CONSENT AND CUSTOMER INVOLVEMENT
Policy
The Care Worker Agency is committed to providing high standards of
customer care and has strong values and beliefs regarding how customers
should be treated and involved in planning their care. People who receive
support from The Care Worker Agency will be referred to as customers ,
not as ‘clients’ or ‘service users’ or any other term so that the relationship
is clear and understood by all concerned.
The Care Worker Agency believes in a ‘can do’ attitude and that
customers are the most important people in the ‘chain’ of care delivery,
and as such deserve due respect and consideration. All staff must treat
customers in a pleasant, polite and professional manner and listen
carefully to the customer’s views. Customer satisfaction will always be a
major decider in the success of the company.
The Care Worker Agency is required by the regulations & law to have
suitable arrangements in place for enabling customers to make or
participate in decision making and for obtaining, and acting in accordance
with the consent of individuals in relation to the care and treatment
provided to them.
Definitions
Consent is defined as that which has been given voluntarily, by an
appropriately informed person who has the capacity to agree to the
activity in question.
‘Informed consent’
means ensuring that a person is informed of all of the
elements involved, including the nature of the care or treatment, possible
alternatives, the potential risks and benefits. In order for informed
consent to be considered valid, the person must be competent and the
consent should be given voluntarily.
The Mental Capacity Act 2005 provides some protection for vulnerable
people and has a number of principles that must be considered where
there are issues around mental capacity. The Mental Health Foundation
produced a research report which outlined some factors which people
found helpful in expressing their views and others that hindered their
decision-making. (Please refer to Appendix 1)
Our service to customers will not commence until a written plan of care is
in place and the customer has been fully involved in agreeing to such a
CONSENT AND CUSTOMER INVOLVEMENT
plan. The company will not under any circumstances provide care to
people which has not been previously agreed with them and/or their
representatives. We will gain customer consent while preparing the care
plan and risk assessment and we will gain their consent each time we call
to see them to support them with tasks. Consent may be in writing, such
as in the initial care plan, and may also be verbal or via body language if
the person has communication issues etc. We will list in our care plan any
communication issues and what ‘consent’
may look like for each
individual. If they do not consent to any of the activities on the care plan,
we will document this in their care call notes.
If there are issues or concerns over the individual’s ability to give
informed consent, we will consider if home is the correct place for this
person to receive care. In our opinion as a company, issues that can
result in the need for a DOLS rarely result in safe homecare delivery. It is
our company stance to review this situation alongside other relevant
professionals and aim to find a safe alternative for the individual in the
event of them becoming unable to make decisions for themselves.
The Care Worker Agency will always try to promote the customers’
independence and enable them to manage their own care where possible.
Our role is not about taking ‘over’ a person’s care.
Customers will be listened to by our staff and we will help to support any
individual to express their views and enable them to access a suitable
person such as an advocate where required or requested by providing
information.
The Care Worker Agency will ensure that due regard is given to the
individual’s human rights and any matters relating to equality including
race, religion, culture, disability, sex, age and any other beliefs and
preferences in order to facilitate good communication and practice.
Procedure
The Care Worker Agency will provide information to customers and/or
their representatives in a way they are able to understand and to give
valid consent. Any information relating to a customer or others will be
maintained, used and stored in line with all relevant pertinent legislation,
(such as The Data Protections Act and GDPR Regulations) and good
CONSENT AND CUSTOMER INVOLVEMENT
practice and they will be aware of what information is held and how to
access this.
The Care Worker Agency customer guide is provided to all customers and
includes a range of topics such as our aims and objectives; code of
practice; how to raise a concern or complaint; the services we offer and
what we cannot provide, as well as many other areas.
The guide also provides advice and information on how to contact
external agencies including the CQC (Care Quality Commission, the local
authority and advocacy services.
Care Planning:
It is central to The Care Worker Agency policy and procedures that
customers are fully involved in all aspects of their care and are central to
the process. This includes the care planning and assessment process
whereby all customers are fully consulted regarding their preferences,
wishes and aspirations.
Staff will respect the human rights and diversity of customers and discuss
what is important to them and how they prefer their care to be provided.
Risk Assessment:
During the assessment process The Care Worker Agency will discuss the
benefits and any risks associated with the provision of care with the
customer and a risk assessment will be produced to minimise or remove
such risks. Risks could be associated with the provision of personal care
(for example moving and handling; help with medication administration)
or other aspects of their lives (for example accessing the community).
Customer choices and preferences will be respected and accommodated
unless others are placed at risk of harm or injury or it is not in line with
our stated aims and objectives for the service.
Review:
We will regularly review a customer’s plan of care with their full
involvement taking into account the ongoing need for consent to care and
treatment, and that this continues to remain valid. For example, that
there has been no deterioration in the person’s ability and capacity to give
such consent.
CONSENT AND CUSTOMER INVOLVEMENT
Mental Capacity:
Staff must always report any concerns around a customer’s mental
capacity or deterioration in their health immediately to the senior
manager in order that an urgent review can be arranged with the relevant
persons.
Where we recognise that there may be concerns around a person’s
capacity to give valid consent, the company will consult significant others
involved in the person’s care including other professionals, relatives, legal
representatives, advocates in order to ensure the best interests of the
person are protected in respect of any decisions that are made affecting
them and/or relating to their plan of care.
It may be necessary to involve an Independent Mental Capacity Advocate
(IMCA) where the legislation dictates this. The Mental Capacity Act 2005
makes provisions for an IMCA service which provides an independent
safeguard to support particular vulnerable people who lack capacity to
make important decisions who have no-one to appropriately consult
regarding certain decisions. The referral to an IMCA service should be
made by the relevant local authority or health authority involved in the
person’s care as required by their obligations under the Act.
Emergency situations:
In 2026 the UK Supreme Court made a judgement on what constitutes a
deprivation of liberty and we note the relevant updates surrounding the
needs for a DOLS (please refer to appendix 2). Our company stance
remains the same, in terms of our understanding that if the individual
needs to be deprived of their liability for any reason, home and
domiciliary/community care is not the most appropriate place for them
and we would look to support finding alternative living arrangements that
are appropriate to meet their needs.
The Care Worker Agency will in the event of an emergency and where the
customer is unable to give consent, inform and consult the relevant
professionals (for example the local authority care manager or general
practitioner) or representatives (for example advocacy services/next of
kin) for advice in order to protect and ensure the best interests of the
individual. We will only share the information previously agreed with the
customer and/or others and in line with legislation and good practice.
Additional information will only be shared with appropriate persons if it is
deemed necessary and in the person’s best interests.
CONSENT AND CUSTOMER INVOLVEMENT
Signing of documentation:
The Care Worker Agency will ensure customers and/or their
representatives are provided with copies of care plans and risk
assessments and that the parties involved are able to sign confirming
their agreement and indicating consent to any plan of care. In the event
of the customer being unable to sign due to chronic arthritis for example,
we will gain verbal consent and document this in our care planning data.
We will also liaise with the POA and NOK where appropriate and
applicable.
Our staff:
The company has a comprehensive induction and training programme for
care workers which includes ensuring staff understand the principles of
respect, dignity, choice and independence and the importance of
customers’ involvement and consent relating to their care. Staff receive
training in accordance with the nationally recognised induction standards
set by Skills for Care and training in mandatory areas to promote the
safety and well-being of customers as per The Care Certificate.
Related Policies:
Care at home
Care Planning
Code of Practice
Confidentiality
Dignity
Emergency Aid
Equality and Diversity
Information sharing
Incident and accident reporting
Risk Assessment
CONSENT AND CUSTOMER INVOLVEMENT
Appendix 1
MENTAL CAPACITY ACT
The Mental Capacity Act 2005 aims to empower and protect people who
may not be able to make some decisions for themselves. To protect
against poor practice, the Mental Capacity Act 2005 (MCA) was initiated
and it came into full effect in October 2007.
The MCA can apply to anyone who is aged 16 or older in England and
Wales and has five principles which should be applied in any situations
where mental capacity is an issue:
1. Every adult has the right to make his or her own decisions and must be
assumed to have capacity to do so, unless it is proved otherwise
2. People must be supported as much as possible to make a decision before
anyone concludes that they cannot make their own decision
3. People have the right to make what others might regard an unwise or
eccentric decision
4. Anything done for, or on behalf of, a person who lacks mental capacity
must be done in their best interests
5. Anything done for, or on behalf of, a person who lacks mental capacity
should be the least restrictive of their basic rights and freedoms
A number of factors were identified by people as being helpful when
expressing their wants and needs and making their own decisions. These
were:
•Communicating through preferred means having the choice to
communicate in the way they feel most comfortable, whether this be
verbal, through writing or other creative means
•Being heard – it was important to customers that the people around
them really listened to what they had to say. By feeling listened to, they
believed their opinions had been understood and were valued
CONSENT AND CUSTOMER INVOLVEMENT
•Familiarity and trust – trust was often built through familiarity with
others and a feeling of knowing those around you well
•Particular service and staff qualities – it was felt that expressing ones’
wants and needs is easier when staff are good communicators, good
listeners, are down-to-earth and respond to individual needs. A warm,
welcoming and safe service environment is also helpful.
The factors people felt hindered them in expressing their wants and needs
and making their own decisions were:
•Lack of confidence – people said they were less likely to make decisions
or express their wants and needs in situations where they felt
unconfident. Some talked instead of trying to hint to others about what
they want, without openly expressing it
•Prejudice and stigma – some people with mental health problems felt
disempowered by the prejudice and stigma they experienced as a
consequence of their mental health problem, and believed this had an
impact on their ability to express themselves and make decisions.
(Whose Decision? Mental Health Foundation 2008)
Appendix 2
UK Supreme Court 2026 judgement on what constitutes a
deprivation of liberty
Background
The Mental Capacity Act 2005 (MCA 2005), which applies in England and
Wales, defines deprivation of liberty by reference to its meaning in article
5(1) of the European Convention on Human Rights (ECHR). This means
that to determine if someone is deprived of their liberty, close
consideration must be given to both domestic law and the case law of the
European Court of Human Rights. The Supreme Court, in P v Cheshire West and Chester Council [2014] UKSC 19, known as Cheshire West 2014, set out an ‘acid test’
to determine if someone is confined and therefore deprived of their liberty.
The Cheshire West 2014 judgment concluded that someone is confined if
CONSENT AND CUSTOMER INVOLVEMENT
they are under continuous supervision and control and are not free to
leave. It proceeded on the basis that, if someone lacks mental capacity to
consent to their care and living arrangements under MCA 2005, they
cannot give valid consent to their confinement.
The 2026 judgment
Read the judgment and the summary judgment
Between 20 and 22 October 2025, the UK Supreme Court heard a case
brought by the Attorney General for Northern Ireland concerning the
definition of a deprivation of liberty.
The Supreme Court handed down its judgment on 2 June 2026 and
concluded that:
●the Cheshire West 2014 judgment was incorrect instead of relying on the single ‘acid test’
, an assessment of whether someone is deprived of their liberty must now consider
multiple factors – that is, it is multifactorial the starting point in assessing whether someone is deprived of liberty is to look at the specific situation of the individual and take into account the type, duration, effects and manner of implementation of restrictions on the person
Crucially, no single factor is determinative the Cheshire West 2014 judgment wrongly assumed that if someone lacks legal capacity under the MCA 2005, they cannot give valid consent to the arrangements. The 2026 judgment clarifies that a person’s expression of their wishes and feelings carries significant weight. A person can give valid consent if they are conscious of their environment, have a basic level of understanding and are capable of expressing a view that they accept and/or are happy with the situation. However, if there is serious doubt, no conclusion of valid consent can be drawn the effect of the restrictions on the person may differ based on whether or not the person is content with their arrangements. Cheshire West 2014 was wrong to conclude that a person’s lack.
CONSENT AND CUSTOMER INVOLVEMENT
of objection is never legally relevant to the question of objective
confinement
These changes to the definition of a deprivation of liberty apply with
immediate effect and extend across the UK.
Who this applies to
The new definition applies to:
●
●
deprivation of liberty in hospitals and care homes for people aged
18 and over where the Deprivation of Liberty Safeguards (DoLS)
process applies (see the DoLS code of practice )
deprivation of liberty in the community for people aged 18 and
over, and for children where it is authorised through the Court of
Protection or the High Court’s inherent jurisdiction
Organisations should begin aligning their practice with this new legal
position. We recognise that there are wide-ranging implications of the
judgment. Providers and local authorities should use their professional
experience and take a proportionate and considered approach in how they
respond to the Supreme Court judgment, before further government
guidance is published.
In the long term, these changes are likely to reduce significantly the
number of deprivation of liberty authorisations. In the short term, we
recognise that a more cautious approach will be needed, with borderline
cases referred for review.
Registered care home providers or managers and supervisory bodies (the
supervisory body is the local authority and is referred to as such in this
update) should expedite plans to:
●
share the ruling (or an accurate summary of the ruling)
throughout their organisations
9CONSENT AND CUSTOMER INVOLVEMENT
●
upskill their workforce on the definition of deprivation of liberty in
line with this change in the law
This should include an initial review of, and update to, individual
organisation-specific operational products to ensure they reflect the new
legal framework for identifying deprivation of liberty. For example, this
could include but not be limited to policies, protocols, websites and
public-facing leaflets.
NHS England will be publishing an updated DoLS e-learning module by 30
July 2026.
We recognise that there will be a period of adjustment before we get to a
new steady state. To help manage this, local authorities should make
plans for how they will prioritise reviews, assessments of cases coming to
the end of their authorisation and new referrals.
Local authorities should also ensure that essential safeguards such as
independent advocacy and access to an appointed relevant person’s
representative (RPR) continue where applicable.
This ruling will not remove the need to comply with ECHR article 5 where
it is engaged. Where there is reason to believe that a person is deprived
of their liberty, the DoLS process still applies in hospitals and care homes,
and the court process still applies in other settings.
In addition, organisations should continue to ensure they meet their
duties and deliver safeguards under:
●
●
●
●
the MCA 2005
the Care Act 2014
continuing healthcare
common law duties of care
The Care Act 2014 provides explicit safeguards for adults with care and
support needs. Section 5 of the Care Act 2014 states that local authorities
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must ensure that the services they commission are safe, effective and of
high quality.
Seeking further advice
Where practitioners from care providers or hospital trusts are in doubt
about whether someone is objecting to their confinement or, in instances
where people fluctuate between appearing content and appearing to
object to their confinement, a referral should be made to the local
authority for consideration of a DoLS authorisation, or the Court of
Protection.
Practitioners from care providers, hospital trusts and the local authority
should continue to use DoLS processes and court applications where there
is any doubt as to whether arrangements constitute a deprivation of
liberty. This includes where there are any doubts about valid consent,
where restrictions are significant or where it appears ECHR article 5 may
be engaged. Hospital trusts and local authorities may want to contact
their own legal teams for advice where necessary.
Reviewed June 2026 by Fay Townsend-Jackson
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