On the Couch with Gary Spencer-Humphrey

Welcome to On the Couch with Biscoes, your home for honest, unscripted business and community conversations brought to you by Biscoes Solicitors. We work with a huge range of local organisations, and we’ve learned so much from the people behind them, now we want you to hear their stories too.

In this episode, Alison sits down with Gary Spencer‑Humphrey, founder of Nova Care Consultants. Gary shares his journey as an experienced social worker and explains the vital work his team does across Portsmouth, from mental capacity assessments and care‑planning support to specialist mental health expertise.

Together, they unpack some of the most misunderstood areas of adult social care: how capacity is assessed, what happens when families disagree on decisions, the realities of deputyship, and how mental health professionals make difficult calls under the Mental Health Act. Gary also offers insight into his work as an Approved Mental Health Professional and expert witness, providing a rare look into the complex decisions that can affect the lives of vulnerable people and their families.

This isn’t a legal deep dive, it’s a genuine, comforting chat that celebrates the individuals shaping our local community.

So grab a cuppa, get comfy, and join us on the couch.

Transcript

SPEAKER_01 0:06

Biscoes great service to every client every time. Welcome to On the Couch with Biscoes, your home for honest, unscripted business and community chats brought to you by Bisco's solicitors. We work with all kinds of businesses and organisations across our local community, and we've learnt so much from the people behind them. So now we want you to hear from them too, to understand the values, lessons, and experience that keep them moving. If you're looking for hard-hitting legal content, this isn't going to be the podcast for you. This is a cozy, comfortable space for local people and our best collaborators to have a voice. So grab a cupper and come and join us on the couch. Hi, I'm Alison from Biscoes and we're on the couch today with Gary Spencer Humphrey. Gary, hello.

SPEAKER_00 1:00

Good morning, Alison.

SPEAKER_01 1:01

How are you?

SPEAKER_00 1:01

I'm really good. How are you?

SPEAKER_01 1:02

I'm great, thank you. So, um, Gary, I want to talk to you today about the work that we do with you. Um, because you run your own business. Could you want to tell everybody what that business is?

SPEAKER_00 1:12

I'll tell you a little bit about it. It's uh Nova Care Consultants. So we are an independent social work, occupational therapy and nursing service based in Portsmouth.

SPEAKER_01 1:21

And you yourself, you're an experienced social worker.

SPEAKER_00 1:24

I I am, yeah. It's about 15 years. It's a long time.

SPEAKER_01 1:27

And um what sort of work um do you get involved with? Could you tell our listeners what uh the various aspects of your business cover?

SPEAKER_00 1:36

Yeah, so that I mean the range of work, it can cover things from family members that are looking for advice around care funding, what type of homes mum or dad might need, or whether they need care and support at home. It could be about technology care, it could be about a monitoring service, or it might be about planning for the future. So things like getting in place LPAs or wheels, and that's when we would come to Bisco's.

SPEAKER_01 1:57

Yeah, so the work we kind of do with you, um, I've certainly recommended clients to you to have capacity assessments done when perhaps um family members are thinking about whether mum or dad who've got a bit elderly, maybe have some mental health issues, uh, are thinking about making an LPA, and we need to be sure that they've got the capacity to do that, and you'll go and see them for me and um do those assessments.

SPEAKER_00 2:18

Yeah, so that that's probably our biggest um service that we provide. So it's a professional opinion on mental capacity. So can the person with support make a decision or not make a decision? Um is it it's somewhat formulaic, but I like that because it's codified in a piece of law. The law tells us how we should do it, uh, and there's a good code of practice that goes alongside it. I say good, not great, because it does need a little bit of improving. But um, yeah, we we apply the kind of principles, we look at how the person makes the decision. It's not necessarily the decision that they're making, is it right or is it wrong? We're looking at can they weigh everything up? Can they understand the decision that they're making? Um, can they balance the risks and can they communicate the outcome? Um, and then we kind of then look at whether if they can't do that, is it linked to a mental impairment to do with their mind or brain?

SPEAKER_01 3:07

And then we carry it's interesting that you said that some, you know, it's not whether it's a right or a wrong decision, because sometimes we do get family members who come to see us who think they've got a very clear view about what should happen for mum. Mum should go into a care home or mum should um have this particular package of care. And um sometimes it's our job to explain that actually if mum's got capacity, yeah, um, that's not their decision to make.

SPEAKER_00 3:30

Yeah, you're right. And that there and that's covered in in the Capacity Act as well. So it talks about um making unwise decisions. And what it says is that just because somebody is making an unwise decision does not mean they lack capacity. And there's lots of examples that even you and I would um do every single day. Every time we get in a car, we're taking a risk. There's there's some degree of risk getting in a car and driving or being a passenger. We might decide to spend a lot of money on a lottery ticket, we might have a gut feeling that we're gonna win the rollover. So we might put 20, 50, 100 pounds on lottery tickets. Um, we might drink alcohol, we might smoke cigarettes, we might um, uh current company included, we might not eat as well as we could do. Um, so there's lots of decisions that we can make over life. And we've got to be really cautious that what we don't do is apply this label that people that are vulnerable or somehow have vulnerability factors are where they're making a bad decision, therefore they can't make it. Let's protect them. So the law is really there to safeguard their rights as well, and but also promote their wishes, views, and opinions.

SPEAKER_01 4:29

Yeah, so uh basically what we're saying is just because somebody has either got a wavering capacity or a reducing capacity, or sometimes no capacity to make those decisions, they still have to be treated as an adult.

SPEAKER_00 4:39

That's right, yeah. And there are some times where there's lots of decisions that need to be made. And I I've had a case fairly recently where we were looking at four or five different decisions. So we were looking at does the person have the ability to manage their property and affairs, their finances? Um, do they understand their care and support needs? Um consent to having sexual relations. Um, and the other one was around the use of alcohol. So it doesn't mean because you have capacity for one, you have capacity for all. So in that case, there were some areas where the person didn't have capacity. Um but my conclusion there was that it was about lack of understanding. So it's not for that individual, it wasn't a decision for life. It was me making recommendations about what steps need to be taken to give the person the right support. And it might be that in a couple of years' time or five years that you go back and actually they've acquired skills, they've acquired new knowledge, and therefore they may acquire capacity.

SPEAKER_01 5:34

Yeah, okay. So the other the other thing I'd like to just talk about is in my line of work, I get people come to me to talk to me about perhaps potentially applying for debtorship orders. So that's where somebody has already lost capacity. Um, and we appoint somebody who acts pretty much like an attorney attorney, but they're court appointed. Um now, when we do that, that often happens as a as a very last-minute type thing, although the process itself is quite long. And people get thrown into these situations where they have to make these decisions. So, does NovaCare provide kind of support around those sort of the decision making that that has to be considered?

SPEAKER_00 6:14

Yeah, we do, and and we recognise as a as a company that usually when families come to us, whether it's a referral through a solicitor or whether they found us on an internet search, they've they've normally exhausted quite a lot of hours into having a very stressful situation or stressful situations. So we're very caring, compassionate, and committed, and those are our three values. So every call that we take, we know that it's most likely that person has been uh advised to do something and they've been searching for hours, for days, for weeks, even. It might be that their family member has been resistive to having support and now suddenly they're having to either make the decision in their best interest, or maybe their loved ones have said, okay, I now accept the support. So we're really, we're really aware when we get that telephone call that that person has probably gone through a lot, um, given lots of different sometimes conflict and advice as well. So we sometimes find that maybe the information that they've been given from their mate down the pub or someone in a in a in a group that they're part of, um, oh, you should do this because that's what we've done for my mum. Um, but every circumstance is is individual and every person is individual as well. So we're very aware of um supporting the individual that's coming to us as much as the person that we're assessing. So we kind of take a family approach, really. We offer an aftercare support service as well, we don't charge for that. So families or those that we've supported, if they need to come back to us just for a debrief, or maybe it's to run down our report because there are sometimes upsetting things that they might read in that report, um, or they might believe maybe that their relative had capacity and we've said no, they no, they don't. So we're we're support people as much as they want as well. So we're always available seven days a week. Our phone lines are open eight till eight, Monday to Friday, and ten to four on the weekend.

SPEAKER_01 8:01

Yeah, and I think the point that you make about every circumstance being different, and don't take advice from from somebody down the pub or somebody at work, or because you know what happens for some people, you know, may depend on their particular levels of capacity, their particular care needs, um, their particular financial circumstances make a make a big difference. So each situation, and I always say this to clients, is is very bespoke around this. Um, so it's about getting proper advice for for all of those aspects. And one of the things that certainly we try to do as a as a firm of solicitors is we we can't advise on care needs, but we're not trained to do that. So we would use somebody like you to help somebody who is in that difficult situation navigate all of that. Um, again, when we're talking about care home funding, though you know, those are particular issues which need specialist advice. So yeah, don't don't listen to uh your mate down the pub. Show down the pub. Come and get some proper advice. Um so that's one aspect of what Nova Care does. So there is another aspect to what you do, and that's around actually mental health, mental illness, mental health illness. Um tell me a little bit about that.

SPEAKER_00 9:04

Yeah, so that that that's one area that I specialise in. So so I'm uh in addition to being a social worker, I'm also um what's known as an approved mental health professional. We call it AMP for sure. And the role of an AMP is to make the decision about whether somebody should be taken to hospital using compulsory powers. So that's the powers under the Mental Health Act, and it gives the rights to those that have the AMP qualification to coordinate, but ultimately take the person to hospital. And if it's under compulsion, it's against their wishes. Sometimes we may do it where the person may appear to be agreeing, but actually what we need is the safeguards of the of the act. So sometimes we take people into hospital that are agreeing, um, but most of the time it's when they don't agree.

SPEAKER_01 9:50

So this is all quite pretty serious stuff, isn't it? So this is this are these are people who are suffering some sort of mental disturbance who either are a danger to themselves or a danger to others, um, and they are compulsorily taken to um to a to somewhere to to be assessed for treatment. That's effectively what we're talking about, isn't it?

SPEAKER_00 10:08

It is, yeah. And and it's always connected to um the mental impairment. It's always connected to the mental impairment. So um there may be times where people are living a lifestyle that others see as dangerous or risky. Um, one area particularly that's excluded is being dependent on alcohol and drugs. So having a dependency on alcohol and drugs is excluded as a reason to be detained in hospital. However, if that person goes on to say develop a psychosis, and a psychosis is maybe having thoughts that are intrusive, are harmful, uh, maybe holding beliefs that aren't actually accepted in society, um, if there's a risk to themselves or others, then it could be a grounds for them going into hospital for a period of assessment. But my um, in addition to that role, so that's that's that's the kind of statutory role that I do, but on the flip side, I also act as an expert witness. So I'm I'm sometimes asked by um solicitors, sometimes barristers if they're involved, to come in and provide an independent report on a on an individual circumstances, uh, on an individual's case. Um and I've had one recently where I've assessed an individual and the the court, the tribunal, found the person didn't have a mental disorder. Um, but because they committed a very serious criminal offence and they were convicted at court of this offence, they rather than go to prison, they were transferred into a hospital for treatment. Now that person, when they're discharged, will need certain aspects of supervision when they're in the community. And it was that aspect that I was asked to get involved because there were lots of disagreements around A, who's going to fund it, and B, what actually needs to be put in place. Um, so in that case, I was asked to come in and provide a particular view on that that um individual.

SPEAKER_01 11:52

So on some occasions, um people are taken to hospital, they're assessed, and then they they may be further detained on a slightly different section of the act um to continue to have treatment. But those those sorts of um detentions can go on for quite a long time, can't they?

SPEAKER_00 12:07

They can, yeah. So the starting off at the beginning, the the primary section that we use to do an assessment is section two of the Mental Health Act, and that allows a person to be kept in hospital for a period of up to 28 days. Doesn't always mean they're going to stay there for 28 days. Um, I've had it before with people who've been in maybe 48 hours, 72 hours, they've been discharged. Um but for those that need longer, either they need a longer period of assessment or they their assessment needs to move on to being treated, then we move from a section two to a section three. And the AMP, who's the social worker, or they could be a nurse or a psychologist. If they agree that a section three is needed, that can last for up to six months. After that period, the power goes over to the doctor, the doctor can renew it for another six months, and then after a year, they can review it every year. So you you could be in hospital for years, years and years. The longest one that I've had is 29 years. So they've been continuously detained for 29 years.

SPEAKER_01 13:10

So that's a really long time. And and have you had any success stories in in people coming out of hospital after a long period of time?

SPEAKER_00 13:18

Yeah, we have, and and there's a couple of um couple of cases that have gone up to the the upper tribunal. So the first-tier tribunal is usually the um panel of judges that will hear your case um on first application, and then sometimes the solicitors can appeal it and it goes up to a more senior court that will review the decision. We've had a couple of cases where it's supported us in getting people to be discharged. Um, so we've supported people coming out of hospital with a long-standing um illness, but we've also put in place or or we've put a plan in place that would support them in that transition.

SPEAKER_01 13:53

Okay, so this is an area of of of law that unless you've it's touched your family or you've been involved in it, kind of sits in the dark, I think, a little bit. So people don't really understand. So that's it's kind of you to explain that a little bit. Um, if anybody had concerns about a family member, is that something that you're happy to to help them with? You know, if they they were concerned that they've got a family member who's behaving in an odd way, that that they might want some support about how how to get treatment for that person?

SPEAKER_00 14:20

Yeah, so we we offer we offer a free consultation to people. Um sometimes that's not always long enough to give the full um time for the family to express what it is, but we can give 20-30 minutes um, and then most times we can normally guide people if they've got a very particular thing, they just want to maybe find out what the local alcohol and drugs uh rehabilitation service is, or they want to just check that something's happened is right. We can normally deal with that. Um we can offer longer consultations as well, and if people want to send us information, because everyone these days has something on email, or they've got documents that have been sent, we're quite happy to go through that with them as well.

SPEAKER_01 14:56

Great, that's great, Gary. Thank you so much. I think that's um probably given our lessons some some insight into to various things that they may or may not, hopefully, don't have to come across, but if they do, uh knowing the right place to turn, I think's really important. Brilliant. Thanks very much.

SPEAKER_00 15:11

Thanks for having me in.