Clinicians are less likely to be familiar with the provisions of the Care Act compared with the MHA or MCA. While the Act is primarily the domain of social workers and local authorities, its effects are so widespread that a general overview of it is helpful in planning care and providing safeguards for people with dementia. The importance to clinicians arises because so much hinges on the assessment of the person’s needs and that the assessment is carried out in accordance with the Care Act. In a typical case in the Court of Protection, the key documents before the court will be determined by the Care Act assessment. These relate to what the person needs and whether they have the capacity to accept or decline the services required. We discuss the main provisions of the Care Act, which places a series of duties and responsibilities on local authorities concerning care and support for adults, as well as safeguarding in the Act. We then discuss the role of Continuing Healthcare, which is legally underpinned by the NHS Act 2006 and the Care Act, with the overlapping legal schemes essentially working in parallel.

The effects of dementia can make older people particularly susceptible to abuse and exploitation. Not only are they likely to be less able to articulate their feelings and experiences, but they may also be unable to remember or understand what has happened to them. People with dementia may also be less likely to seek help, advocate for themselves or have the mental or physical capacity to remove themselves from potentially abusive situations. The relatively high psychological and physical demands placed on family members who care for relatives with dementia may be a contributing factor. We will therefore discuss the law in relation to safeguarding, provided by the Care Act 2014. We will then consider how the three relevant acts, the Care Act, the Mental Capacity Act and the Mental Health Act, may be deployed in relation to safeguarding situations. Finally, we will discuss safeguards relating to lasting powers of attorney, and what to do if one has concerns about attorneys and deputies.