Mental Capacity Act

Mental Capacity Act
Purpose of training session
To gain a basic understanding of the Mental Capacity Act
and how it applies to your role including:
The 5 Principles of the act
Assessing capacity and who decides
Best interest decisions
Documenting decisions
Independent Mental Capacity Advocates
Lasting Powers of Attorney
Advance decisions
Court of Protection
The Public Guardian
Criminal offences
Where to get more information
Human Rights Act Influences
• Article 2
• Article 3
• Article 5
• Article 8
- Right to life
- Prohibition of inhuman
or degrading treatment
- Right to liberty
- Right to respect for
private and family life
such as autonomy
Impairment or disturbance that affects
the way that the mind or brain works
What’s in a name?
Ability to Make a Particular Decision at
the Time it Needs to be Made Act!
Mental Capacity Act
Summary – When does the act apply?
Is the person 16 or over?
Are they in England or Wales?
Do they have an impairment?
Is the impairment severe enough that it could
effect their capacity to make a particular
decision at the time it needs to be made?
Does their behaviour, previous capacity issues
similar to this decision or information available
from others suggest that an assessment needs
to be made?
The 5 Core Principles of the act
1.A person is assumed to have
A lack of capacity has to be clearly
Capacity cannot be determined by
age, disability or appearance alone
The 5 Core Principles of the
No-one should be treated as unable to make a decision
unless all practicable (realistic) steps to help them have
been exhausted and shown not to work.
A person can make an unwise decision. This does not
necessarily mean they lack capacity.
If it is determined that a person lacks capacity then any
decision taken on their behalf must be in their best
Any decision taken on behalf of a person who lacks
capacity must take into account their rights and freedom
of action. Any decision should show that the least
restrictive option or intervention is achieved.
How did you decide?
‘Look’ at/hear the information
Understand the information
Remember the information
Think about it and weigh it up
Communicate the decision
•H ead
•U nderstand
•R emember
•B alance
•E xpress
Assessment should lead to..
A reasonable belief that
someone has or lacks
capacity to make the
necessary decision at
the time that it needs to
be made
Who is the assessor and who
makes the final decision?
It could be
Complex decisions,
consulting others
You may need to consult others to
help you to make a decision
about capacity
(but the final decision
remains with you)
What decision should you make
for someone who lacks capacity?
A decision made on the behalf of
someone else should always
be in their
Best Interests Exercise
Favourite colour
Holiday destination
Place to retire to
Favourite meal
Resuscitation or not?
Making sure decisions are in the
person’s best interests
Things you may need to consider
• Equality and Diversity
• Adult protection
• Human rights
• Who you would consult with
• How you would involve the service
user as much as possible
Best Interests
• Ensure that you do not make assumptions about someone’s
best interests
• Consider all the relevant circumstances relating to the
• Consider whether the person is likely to regain capacity. If
so can the decision or act wait until then?
• Ensure that you have done whatever is possible to permit
and encourage the person to take part, or to improve their
ability to take part, in making the decision.
• Decisions concerning the provision or withdrawal of life
sustaining treatment the must not be motivated by a desire
to bring about the person’s death.
• Consider the person’s past and present wishes and feelings
(in particular if they have been written down)
• Consider any beliefs and values (e.g. religious, cultural or
moral) that would be likely to influence the decision in
question and any other relevant factors.
Documenting assessments and
best interest decisions
Do you need a specific form to
document capacity issues?
Documenting assessments and
best interest decisions
• Care plans should show that capacity
assessments have been made.
• Records should show in which
instances the person may lack
• Day to day decisions may not need
to be documented.
• New decisions or more complex
issues should be recorded and
What else does the act say?
Independent Mental Capacity Advocacy
(IMCA) Service
In some cases an IMCA must be appointed.
Some people who lack capacity may have no one to support them
(other than paid staff) with major, potentially life-changing decisions
so the Act creates a service which will represent and support them.
The decision must be regarding major medical treatment or
accommodation moves.
Adult Protection
Capacity assessment must be made by referrer first.
What else does the act say?
Independent Mental Capacity
Advocacy (IMCA) Service
Bev Price – Manager of service
[email protected]
01208 74243
What else does the act say?
Lasting Powers of Attorney (LPAs)
Replace the old Enduring Powers of Attorney
in October 2007 and allow people to put in
writing who should make decisions for them
in the following areas:
• Health
• Welfare
• Property
• Money
Important safeguards
A new Court of Protection
Will have the power to make declarations
• Whether someone lacks capacity,
• Make orders or appoint deputies to act and
make decisions on behalf of someone who
lacks capacity.
On many occasions, there may be other ways
of dealing with difficult situations without
having to go to Court, such as via existing
complaints procedures.
Public Guardian
Tel: 0845 330 2900
What else does the act say?
An advance decision
• Is prepared when a person has
• It is a decision to refuse
specific treatment and is
binding (must be written and
witnessed if life-sustaining
treatment is being refused)
Advance Decision Website
Important safeguards
A new criminal offence
• ill- treatment or
• wilful neglect of a person
who lacks capacity
• can lead to fines and
Copies of the Code of Practice can be
downloaded from
Hard copies of this publication are
available from
Tel 0845 3302900
For more information
Paul Wilkins
Mental Capacity Act Implementation Lead and Trainer
Department of Adult Social Care
Learning, Training and Development
Room 500
Old County Hall
Cornwall TR1 3AY
Tel: 01872 322289
email: [email protected]
Useful Information
• 6 Booklets – Making decisions, a guide for………….
023 80 878038
[email protected]
• DoH Training sets:
Mental Capacity Act 2005
Order Core set and the one that relates to your
work area
08701 555455
[email protected]

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