Dr Walker has an admirable depth and breadth of knowledge and experience in this field. Lindsey Williams, Family Court Assessment Service
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Simon is a 27-year-old man with a Learning Disability. Simon has limited communication abilities with him using approximately five Makaton signs for basic needs to be met, such as ‘tea’, ‘toilet’ and ‘walk’. At this stage in Simon’s life, his father had become concerned that professionals working with him were assuming that Simon ‘could understand everything that was said to him’ including information relevant to important medical decisions, including his occasional refusal of anti-Epilepsy medication. Through the help of his Solicitor, Simon’s father instructed a Psychologist to conduct an assessment of Simon’s capacity to make decisions in relation to his health and welfare with a view to applying to become Simon’s Deputy to make such decisions if it were found that he did not have capacity.
In order to assess Simon’s capacity to make such decisions, the Psychologist was guided by four central questions:
The Psychologist carried out the assessment by reviewing Simon’s medical and educational records, which included some past assessments of his capacity to make and communicate medical decisions by Speech and Language Therapists and Psychiatrists. This revealed that Simon had been diagnosed with a Severe Learning Disability, had attended schools for children with Learning Disabilities and had consistently been assessed as lacking capacity to make health decisions.
In addition, the Psychologist also interviewed Mr Jackson, Simon’s father in order to obtain a full developmental history of Simon. A member of care staff, Mrs Allen, who had known Simon since the age of 11 was also interviewed to assess Simon’s functional abilities over time. Both Mr Jackson and Mrs Allen were asked to complete standardized questionnaires in relation to Simon’s abilities across a wide range of skill areas. Collectively, the data collected from Mr Jackson and Mrs Allen were consistent with Simon’s records, suggesting that he was likely to lie within the extremely low range of comprehension and communication.
Simon was also observed on two occasions at his home. Attempts were made to introduce some formal tests to assess Simon’s receptive language abilities and while he tolerated a short period of testing, he politely indicated that he did not wish to continue with this. What was established from the short episode of testing was that Simon appeared to be able to identify very simple items of vocabulary, such as bus and drink, but did not appear to understand more complex words, such as river or skipping.
The Psychologist concluded that while Simon appeared to be able to make simple choices in his life, such as a meal or activity choice, the evidence consistently suggested that he lacked capacity to understand, retain, weigh up and communicate complex information in relation to medical decisions. The report helped to provide a clear and detailed assessment of how Simon lacked capacity in each of these areas and it is understood that this assisted the Court of Protection making a decision to award Deputyship of health decisions to Mr Jackson.
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