1.3 Explain what is meant by ‘valid consent’

This guide will help you answer 1.3 Explain what is meant by ‘valid consent’.

Valid consent is a key concept in the health and social care sector. It refers to the agreement given by an individual for an action or decision affecting them, where this agreement is made freely, with proper information, and by a person with the capacity to decide. In adult care, understanding valid consent ensures that individuals’ autonomy and legal rights are respected, while also upholding the professional and ethical standards required in the sector.

This guide covers the components of valid consent, its significance in care settings, and how care workers can ensure consent is appropriate and lawful.

What Makes Consent Valid?

The term “valid consent” has a specific meaning in care settings. Consent is considered valid when it meets the following three criteria:

Voluntary Consent: It must be given freely, without pressure or coercion. Coercion refers to forcing someone into a decision using threats, manipulation, or undue influence. Even subtle pressure, such as repeatedly suggesting one option, can invalidate consent.

Informed Consent: The individual must have all relevant information to make a decision. This includes an understanding of:

• What is being proposed
• Why it is necessary or beneficial
• Any potential risks, benefits, or alternatives involved It’s important to present this information in a way the person can understand. For example, using simple language or visual aids for those who might find complex terms confusing. If someone does not fully understand the situation, their consent cannot be classed as valid.

Capacity to Consent: The individual must have the ability to make the decision themselves. This involves understanding the information provided, weighing up the options, and communicating their decision. For people who may lack capacity, the Mental Capacity Act (MCA) 2005 provides guidelines on how decisions should be made on their behalf.

Levels of Consent

Consent can be required for a wide range of activities in adult care. The type of consent needed depends on the situation:

• Implied Consent: This is non-verbal and based on the person’s actions. For instance, when a worker asks, “Can I help you to stand?” and the individual extends their hand for support, they are implying consent.
• Verbal Consent: This involves spoken agreement, such as saying “yes” to taking medication or participating in an activity.
• Written Consent: Some situations require formal documentation, such as agreeing to share medical records or signing a care plan.

When providing support, care workers must ensure the level of consent is proportionate to the activity. For example, minor day-to-day interactions might only require implied consent, while more significant decisions demand written confirmation.

Consent in Adult Care

Valid consent is more than a legal requirement; it is the foundation of individual rights, dignity, and respect. Understanding its importance helps to maintain ethical care relationships and ensures individuals remain at the centre of their own care.

• Promoting Autonomy: Adults have the right to make their own choices about their care or treatment. Obtaining valid consent respects the individual’s autonomy, even if their choices differ from what the professional might think is best.
• Building Trust: When care workers explain options and seek approval before proceeding, it builds trust. This encourages individuals to engage in their care and openly communicate their needs.
• Meeting Legal Obligations: Failing to obtain valid consent could lead to accusations of assault or negligence. For instance, performing a medical procedure without consent, even if intended to help, is unlawful.
• Avoiding Harm: Acting without consent can have both emotional and physical consequences. For example, imposing treatment on someone who doesn’t want it can cause trauma or distress.

Examples in Practice

Examples of valid consent in practice include:

1. Personal Care: A care worker asks, “Would you like help with washing today?” and the person agrees. This verbal consent validates the worker’s actions.
2. Medication: A worker provides clear information about why medication is needed and any side effects. The individual confirms they understand and are happy to take it.
3. Restraints or Restrictive Practices (if used): For actions like placing bedrails for safety, care staff must give the person detailed information about why this is necessary. If the individual objects, alternative methods must be considered.
4. Sharing Information: Before sharing someone’s data with other professionals, the individual must agree, ideally in writing. For example, they might sign a document giving their GP permission to discuss their health with relatives.

Challenges in Gaining Valid Consent

In adult care, there are certain challenges when trying to obtain valid consent. Being aware of these issues ensures professionals take the correct steps to address them.

• Language Barriers: If English is not the individual’s first language, interpreters or translated documents may be necessary.
• Sensory Impairments: For those with hearing loss or visual impairment, care workers can use tools like sign language, hearing aids, or braille to guarantee understanding.
• Fluctuating Capacity: Someone’s ability to consent may change depending on their health condition or environmental factors. For example, people with dementia might understand something better in the morning than later when they are tired. Care workers need to time conversations carefully.
• Lack of Understanding: If the person struggles to grasp complex issues, care workers should simplify the information or seek support from a colleague or advocate.

Actions When Consent Is Not Valid

If an individual’s consent is not valid, care workers must pause and take alternative steps. For example:

• If someone lacks the capacity to consent, the MCA allows decisions to be made in their best interests. However, their views and preferences should still be respected as much as possible.
• If someone feels pressured, care workers should make adjustments to avoid any undue influence. This could involve giving the person more time or speaking to them alone.
• If the person is unsure, workers should provide further information or support to help them decide.

Recording Consent

Finally, documenting consent is important, especially for decisions involving health interventions, finances, or legal matters. Care professionals should:

• Keep clear records of what information was provided, how it was explained, and whether consent was obtained verbally, in writing, or implied.
• Note any refusals and the reasons behind them.
• Review consent regularly, as people’s decisions or circumstances may change over time.

Final Thoughts

Respecting valid consent empowers individuals, protects their rights, and strengthens care relationships. It ensures actions taken are lawful and ethical, which is crucial in providing high-quality, person-centred support. By embracing the principles of valid consent, care workers uphold the dignity and wellbeing of the people they serve.