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Terms beginning with C and D
- Caldicott Guardian
- Capacity
- Care coordinator
- Care pathway
- Care plan
- Care Programme Approach
- Care Quality Commission
- Community care
- Community Treatment Order
- Clinicians
- Commissioning
- Deprivation of Liberty Safeguards
- Disclosure
Caldicott Guardian
Every health and social services organisation has to nominate a senior person to be their ‘Caldicott Guardian’. This person is responsible for protecting the confidentiality of patient and service user information and enabling appropriate information-sharing.
Capacity
When someone is unable to make an informed decision, they are described as ‘lacking capacity’. The Mental Capacity Act 2005 gives a legal way of making decisions on behalf of someone else. It applies only to people age over 16 living in England and Wales. The law says that adults must be assumed to have capacity to make a decision unless it is proven otherwise, even if someone makes a decision that seems unwise. The Mental Capacity Act says that someone is unable to make their own decision if they cannot do one or more of the following four things:
• understand information that is given to them;
• retain that information long enough to be able to make the decision;
• weigh up information to make the decision;
• communicate their decision in any way they can.
Care coordinator
A care coordinator (who is sometimes called a keyworker) is the mental health professional responsible for someone’s care who is the first point of contact regarding treatment and support for the individual who is unwell and their families. The job of the care co-ordinator is to make sure people gets the package of care that has been decided, and answer any questions about treatment. Not everyone will have a care co-ordinator. In community mental health teams for adults, for example, care co-ordinators only deal with people who have more complex needs.
Care pathway
This is the route someone who is unwell follows through health services. The path starts when someone first contacts health services – through their GP or an accident and emergency department, for example. The path continues through diagnosis, treatment and care.
Care plan
Mental health professionals draw up a care plan when they first start offering support to someone with a mental health problem, after they have assessed what someone’s needs are and what is the best package of help they can offer. People should be given a copy of their care plan and it should be reviewed regularly. A separate care plan will be drawn up if someone is admitted to hospital: that will include the treatment and care to be offered while they are on the ward.
Care Programme Approach
The ‘Care Programme Approach’ is the system that sets out the way treatment and care is given to people with serious mental illness. It includes an assessment of an individual’s symptoms and needs so mental health professionals can work out what sort of treatment and social support they need. The treatment and support plans will then be written down in a care plan.
Care Quality Commission
The Care Quality Commission is responsible for protecting the interests of people detained and treated under the Mental Health Act. It makes sure that the Mental Health Act is used correctly, and that patients are cared for properly while they are kept in hospital, are on supervised community treatment or on guardianship. It does this by monitoring the use of the Mental Health Act and by visiting hospitals and speaking to patients.
People who have a complaint about treatment under the Mental Health Act that cannot be dealt with by a Mental Health Tribunal can ask the Care Quality Commission to help.
Community care
This is the term for all treatment and support that is offered to people outside of hospital or outpatient clinics.
Community Treatment Order
When people are detained under the Mental Health Act for treatment, they can be discharged from hospital onto ‘Supervised Community Treatment.’ This means they can return home but continue to be treated without their consent. A Community Treatment Order is the name of the order that says someone should go onto Supervised Community Treatment.
There are conditions attached to a Community Treatment Order – staying at a particular address, attending for treatment at a particular time or place, or taking medication, for example. Failure to comply with the conditions may result in the individual being called back into hospital as an involuntary patient.
Clinicians
Clinicians is a general term for doctors, nurses and other health professionals.
Commissioning
NHS organisations called primary care trusts cover specific areas and decide what health services people living within their boundaries need. Primary care trusts are responsible for providing health services directly, or for paying other organisations to provide them. This is called ‘commissioning.’ Primary care trusts work together with local authorities as ‘joint commissioners’ to plan and provide some services, particularly community mental health services.
Deprivation of Liberty Safeguards
These are part of the Mental Capacity Act. The Act gives a legal way of making a wide range of decisions on behalf of someone aged over 16 when they are unable to make a decision for themselves because they ‘lack capacity’. The law defines what ‘lacking capacity’ is and says what checks must be made to prove someone is lacking capacity at any one time.
The Mental Capacity Act can be used to give treatment to somebody without their consent if it is proven that an individual lacks capacity at a particular time, and that the treatment is in their ‘best interests’. Treatment cannot be given under this law to protect other people.
If it is in the best interests of a person to be detained in hospital, then mental health professionals have to follow the rules of the ‘Deprivation of Liberty Safeguards’. These are part of the law and involve six assessments of an individual.
Disclosure
The term ‘disclosure’ describes when someone decides to tell someone else about their mental health problems or history of mental illness. It is used particularly in discussions about employment – the decision about whether to ‘disclose’ experience of mental illness to an employer and/or colleagues can be a difficult one because of the discrimination people face when looking for a job.
