Paid Relevant Person’s Representatives

Once a standard deprivation of liberty authorisation has been given for a person who lacks mental capacity to agree to care they are receiving in a hospital or care home, supervisory bodies (i.e. a Local Authority) must appoint a Relevant Person’s Representative (RPR) as soon as it is possible and practical to do so in order to represent the person who has been deprived of their liberty. The RPR must be independent of the commissioners and providers of the care services the relevant person is receiving.

The role of the relevant person’s representative, once appointed, is:

• to maintain contact with the relevant person, and
• to represent and support the relevant person in all matters relating to the deprivation of liberty safeguards, including, if appropriate, triggering a review, using an organisation’s complaints procedure on the person’s behalf or making an application to the Court of Protection.

For people who do no have someone who can act as their RPR, the supervisory body must appoint a paid RPR. This may be for someone who has no immediate family or friends who can take on the RPR role or where the supervisory body has a reasonable belief that a family member or friend would not be able to fulfill the RPR role. For example, if a family member has been involved in the relevant person being accommodated in a care home and believes the relevant person should remain there, it may be reasonably considered by the supervisory body that the family member may not support a wish of the relevant person’s to challenge the decision about being in the care home. In this case, if no one else is available, the supervisory body has the responsibility to appoint a Paid RPR who can then act for the relevant person independently. Often this can take pressure off family members or friends who may feel conflicted about wanting to support the wishes of the relevant person whilst believing in all good faith that being in the hospital or care home is in their best interests. Members of family or friends may also live too far from the hospital or care home to maintain meaningful contact or may feel that taking on the RPR role is too great a commitment on top of their existing commitments.

When a Best Interests Assessor completes four of the six assessments required when assessing whether the supervisory body should authorise a deprivation of liberty, they are required to recommend someone who is eligible to act as the relevant person’s representative or to indicate if there is no such person. The supervisory body will then seek to appoint the recommended person or to make arrangements for a paid representative if no other eligible person can be found. If a recommended person then also withdraws their consent to act as the representative, again, a paid representative will need to be appointed by the supervisory body.

The supervisory body will then contact a paid RPR service and make arrangements for the appointment of a paid RPR. If you are a Local Authority seeking to appoint a Paid RPR for a relevant person you can contact us via the ‘Contact’ link above or by clicking ‘Make a Referral’.

 

A Paid RPR will agree with the supervisory body how they will maintain contact with the relevant person, usually by an agreed frequency of visits to the relevant person in the hospital or care home.

The Paid RPR will meet the relevant person in private wherever possible and seek to support them to understand:

• the effect of the DoLS authorisation
• their right to request a review of the authorisation
• their right to make an application to the Court of Protection to seek variation or termination of the authorisation
• the formal and informal complaints procedures that are available to them

If the person expresses that they wish to exercise their right to request a review of the authorisation or apply to the Court of Protection, the RPR will support them to exercise this right. If the person lacks mental capacity to communicate this wish (including being unable to communicate their decision), the Paid RPR will determine whether the relevant person objects to the deprivation of liberty and act accordingly, including by exercising the person’s right to a review of application to the Court of Protection.

Wherever possible, the Paid RPR will build the professional relationship with the relevant person and work to improve their understanding of the relevant person’s wishes, feelings, beliefs, values and other factors that would be likely to influence the person in making decisions in relation to their care. This ensures that the Paid RPR develops their expertise in representing the relevant person’s views and wishes over time, allowing them to have an increased beneficial outcome on the care that the relevant person receives.

In addition, the Paid RPR will have general oversight in regard to monitoring the welfare of the relevant person and act on any concerns they may have, including by reporting concerns to the supervisory body or raising a safeguarding concern if the relevant person or anyone else the RPR comes into contact with in the managing authority appears to be subject to abuse or neglect.

Where a relevant person requires a Paid RPR, the requirement for having someone in the RPR role will last for as long as the period that the relevant person remains under the standard authorisation. A standard authorisation lasts for a period upto 12 months and a new standard authorisation may come into force immediately after an existing standard authorisation is due to expire. Unless another person (i.e. a family member or friend) is identified as being able to undertake the RPR role, the supervisory body will need to obtain a Paid RPR for the duration of the authorisation and subsequent standard authorisations.

In the event where an RPRs role ends prior to the standard authorisation ending and where the supervisory body is unable to identify a Paid RPR service, then the ‘gap’ created by the departure of the existing RPR can be temporarily filled by a ’39C IMCA’. The Mental Capacity Act 2005 created a role for Independent Mental Capacity Advocates to fill this gap and to act as a Paid RPR would do otherwise, in order that a relevant person will not be left without representation and support whilst under an authorised deprivation of liberty. The appointment of a 39C IMCA should only be for a limited period to cover the gap between the departure of the RPR while the supervisory body is taking reasonable steps to appoint a Paid RPR.