intimidation or enforced compliance without physical touch. Lastly, the mere threat of any restraint type reflects restrictive practice by inciting fear to control behaviour.

While some circumstances may necessitate these approaches for safety reasons, it is critical for practitioners to understand their potentially profound implications on personal dignity and liberty (American Psychiatric Association [APA], 2015).

3.2 Explain the importance and impact of seeking the least restrictive option for individuals

When considering the principle of applying the least restrictive option for individuals, particularly within care settings, it’s paramount to understand its inherent significance. Firstly, an individual’s autonomy is afforded respect when the least restrictive approaches are sought (Mental Health Foundation, 2014). By prioritising less intrusive interventions or support measures, we cultivate an environment conducive to personal growth and self-determination.

Affirming this approach contributes both ethically and legally to the maintenance of an individual’s dignity and rights (National Institute for Health and Care Excellence [NICE], 2021). Furthermore, empirical evidence suggests that empowerment through such choices can accelerate recovery from health setbacks by bolstering morale (Szmukler & Appelbaum, 2008).

In legal contexts, legislation often underscores the imperative of minimal restriction. For instance, mental health laws typically necessitate that treatment should not be imposed unnecessarily upon a person’s liberty or freedom (Department of Health & Social Care, 2015). Through these legal parameters, professionals are encouraged to consider a spectrum of options before settling on the most appropriate one.

Moreover, societal impacts cannot be understated. When individuals sense their agency being valued and safeguarded by systems in place—be it healthcare or social services—their trust in these structures increases (Dawson et al., 2015). This not only fosters better relationships between service providers and users but also underpins robust communities where every member feels acknowledged as capable and significant. Such environments encourage engaged participation—benefiting societies at large.

3.3 Identify how to raise concerns when restrictions appear out of proportion with evident risk

Identifying and addressing instances where restrictions seem disproportionate to the evident risk involves a measured and strategic approach. Firstly, gathering solid evidence is crucial. This means meticulously documenting specific cases where restrictions exceed the necessity dictated by actual risks (World Health Organization, 2020). Clarity and precision in your documentation will strengthen the basis of your concerns.

Secondly, understanding the policy and its rationale deeply enriches your argument (Centers for Disease Control and Prevention, 2021). This step demands reviewing existing policies and guidelines related to the restrictions you’re questioning. It’s about getting to grips with the ‘why’ behind these measures. Sometimes, policies that appear excessive on the surface are rooted in precautionary principles or historical precedents that might not be immediately apparent.

When it’s time to raise your concerns, direct communication with those responsible for implementing or creating these policies is key. Framing your argument in a manner that aligns with organisational goals can increase receptiveness (Occupational Safety and Health Administration, 2021). For instance, emphasising how more proportionate measures could enhance efficiency without compromising safety could appeal to decision-makers focused on operational success.

Lastly, if direct efforts do not yield results, seeking external advice or support becomes necessary. Professional bodies or regulatory agencies can offer guidance or intervene if required (National Institute for Health Care Excellence, 2018). Engaging them in dialogue brings an impartial perspective which can catalyse reconsideration of restrictive measures.

In conclusion, raising concerns about disproportionate restrictions ties back to careful preparation: documenting discrepancies between risk and response; thorough policy analysis; empathy-driven yet assertive communication; and finally, when needed, reaching out for external support anchors this approach firmly within rational advocacy

3.4 Summarise the organisational policies and procedures in relation to restrictive practices and own role in implementing these

Organisational policies and procedures concerning restrictive practices are instrumental in safeguarding the rights and well-being of individuals under care. These policies typically encompass guidelines for the safe and ethical application of measures that limit an individual’s freedom or movement, aiming to prevent harm and de-escalate situations of elevated risk (Healthcare Improvement Scotland, 2015). My role within these frameworks is versatile: I am accountable for understanding the legal aspects, ethical considerations, as well as local protocols which emphasise a preference for the least restrictive options (Queensland Government, 2019).

Equally important is maintaining comprehensive documentation when such practices are employed; this ensures transparency and provides a tool for oversight. Additionally, consistent training keeps me apprised of alternative strategies to manage challenging behaviours without resorting prematurely to restrictions. A crucial aspect lies in evaluating each scenario; bringing forward my knowledge gathered from continuous learning about person-centred care practices can often mitigate circumstances that otherwise might lead to restraint (Brooker & Latham, 2016).

Furthermore, it is imperative that my actions adhere strictly to policy directives – unauthorised deviation could result in disciplinary action or compromise client safety. This alignment speaks volumes about an organisation’s commitment to standards outlined by governing bodies like The National Institute for Health and Care Excellence (NICE), which stipulates guidance on when such interventions may be justified (National Institute for Health and Care Excellence [NICE], 2015).

While managing challenging behaviour through restrictive practices remains an option of last resort, comprehending organisational policies thoroughly allows practitioners like myself to navigate this delicate aspect responsibly. Adherence not only protects those we support but also upholds the integrity of our practice.

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