Does the NHS & Community Care Act 1990 provide powers to force Maeve to comply with an assessment or a care plan? The NHS and Community Care Act (1990) s.47(1), places an overarching duty on the local authority to carry out an assessment of needs for community care services with people who appear to be in need of those services; if services are provided the assessment must lead to a care plan facilitated by the service user and all services involved in her care. Maeve can be assessed in line with Single Assessment Process (SAP) identified in the National Service Framework for Older People (2001) which places a responsibility under s.7(1) Local Authority Social Services Act (1970). Section 47(2) NHSCCA (1990) advises that if during the assessment it becomes apparent that the person being assessed is disabled according to the definition in s.29(1) National Assistance Act (NAA) (1948), a duty is imposed on local authorities under s.4 Disabled Persons Act (1986) to decide whether the needs of a disabled person call for the provision by the LA of any services. The LA has no powers to force a person to accept services; however, s.47 N AA (1948) can be used to force the receipt of services to “prevent injury to the health of, or serious nuisance to, other persons” (s.47 NAA (1948) In light of the information available to you from the GP, including all the information from Kenneth and the neighbours, are there grounds for considering use of powers under the Mental Health (Amendment) Act 2007 with Maeve? In your answer, you need to name any sections that you consider to be relevant, explain their grounds and show why you think those grounds could be met by Maeve’s current condition and situation. What assessment processes would need to be followed by which professionals in order to decide if such powers were applicable? What would be the effect upon Maeve if such powers were used? Maeve’s current behaviour is out of context to what is ‘normal’ for her. She is reportedly posing a risk to herself: * she presents as ‘malnourished’
* risk of eviction due to unpaid rent
* climbing up the drainpipe
* leaving unlit gas
She poses a risk to others
* leaving lit gas reportedly causing a fire
* damage to neighbours property
* concern around her ‘unpredictable and aggressive behaviour’, Section 1(2) of the MHA (1983) defines a mental disorder as “Any disorder or disability of the mind”. The COP’s description of clinically recognised conditions includes “organic mental disorders such as dementia and delirium” (COP 2008 Ch. 3.3). Given the reports about Maeve’s presentation and the risk to her safety to others, there are grounds for a MHA (1983) assessment under the conditions of ‘admission for assessment’ s.2 which would necessitate Maeve being assessed by two registered medical practitioners and an AMHP, for evidence of a mental disorder of a nature or degree which warrants detention for assessment, and which may be followed by appropriate treatment. This is a non-renewable section which lasts for a maximum of 28 days. However, Maeve would then be detained in a psychiatric hospital against her will, her liberty taken away from her; with the added stress of being in an environment where there are a lot of distressed people which may impact more negatively upon her current state of mind. Maeve has no history of mental health issues which makes a first onset unlikely. There might be some organic brain problems; it is equally likely that other physical problems may be the causal factor of her distress, such as a urine infection. Her physical needs could not be compulsorily investigated or treated under the MHA (see [St George's Healthcare NHS Trust v S; R v Collins and others, ex parte S  3 All ER 673] for an example of relevant case law). A least restrictive approach would be to assess Maeve’s capacity according to five statutory principles in s.1 MCA (2005). The MCA (2005) has a framework which allows...