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Mental Capacity Act 2005
DEPRIVATION OF LIBERTY FORM No. 24
SELECTION OF A REPRESENTATIVE
(To be completed by best interests assessor)
The process has two stages:
(1) the selection of a representative by a best interests assessor (Form 24)
(2) the representative’s appointment by the supervisory body (Form 25).
The process of selecting a representative must begin as soon as a best interests assessor is appointed
following a request for a standard authorisation.
Regulations state that an individual can only be selected and appointed if they are eligible to be the person’s
representative. An individual is eligible if they are:
(a) aged 18 or over
(b) able to keep in contact with the relevant person
(c) willing to be the relevant person’s representative
(d) not nancially interested (see notes at end of form) in the relevant person’s managing authority
(e) not a relative (see notes at end of form) of a person who is nancially interested in the managing
authority
(f) not employed by, or providing services to, the relevant person’s managing authority (where the relevant
person’s managing authority is a care home)
(g) not employed to work in the relevant person’s managing authority in a role that is, or could be, related to
the relevant person’s case (where the relevant person’s managing authority is a hospital); and
(h) not employed to work in the supervisory body that is appointing the representative in a role that is, or
could be, related to the relevant person’s case.
Any person selected must inform the supervisory body in writing that they are willing to accept the
appointment. Part H of this form allows for a potential representative to indicate their willingness to be
selected as the representative should they be offered the appointment. Completion of this part of the form
will remove the need for the supervisory body to check separately that the person concerned is willing to act
as the representative.
A representative’s appointment expires when the standard authorisation comes to an end. Therefore, the
selection and appointment process must be done afresh if a further standard authorisation is required.
PART A — WHY THIS FORM IS BEING COMPLETED
Place a cross in box A1 or A2 Ø
A1 This form is being completed in relation to a new standard authorisation (which
includes one that is to come into force on the expiry of a previous standard authorisation).
A2 This form is being completed because a representative’s appointment has been
terminated before it was due to expire and it is necessary to appoint a replacement.
CASE
NUMBER
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PART B — BASIC INFORMATION
Name and address of the best interests
assessor
Full name of the person being assessed
Their date of birth (or estimated age if
unknown)
Name of the relevant hospital or care home
Name of the supervisory body
Address of the relevant person
(Place a cross in the relevant box and,
where applicable, state the address)
Address of the relevant hospital or care
home
(Place a cross in the relevant box and,
where applicable, state the address)
PART C — PERSONS WHOSE ELIGIBILITY COULD NOT BE CONFIRMED
Note: this part of the form should be used to record the details of any individuals who were selected by
someone to be the person’s representative but who were not recommended by the assessor because their
eligibility could not be con rmed.
I was unable to con rm the eligibility of the following individual(s) selected by the person themselves, or by
a donee of a lasting power of attorney or deputy appointed by the Court of Protection:
Name
Address
Name
DOB
Est. age
Name
Name
As stated on the request for a standard
authorisation
As stated immediately below
Address
As stated on the request for a standard
authorisation
As stated immediately below
Address
ddm
m
yyyy
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Name of the individual Who selected them Reason why their eligibility could not
selected (e.g. person, donee) be con rmed (e.g. not willing to act)
C1
C2
C3
C4
C5
PART D — CAPACITY OF THE PERSON TO SELECT THEIR OWN REPRESENTATIVE
I have determined whether the person has capacity to select a representative. I have determined that:
Place a cross in one box only (D1, D2, D3 or D4) Ø
D1 The person has capacity to select a representative. They have selected the family
member, friend or carer named in Part G of this form. This individual is eligible to
be appointed. I therefore recommend their appointment as the person’s representative.
If you placed a cross in Box D1, please now:
enter the representative’s details in Part G of this form
invite the representative to sign Part H of this form
enter, in Part C of this form, the details of any individuals selected by the
person who you did not recommend because you could not con rm their eligibility
sign and date the form (no other part of this form needs to be completed).
D2 The person has capacity to select a representative. Although they selected one or
more family members, friends or carers to be their representative, I was unable to
con rm the eligibility of any of the individuals selected.
I advised the person of this and of my reasons, and invited them to make a further
selection. They did not make a further selection.
If you placed a cross in box D2, please now:
enter, in Part C of this form, the details of any individuals selected by the
person who you did not recommend because you could not con rm their
eligibility; and then
proceed to Part F of this form (do not complete Part E).
D3 The person has capacity to select a representative but does not wish to select a
family member, friend or carer to be their representative.
If you placed a cross in box D3, please proceed to Part F of this form
(do not complete Part E).
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D4 The person lacks capacity to select a representative.
If you placed a cross in box D4, please now:
proceed to Part E of the form if a donee or deputy has been appointed for
the person; or
proceed to Part F of the form if they do not have a donee or deputy.
PART E — PERSON LACKING CAPACITY HAS A DONEE OR DEPUTY
Place a cross in one box only (E1, E2 or E3) Ø
E1 The person has a donee or deputy whose authority permits them to select a
family member, friend or carer of the person to be their representative.
The donee or deputy has selected the family member, friend or carer named in
Part G of this form. This individual is eligible to be appointed. I therefore recommend
their appointment as the person’s representative.
If you placed a cross in box E1, please now:
enter the representative’s details in Part G of this form
invite the representative to sign Part H of this form
enter, in Part C of this form, the details of any individual selected by the donee or
deputy who you did not recommend because you could not con rm their eligibility
sign and date the form (no other part of this form needs to be completed).
E2 The person has a donee or deputy whose authority permits them to select a family
member, friend or carer of the person to be their representative.
Although that donee or deputy selected one or more family members, friends or
carers to be the person’s representative, I was unable to con rm the eligibility of
any of the individuals selected.
I advised the donee or deputy of this and of my reasons, and invited them to make
a further selection. They did not make a further selection.
If you placed a cross in box E2, please now:
enter, in Part C of this form, the details of any individuals selected by the donee or
deputy who you did not recommend because you could not con rm their eligibility
proceed to Part F of this form.
E3 The person has a donee or deputy whose authority permits them to select a family
member, friend or carer to be the person’s representative.
However, the donee or deputy does not wish to select a family member, friend
or carer to be the person’s representative.
If you placed a cross in box E3, please now proceed to Part F of the form.
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PART F — SELECTION OF A REPRESENTATIVE BY BEST INTERESTS ASSESSOR
Place a cross in one box only (F1 or F2) Ø
F1 I have selected a family member, friend or carer of the person who is eligible to
be a representative.
The person does not object to the individual selected by me and nor does any donee or
deputy appointed for them.
I therefore recommend the person selected by me for appointment as a representative
to the supervisory body.
If you placed a cross in box F1, please now:
enter the representative’s details in Part G of this form
invite the representative to sign Part H of this form
enter, in Part C of this form, the details of any individual you did not recommend
because you could not con rm their eligibility
sign and date the form.
F2 I have not been able to select an eligible person to be a representative.
If you placed a cross in box F2, please now:
enter, in Part C of this form, the details of any individual you did not
recommend because you could not con rm their eligibility
sign and date the form.
PART G — DETAILS OF THE INDIVIDUAL SELECTED TO BE THE REPRESENTATIVE
The following individual has been selected to be the person’s representative:
G1 Full name of the person selected
G2 Their address
G3 Their contact details
G4 Their relationship with the relevant
person
Name
Address
Telephone
Email
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PART H — CONSENT OF THE PERSON SELECTED TO BEING APPOINTED
Note: this is an optional Part of the form. Its completion will save the supervisory body having to write
separately to the person to obtain their consent before offering them the appointment.
I am willing to be appointed as this person’s representative under the deprivation of liberty safeguards
provisions of the Mental Capacity Act 2005, and I am aware that I am expected to:
(a) maintain contact with the person
(b) represent the person in matters relating to, or connected with, their deprivation of liberty under the
standard authorisation
(c) support the person in matters relating to, or connected with, the standard authorisation.
Signed (person named in Part G above)
Dated
As soon as it is completed and signed, this form should be passed to the supervisory body, so that
a representative can be appointed.
Signed (best interests assessor)
Dated
NOTES
The arrangements for the selection and appointment of representatives are contained in the Mental
Capacity (Deprivation of Liberty: Appointment of Relevant Person’s Representative) Regulations
2008 accessible via: http://www.dh.gov.uk/en/SocialCare/Deliveringadultsocialcare/MentalCapacity/
MentalCapacityActDeprivationofLibertySafeguards/DH_084948
De nition of a relative
Regulation 3(2) de nes a ‘relative’ as
(a) a spouse, ex-spouse, civil partner or ex-civil partner
(b) a person living with the relevant person as if they were a spouse or civil partner
(c) a parent or child
(d) a brother or sister
(e) a child of a person falling within sub-paragraphs (a), (b) or (d)
(f) a grandparent or grandchild
(g) a grandparent-in-law or a grandchild-in-law
(h) an uncle or aunt
(i) a brother-in-law or sister-in-law
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(j) a son-in-law or daughter-in-law
(k) a rst cousin; or
(l) a half-brother or half-sister.
De nition of ‘ nancial interest’ in a managing authority
Regulation 3(3)(c) states that a person has a nancial interest in a managing authority where:
(i) that person is a partner, director, other of ce-holder or major shareholder of the managing authority that
has made the application for a standard authorisation, and
(ii) the managing authority is a care home or independent hospital.
Regulation (3)(3)(d) states that a major shareholder means:
(i) any person holding one tenth or more of the issued shares in the managing authority, where the
managing authority is a company limited by shares, and
(ii) in all other cases, any of the owners of the managing authority.
Donees and deputies
The appointment of a representative is in addition to any appointment of a donee or deputy. The functions
of a representative do not affect the authority of any donee, the powers of any deputy, or any powers of the
court.
Section 39A IMCAs
If the person has a section 39A IMCA, the effect of the appointment of a representative for the person is
generally that the duties imposed on, and the powers exercisable by, the IMCA no longer apply. The IMCA
may, however, still make an application to the Court of Protection concerning the standard authorisation, but
must take account of the views of the representative in doing so.
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