The new report of the Mental Welfare Commission, ‘Authority to Discharge’, which examines the issue of decision-making for people in hospital who lack capacity and their discharge from hospitals to care homes from March to May 2020 makes for disturbing reading.
Its identification of very real knowledge and skills gaps in discharge practice from hospital to care homes and the community should be a matter of very real concern. Of perhaps even greater concern is the analysis that failures were happening even before the start of the pandemic.
Organisations like Scottish Care have long argued that it is critical that we reform our processes around discharge from hospital, especially for those who may have diminished or fluctuating capacity. This means we need to involve families, relatives and staff from care homes and homecare at a much earlier stage in decision-making.
There are simply too many instances where decisions are being made with a limited knowledge of the best interests and needs of the person involved. A professional knows best attitude has no place in modern care and support. That is regrettable at any time but especially so during a pandemic.
It is important that the eight recommendations of the Report are put into practice but we must go even further so that we arrive at a stage where no-one with reduced capacity does not have people in their corner to advocate on their behalf.
After years of training and learning budgets being reduced or even stripped away in social care contracts it is critical that we invest resource in making sure all staff know not just the letter of the law but what good human rights-based practice really looks like.
