WHAT DOES GOOD COMPLEX CASE MANAGEMENT PRACTICE LOOK LIKE?

FOCUS ON COMPETENCY 5: DUTY OF CARE

Practice issue:

Working with an 18 year old with compromised capacity whose mum is making all his decisions. She wants him to finish with his girlfriend as she doesn’t like her. I can see why mum might be worried about him engaging in a relationship, because she wants him to be safe and not exposed to risk of future rejection. She would be really happy if I let her make this decision and my life would certainly be easier but I need to listen to my client and he likes spending time with her, so it may not be in the client’s best interests to finish the relationship. Letting mum make all the decisions would certainly mean she gave the deputy a good review of my input however, the client isn’t going to be fulfilling his desire for a relationship and may then feel misrepresented. My client will probably do what his mum asks, but he is likely to disengage with the case management process if he feels I am ignoring his views.  In order to support this client to the best of my ability, I am going to have to find a way to achieve consensus in the client’s best interest.

Case Management Actions:

  • Consider capacity assessment on this specific area and who would be best to carry that out
  • Education and support to parents around mental capacity, best interests, risk taking and the role of the case manager to establish an agreed way forward if possible
  • Listen to the client and explore what he wants, establishing how much information the client is happy for you to share with his parents
  • Consideration of the client’s views within his level of capacity and human rights
  • Conduct a risk assessment of the relationship
  • Explore the need for supported decision-making and education for the client around relationships
  • Supporting the client with their vulnerability around making and forming relationships

 

Skills used from competency 5:

Client focused

Advocacy

Guiding decision making

Risk management

Managing expectations

 

Positive indicators demonstrated:

Client central to the process

Client is listened to

Client achieves his goals

Client is able to grow and develop

Case manager respects client’s choice

Constructively resolves conflict

aware of family dynamics

all parties feel they are valued and being heard

 

Bear traps avoided:     Client disengages

Client’s ability to make choices is ignored

My temptation for a quiet life

Ignoring the parents’ right to parent

Case management being ineffective

 

Competencies demonstrated:

Duty of Care

Communication

 

 

Referencing documents and legislation:

BABICM Code of Ethics and Conduct in Case Management Practice

Mental Capacity Act 2005

 

Practice reflections:

Families are very often not supported through transition which leads them feeling lost. Case managers should proactively support this transition at an earlier stage.

Case managers should use all available support and advice from other professionals, parties and agencies to support decision making and the case management process.

Case managers can be in a difficult position when navigating circumstances where their client’s wishes are not in keeping with their family’s wishes. Sometimes that can result in a breakdown in relationship with the case manager but the case manager should always be acting in the client’s best interests.