Most care home providers state that Care Quality Commission reviews now require a health and welfare power of attorney for all residents.

The Care Quality Commission regulates health and social services, making sure standards are met with safe and effective high quality care.

Why make an LPA?

A power of attorney is a legal document which allows someone trusted by you to decisions for you on your behalf, if for any reason you are unable to make your own decisions.

For example, many people with dementia lose mental capacity and choose to appoint someone as a power of attorney.

There are different types of power of attorney available, but only health and welfare is required for care homes, regarding health and care decisions.

If you are concerned you have been diagnosed with an illness which may prevent you from making significant decisions in the future, it is highly recommended that you consider making and LPA.

Common illnesses which can impact mental capacity are:

  • Mental health problems
  • Brain injury
  • Alcohol and drug misuse
  • Side effects of certain medical treatment
  • Dementia

A health and welfare attorney decides on factors to do with medical care and treatment, what you eat, where you live, and social activities:

  • giving or refusing consent to healthcare
  • staying in your own home and getting help and obtaining social service support
  • moving into residential care and finding a care home
  • day-to-day matters such as diet, dress and daily routine

Permission can also be granted to attorneys regarding lifesaving or life sustaining treatment. Health and welfare attorneys also decide on future care needs such as whether a person can continue to live at home with help from social services, or whether a care home or nursing home would be more appropriate.

Mental Capacity

Mental capacity is the ability to make significant decisions in your life. To have mental capacity, you understand the decision and the circumstances. For example, someone with dementia may not have mental capacity.

As long as you have mental capacity, you can make changes to your LPA. All changes need to go through the Office of the Public Guardian.

Choosing an Attorney

If you are married or in a civil partnership, do not assume your partner can decide on your healthcare. Without making an LPA, your spouse will not have the authority.

Firstly, an attorney must be over the age of 18. The application can be from any walk of life; a partner or spouse, a friend, a relative, or a professional. What is important is that the chosen attorney is someone you trust to manage your affairs.

You can also choose more than one attorney, for example you wish to appoint your children. They can come to decisions jointly or severally.

When selecting an attorney, consider if they’ll be able to work together coherently. Do you trust them to act in your best interests? How well do they understand you, and how well do they organise their own affairs?

How do I set this up?

The LPA forms need to be signed by:

  • The person making the LPA
  • The person nominated as attorney
  • Witnesses to the signatures of the LPA, and the attorney
  • A certificate provider: someone you have known for at least two years, or a professional person (doctor, social worker or solicitor.)

You must register the LPA before you can use it. The registration fee in England and Wales is £82 for each LPA you may have.

Once the LPA is registered, the chosen attorney or attorneys, have to follow the Mental Capacity Act, when deciding on the behalf of someone with an LPA.

The health and welfare power of attorney doesn’t come into force until the person has lost the mental capacity to make decisions for them self.

Attorneys must:

  • Act in the persons best interest
  • Consider the persons past and present wishes
  • Do not take advantage of the person

How much does this cost?

Making an LPA enables you to remain in control of your affairs after you the lack the capacity to do so yourself. By making an LPA, you’re actually safeguarding your own future against any issues that may arise. Please call Dominic Mackenzie on 0113 284 5086 or email for any further information.

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