DNACPR recommendations in care homes

Autonomy Project Research

As part of our Human Rights in Locked-Down Care Homes project, we sought to understand how DNACPR recommendations were made and applied within the care home setting. Our research explored the experiences of a group of professionals we termed ‘capacity professionals.’ These are professionals who typically have a social work background, and who have responsibilities for implementing the provisions of the Mental Capacity Act 2005. Where a care home resident lacks decision-making capacity, these professionals may be involved in the DNACPR decision-making process, but their work in and with care homes also makes them well-placed to identify unlawful or otherwise problematic practices.

In this research, we found evidence of:

  • So-called ‘blanket’ decisions, for example, decisions applied to all residents in a care home without individualised assessment
  • DNACPR recommendations being put in place without the requisite consultation, or details of the consultation not being provided on the DNACPR form
  • a perception among some capacity professionals that care home residents and their families were not sufficiently involved in DNACPR decision-making
  • a lack of review of DNACPR recommendations where review would have been appropriate
  • DNACPR recommendations influencing care or treatment other than the administration of CPR

What does the law say about DNACPR recommendations?

What happens when a DNACPR decision is not in place?